Sierra Leone's Model for Improving Maternal Health and Women's Rights

As the world moves toward review of the Millennium Development Goals, other nations should take a closer look at the success of Sierra Leone's maternal health program and commit to apply its lessons around the world.
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Freetown, Sierra Leone -- Continuing high rates of maternal mortality and persistent gender-based violence must be addressed through a holistic and rights-based approach that strengthens health systems and empowers women. As we approach the ten-year review of the United Nations Millennium Development Goals in September, we have an extraordinary model of leadership to look to in Sierra Leone of how such approaches can be implemented in practice.

My last trip to Sierra Leone was in 1999, when I was serving as UN High Commissioner of Human Rights. At that time, the country was still in the midst of terrible conflict. I returned last week to a nation still struggling to rebuild following more than a decade of civil war. But much has changed, and those changes are nothing short of stunning.

One area were Sierra Leone has made important advances is in addressing women's health. The government has focused on combating the tragedy of maternal mortality, increasing access to reproductive health, and strengthening policies around gender and women's rights. I found a spirit and determination amongst political leaders starting with the president right through to the individuals we met from all walks of life. The people of Sierra Leone are convinced that focusing on the health of women and children is one of the best investments they can make in their future.

Sierra Leone took the bold step of launching earlier this year it's Free Care Initiative for both maternal and child health , including pregnant women, lactating mothers and children under the age of five. During my visit, I joined colleagues from Concern Worldwide, the Ministerial Leadership Initiative for Global Health (MLI), a program of Realizing Rights, and representatives of the Embassy of Ireland in Sierra Leone to observe progress being made in Sierra Leone's initiatives related to maternal mortality, family planning and reproductive health. We met with senior officials from the government, representatives from UN agencies, bilateral agencies and non-governmental organizations, visited health care facilities and talked with health care workers, clinic visitors as well as members of the local media to understand the steps being taken to improve women's health and where challenges remain.

We know from our own work at Realizing Rights which has been supporting the Ministry of Health and Sanitation in Sierra Leone through the Ministerial Leadership Initiative for Global Health (MLI) that making further progress requires a range of interventions, not least strengthening the Ministry's capacity to address administrative challenges from financial management to donor coordination to the implementation of new policies and programs to address reproductive health.

To get a better sense of what is being done at local level, we visited one of the health facilities of the Grey bush slum area constructed and supported by Concern Worldwide, Princess Christian Maternity Hospital (PCMH) and Ola During Children's Hospital. In spite of the challenges and pressures on the health system, the incredible efforts of the health workers at Grey bush community health clinic were evident. It was gratifying to see the collaboration between an NGO such as Concern and the health facility staff in training traditional birth attendants and establishing a pregnant women's support group to educate women about pregnancy and care at birth, HIV/AIDS, family planning and nutrition.

In our meeting with Sierra Leone's President, Ernest Bai Koroma, and other government officials we discussed the importance of building upon lessons learned from the launch of the Free Care program, including the critical role of strong and effective political leadership to galvanize action. We also stressed the need to strengthen the quality and capacity of service delivery provision, particularly in light of increased demands on the health system. In order to truly improve the health of the women and children of Sierra Leone, it is essential to continue to improve the quality of service provision.

Sierra Leone has taken a major step forward in promoting maternal health and gender equality not only for its own people, but also globally as a model of leadership and initiative in this critical area. It is time for other nations, indeed for us all, as we move toward review of the Millennium Development Goals to take a closer look at the success of the Sierra Leone program and commit to apply its lessons in other countries around the world.

Mary Robinson, President of Realizing Rights and former President of Ireland, and UN High Commissioner for Human Rights, recently returned from a weeklong trip to Sierra Leone, where she witnessed the commitment of the government, non-governmental organizations and health workers to improve the health of the country's women and girls.

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