New campaign aims to boost hospital visits in Sierra Leone

By Kemo Cham

[First published on www.politicosl.com] An initiative designed to shore up hospital visits has been launched in Sierra Leone as part of the government’s effort to beat down the world’s highest maternal mortality ratio.

The campaign, dubbed ‘Get Kol Art, pik welbodi’, from the local Krio loosely translated ‘choose a healthy living and be assured of a peaceful mind,’ is targeting the most vulnerable segment in society - pregnant women, breastfeeding mothers and children under five. This is the same group of people who are catered for in the government’s partial free healthcare initiative which, apparently, has done little to turn around one of the world’s worst health systems.

The campaign is implemented by the Ministry of Health in collaboration with the Health Communication Capacity Collaborative (HC3), a project of the Johns Hopkins Center for Communication Programmes, and it specifically aims to increase demand for health services and increase healthy practices at home and in communities.

The Health Ministry and its partners hope to use the initiative, which is funded by the USAID, to address the worrying problem of maternal mortality in the country. Officials say it basically seeks to enable pregnant women and families with children under five to know what they can do to protect their health, feel confident they can do it, and practice the promoted behaviors.

The initiative is also designed to build trust among people for health facilities. The 2014 Ebola epidemic notably eroded that trust, leading to people shunning health facilities. A direct consequence of that was illustrated by the high rate of infant and maternal mortality.

According to World Bank data for 2015, Sierra Leone ranks at the top with a maternal mortality ratio of 1,360 per 100, 000 live births. This is worst than in even war torn countries like Central African Republic (882) and Afghanistan (396).

The ‘Get Kol Art pik welbodi’ campaign therefore seeks to promote and create demand for improved quality reproductive, maternal, new born and child health (RMNCH) services.

It “envisions a Sierra Leone where families and communities thrive by practicing key RMNCH behaviors for pregnancy, delivery, new born and child health,” the concept note of the project handed out to the media reads in part.

Gandhi Kallon, Social Mobilisation Coordinator at the Western Area District Health Management Team, said the campaign will also seek to address both behavioral and institutional barriers that limited access to health care services. He told Politico that they will specifically seek to encourage at least four Anti Natal Clinic visits during pregnancy and ensure that all pregnant women deliver in hospitals, make monthly hospital visits for growth monitoring, vaccination, and other preventive measures for babies under five.

People will also be encouraged to inculcate the idea of visiting hospital at every realization of a sign of sickness, he said.

“A lot of people complain that hospitals lack facilities to take care of pregnant women or who newly delivered women, that they have no toilets or water supply. So we are saying in other to make the hospital friendly, you have to provide these facilities.”

The Health ministry and partners have identified three key issues, behavioral and institutional, which they specifically aim to address, as fueling apathy towards health facilities. The first is entrenched traditional beliefs and practices. There is also the issue of drug shortages in hospital. Officials will also look at how to address the issue of Traditional Birth Attendants (TBAs).

Kallon said 80 percent of deliveries recorded nationwide were done with no complication.

“The reason why we are encouraging people to go to hospital is because you don’t know who falls within the 20 percent,” he told an orientation session of the media and civil society organizations prior to the official launch of the campaign last week.

Another key activity in this initiative is a national mass media campaign. Posters will be distributed widely carrying messages of the campaign. There will also be drama performances and real life testimonies from interviews.

Some 20 episodes of a radio magazine programme and four radio advertisement spots will be aired in 33 stations nationwide as part of the campaign that also include focus group discussions on issues raised through the radio drama.

75 communities in five districts - Bombali, Port Loko, Tonkolili, Western Area Rural, and Western Area Urban – will be targeted.

Kallon said special messages have been done and distributed right across the country, and relevant training conducted for community health workers.

“Health promotion is evidenced based. We believe that with this initiative we can create the necessary impact on the lives of the people,” he said, adding: “We know that all the gaps in how health facilities are used by pregnant women and lactating mothers and children under five is an issue of communication,” he added.