Sierra Leone ranks 181 out of 188 countries of the Human Development Index. The country fights one of the world’s highest maternal and child mortality rates and a shortage of qualified medical professionals in an overall weak health sector. From 1991 to 2002, today’s Presidential Republic was devastated by civil war. Due to the Ebola epidemic in 2014 the already tense situation in the health sector has further worsened especially for pregnant women, breastfeeding mothers and children under five. Many health workers, among them many midwives, lost their lives while caring for the sick during the Ebola epidemic. This led to an increased demand for counteraction in order to avoid a lack of well-trained medical professionals, particularly midwives.
Critical Shortage of Midwives in Rural Communities
With only 311 practicing midwives and 222,000 deliveries per year, Sierra Leone suffers from a critical shortage of midwives. Furthermore, 65 percent of the midwives work in major cities. This leads to a shortage of maternity care in the rural communities. Additionally, more than 80 percent of the midwives are between 40 and 60 years old, therefore the chronic undersupply tends to become even worse in the future. According to the Human Resources Division of the Ministry of Health and Sanitation, only 24% of births occurred in the presence of a skilled birth attendant. An additional 3,000 midwives are needed to ensure adequate care during pregnancy and birth.
Action medeor, the German Medical Aid Organization, has many years of experience providing high quality medicines and medical supplies with various partners in Sierra Leone. Since 2014, action medeor has continued to support Ebola Emergency Relief projects in collaboration with local partner organizations in Sierra Leone, especially in the district capital Bo, in the South and its surroundings.
Before setting up the midwifery school in Bo, Sierra Leone had two midwifery schools. One school was located in the Western area in the capital Freetown and one in the Northern district in the city of Makeni. Both schools had an average of 100 midwives graduating annually. These two institutions lack sufficient capacities to cover the minimum requirement of training around 3,000 midwives. Due to their locations midwives are currently trained primarily in the western and northern part of the country. According to the “Post Ebola Recovery Plan” of the Government two more midwifery schools are needed to fill the gap of health workers, one in the Eastern and one in the Southern province. In Bo district 8 midwives are currently working in the 121 primary health stations which serve a population of around 570,000 people.
The Midwifery School in Bo
In October 2017, with the financing of the German Federal Ministry for Economic Cooperation and Development (BMZ), the School of Midwifery Bo (SOMBO) has been inaugurated. The school is currently educating 50 students to become midwives during a two year vocational training. The students (48 female and 2 male) are state enrolled community nurses, who are trained in teaching modules at the new school and practical lessons in hospitals and health centers.
With the new school, the gap of health workers for the southern region could be closed. Through the School of Midwifery Bo every year 50 newly graduated midwives will be available for the labor market. These midwives will particularly work in the underserved rural areas in the south of the country and thus reduce the risks related to pregnancy and childbirth. The school contributes significantly to improving the health of pregnant women, mothers and newborns and contributes to an overall strengthening of the health sector.
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Contribution by action medeor to the Annual Report 2017 of the MMI Network
Author: Christina Padilla, project manager
Photo: State enrolled community nurses on their way to become a midwife
More information: https://medeor.de/en/news/2221-opening-school-of-midwifery-sierra-leone.html