Sierra Leone to receive $10 million dollar loan from IDB

The Ministry of Health and Sanitation will receive $10million dollars loan from the Islamic Development Bank (IDB) to provide quality health care services for women and children.

Representatives from the Islamic Development Bank (IDB),  senior officials from the Ministry of Health and Sanitation (MoHS), representatives from the Ministry of Finance and Economic Development (MFED) and District representatives have started a three day discussions at a workshop held at the Ministry of Health and Sanitation Conference Hall on Tuesday 17th May.

These discussions will mark the finalization plans for the $10 Million Dollars loan IDB has committed to provide to the Government of Sierra Leone. The loan will help to promote quality health care for women and children in three districts i.e. Bombali, Kenema and Koinadugu.

In giving an overview about the project, Dr. Santigie Sesay Director of the Reproductive and Child Health Directorate said the Health System Strengthening Project is a four-year project with Loan financed by the Islamic Development Bank (IDB). He went on to say, the total project cost - US$ 11.10 million, IDB’s contribution - US$ 10.00 Million and the Government’s contribution US$ 1.10 Million.

I learnt from Dr. Sesay’s presentation that the overall objective of the project was:

To contribute to the realization of one of the main targets of the National Health Sector Strategic Plan of reducing maternal and neonatal mortality through strengthening the health system

However, the project’s specific objective is to improve access to and quality of maternal health care services by 2019.This project will enable the Ministry to:

  • Establish two new Basic Emergency Obstetric and Neonatal Care (BEmONC) facilities
  • Equip 8 existing BEmONC facilities
  • Establish a Midwifery Training School (MTS)
  • Improve the referral system among healthcare facilities at different levels of the health care system
  • Equip the School of Clinical Sciences (SCS)
  • Supports training and management of Community Health Workers (CHW).

In explaining  to his audience why the country is in need of such support, Dr. Sesay disclosed in his presentation that "Sierra Leone ranks low in the Human Development Index (177 out of 186 (UNDP, 2013)) with unacceptably high maternal and child mortality figures. It has one of the highest fertility rates (4.8 in 2012) while only 24% of the births take place in health facilities. The country is estimated to have about 100 obstetrical and neonatal complications every day. However, only 2% of the existing Primary Health Units (PHU) fulfils the WHO standards for serving as BEmONCs. The UNFPA classifies Sierra Leone among the nine countries with the highest shortage of Midwives. These countries have to increase the number of their midwives by 6 to 15 folds to achieve the target of 95% coverage of all births with a skilled birth attendant".

  • PHE Makeni laboratory
  •  Ministry of Health and Sanitation Meeting

It is worth noting that the project will be delivered under four Components.

Component 1: Capacity Building for Maternal and Child Health (MCH)

Component 2: Infrastructure Development

Component 3: Community Sensitization

Component 4: Support to Project Management

The first component will provide training for 200 Community Health Workers (CHWs) using the standard training package. They will also be receiving refresher trainings, on the job coaching and review meetings for the community health workers' program.

In the area of midwives, 280 midwives will be trained in 4 four years at the Mid Wives Training School in Kenema. The school will be equipped with furniture and equipment.  2 buses (1 for students and 1 for the faculty) and a Modern library which will include electronic library with internet will be provided.

The project will also provide training for 200 Community Health Officers. They will receive their training at the new School of Clinical Sciences in Makeni that will be built with funds from the project. In addition, the project will provide tuition and transportation fare for CHOs and a modern library which will include electronic library with internet facilities.

According to the project design, 10 Obstetricians will be trained.  6 female and 4 male, they will receive tuition fee, transportation fare, living expenses and books. After the training, an agreement will be signed with these doctors to serve for five years.

In the area of referral support, the project will support the Ministry with 5 ambulances with VHF Radio. 

Component two of the project will focus on infrastructural development, this project will provide funds for the construction of two new BEmONCs  in Koinadugu district and equip 10 exiting BEmONCs including the two new ones. In the area of electricity, the above BEmONCs will have uninterrupted electricity and water supplies (solar panels and bore holes).

In Kenema, a Midwives Training School will be established and the construction of over 200 students’ capacity hostel - with canteen, library, skill lab and multipurpose auditorium and the construct staff quarters.

Component three of the project will be focusing on community sensitization and the establishment of a “Family Radio” Station that will be operated by the Midwives and Faculty. The Radio Station will mainly focus on broadcasting maternal and child health information used by MoHS to reach out to community for various health related campaigns with support from health communication specialists.

The final component of the project will provide support to the project management in terms of manpower, skill mix and equipment, project start-up workshop, mid-term review & completion workshops, orientation on the bank's procurement and disbursement procedures at IDB Quarters for selected staff project supervision and financial audit.

The three key Directorates that will benefits from this project are the Directorate of Reproductive and Child Health, Directorate of Policy Planning and Information, Directorate of Primary Health Care & the Directorate of Hospitals and Laboratory Services.

It can be recalled that, as the Ebola outbreak stroke the country, the Government of Sierra Leone put together the Road to Recovery Plan. The plan has two initiatives which include 6 – 9 Months and 10 – 24 Months:

 6 – 9 Months

  • Ensuring patient and health worker safety
  • Restoring essential health services

10- 24 Months

  • Reducing Maternal and Child deaths
  • Maintaining a Resilient Zero

In this plan, the Government hope to save the lives of 600 women and 5, 000 children by 2018:

  • Increase quality of care, referral capacity and utilisation of basic and comprehensive, emergency obstetric and neonatal care saving 600 mothers and 1, 600 newborn lives.
  • Improve quality of ANC, PNC & Essential newborn care.
  • Increase contraceptive uptake amongst teenagers to reduce teenage pregnancy by 15, 000; all women in need of EmONC transferred to a facility in 2 hours.
  • Bring 25 BEmONC and 4 CEmONC facilities up to the required standards including IPC compliance and sanitation and hygiene facilities.

This loan in my opinion, will help to boost the country to achieve greater parts of its Road to Recovery Plan if the loan is utilised well.

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