By Aruna Turay
Sierra Leone’s decade long civil war has been mapped out as being
responsible for the country’s low standards in the reduction of
maternal, infant and child mortality and also its insufficient
infrastructure and healthcare which has ranked the country 183 out of
187 on the Human Development Index of 2002.
Investigating on how to reduce maternal, infant and child mortality in
Sierra Leone, this reporter between June and July 2016 spoke with
Sierra Leone’s senior Obstetrician/Gynecologists, Dr. Alimamy Philip
Koroma who is currently a Senior Medical Superintendent at the
country’s only existing maternity hospital, Princess Christian
Dr. Koroma said despite the Government of Sierra Leone’s tremendous
effort to reduce maternal, infant and child mortality and above all
transform the country’s healthcare delivery system, it is still
recorded that maternal mortality ratio is 1,165 per 100,000 live
births (Demographic Health Survey 2013).
He said the country has the highest infant mortality rate in the world
at 117 per 1,000 live births and a total fertility rate of 4.8 with a
contraceptive prevalence of only 11% with 25% of married women having
an unmet need for family planning (2013 DHS).
He said an estimated 20,000 women live with obstetric fistula,
cervical cancer: over 500 new cases diagnosed annually with nearly 400
Despite the free government maternal healthcare, Dr. Koroma informed,
levels of service delivery for basic and comprehensive obstetric care
remains inadequate due to the low numbers of healthcare providers in
He said access to specialized women’s healthcare is extremely limited
largely due to a lack of trained providers, and there is no in-country
OBGYN postgraduate training program.
The doctor furthered that Sierra Leone has only 2 full-time OBGYNs
practicing, and that they are both located at the national maternity
referral hospital (PCMH) in the capital of Freetown.
He said the lack of women’s reproductive health providers, including
physicians, clinical health officers, midwives and nurses is a major
reason for increased maternal and infant mortality in the region.
On reducing maternal, infant and child mortality in the country, Dr.
Koroma recommended that government increase structure by having more
equipped national referral centres and Peripheral Health Units taking
care of maternal mortality and comprehensive maternal cases.
He recommended an increase in skill workers to manage emergency cases,
deploy more doctors countrywide to respond to emergency care and
sensitize the public on the need to attend antenatal clinic among