Marley Rashad Maternal Health in Sierra Leone From: Secretary of Health, Sierra Leone To: Minister of Finance, Sierra Leone Introduction


Nature and Magnitude of the Problem



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Nature and Magnitude of the Problem

The maternal mortality ratio (MMR) in Sierra Leone is among the highest in the world. Although estimates range from as low as 857 deaths per 100,000 live births (country-reported statistics) to as high as 1,800 per 100,000i live births, the actual ratio is most often reported at around 1,300 deaths per 100,000 live births.ii This is down from around 2,000 deaths in the year 2000iii. Although there is a long list of maternal health problems that affect Sierra Leonean women, MMR is one of the strongest indicators of maternal health as a whole, and the dismal MMR of Sierra Leone stands out among other maternal health issues.

Women in Sierra Leone who die in childbirth are most likely to die of hemorrhaging, infection, obstructed labor, hypertensive disorders in pregnancy, and complications of unsafe abortion.iv Among these, all but complications of unsafe abortion are related to lack of emergency obstetric care (EmOC) during childbirth. According to the latest WHO estimates, 87% of Sierra Leonean women receive at least one antenatal care visit during pregnancy, but only 45% continue with consistent care and have at least four visits.v Beyond this, only 42% of births are attended by skilled health personnelvi and only approximately 10% of expected births were seen in health facilities.vii




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