The Saving Lives Programme (SLP) seeks to save women’s and children’s lives by improving the quality, availability and accessibility of reproductive, maternal, newborn and child health services.
The first two years of the programme focuses on increasing access to preventive services, including family planning, water, sanitation and Long-Lasting Insecticidal Nets (LLINs), and improving service quality in line with the maternal and child health results of the President’s Recovery Priorities (PRP). The second phase will embed and build on the gains of the first phase, and will increase equitable access to the improved reproductive, maternal, neonatal and child health (RMNCH) services, whilst strengthening priority health systems for more sustainable service delivery.
The project’s purpose is to achieve a sustainable step-change in health outcomes for under-fives, adolescents, pregnant women and mothers. This is being delivered through eight components:
Reducing maternal and neonatal deaths
DFID is the largest donor supporting the health sector and the largest funder of the President’s Recovery Priorities. Saving Lives is an ambitious five-year programme, providing significant support in all 14 districts, with the potential to make a significant impact in terms of strengthening the health system in Sierra Leone. Each year of the programme from 2017 onwards aims to reach 300,000 mothers, 250,000 newborns, and 1,200,000 children under 5 years, who will benefit directly or indirectly; as well as 222,000 adolescents, overall 20% of the population. Key results of DFID support to by the end of phase one are expected to be:
· Finalisation and dissemination of key strategies and guidelines under the PRP
· Strengthened health information systems at national and district level
· Improved infrastructure to save lives of women, newborns, children and adolescents, with eight emergency obstetric and newborn care (EmONC) facilities, 30 adolescent and youth friendly health facilities, WASH facilities in 175 community health posts upgraded, and four newborn intensive care units operationalised
· Strengthened supply chain for lifesaving commodities, through distribution of LLINs, and non-net costs supported for the 2017 malaria campaign, to complement Global Fund investments and procurement of Free Health Care (FHC) commodities
· Improved human resources for health, through: support to three midwifery schools, and the training of 1,000 maternal child health (MCH) aides and over 4,000 CHWs, complementing Global Fund and World Bank investments The programme is taking place in a difficult operating environment, as the health sector is still recovering from the Ebola epidemic of 2014/15, with weak core systems and low levels of capacity at all levels. The sector is severely under funded and the Government of Sierra Leone’s (GoSL) funding to health has declined as a share of the national
The programme is implemented by three UN agencies (WHO, UNICEF and UNFPA), the Clinton Health Access Initiative (CHAI), Aecom and the CHANGES consortium of NGOs, comprised of World Hope International, VSO, Focus 1000, Cordaid, Charlie Goldsmith Associates and 4-M solutions (who act as the secretariat), in partnership with the MoHS. A supplier to provide monitoring, evaluation, learning and review (MELR) services has been identified, and is being contracted..
The programme is contributing to a number of DFID strategic objectives and results commitments. It is aligned with DFID Strategic Objective two; to improve access to services for the world’s poorest people, and Strategic Objective six, to increase voice, choice and control for girls and women in poor countries. It will contribute directly to increased numbers of additional family planning users and to the commitment to save maternal and child lives. The programme is consistent with the post-Ebola approach approved by Secretary of State, and focuses on all of the key result areas of the PRP which are:
§ Save child lives from acute respiratory infections, diarrhoea, malaria and vaccine preventable diseases
§ Save maternal neonatal lives through universal access to comprehensive antenatal, obstetric and neonatal care
§ Improve cost effectiveness and performance of critical health systems It will contribute to the following of DFID Sierra Leone’s objectives:
§ Tackling entrenched discrimination against women and girls by allowing them to claim their reproductive health rights
§ Increasing the community and youth engagement started during the Ebola response to achieve social mobilisation around public health objectives
§ Strengthening justice, democracy, transparency and accountability, and tackling corruption through greater community and civil society monitoring of service delivery and faster, more transparent health system performance data What are the expected results? The programme’s impact is significantly fewer preventable deaths among women, adolescents, girls and children in Sierra Leone.
In a bid to reduce child mortality in Sierra Leone, the Child Health and Mortality Prevention Surveillance (CHAMPS) program seeks to provide better data about how, where and why young children are getting sick and dying. The overall goal is to collect robust, standardized data that can be shared across a range of partners and stakeholders to analyze and track the preventable causes of child mortality. The resulting data can be used to develop evidence-based policy, set priorities for research and inform the provision of much-needed vaccines and medicines.
CHAMPS will determine cause of child death through 3 main surveillance methods. First is a verbal autopsy interview which will be administered to the parent and care giver of the deceased child; second is a clinical data abstraction of all health records of the child. Third is a procedure called minimally invasive tissue sampling (MITS), which was developed to reduce the uncertainty regarding causes of death in low- and middle-income countries. The MITs would be conducted in facilities within 24 hours of death for children under five who die either at health facility or at community.
Given the numerous cultural and religious beliefs and practices relating to death, burial and grieving of loved ones in Sierra Leone, MITS may not be readily acceptable in the implementation site.
It is with this backdrop that FOCUS 1000, which is the Social Behavioral Science (SBS) partner for the CHAMPS program, is tasked with conducting formative research and community engagement to aid the implementation of CHAMPS activity. The formative research aims to evaluate the feasibility (i.e. acceptability, practicality and implementation) and ethical considerations of child mortality surveillance in different cultural, social, religious and geographical contexts. While community engagement looks at approaches for working with key community stakeholders and community members for community entry, community sensitization, community ownership and community acceptance.
In Sierra Leone, CHAMPS is implemented in Bombali Shebora Chiefdom located in Bombali District, in the northern province of Sierra Leone. It was initiated in January of 2017, with implementation plans for the next 20 years.
Kombra Media Network (KMN) was established on 13th March 2015 after training sessions conducted by FOCUS 1000 on Scaling-Up Nutrition and Immunization (GAVI). Our key objective is to report on issues related to heath like nutrition, immunization and other health-related issues as well as sensitize the public for positive behaviour and social change.
The Network is made up of fifteen (15) journalists from different media houses (Print and Electronic Media). Among these active members, an interim executive was formed to coordinate the activities of the Network.KMN has held seven meetings since its establishment during which members discussed the drafting of byelaws, rules and regulations for the network.
Objectives of Komba Media Network
Scaling Up Nutrition and Immunization Civil Society Platform (SUNI- CSP) Sierra Leone is a Civil Society Platform born out of two entities; Scaling up Nutrition Civil Society Platform (SUN) and the Immunization Civil Society Platform (GAVI).
As part of Government commitment to improve the health and nutritional status of children and women in Sierra Leone, SUNI CSP is a united platform that speaks with one voice to engage government and other development partners in promoting nutrition, immunization and health system strengthening activities.The platform is made up of over 200 members from various civil society organisations (CSOs) and community networks. It has District Coordinating Bodies (DCBs) or taskforces in all fourteen districts in Sierra Leone, with the aim to reach, support and empower the most vulnerable groups in our society and ensure that all Sierra Leoneans have access to and benefit from good nutrition and health.A key strength of SUNI CSP is the diversity of its membership-including International NGOs, National NGOs, Faith -Based Organisations (FBOs), Community Based Organisation (CBOs), Market Women Association, Farmers Union, Teachers Association and other Development Partners. The Platform also includes the media known as the Kombra Media Network (KMN), responsible for reporting and writing on health related issues.