Mother and Child Health
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Sierra Leone
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Ensuring Mother and Child Health Care in Rural Areas of Sierra Leone through the Training of Midwives in the Southern Province

Organisation: German Medical Aid Organization „action medeor“ e.V.
Partner country: Sierra Leone
Partner organisation in partner country: Caritas Bo
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Situation:

Sierra Leone has one of the highest maternal mortality rates in the world. The health system is severely affected by a lack of qualified health workers. The Ebola epidemic from 2014 until 2016 and the rural attrition of health workers have exacerbated the situation of mother-child health care. Only 65 midwives are available in the project area (popula-tion of approx. 900,000).

Objectives:

The aim of this project is to sustainably strengthen maternal and child health care ser-vices in rural areas by training 150 midwives and improving their working and living conditions. In addition to competency-based midwifery training, a special focus is placed on strengthening the Maternal Death Surveillance and Response (MDSR) system.

Indicators:
  1. 145 additional state-certified midwives will be working in governmental health facilities in rural areas by the end of 2023.
     
  2. Five midwifery tutors and the principal of the school of midwifery have acquired fur-ther competencies in midwifery education and use a competency-based curriculum based on international standards for the theory and practical training components.
  3. An effective MDSR system (ICD-MM, SMART recommendations, community involve-ment) exists in the project districts.
Measures:

To increase the number of midwives in rural areas in Sierra Leone by 150 state certified midwives by December 2023

  • Recruitment and selection of midwifery students from rural areas.
  • Support of 100 students with scholarships to cover school fees and a contribution to living costs.
  • Preparation of 150 students for and participation in the state final examinations.
  • Facilitate the deployment of graduates to rural areas after graduation by the Ministry of Health and Sanitation and follow-up on deployment.

To promote competency-based learning and advocacy skills in the midwifery education programme

  • Organize capacity building training for five midwifery tutors and the Principal of the midwifery school.
  • Facililitate hands-on sessions for students on management and referral of complications.
  • Conduct quarterly joint supportive supervision, mentoring, monitoring of students and preceptors at health centres to guarantee quality skills transfer and care.
  • Conduct two trainings in participatory advocacy for 100 students and 60 preceptors in Bo and Moyamba Districts.

To strengthen the MDSR system in Bo and Moyamba District

  • Conduct a baseline study on maternal mortality.
  • Conduct 3 trainings for 16 MDSR committee members on best practices and standard operating procedures for MDSR.
  • Train 6 clinicians and 8 midwives in ICD-10 classifications of maternal death.
  • Support DHMT in conducting quarterly MDSR reviews with follow-up on actionable recommendation.
  • Conduct quarterly community outreaches on MDSR review findings and recommendations as well as sensitization on institutional MNCH.
  • Facilitate MDR learning sessions at SoMBo between clinical instructors and students.
Sustainability:

The project contributes to strengthening the maternal, newborn and child health care system in Sierra Leone. The competency-based training of midwives for rural areas ad-dresses the lack of qualified health personnel and improves mother-child health care in the longer term. To counteract the rural attrition of health workers, midwives are strengthened in their advocacy skills, which enable them to lobby for better living and working conditions in rural areas.

Through strengthening the MDSR system, the documentation of maternal mortality will be improved. High-quality, evidence-based recommendations can be formulated and shared with health workers, midwifery students, communities and relevant govern-mental and non-governmental institutions. The findings from the MDSR system serve the Ministry of Health officials at local and national levels as a basis for further policy development and decision making.

Special features:

Linking practice and theory:

action medeor e.V. set-up the midwifery school together with Caritas Bo in 2017. The teaching staff is actively involved in the project implementation and uses its expertise in the field of mother-child health care. Through cooperation with representatives of the MDSR committees, there is a close exchange between practice and theory. The findings from MDSR are also used in teaching.

Advocacy:

Through trainings in participatory advocacy, health personnel from the mother-child health sector are empowered to demand their rights with the aim of improving working and living conditions. In this way, rural attrition can be counteracted.

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