Sierra Leone

Despite an overall reduction in maternal mortality in recent years, Sierra Leone remains among the most dangerous places to bear children. Many women living in remote areas particularly struggle to access reproductive health services and emergency care. Basic and emergency obstetric care are now provided free of charge in public facilities, but meeting the demand for reproductive health services without sacrificing quality remains an issue.

EngenderHealth’s work in Sierra Leone focused on obstetric fistula, a vaginal injury usually caused from prolonged labor without timely medical attention. Through the U.S. Agency for International Development (USAID)–funded Fistula Care project, EngenderHealth supported the Aberdeen Women’s Centre (AWC), a private clinic in the capital city of Freetown that is managed by the Gloag Foundation. AWC dedicates its work to the repair and prevention of obstetric fistula through the provision of high-quality delivery care, including around-the-clock cesarean sections.

Throughout the course of the EngenderHealth-supported project, AWC repaired hundreds of women with fistula. Women who had a fistula repair were offered family planning counseling, physiotherapy, and the opportunity to participate in basic life skills programs, to ease their reintegration back into society and improve their chances for better economic livelihoods.

AWC also committed itself to training and mentoring nurses in pre- and postoperative care and obstetric emergency response. AWC’s midwife-led maternity unit opened in 2010, providing high-quality delivery care for women and professional development opportunities for staff. Its successes were featured in the special Millennium Development Goal issue of Midwifery, available here.

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