117 alert system transformed into a public health hotline

One of the operators in action at the 117 Call Center within the EOC

KMN – Freetown (June 22) The Sierra Leone government has transformed the Ebola-era free toll alert system into a public health hotline with an eye on the twin epidemics of maternal and infant mortality.

The Ministry of Health and Sanitation and its partners on Thursday inaugurated a facility housing the 117 Call Center located within the Public Health National Emergency Operation Center (PHNEOC).

The 117 alert system was first created as a public health surveillance tool in 2012 as part of the government’s Free Health Care initiative which targets the three most vulnerable segment of the population: Pregnant women, lactating mothers, and children under five. But it was not until 2014, at the height of the West African Ebola epidemic, that it became popular. This is because it was used to report deaths and illness after the government outlawed burial without official permission.

With Ebola over, there had been discussions about the fate of the system which was located within a privately run telecommunication outfit. The UK government, through its international development arm DFID, purchased equipment and provided technical support through the technology firm e-Health Africa to relocate the call center to the EOC which is located within the Cockerill Military Barrack along Wilkinson Road in the west end of Freetown.

Health ministry officials say the move is part of the health strengthening program of the government. The call center, the alert system was designed to ensure strong disease surveillance system in place to enable more timely response to any threat of epidemic, the MoHS said in a statement.

“The 117 was critical during the Ebola outbreak for reporting suspected deaths. It was one of the most powerful community engagement tools during the time and showed us the commitment of the community towards helping the country fight the deadly disease,” Chief Medical Officer at the MoHS, Dr Brima Kargbo, said in the statement.

“The ministry,” he added, “is happy that this will continue to be operational and can now spread to beyond Ebola.”

The government and its development partners have been preoccupied by a silent epidemic of maternal and infant mortality rates. The World Health Organisation ranks Sierra Leone as having one of the highest rates of maternal deaths globally. According to the government’s most recent published data, there is an estimated 1,165 deaths per 100,000 live births. This is said to be equivalent to eight maternal deaths every day.

The Maternal Death and Surveillance Report, released at the end of May, revealed that a total of 706 maternal deaths were reported during 2016, though the report suggests that the true figure may be much higher. The authors called for united actions from government, health workers, communities and partners to tackle the high number of maternal deaths in the country.

The report also estimates that up to seven in ten maternal deaths currently go unreported, with gaps occurring especially when deaths occur outside of government maternity wards. This, it stresses, undermines health workers ability to adequately address the causes of mothers dying.

The 117 therefore comes in handy for communities to report any maternal death that happens outside the health facilities.

Deputy Minister of Health [I], Mrs Madina Rahman, said Thursday at the EOC that as the health sector moved into renewed priorities beyond the [Ebola] response, it was imperative that the country was armed with the right tools to tackle public health issues.

“The current and short to medium term goal is to use the 117 to strengthen the national disease and mortality surveillance system, including surveillance of such events as maternal and child death, suspicious infectious cases in communities and health facilities,” she said.

She then stressed that the line must not be seen as an Ebola line, rather, it should be seen as a public health hotline used to support the health sector’s current and long term priorities.

(Reported, written and edited by Kemo Cham)