Sierra Leone

Sierra Leone is recovering from a civil war that displaced millions of people and undermined its struggling health system. As part of the Action for West Africa Region—Reproductive Health (AWARE-RH) Project, funded by the U.S. Agency for International Development (USAID), EngenderHealth is working in Sierra Leone to:

• Combat malaria
• Prevent and treat fistula
• Expand contraceptive options

 
Combating Malaria
Malaria infection during pregnancy poses a substantial risk to both mother and baby. In areas where malaria is endemic, pregnant women are especially susceptible, and because the infection in women is largely asymptomatic, the risk of malaria is often overlooked. To help prevent the spread of malaria in children and pregnant women, EngenderHealth has:

• Arranged for bed net and vitamin A distribution to accompany a measles vaccination campaign;
• Developed a strategy to use peer educators and other community-based activities to control malaria;
• Encouraged the government to remove taxes and tariffs on malaria control products, such as bed nets, insecticides, and drugs;
• Helped draft national guidelines and strategies for malaria control during pregnancy;
• Organized a regional workshop on the prevention and treatment of malaria in pregnancy. During this workshop, EngenderHealth and our partners developed and implemented an advocacy plan to increase the government’s budget allocation for malaria by 100%.

 
Preventing and Treating Fistula
In Freetown, EngenderHealth works with a faith-based group, Mercy Ships International, to prevent and treat obstetric fistula, a vaginal tear resulting from prolonged obstructed labor that can lead to incontinence, nerve damage, and severe social stigma. At the Aberdeen Clinic and Fistula Centre, EngenderHealth works to:

• Train surgeons and nurses in fistula repair and management;
• Provide surgical repair services to women living with fistula;
• Maintain a medical library for nursing staff;
• Provide computer training to improve nurses’ record keeping and reporting skills;
• Raise awareness of the issue through radio and community mobilization campaigns;
• Develop a draft document regarding fistula prevention and treatment as well as reintegration of fistula clients.

 
Expanding Contraceptive Options
In Sierra Leone, as in other developing countries, several factors limit access to and use of contraception, including a shortage of skilled and trained providers, inadequate supplies, and lack of accurate information about the methods. EngenderHealth works to advance the availability, quality, and use of reproductive health and family planning services in several ways:

• By promoting the use of Norplant and the intrauterine device (IUD), two low-cost, long acting contraceptive methods, EngenderHealth helps women space or limit their families. In addition to raising awareness about these methods, EngenderHealth has taught a team of trainers how to insert and remove the devices.
• Training 16 health care providers from three districts (Western-Freetown, Bo, and Makeni) to safely insert and remove IUDs;
• Proving technical support to Sierra Leone’s Ministry of Health as they implement an action plan revitalizing family planning in the country;
• EngenderHealth supporting Sierra Leone’s Ministry of Health development of a national reproductive health commodities security plan that will ensure the availability of family planning and reproductive health supplies.