Sierra Leone is a West Africa country with a challenging context. The country has faced a civil war between 1991 and 2002 which collapsed their economy and health infrastructure. In 2013-2014, Sierra Leone has been one of the focus areas of the largest Ebola virus epidemic ever recorded (Figueroa, 2017). In the years prior to the outbreak the government worked to reform and update the health care infrastructure, in 2010 the Free Healthcare Initiative (FHCI) was launched by the government in conjunction with the United Nations and NGOs (Center For Public Impact, case study, April 2016). This system has helped to reduce the mortality rates in Sierra Leone and provided greater access to health care. However this system was not designed to cope with the demands that the Ebola outbreak placed on it, this outbreak caused a lag in the provision of the health care services that is was necessary for women to have (The Lancet, Witter, 2016).
Currently, the operating model of WCC in Sierra Leone is only restricted to advisory services. however, the WCC plan and vision includes a focus on developing the region by transforming health and sanitation standards depending on many factors, among which are:
1- Social mobilisation and awareness-raising around disease prevention.
2- Establishment of a healthcare centre in Sierra Leone.
3- Providing essential services for pregnant women and newborns to overcome any challenge or obstacle they face.
4- Long term plans include investment in the healthcare system infrastructure.
In its efforts to achieve the required objectives, WCC faces several challenges. These challenges include finding the suitable funding, building a reliable and an accessible healthcare center in the Eastern communities of Kissy and Calaba Town and ensuring accessibility and community engagement within this region.
Statement of Need
There is a tremendous need for accessible health care in the Eastern communities of Sierra Leone. Specifically, centers targeted to the delivery of health education and clinical care to improve the lives of the communities and to combat issues surrounding child birth and early infant care. The quantity of health services and condition of the locations where it is administered are severely lacking. Fewer than 50% of the existing health facilities have portable water or delivery kits. Only 2% of women are screened on their first prenatal visit, screening allows the medical professionals to asses the pregnancy and test for abnormalities (Koroma, et al, 2018). This is an important step in creating healthy and less risky pregnancies for the women in these communities. Neonatal mortality is highest in sub-Saharan Africa at 29 deaths per 1,000 live births in each of those regions in 2015 (WHO, country profile, 2015). Mortality among children under 5 years of age remains high in sub-Saharan Africa, with a rate of 185 deaths per 1,000 live births with most of these deaths from avoidable and curable illnesses (ibid). As part of the recently adopted Sustainable Development Goals, the global maternal mortality ratio needs to be reduced to less than 70 per 100,000 live births by 2030. To achieve this target in Sierra Leone, it is important to provide pregnant women with equitable access to high quality care by skilled personnel during pregnancy and childbirth.
In the Kissy and Calaba Town region in Sierra Leone there currently are five medical centers, including a mental health center, a private clinic and two hospitals. The work that they do is vital to the community, however they have not been able to answer the need that is still present in these communities for a focus on pregnancy and early life and development of the children born in this area. This is where the WCC has developed the initiative for a health care center as a response to this need.