By Morlai Sesay
In a landmark event held at the Freetown International Conference Center, Bintumani, the Ministry of Health and Sanitation, UNICEF, as well as the Foreign Commonwealth and Development Office (FCDO) on Friday, 16th February 2024, held a phase 3 meeting on saving lives in Sierra Leone with the theme "Strengthening Free Health Care Initiative and the care of small and sick Newborns in Sierra Leone."
In the keynote address, the Deputy Minister of Health 2, Dr. Jalikatu Mustapha, updated the gathering that the Special Care Baby Unit, which plays an instrumental role in preserving the lives of especially newborns, provides care one level below that of a neonatal intensive care unit. Since opening its doors, she asserted that the unit has already raised the quality of care for newborns at all healthcare facilities available and has helped clinicians avoid worst-case scenarios.
Since the introduction of this unit, clinicians have been given access to advanced medical supplies and equipment, from infant warmers and phototherapy lamps to vital sign monitors and emergency medications. And because the unit is attached to the maternity ward, they can transport newborns in need of emergency care quickly. Mustapha continued to explain that those infants born at the hospital receive 24-hour care in a room separate from babies born outside the hospital—a strict infection prevention and control system that keeps patients safe in their delicate states. The unit also provides new clinicians with training and mentorship from pediatricians like Nyirimanzi, meaning more clinicians at their respective centers are developing crucial expertise in neonatal and pediatric care.
According to her, these new resources and protocols are tackling significant barriers to saving at-risk infants and have helped keep newborns across the country alive. "All mothers deserve all the care extremely premature babies need to survive, ranging from oxygen support, infection prevention, control, antibiotics, and temperature control," she noted.
Commenting on a concern raised by one of the stakeholders as regards sustainable electricity supply at medical centers, Dr. Mustapha reiterated the government's commitment towards sustainable solar energy by stating that the Minister of Health and Sanitation, Dr. Austin Demby, unveiled a solar project that electrified six hospitals with decentralized solar photovoltaic (PV) systems with batteries.
These renewable energy systems, she said, would provide the hospitals with a reliable and less-polluting alternative to their current systems, helping improve the quality of healthcare delivery to patients. According to her, the government took up such a venture because hospitals currently rely on either polluting diesel generators or the primary electricity grid, making them prone to power cuts that put patients’ lives at risk.
"Freetown, Kambia, Masanga, Kabala, and Bonthe, the hospitals will receive more than 0.6 megawatt-peak (MWp) of installed solar PV capacity with battery storage. They were selected following detailed energy audits at major hospitals in the country by the Ministry. That study found that more than 1,000 health facilities in Sierra Leone need either a complete power solution or a backup solution, requiring an investment of approximately USD 64 million", she averred.
The project, she stated, was being implemented by Sustainable Energy for All (SEforALL) in partnership with Sierra Leone’s Ministry of Health & Sanitation, the UK’s Foreign, Commonwealth & Development Office, Crown Agents, and EM-ONE Energy Solutions. Mustapha concluded her speech by assuring all stakeholders present that by next year, the government will be working tirelessly to ensure that all major medical centers are solarized since funding, according to the Minister, has already been secured for that.
The UNICEF Sierra Leone Chief Health and Nutrition, Dr. Vandana Joshi, asserted that through the generous support from the Foreign and Commonwealth Development Office (FCDO), UNICEF has established 14 SCBUs in 14 out of the 16 districts in Sierra Leone to provide emergency care and treatment for babies born early, such as monitoring their breathing and heart rate; treatment with oxygen and treatment for jaundice. The Special Care Baby Units, she said, are part of the Saving Lives Programme, which aims to save the lives of women and babies by improving the quality, availability, and accessibility of Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) services.
As part of the Sustainable Development Goals, Joshi noted that world leaders have committed by 2030 to reduce neonatal mortality to at least 12 per 1,000 live births, with under-five mortality reduced to at least 25 per 1,000 live births. To achieve this target in Sierra Leone, many pregnant women will need equitable access to high-quality care by skilled personnel during pregnancy and childbirth. Newborns will also need improved care, particularly during the first 24 hours immediately after birth and the following 28 days of life.
Joshi emphasized that improving maternal and child health in Sierra Leone is a key concern for the Ministry of Health and Sanitation, supported by UNICEF, the World Health Organization (WHO), and other partners. “We have been working with the government to tackle maternal and child deaths through investment in the training of health workers and provision of equipment and medical supplies,” says Dr.Vandana Joshi, Chief of Health and Nutrition UNICEF Sierra Leone.
Building on previous efforts, UNICEF, WHO, and the United Nations Population Fund will work with the Ministry of Health and Sanitation to accelerate the reduction of maternal, newborn, child, and adolescent mortality and morbidity. The initiative, she said, supports the President's Recovery Priorities (PRP), which aims to save the lives of 600 women and 5,000 children in the country. “Through this Saving Lives Programme, we aim to work relentlessly to improve the country’s maternal and child health system and drastically reduce maternal and child deaths in Sierra Leone,” she adds.
In the first and second phases of the programme, UNICEF and other partners worked on improving several essential areas of health service delivery. According to Dr. Vandana Joshi, Chief Health and Nutrition UNICEF, nine emergency obstetric newborn care (EmONC) facilities and 100 adolescent-friendly health facilities had been upgraded; three newborn intensive care units was established at regional hospitals; one at Ola During Hospital in Freetown; and three midwifery schools were as well set up.
She ended by craving the indulgence of every nurse to see themselves as equally important as anybody in their discipline and the job with professionalism. "We are all critical as far as UNICEF is concerned. Let us continue to work as one and save our families from early death. I also want to thank all stakeholders gathered here today to grace this significant occasion. Without you, we would not have been at this place to stage this special event that seeks to promote the cause of humanity", she concluded.
During his presentation, the Director of Reproductive and Child Health at the Ministry of Health and Sanitation, Dr. Tom Sesay, narrated that saving lives in the Sierra Leone programme has been implemented by the Ministry of Health over five to six years with the engagement of key government directorates and DHMT, UN agencies as part of UN consortium (UNICEF, WHO, UNFPA), and various NGOs as part of NGO consortium selected and constituted by FCDO (IRC, GOAL, Marie Stopes, Crown Agency, among others).
On the aspect of funding, he revealed that they have secured funding from the government of the United Kingdom through the Foreign Commonwealth and Development Office (FCDO). He said the component supported through UNICEF has focused primarily on two significant areas - procurement of essential drugs under free healthcare initiative and care for tiny and sick newborns through Special Care Baby Units (SCBUs).
Commenting on the Free Healthcare Initiative, Dr. Batema recounted that the FHI was officially launched on April 27, 2010, to offer a comprehensive range of healthcare services free of charge at the point of service, with a particular focus on improving maternal and child health. He updated that over $70M was committed to its funding. From 2010, he disclosed that DfID, now FCDO, has been the most significant contributor; additional support came from the global fund, the World Bank, the African Development Bank, the EU/EC, GAVI, Irish Aid, JICA, the UN ( UNICEF, UNFPA, WHO and WFP) plus various NGOs.
According to Batema, UNICEF has played a vital role by offering procurement support to NMSA and forecasting and qualification support to DPS. "UNICEF will support DPS for conducting annual and semi-annual quantification reviews, preparing necessary reports and disseminating them to stakeholders. UNICEF has also improved inventory management at NMSA Warehouses, inventory management and accountability at district medical stores, hospitals, and PHUs, and supply end-user monitoring", affirmed Dr. Batema.
So far, he updated that FCDO has committed $9M for 2024 procurement and that UNICEF supports NMSA in the procurement process.
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