Welbodi Partnership Community Engagement Project: closing report Feb 2017
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.
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.
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.
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.
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!