The Gillings program fights maternal mortality and hunger in Sierra Leone

More than 4,500 miles away, researchers from the Gillings School of Global Public Health are working with community members in Sierra Leone to increase the safety of pregnant women and tackle malnutrition.

The Humanitarian Health Initiative (HHI), an initiative within Gillings, works with the Rural Health Care Initiative (RHCI), a non-governmental organization located in Tikonko Chiefdom, part of the province of southern Sierra Leone.

RHCI was founded by Sierra Leonean Alice Karpeh in 2011. The group’s goal is to help reduce maternal mortality rates, or the rates of women who die during pregnancy, childbirth or shortly after childbirth.

A woman in Sierra Leone is 100 times more likely to die of pregnancy or childbirth than a woman in the United States, said Carol Nelson, RHCI’s program coordinator in Sierra Leone.

HHI and RHCI began collaborating in early 2021, after RHCI reached out to Sheila Leatherman, professor of global health policy and Gillings’ global adviser, who would go on to lead the UNC team.

The collaboration came about as part of RHCI’s interest in evaluating its program in Sierra Leone, said Doreen Alumaya, who led the nutrition assessment program. At the time of her involvement, Alumaya was a graduate student at Gillings.

“It was a really collaborative, community-driven, community-driven project,” she said. “Exactly what global health needs right now, programs where we center communities and let communities lead.”

The Gillings program conducted interviews with members of the Tikonko community to learn more about how RHCI could better serve them, Leslie Lytle, education advisor for HHI, said in an emailed statement. Her research work focuses on interventions to promote community health.

“Our goal was to basically help monitor and evaluate health programs,” Alumaya said. “Specifically, we worked on their maternal health programs.”

The project in Sierra Leone was already underway when UNC joined UNC, and working with the University gave RHCI the additional tools, funding and staff needed to evaluate its programs, said Maggie Pilacinski, board member and communications coordinator for the initiative.

There are four key program areas: redesigning the rural health system, establishing birth waiting homes, child health programs, and sustainable food and agriculture.

“The development of the (rural) health system includes many different things, including the medical donations that we send, trainings, health workers, a transport system, outreach clinics on motorcycles, and then two-way support. other rural clinics,” Nelson said.

Sierra Leone is still recovering from a civil war that ended in 2002 and the Ebola outbreak from 2014 to 2016, which devastated the country’s health system, she said.

Birth-waiting homes are places where pregnant women can stay at the end of their pregnancy.

“The houses allowed them to rest and be well nourished before their babies were born and also meant that they would be close to the community health clinic at the time of delivery,” Lytle said in an email. .

Access to health care during childbirth has helped reduce maternal mortality in the community. So far, the homes have served more than 900 women, and she said 99% of them delivered healthy babies.

RHCI has two maternal waiting homes. The first opened in 2018 and has 24 beds available; the second house opened in 2021 and has 11 beds available.

The food security program produces food for expectant homes and has demonstration farms, where local community members educate local farmers on improved farming practices, Nelson said.

RHCI has 16 full-time employees and more than 60 part-time employees from the Tikonko Chiefdom as of May 2022.

As part of the project, Alumaya designed a network of community health workers, a network of women in communities who are learning to assess malnutrition. These women teach other mothers in the community basic infant and young child feeding and nutrition practices. They also liaise between RHCI and members of the Tikonko chiefdom.

“Based on the results of the assessment provided to the RHCI board, they have decided to extend the clinic days for malnourished children, providing additional treatment and follow-up care,” said Lytle in a statement. “In addition, training for rural community health workers has been strengthened and a better protocol for nutrition education and nutrition care for the on-site nutritionist has been instituted.”

The collaboration is strong and the two are looking for further opportunities to work together to improve the health of mothers and children in Sierra Leone, she said.


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Ryan H. Bowman