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Communities Fighting Ebola in Urban Sierra Leone

by The Welbodi Partnership
Communities Fighting Ebola in Urban Sierra Leone
Communities Fighting Ebola in Urban Sierra Leone
Communities Fighting Ebola in Urban Sierra Leone
Communities Fighting Ebola in Urban Sierra Leone
Communities Fighting Ebola in Urban Sierra Leone
Communities Fighting Ebola in Urban Sierra Leone
Communities Fighting Ebola in Urban Sierra Leone
Communities Fighting Ebola in Urban Sierra Leone
Communities Fighting Ebola in Urban Sierra Leone
Communities Fighting Ebola in Urban Sierra Leone
Communities Fighting Ebola in Urban Sierra Leone
Communities Fighting Ebola in Urban Sierra Leone

Welbodi Partnership Community Engagement Project: closing report Feb 2017

Introduction

The generous support of people giving through GlobalGiving enabled our community engagement work to have a real impact, particularly when Ebola threatened to completely devastate the country.  This model of volunteers engaging communities in social mobilisation, with the aim of improving health access and health outcomes, proved very successful. As we reach a new phase in our work post Ebola, we reflect on the highlights of this programme, and also describe a little of the next programme that we will ask for support from Global Giving donors.

The issues

Despite some gains in the fight against maternal and infant mortality, a recent UN report ranked Sierra Leone as having the highest maternal mortality rate in the world,  and an under-five mortality of 217/1,000 live births.  Part of the reason for that is the lack of access to healthcare services and lack of health knowledge, particularly in the rural and semi-rural community areas.  

 

The Ebola Virus Disease (EVD) outbreak severely disrupted the basic healthcare service delivery system in the country and further compounded the health problems, lack of knowledge, and lack of access to the health system experienced by people outside the urban areas.

 

The aims of the Welbodi Partnership Community Engagement Project

 

  • To use volunteers from the community to plan for the greatest possible social mobilization of communities
  • Spread key messages about how communities could work to protect themselves from Ebola, what to do if Ebola was suspected, and how to minimise its spread.
  • To engage in other initiatives as needs arose, such as promoting the uptake of vaccination and other health services amongst people who might not otherwise have access to health services.

 

 

What did we do:

Welbodi Partnership recruited community facilitators to work with their own and local communities, and offered training in how to spread health messages and engage mothers in talking about their views on healthcare.

The project coordinators worked closely with the District Health Management Team and local health facilities and teams, such as Jenner Wright under- fives Clinic, Looking Town MCHP, Kissy Health Centre, St Joseph’s Health Centre, PMO, Ross Road, and Moyiba Health Centre.  

What worked so well for this programme is that the project facilitators are residents of the communities, and fully understood the people, the environment, and the issues that are important to them.  They were able to talk to all members of the community, including those who would often be ignored as they were in remote or isolated places. 

This proved its value both in terms of spreading messages about how to deal with the threat of Ebola, how to respond when Ebola was suspected, and then following the successful management of the outbreak, how to protect their children against other diseases, such as through the polio vaccination programme. They could work effectively to work with local people to gather the mothers and children for vaccinations, or to hear about how they could safeguard their families.

We also produced banners displayed at strategic points to inform communities about the vaccine exercises and Welbodi participation. This helped prepared mothers so that their children would receive the polio vaccine. The project volunteers provided key messages of the benefits of the vaccine to the child and the nation as a whole.

The project community facilitators joined vaccination teams conducting outreach activities and carrying out door to door vaccination of every child under the age of five years whose parents were at home. Some acted as tally clerks documenting the number of children immunized in the daily vaccine register provided by the health ministry.

Our Partner:

Tok fo Pikin Welbodi are a collection of volunteers that are passionate about improving child and maternal health in Eastern Freetown. We have worked with this group, training members in data collection, and supporting them in surveying primary health centres and the people they serve. This provided skills to the volunteers that can be used to help their group become more effective. We shared these findings with the government’s District Health Management Team and will use it to inform site selection for a future large project that creates women's groups to address maternal and child health issues.

We also trained Tok fo Pikin volunteers to lead Participatory Learning and Action (PLA) approach groups, a great way of helping communities tackle health issues. The project trained a total of 50 women facilitators and five of these were from Tok fo Pikin Welbodi.  All participants received training on facilitation skills to implement PLA group meetings in the communities we serve. As well as learning about the methodology, the volunteers learnt leadership and training skills. 

We engaged with Tok fo Pikin Welbodi leaders on how to transition from Ebola response projects to projects that support longer term health improvement initiatives. A key part of this was to continue to address the issues caused or highlighted by the outbreak, rebuilding trust in the healthcare system, and improving access to healthcare in the communities we serve.

 

The impact:

 

This project built a community of motivated, skilled volunteers, with expertise in spreading health messages and supporting health care workers in reaching communities that would otherwise go unserved.

 

 

Two key impacts were:

Building the communities knowledge about Ebola and stopping the spread of infectious disease

The Welbodi Partnership community engagement team was a vital part of helping the local Sierra Leone health organisation, the District Health Management Team, to reach and deliver vital health messages about how to safeguard themselves and their families against Ebola, how to recognise Ebola, what to do if they suspected the disease, and the importance of safe burial practice. This was key to containing the spread of the Ebola outbreak in these communities.

On the 17th of March 2016, Sierra Leone reached 42 days without a confirmed Ebola case. One of the lessons learnt from the outbreak was that infection was all too easily passed on. We focused on tackling this in facilities though training, mentoring and supplies and in the community with taps, equipment and advocacy.

We ran a waste management project teaching communities how to minimise the risk of passing on diseases such as Ebola and tackle some of the major causes of child and maternal mortality including malaria and diarrheal diseases. We identified 47 mosques, 20 churches, 35 primary schools and 120 youth organizations within the communities in which this project operates and invited two or more members from each of these groups to attend interactive community dialogue sessions. We reached a total of 345 influential community stakeholders with health promotion messages on waste management and child health.

Supporting national vaccination campaigns

With support from health sector development partners, the Ministry of Health and Sanitation (MoHS) introduced the Maternal and Child Health (MCH) week (Mami en Pikin Welbodi Week) in 2013 as a national campaign, undertaken twice a year. It aims to improve the health status of women and children in Sierra Leone. With the emergence of the EVD outbreak in 2014, this nationwide event, like many other health care services, was hugely disrupted and thousands of under-five children failed to receive lifesaving vaccines

The MoHS requested all health partners to support them in making sure that it achieves its target of reaching 90% of under-five children and pregnant women in the national vaccination exercise. Among the key areas the ministry requested support in were social mobilisation, logistical support and training of vaccinators.

Welbodi Partnership responded to the request of the Health Ministry by supporting Tok fo Pikin Welbodi (Speak for Children’s Health) to conduct a three-day social mobilisation exercise which included house to house visits and radio panel discussion all within communities in the east of Freetown. The aim of the exercise was to reach a minimum of 10,000 homes with messages related to the vaccination campaign and also promote other positive health seeking behaviours that can contribute to improving the lives of women and children.

An estimated 20,000 families were reached in the three-day exercise and throughout the project period. It was observed that most of the communities had received no prior information about the vaccination exercise. The radio panel discussion attracted a number of calls from listeners and the panelists were able to appropriately respond to relevant questions related to the exercise. Among the key services provided during the November 2015 MCH week were:

Administration of Oral Polio vaccine

Vitamin A supplementation

Albendazole administration - deworming

Defaulter tracing for immunization (targeting children less than one year and referred to health facilities)

Identification of malnourished children using the Mid Upper Arm Circumference (MUAC) system

Antenatal care (ANC) for pregnant women

Following the completion of the vaccination exercise, the president stated “over 1,475,000 children 0-59 months were vaccinated against Polio which represented 98.8% coverage and over 206, 000 women of child bearing age have received at least two doses of tetanus toxoid vaccine”. As a key partner in Sierra Leone’s healthcare service delivery, we are proud to play a part in this success.

 

Many thanks to the Women Coordinators, Sia Kasso and Miriam Fornah, and the Welbodi Community Engagement Project Manager, Khadijatu Bakarr!

 

Our next Global Giving project

 

Challenge: Women and children are dying completely avoidable deaths. In 2015 it was estimated that 120 out of 1,000 children would not reach their fifth birthday. Sierra Leone has the worst record for mothers dying in the world, with 1,360 out of 100,000 mothers dying due to wholly avoidable and treatable complications. The Sierra Leone government is making plans to address this, but needs the kind of expert help and resources that Welbodi Partnership can provide to improve this situation.

Our approach: This project will enable our clinical teams to do more of their vital work at the largest children's and maternity hospitals in Sierra Leone. This includes training and mentoring local doctors and nurses, working with them to identify problems and address the issues, provide much needed clinical equipment, and continue to offer the Sierra Leone government expert advice. They also work in the community, offering mothers information about how to keep their families healthy, and how to seek help.

Long-Term Impact: The training and mentoring we provide enables Sierra Leonean doctors and nurses to become better at their jobs, more able to diagnose and treat the preventable problems claiming so many lives. Our work to improve hospital systems will ensure that families get the affordable health service that they need, with limited resources effectively applied. Our work with mothers means that they have better knowledge about how to maintain their families' health, and how to get help when they need it.

Summary

Over the project your support allowed us to focus on getting vital messages into the community at a time when trust in the healthcare system was severely damaged. We used the generous donations from the Global Giving community to work with community health facilities and the local community to deliver projects that not only protect against a re-emergence of Ebola but also delivered long term, lifesaving benefits to communities in desperate need. 

This project is a tremendous example of the very real difference to children and their families that your donations make.  Please continue to support us, so that we can do more work to protect the health of children and their families in Sierra Leone!

Thanks again!

The community engagement project
The community engagement project

Welbodi Partnership Report October – December 2016

Community engagement: participation in the Polio vaccination campaign (round 4) in Western Area Urban District, Freetown, Sierra Leone, 28th - 30th October 2016.

Introduction

Listening to local people and involving them in decisions about local health care provision is key to Welbodi’s partnership approach.   Now that the ebola outbreak has finished, we can focus again on engaging the community in  programmes to support their children's health. A great example is the Welbodi Partnership community engagement project to support the eradication of polio in Sierra Leone, in collaboration with the government District Management Team (DHMT) and community members.  Welbodi Partnership was able to fund this project through your donations made through Global Giving.

The Welbodi Partnership Community Engagement Project

The community engagement project’s aim was to improve the take up of polio vaccination for under-fives, by using volunteers to provide key messages of the vaccine’s benefits both for the child, and the nation as a whole. The project community facilitators joined vaccination teams in seven health facilities (Jenner Wright under- fives Clinic, Looking Town MCHP, Kissy Health Centre, St Joseph’s Health Centre, PMO, Ross Road, and Moyiba Health Centre).  They took part in meetings organised by the DHMT to plan for the greatest possible social mobilization of communities, and worked side by side with the vaccination teams to mobilize mothers, disseminate polio campaign information and ensure that as many as children as possible could receive the vaccination.

How Welbodi Partnership engaged with the community

Welbodi Partnership recruited community facilitators to work with their own and local communities, and offered training in how to spread health messages and engage mothers in talking about their views on healthcare. We also produced banners displayed at strategic points to inform communities about the vaccine exercises and Welbodi participation. This helped prepared mothers so that their children would receive the polio vaccine. The project volunteers provided key messages of the benefits of the vaccine to the child and the nation as a whole.

The project community facilitators joined vaccination teams conducting outreach activities and carrying out door to door vaccination of every child under the age of five years whose parents were at home. Some acted as tally clerks documenting the number of children immunized in the daily vaccine register provided by the health ministry.

Spreading the messages so that everyone could hear

The project facilitators are residents of the communities and fully understood the terrain, therefore they engaged and led the vaccinators in hard to reach areas in the communities. In some cases in isolated areas they would work with local mothers to identify places where they could all converge to fast track vaccine uptake for their children. As a result many children were reached and received the vaccine.

As part of spreading the health messages Welbodi Partnership provided megaphones to community facilitators to enhance messaging and assist in the speedy mobilization of mothers presenting their children for the vaccine services. 

The impact

A total of forty-nine (49) women groups supported the campaign in collaboration with vaccination teams from the seven health facilities that cover these communities. Together we supported the immunization and recording of over 70,000 children under-five years old.

Mothers of the children under five years cooperated due to the trust they had in the community PLA facilitators. The women facilitators addressed all myths and taboos around the vaccine, targeting communities who thought vaccine was not culturally accepted. This was an amazing breakthrough for the vaccinators who had previously found it difficult to deal with these myths and taboos.  The community and health facility staff commended Welbodi for assisting in the mobilization, which for them made a significant difference in the campaign process, particularly in increasing the coverage and reaching the most difficult parts of the communities which in the past had been difficult for vaccinators to reach. This was excellent!

Many thanks to the Women Coordinators, Sia Kasso and Miriam Fornah, and the Welbodi Community Engagement Project Manager, Khadijatu Bakarr.

This project is a tremendous example of the very real difference to children and their families that your donations make.  Please continue to support us, so that we can do more work to protect the health of children and their families in Sierra Leone.


Welbodi Partnership facilitators with MoHS staff
Welbodi Partnership facilitators with MoHS staff
spreading the message
spreading the message
Fatmata, a facilitator, administering the vaccine
Fatmata, a facilitator, administering the vaccine
Training
Training

We have been busy!

As we come out of the Ebola response phase of our work we are now focusing on working closely with the community advocacy group that did so much during the outbreak. Tok fo Pikin Welbodi are a collection of volunteers that are passionate about improving child and maternal health in Eastern Freetown. This month we trained members of this group in data collection and worked closely with them to undertake a survey of 11 primary health centres and the people they serve. This not only provides vital data for our work and future Global Giving funded projects, but strengthens the relationship Tok fo Pikin Welbodi has with these facilities and provides skills to the volunteers that can be used to help their group become more effective. We shared these findings with the government’s District Health Management Team and will use it to inform site selection for a large project that creates women's groups to address maternal and child health issues.

We have also been training Tok fo Pikin volunteers to lead Participatory Learning and Action (PLA) approach groups, a great way of helping communities tackle health issues. The project trained a total of 50 women facilitators and five of these were from Tok fo Pikin Welbodi.  All participants received training on facilitation skills to implement PLA group meetings in the communities we serve. As well as learning about the methodology, the volunteers learnt leadership and training skills. 

In the last report we told you about the TB clinic we were planning on building at a local primary health unit, this has been progressing well and has now been approved by the Ministry of Health and we look forward to keeping you up to date as we move forward with its construction!

All this was made possible by Global Giving and the amazing supporters that reached us through the site - Thank you all! 

Until next time!

 

Khadija, Sebastian and the Welbodi Team.

Training
Training
Community team providing workshops
Community team providing workshops

Although the Ebola outbreak has officially been declared over, it is essential that we continue to address the issues caused or highlighted by the outbreak. We are focusing on rebuilding trust in the healthcare system and improving access to it in the communities we serve.

We are working with an advocacy group called Tok fo Pikin Welbodi to reach out to the community and deliver vital messages on how to keep communities safe from a resurgence of Ebola, how to access healthcare and how to tackle some of the most common preventable illnesses. Over the last few months we have been engaging with Tok fo Pikin Welbodi leaders on how to transition from Ebola response projects to projects that support more longer term health improvement initiatives. We will keep you updated as this plan is developed.   

We are currently supporting the design of a project to tackle Tuberculosis (TB) in Eastern Freetown. Working with the Jenner Wright Clinic (JW), we will build a structure to be used for the screening and treatment of TB patients. The existing TB room is located in an area where other treatment takes place. As TB is an airborne disease, it poses a high risk to other patients. The average monthly number of TB patients at JW is 75 and this number continues to increase. This facility serves as one of the key referral TB treatment facilities within Eastern Freetown. The structure will accommodate at least 10 patients at a time and office space for the TB focal point in the facility.

We look forward to keeping you up to date as this and other projects progress. None of this would be possible without the fantastic support of Global Giving and those who donate through it – thank you! 

Volunteers from the local community
Volunteers from the local community

The worst of the Ebola outbreak is over and, on the 17th of March 2016, Sierra Leone reached 42 days without a confirmed Ebola case, however, this is the second time the country has had to pass this marker and, on the same day of this declaration, Guinea announced new confirmed cases. The need to remain vigilant is as important as ever. Now the outbreak is over our efforts have shifted to helping the country stay free of the disease through ensuring that standards in the facilities are maintained and communities continue with preventive measures.

Over the last year your support has allowed us to focus on getting vital messages into the community at a time when trust in the healthcare system was severely damaged. In the coming months we will use the generous donations from the Global Giving community to work with community health facilities and the local community to deliver projects that not only protect against a re-emergence of Ebola but will also deliver long term, life saving benefits to communities in desperate need. 

One of the lessons learnt from the outbreak was that infection was all too easily passed on. We have focused on tackling this in facilities though training, mentoring and supplies and in the community with taps, equipment and advocacy. Now we will take this a step further through a waste management project that will teach communities how to minimise the risk of passing on diseases such as Ebola and tackle some of the major causes of child and maternal mortality including malaria and diarrheal diseases. We have identified 47 mosques, 20 churches, 35 primary schools and 120 youth organizations within the communities in which this project operates and we plan to invite two or more members from each of these groups to attend interactive community dialogue sessions. We will reach a total of 345 influential community stakeholders with health promotion messages on waste management and child health.

As well as a period of intense work to ensure Ebola does not resurface, we will also be using this milestone to reflect and plan the next stage of the response. Tok fo Pikin Welbodi with guidance from the Welbodi Global Giving Project team will be finalising a 12 month action plan and we look forward to sharing this with you all when it is complete.

Thank you to everyone that has supported us over the last 18 months, we could not have achieved what we have without you. The next stage of this project will present new challenges, however, we are confident with your help we can help Sierra Leone remain resilient and Ebola free.

 

 

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Organization Information

The Welbodi Partnership

Location: Headcorn, Kent - United Kingdom
Website:
Facebook: Facebook Page
Twitter: @welbodi
Project Leader:
Ryann Manning
London, United Kingdom

Funded Project!

Combined with other sources of funding, this project raised enough money to fund the outlined activities and is no longer accepting donations.
   

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