FREETOWN, SIERRA LEONE – BERLIN

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Slide iStock 182505788 Slide Foto Seite 2 1 Slide Statt Partnerfoto Slide Nadia Collection 19 1 scaled

PARTNERSHIPS

PARTNERSHIP BETWEEN:

Charité – Universitätsmedizin Berlin, Institute of Tropical Medicine and International Health / Germany

&

Princess Christian Maternity Hospital (PCMH), Freetown / Sierra Leone

Healthy mothers and newborns – through improved obstetric care and the use of teleconsultation

High maternal mortality is still a severe problem in many low- and middle-income countries (LMIC). 94% of all maternal deaths occur in LMIC, and in 2017, each day 810 women died from preventable causes related to pregnancy and childbirth. Reasons for this situation often include a lack of qualified nurses and midwives, especially in rural health facilities, and a low number of facility-based deliveries caused by a variety of barriers and unequal access to maternal care.

MORE ABOUT SIERRA LEONE

  • Sierra Leone, a country in West Africa, has a population of 7.4 million living on an area of 71.7 km². The annual population growth rate is 2.27%.
  • Mount Bintumani is the highest point of the country (1,948 m) and situated in eastern Sierra Leone.
  • Sierra Leone has over 400 km of coastline on the Atlantic Ocean, offering white sand beaches and a wide range of marine resources.
  • The country suffered greatly during its brutal civil war (1991-2002) and West Africa’s Ebola epidemic (2014-2016).
  • Life expectancy at birth in Sierra Leone is 52(m)/ 54(f) years.
  • The probability of dying before age five was at 105 for 1,000 births in 2018.

 

 

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Sierra Leone is one of the countries with the highest maternal mortality in the world. Major reasons for this situation are the insufficient qualification of midwives to handle obstetric emergencies properly, poor referral procedures from low to higher level and to better equipped facilities and the preference of women to deliver at home. Strengthening the ability of nurses and midwives to carry out emergency obstetric care and ensuring that referral to better equipped, higher-level facilities happens early enough, can save the lives of many mothers and newborns. Recent studies have also shown that delivery outcomes improve if another person chosen by the pregnant woman stays with her and supports her during and after delivery. This is also thought to increase the acceptance of facility-based delivery.

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The government of Sierra Leone has recognised this situation and developed the National Reproductive, Maternal, Newborn, Child & Adolescent Health (RMNCAH) Strategy with the goal of “accelerating reduction of preventable deaths of women, children and adolescents and ensuring their health and wellbeing”, in particular with the strategic objective of achieving “improved quality of RMNCAH services at all levels of service delivery”.

The two partner hospitals have decided to tackle this important problem. Approaches chosen are to strengthen the capacity of midwives in the partner in the Freetown hospital and 10 rural health facilities in the nearby district to improve the delivery care, make facility-based delivery more attractive and improve referral procedures.

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eHEALTH

Our eHealth Contribution

To achieve their objective, the partners have chosen an innovative approach which is also in line with a national strategy: the “National Digital Health Strategy 2018-2023” postulates that “by 2023, an effective and efficient Information and Communication Technique (ICT) system supports delivery of quality, accessible, affordable, equitable, and timely healthcare services that moves Sierra Leone closer to achieving universal health coverage”.

The peripheral health units (PHUs) are linked with the referral hospital PCMH, by teleconsultation through an app. This allows the remotely-working midwives to contact their colleagues at the referral hospital in case of an emergency they cannot handle. The staff at the referral hospital receive relevant patient data through the app, discusse the case and advise the PHU staff how to manage the woman or refer her. In the latter case, the referral hospital can take all necessary measures for receiving the woman in labour. Interesting cases are loaded up on an e-learning platform for teaching purposes for midwifery students, and guiding questions are added. This system supports the remotely-working midwives and contributes to their continuous capacity strengthening.

In addition to training the midwives, the partnering hospitals have introduced an IT component to continuously support and further qualify the trained midwives. Better care leads to increasing numbers of facility-based deliveries. To emphasise this trend, a further approach has been added: the “companion strategy” allows the expectant mother to come to the health facility with a person of her choice who stays with her before, during and after delivery. Adding a research component, which can prove the effectiveness of the approach chosen, will contribute to convincing the government to roll it out as a national approach.

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Charité – Universitätsmedizin Berlin / Germany

Charité – Universitätsmedizin Berlin , a corporation under public law and a legal entity, is one of the largest university hospitals in Europe. It represents the medical faculty of both Humboldt University Berlin and Free University Berlin, and is a corporate member of the Berlin Institute of Health. Clinical care, research and teaching are delivered by physicians and researchers of the highest international standard. Charité stands for modern medical training in Germany with high scientific standards and combines care, responsibility, respect and entrepreneurship in university medicine. Charité proudly lays claim to more than half of all German Nobel Prize winners in Physiology or Medicine, including Emil von Behring, Robert Koch, and Paul Ehrlich.

Contact:

Dr. Stefanie Theuring
Charité- Universitätsmedizin
Institut für Tropenmedizin und Internationale Gesundheit
Augustenburger Platz 1
13353 Berlin
stefanie.theuring@charite.de

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Princess Christian Maternity Hospital (PCHM), Freetown / Sierra Leone

Is a governmental hospital with a capacity of 141 beds that reopened in 2006 and houses the largest public birth clinic in Sierra Leone. It is the main referral maternity hospital for the entire country. Its main catchment area, the Western Region, has a population of over 1.5 million people. PCHM collaborates with the School of Midwifery (supported by a GIZ health project in Sierra Leone) and provides teaching for student nurses and midwives.

Contact:

Dr. A. P. Koroma
Princess Christian Maternity Hospital, Freetown,
Medical Superintendent
Fourah Bay Road, Freetown
Apkoma2@gmail.com
T: +232 76 692 993

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ABOUT

Charité – Universitätsmedizin Berlin / Germany

Charité – Universitätsmedizin Berlin , a corporation under public law and a legal entity, is one of the largest university hospitals in Europe. It represents the medical faculty of both Humboldt University Berlin and Free University Berlin, and is a corporate member of the Berlin Institute of Health. Clinical care, research and teaching are delivered by physicians and researchers of the highest international standard. Charité stands for modern medical training in Germany with high scientific standards and combines care, responsibility, respect and entrepreneurship in university medicine. Charité proudly lays claim to more than half of all German Nobel Prize winners in Physiology or Medicine, including Emil von Behring, Robert Koch, and Paul Ehrlich.

Contact:

Dr. Stefanie Theuring
Charité- Universitätsmedizin
Institut für Tropenmedizin und Internationale Gesundheit
Augustenburger Platz 1
13353 Berlin
stefanie.theuring@charite.de

Logo Charite.svg 2

Princess Christian Maternity Hospital (PCHM), Freetown / Sierra Leone

Is a governmental hospital with a capacity of 141 beds that reopened in 2006 and houses the largest public birth clinic in Sierra Leone. It is the main referral maternity hospital for the entire country. Its main catchment area, the Western Region, has a population of over 1.5 million people. PCHM collaborates with the School of Midwifery (supported by a GIZ health project in Sierra Leone) and provides teaching for student nurses and midwives.

Contact:

Dr. A.P. Koroma
Princess Christian Maternity Hospital, Freetown,
Medical Superintendent
Fourah Bay Road, Freetown
Apkoma2@gmail.com
T: +232 76 692 993

Sierra leone3

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