UN Report: Sierra Leone has the highest MMR in the world

According to new UN estimates, Sierra Leone had the highest maternal mortality ratio globally. National Conference reveals the government's commitments to improve maternal health.

According to new UN estimates, Sierra Leone is still estimated to have the highest maternal mortality ratio (MMR) globally. The recent report states that the maternal mortality ratio for Sierra Leone is 1,360 maternal deaths per 100,000 live births. A woman in Sierra Leone has a 1 in 17 lifetime risk of dying from a maternal cause; that is, the probability that a 15-year-old woman will die eventually from a maternal cause in Sierra Leone.

The new MMR replaces the previous UN estimate of 1,100 maternal deaths per 100,000 live births. The latest estimate is based on an updated and slightly different methodology.

The report shows that there seems to be an improvement over time from 1990 to 2015, as shown in the graph below. However, as the graph also shows, the maternal mortality is far higher in Sierra Leone than that for Sub-Saharan Africa as a whole, where the maternal mortality ratio for 2015 stands 546 maternal deaths per 100,00 live births – that’s less than half that of Sierra Leone.

Whilst this downward trend is encouraging, we must speed up the rate of progress in saving the lives of mothers in Sierra Leone. Long-term investment in maternal health and the Free Health Care Initiative must be a priority for our government and our donors.

The government showed its commitment to maternal health by hosting a national conference on the theme, titled: Improving and Sustaining Status of Emergency Obstetrics and Neonatal Care Facilities (EmONC) in Sierra Leone” on 12th November 2015. The conference was supported by Options Consultancy Services, including Evidence for Action-MamaYe and PMEL.

The purpose of the Safe Clinics Conference was to highlight the compliance of facilities in achieving and sustaining the EmONC requirements for each enabler as assessed through the Facility Improvement Teams (FIT) assessments.  

Women and newborns are dying in Sierra Leone because our health facilities do not provide an enabling environment for EmONC. To address this, the Ministry of Health and Sanitation introduced the FIT assessment approach to monitor the progress of selected facilities towards readiness to provide EmONC.

There are seven identified domains, referred to as enablers, which are necessary to provide a safe environment for provision of EmONC services. These enablers are:        

  1. Water & sanitation
  2. Electricity
  3. Referrals
  4. Blood handling & laboratory services
  5. Staffing
  6. Equipment
  7. Drugs & essential supplies

During the conference, evidence presented from the most recent FIT assessment in June found that none of the government hospitals and clinics that were assessed across the country met all seven enablers. The government and its partners explored different approaches to improving this situation and agreed the need to invest in improvements to EmONC readiness during this post-Ebola recovery period. 

The safe clinic conference created an opportunity to galvanise efforts of local councils, MoHS, relevant Ministries and health partners to support safe clinics in order to reduce maternal deaths in the country. 

We hope that in future, Sierra Leone will be in a better position than worst in the world.

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