By Alieu Amara Suwu
Project HOPE, with support from Later Days Saint, has teamed with the Ministry of Health to build the skills of health care workers at all levels in maternal child health and safe delivery, targeting 180 healthcare workers at 32 health facilities in the Western Area Rural district.
The capacity-building training commenced on February 13, 2024, and will run for the next five days at the District Health Management Team (DHMT) in Waterloo. Prior to this, for efficiency, Project HOPE had conducted Training of Trainers (TOT) for 23 midwives in January this year.
Over the years, the work of Project HOPE in Sierra Leone has not been limited to expanding community support for mothers and newborns, developing new neonatal nursing education programs, helping the College of Medicine and Allied Health Sciences at the University of Sierra Leone establish a specialized neonatal nursing program, developing curricula, and training key faculty members in the medical field.
Sierra Leone has one of the highest rates of maternal mortality in the world, with 717 mothers dying annually for every 100,000 live births as of 2019 (DHS, 2019). One of the primary contributing factors is the delayed first visits to health facilities by mothers-to-be. The provision of quality preconception, antenatal, intrapartum, and postnatal care to all mothers is also inequitable. High out-of-pocket expenditures for accessing basic care, as well as inadequate delivery of patient-centered care at both primary and secondary levels, compound the challenges.
The government of Sierra Leone, through the Minister of Health and Sanitation, has been appealing to world organizations, such as Project HOPE, to support the nation in its efforts to reduce maternal and infant mortality, with a specific note that every case of maternal mortality constitutes an emergency for the nation.
Speaking to the Independent Observer at the training, Banneh Daramy, the Programme Officer of Project HOPE, confirmed that they converged at the DHMT to do a training on maternal and child health on the special topic of helping mothers survive and also bleeding after birth, helping babies breathe (HBS), essential care for every baby, and essential care for small babies. She said the training will be conducted by batches of participants (health care workers) representing different facilities in the Western Area Rural. She noted that the aim of implementing the project or training the health care workers is to curtail the deaths of pregnant women and children during birth, a reason they have targeted 32 facilities in Waterloo and 180 healthcare workers under the cascading program for four months. And because of the large number, she said participants have been placed into groups, with each group having 35 participants and seven facilitators.
On the monitoring and evaluation after the training, she asserted that they will surely follow up on that, and for that reason, she said they have the Ministry and DHMT to really ensure the training does not stop there. “And we shall visit those facilities to know if the training was well understood,” she said.
Mariama Y. Kanu, District Health Sister 2, working with the District Health Management Team in Western Area Rural, explained that the training is about building the technical capacity of the health workers, impacting them with knowledge on what they should do at their facilities with regards to maternal and child health. She said Project HOPE has selected the district to really bring to light the major reasons babies and mothers die at birth: more bleeding, which is one major cause if not handled properly. She believed that impacting the health workers with such knowledge would empower them more, for knowledge is power.
On the importance of the training, she said it was not only important but also timely, especially when 19 women died last year in the Western Area Rural District, all of whom died of excess bleeding. She said complications can occur at any moment, but if the knowledge is there, they can be handled. And she wished they could reduce that figure to zero, emphasizing the timeliness of the training. She said they will actually do follow-up mentoring and supervision to further identify gaps, not limited to only knowledge but also equipment or medical supplies.
Christiana Alpha, a facilitator, explained that to prepare for a delivery, they must first identify the helper, reveal an emergency plan, prepare the place for birth, wash hands, and get the functional equipment ready. She said the topic is important because most late preparations make complicated situations worth it.
The training will run into essential topics like saving lives at birth, providing respectful care, communicating effectively, preparing for birth, the main causes of bleeding after birth, routine care for mother and baby, medication (oxytocin or misoprostol), controlled cord traction, delivering placentas, checking placentas, etc.
