Description
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Sierra Leone remains among the countries with the highest maternal mortality rates in the world with 443 per 100,000 live births in 2020. Neonatal mortality also remains high by international standards, at an estimated 31 per 1,000 live births (2021). The Sierra Leonean health system is not yet sufficiently aligned with the health needs of the population. Inadequate management of the health workforce, which is frequently rotated and for which there is no continuous, evidence-based competency development strategy, results in inadequate staff competencies, especially in the area of maternal and newborn health. The GIZ project "Health System Strengthening and Epidemic Prevention in Sierra Leone" builds on its predecessor. Through its support, a nationwide overview of all in-service trainings for health workers exists, which provides the basis for future institutionalized training plans. A digital roadmap for the implementation of Sierra Leone's digital strategy, the development of which was supported by the predecessor module and the DIPC project, is available. Much has also been achieved in the target districts: health workers in obstetric and neonatal emergency care have been strengthened through a national mentoring approach. Community members are taking more responsibility for the external environment of the health facilities and health workers are better integrated into the communities. Since the introduction of the digital DQA tool, 74.9% of routine health data in Kailahun and 86.9% in Kambia have been collected correctly. The basis for evidence-based decision-making and quality assurance in the selected facilities is therefore largely in place. The new project builds on the competencies of health care providers and capacities of health care facilities, with a special focus on maternal and newborn health and epidemic prevention and response with a One Health approach. The module objective aims for the Sierra Leonean health system to be better aligned with the gender-specific health needs of the population in selected areas in the three districts Kailahun, Kambia and Pujehun. The project aims to strengthen selected competencies of service providers in the health sector in a gender-sensitive manner and capacities in emergency obstetric and neonatal care in selected health facilities. It also focuses on improving the quality assurance in health services, and strengthen the capacity of selected actors for epidemic prevention and response according to the One Health approach. The development of training plans, the monitoring of the plans using the Integrated Human Resource Information System (iHRIS), and the implementation of trainings in the areas of obstetric and neonatal emergency care, digital, and pandemic prevention and One Health will contribute in strengthening the capacities of health staff. Focusing on obstetric and neonatal care, a mix of human capacity development measures (in-service trainings, mentoring and an internship programme) and several institutional capacity development measures concerning the availability of basic medical equipment as well as standard operating procedures, quality assurance processes and the referral system will be applied. Also, the development of a gender policy, including a policy against sexual harassment in the workplace, is being supported with the involvement of the relevant departments of the Ministry of Health as well as specialists and managers at various levels. In addition, the project focuses on the quality assurance of health services, including gender-sensitive community participation by implementing integrated supported supervision digitally. The participation of the population in planning and through feedback mechanisms, including women, the poor and people with disabilities as well as analphabetic, promotes transparency and the needs-based orientation of health services. The capacity of selected actors for epidemic prevention and response according to the One Health approach in the partner districts will also be strengthened by the project. By engaging all One Health actors, including the authorities for human, livestock, and wildlife health, as well as local communities, cross-sectoral coordination, collaboration, and information sharing will be institutionalized in partner districts.