Analysis
The 11-year civil war peaked in Kono district, a diamond-rich region of Sierra Leone, causing untold suffering and devastation to human lives and property. The most vulnerable people, the elderly, women and children, bore the brunt of the burden. Besides the death toll, jobs and educational opportunities became limited. The healthcare system in particular was broken, which made it very challenging for many, especially pregnant women, to access high-quality medical attention. But, all this is changing now and it is changing very fast!
Freetown, Sierra Leone 4th February, 2025.
Work is currently in full swing at the ongoing construction of the maternal center of excellence in Kono led by Partners In Health and supported by the Government of Sierra Leone.
What was once the epicenter of blood diamonds, is now the hub for top-quality maternal and child health care in post conflict Sierra Leone. In collaboration with the Government of Sierra Leone, Partners In Health (PIH), is far gone with the construction of a maternal center of excellence (MCOE), a-modern-day hospital aimed at improving reproductive, maternal and child health services as well as providing clinical training opportunities for health workers.
The facility is considered a blueprint of future investments for the wellbeing of mothers and their babies not only in Sierra Leone, but also within the Africa Sub-region. When completed, this 166-bed hospital is expected to dramatically expand the Koidu Government Hospital’s current 48-bed maternal ward and special care baby unit (SCBU). The Minister of Health, Dr. Austin Demby, is proud of this development, describing it as “no mean feat.”
Minister’s Inspection Visit
The Minister of Health, along with the WHO Country Representative, the World Bank Country Manager and other senior members of the Ministry of Health, recently made a facility inspection visit to assess the progress made with the ongoing construction of the maternity center of excellence.
Minister Demby and his visiting delegation, including the WHO Country Rep and the World Bank Country Manager, were well pleased with the progress of the construction work of the MCOE in Kono.
Dr. Demby and his visiting delegation were overly impressed by the sense of community participation and ownership demonstrated by the women of Kono in the construction of this state-of-the-art hospital. Minister Demby was very pleased to see that over 60% of all site workers are women from within Koidu town and its nearby villages. They are determined to build a facility for women by women.
Active community participation is critical to the effective functioning of a healthcare system, the Minister pointed out. He went on, “that is why we are very pleased to see the women in this district taking on the challenge to build a hospital for themselves and their children. This is exciting to see. What more can you ask for?”
Women constitute about 67% of the workforce at the construction site of the MCOE in Koidu, demonstrating a true sense of participation and community ownership.
According to the Minister, Kono is leading the way in the delivery of quality maternal and child health services in Sierra Leone with a true healthcare revolution well underway in Koidu City. While addressing a team of journalists during the two days site inspection visit, Dr. Demby said that when the facility is completed by the end of this year, it will become the beacon of hope for advanced medical services for women and children in Africa; one that will be driven by high-level technology as well as research and innovation.
He said; “it will be a hub for clinical training; one that provides the platform for enhanced learning and exchange of expertise to help improve health outcomes and safety of women and children in Kono and beyond.”
The Minister of Health, Dr. Austin Demby, left, and the PIH Executive Director, Vicky Reed, discuss timelines for the completion of the construction of the maternity center of excellence in Koidu, Kono District.
This high-level facility inspection visit, ended with an excitement that was hard to ignore as locals gave live testimonies of the great job that health workers at the Koidu Government Hospital, supported by Partners In Health, are doing to deliver top-quality health services.
The Bigger Picture
There is a steady and remarkable improvement in reproductive, maternal and child health outcomes not only in Kono district, but the entire country. Since the Ministry of Health (MoH) partnered with PIH in 2014, not only have they supported MoH introduce a pharmacy near the maternal ward at Koidu Government Hospital (KGH), they have also started a functional blood bank and continue to provide hands-on training for nurses and midwives as well as continue to improve access to family planning services.
All these measures have contributed significantly to reducing maternal and child deaths in the region. In fact, before now, nearly every woman who gave birth to a premature baby ended up losing the child. This contributed significantly to the high maternal and child deaths in the country. Now, the recently established special care baby unit (SCBU) has changed this narrative drastically. There is now a 96% chance of survival for all high-risk or premature newborns.
Minister Demby, addressing mothers who were patiently waiting for medical care at the Koidu Government Hospital. The bright smiles on their faces tell a story of improvement in the quality of services they receive.
As indicated already, these changes have dramatically improved the healthcare fortunes of mothers and their babies in a country that was once dubbed as the worst place for women to become mothers.
Life Stages Approach; A Bold Solution.
Daily life challenges in Sierra Leone continue to pose serious problems for the health sector. Infrastructural investments are currently inadequate, there are ongoing challenges with drugs and medical supplies and still, the country continues to grapple with skilled medical professionals, among others.
Although hospital deliveries have improved over the years, there are still pockets of the country where women continue to give birth at home in the hands of traditional midwives, thus putting them at risk of complications and even deaths. All these challenges made health service delivery, particularly to women and children, very complicated.
Dr. Austin Demby having a very lively chat with the hardworking nurses and midwives of KGH during a special visit to thank them for all they do. He described them as the unsung heroes for mothers and children.
It is in recognition of these problems that the Minister of Health, Dr. Austin Demby, has introduced the “Life Stages,” an innovative approach to health service delivery that prioritizes care to the individual from the moment of conception up to when the baby becomes a senior citizen.
Dr. Demby is leading a health sector that is on a transformative shift; one that is firmly premised on the life stages approach with “the patients” being at the center of service delivery. Using this strategy, the country is well on its way to achieving Universal Health Coverage (UHC) through an unwavering commitment and an urgency to deliver quality healthcare that is accessible to all irrespective of social or financial status.
The Minister of Health, in orange reflector and white helmet, being led on a conducted tour of the PIH-led construction of the MCOE in Kono.
Already, the introduction of this innovative approach is bearing major fruits in maternal health outcomes. Sierra Leone has drastically reduced maternal mortality from 1,360 per 100,000 live births in 2013 to 443 per 100,000 in 2024. This represents more than 60% reduction.
But, the ultimate goal is to achieve zero maternal deaths–an acknowledgement of the power of targeted investment in emergency obstetric care, antenatal care and access to improved family planning services. As the Minister of health concludes his visit to Kono district, the huge healthcare investment in Koidu town is a testament to the country’s desire to radically shift the future of medical care by deliberately decentralizing critical health services to everyone across the country.