Maternal

Mortality in
Sierra Leone
Katelyn Sult, RJ Palma, Chelsea Ruthrauff, Vanesa
Executive Summary

 In 2010, approximately 40 percent of the population

in Sierra Leone had access to health care
 Sierra Leone has one doctor for every 33,000
people

Primary goal: We aim to reduce the maternal

mortality rate in Sierra Leone from 1,360
Background
UNICEF states, “2015, 1 in 17 mothers [in
Sierra Leone] have a lifetime risk of death
associated with childbirth.”
There is a shortage in skilled health care
workers in Sierra Leone because of the
Ebola outbreak; this has negatively
affected the provision of health care in this
location
The quality of care provided by a health
care facility is significantly better than
that of TBA usage.
TBAs are not trained to care for
postpartum hemorrhage, which is a major
cause of maternal deaths,
Approximately only 53.6% of women and
“Efforts should be made to newborns, delivered at home, had
improve geographic access postnatal checks. In contrast, if delivery
to facility-based care in was done within a health care facility,
these settings, and 94.1% of cord
Clean women and
care, newborns
delaying received
first baths, and
traditional and community- postnatal care
immediate breastfeeding were inadequate
based providers should be across all districts
engaged as key partners in
Literature Review &
Analysis
Article #1
 Purpose: discuss many
interacting vulnerabilities that
influence their healthcare-
seeking decisions during
pregnancy and childbirth
 Design: Qualitative with in-
depth interviews
 Results: childbirth decisions
are greatly influenced by the
Literature Review &
Analysis
Article #2
 Purpose: examine the quality of
free antenatal services and access to
emergency obstetric care in Sierra
Leone
 Design: Cross-Sectional Survey
 Results: none of five basic
emergency obstetric care facilities
Literature Review &
Analysis
Article #3
 Purpose: identify why women use
traditional birth attendant (TBA) services
as compared to health facilities, suggest
strategies to improve utilization of health
facilities for maternity & newborn care
services
 Design: Qualitative with group
discussions
Literature Review &
Analysis
Article #4
Purpose: evaluate the
implementation of an emergency
obstetric referral system- acceptability
& accessibility
Design: Mixed-method - records &
in-depth semi-structured interviews
Results: motorbike ambulance
Literature Review &
Analysis
Article #5
Purpose: evaluate the effectiveness of healthcare
provider training in Emergency Obstetric and Newborn
Care, a large component of intervention programs with
goal of reducing maternal and newborn mortality
Design: Linear Regression of pre & post tests
Results: short in-service of EmOC&NC training was
associated with improvement in knowledge & skills for all
cadres of healthcare providers working in maternity wards
Literature Review &
Analysis
Article #6
 Purpose: determine retention
of knowledge & skills after
standardized “skills & drills”
training in Emergency Obstetric
Care
 Design: Longitudinal Cohort
Study
 Results: after training,
Project Goal /
Primary Goal: To reduce the
Objectives
maternal mortality rate of Sierra
Leone to 70 out of 100,000 live
births by 2030
Objectives:
1. Education regarding maternal mortality and prevention will
increase in the Sierra Leone community within one month.
2. Women will have increased accessibility to family planning
services within a 12 month period.
3. Women in Sierra Leone will have an increased access to health
Technical Approach
Phase 1: Preparation
Phase 2: Relationship Building
Phase 3: Awareness of the Problem
Phase 4: Education Part 1
Phase 5: Education Part 2
Phase 6: Evaluation
Monitoring
Qualitative Quantitative
Measures Measures
● Face-to-Face Interviews
○ Semi-structured interviews
● Quantitative
with all participants being Surveys
asked the same open-ended ○ Closed-ended
questions questions that will be
● Paper paired with
Qualitative questions
Survey/Questionnaire ● Quantitative
○ Gathering more details for
● Involve stakeholders ● After the first trip of
from the beginning volunteers/medical
● During the program professionals, outcome
evaluation, define evaluation shall assess
strengths of team and the progress of outcomes
stakeholders from logic model
● Process evaluation will ● Findings to stakeholders
be done periodically will be disseminated by
throughout the program discussing the Why,
to review the activities What, To whom, How,
and output components and When of the project
Evaluati
of the logic model ● Other plans for
What to take home...