Our focus is on improving maternal and child health in the Kambia District by tackling a number of the causes of poor maternal health that contribute to the high rate of maternal and infant death in Sierra Leone.

These causes include:

• · Poor community understanding of basic maternal health
• · Limited transport access to health services in rural areas
• · Financial limitation due to the poverty of rural communities
• · Severe shortages of qualified health staff
• · Poor health services and facilities

The Kambia Appeal works in collaboration with the key groups in the Kambia District to support and strengthen the existing health facilities owned and managed by the government of Sierra Leone. Our work is designed and planned in close co-operation with the Ministry of Health and Sanitation through the District Medical Officer and the District Health Management Team, the local government through Kambia District Council, and with the local community, represented by the Paramount Chief.

Our work helps to improve the lives of women, their children and their families by strengthening maternal health services to help reduce the number of women that die during pregnancy and childbirth.

See our current projects

Health Services in Sierra Leone

The 1992-2002 civil war in Sierra Leone severely undermined the functioning of the health system. Many health workers were killed or displaced; access to health care was disrupted as people were forced to flee to neighbouring countries. Much of the country’s health infrastructure (including hospitals and community-based ‘peripheral health units’, or PHUs) was damaged or destroyed.

Despite some progress in recent years, Sierra Leone is ranked as one of the poorest countries in the world (GNP per capita US$260 in 2007; World Bank). Since the end of the war, the government has set up free or low-cost district-level medical services for many vulnerable groups, including pregnant women, lactating mothers, school children, children under the age of 5, and the elderly (65 years and above). However, set fees for drugs and services may not always be adhered to, and additional charges are often levied. Such additional fees are used to help make up funding shortfalls faced by hospitals and health centres. Funding for services has become more difficult in recent years as some international NGOs have scaled back their relief efforts, following the end of the civil war. Financing difficulties at government level also mean that many medical staff receive little or no regular remuneration; this also contributes to a climate where some health workers may seek to make a modest income through charging informal fees. As a result of these factors, many theoretically “free” services are in fact not free at the point of provision; such hidden charges reduce the affordability of health care for the poorest.

There are regional inequalities in access to health care; service provision in rural areas is poor compared to larger urban areas. Human resources for health remain very limited at the district level, in terms of both the number and skills level of staff. Turnover rates can be very high (partly reflecting the low levels of remuneration.) Much of the country’s health infrastructure remains dilapidated, with shortages of equipment, facilities and drugs.

The results of these difficulties can be seen in the country’s health indicators:

• Life expectancy at birth (years) 39  (Africa 48)
• Maternal mortality ratio (deaths/100,000 live births) 1,800  (Africa 910)
• Infant mortality ratio (deaths/1,000 live births) 170 (Africa 100)

Source: Health needs and health services of Sierra Leone, A Situational Analysis, March 2007, JICA.

Learn more about the government health services in Kambia via the website of Sierra Leone Ministry of Heath and Sanitation

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