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Update Sierra Leone
September 2013
Globally, UNICEF and other UN agencies together with
partners from the public, private and civil society sectorsreach out to intensify their action to fulfil their promise to
the world's children and mothers: A Promise Renewed
represents a global movement to revitalize action and
double efforts in the fight for child and maternal survival
so that more countries will achieve the Millennium
Development Goals (MDGs) 4 and 5 by 2015.
The new UNICEF report shows that if current trends
continue, the world will not meet Millennium Development
Goal 4 to cut the rate of under-five mortality by two-
thirds by 2015. Worse, if current trends continue, the goal
will not be reached until 2028. In Sierra Leone,
development partners recognize that the country has
taken a very important step to reach the MDGs with the
launch of the Free Health Care Initiative in 2010. The
initiative provides health services free of charge for
children under five years as well as for pregnant and
nursing women.
In February 2013, the Government of Sierra Leone
renewed its promise to accelerate child survival and the
EU and UNICEF signed an agreement to increase support
to the Free Health Care Initiative with Euro 20 Million.
Other donors such as the UK Government and Irish Aid
also contribute to the initiative. Working hand in hand with
the Ministry of Health and Sanitation and partners,
UNICEF Country Representative Roeland Monasch
welcomed the government's renewed promise to make
child and maternal health a priority, also in its new Poverty
Reduction Plan, the Agenda for Prosperity.
In many cases, simple solutions can save lives. The
Maternal and Child Health Week (MCHW) is an example
for how UNICEF Sierra Leone works around the clock to
On 11 September UNICEF released the 2013 Report on Committing to Child Survival: A Promise
Renewed. It examines trends in child mortality since 1990, analyses the main causes of under-five
deaths, and highlights national and global efforts to save children's lives.
A PROMISE RENEWED: ACCELERATING RESULTSFOR CHILD AND MATERNAL SURVIVAL IN SIERRA LEONE
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boost the provision of life-saving services and information
for mothers and children. During the bi-annual campaigns
organized by the Ministry of Health with support from
UNICEF and other partners, health workers vaccinate
children on a large scale, deliver mosquito nets, provide
Vitamin A and de-worming tablets. The intervention is
also being used for HIV/ AIDS testing during pregnancy.
A Promise Renewed is about accelerating results, it is
about scaling up efforts. It is a promise which needs to be
fulfilled as its major implication means: "To be or not to
be" for millions of children and mothers in Sierra Leone.
Therefore, we cannot forget our obligation: UNICEF Sierra
Leone pledges to support the goal of A Promise Renewed
and calls upon partners to fulfill the promise the world
made to children in MDG 4 and 5: Give every child the best
possible start in life!, says UNICEF Representative in
Sierra Leone, Roeland Monasch.
For more details: http://www.apromiserenewed.org
Harmful social and cultural practices are among the many
factors that continue to hamper Sierra Leone's
development and prevent it from reaching the Millennium
Development Goals. For the government's Agenda for
Prosperity, the new Poverty Reduction Strategy, to reach
its full potential and lead the country out of poverty and
bad health, these practices must be addressed.
To mark the day, children from all districts in Sierra Leone
met and discussed harmful practices affecting their lives
such as the low rate of exclusive breastfeeding, teenage
pregnancy, prejudice against children with disabilities,
HIV/AIDS and more. Two children from each district then
travelled to Freetown to declare what they expect from the
government , reminding adults that only joint
responsibility by communities, the private sector and civil
society will ensure that children do not become victims of
harmful social and cultural practices.
Malnutrition is the underlying cause of 37% of children's
death in Sierra Leone. Exclusive breastfeeding during the
first six months of an infant's life is the safest and cheapest
way of preventing malnutrition and other illnesses. Yet in
Sierra Leone only 31% of women exclusively breastfeed
their children for six months. Addressing the myths and
cultural practices preventing proper feeding practices
entails comprehensive behaviour change activities and
engagement of communities in improving child care and
feeding.
Teenage pregnancy is the reason for about 40% of
maternal deaths and the leading cause of death foradolescent girls. Among the multiple causes behind this
problem are lack of knowledge on reproductive health
and inhibiting attitudes towards contraceptives.
Acknowledging that this phenomenon poses a serious
THE DAY OF THE AFRICAN CHILD-
A CALL TO END HARMFUL PRACTICES
TO REACH PROSPERITY
barrier to development, the Government of Sierra Leone
launched a strategy to prevent teenage pregnancy, in May
2013.
Another harmful practice affecting the girls in Sierra
Leone is Female Genital Cutting (FGC). FGC in Sierra
Leone is associated with becoming a full member of
society and eligibility for marriage. Questioning the
practice means questioning the social and spiritual
system, making the very sensitive issue difficult to
address. UNICEF is supporting a coalition of local
organisations which work in communities and trigger
dialogues on the issue, with different groups ofstakeholders and across generations. This will inform
strategies working towards abandonment of the practice.
By Charlris Okafor, Communication Officer, UNICEF Sierra Leone
On 16th June, Sierra Leone joined other countries in
Africa to celebrate the Day of the African Child, to draw
attention on the condition of children on the continentand to unite the efforts of all actors to combat the ills
that plague the daily lives of children. This year's theme
was Eliminating harmful social and cultural practices
affecting children: our collective responsibility.
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By Rosmarie E. K. Jah, Reports Officer, UNICEF Sierra Leone
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By Rosmarie E. K. Jah, Reports Officer, UNICEF Sierra Leone
Last year, Sierra Leone's President Ernest Bai Koroma had
to declare a national state of emergency because of the
worst cholera outbreak in over 15 years with over 20,000
people infected and 300 killed. This year the credo for
Sierra Leone is: Cholera Preparedness! In June the
Ministry of Health and Sanitation called on Sierra Leone's
population to take precautionary measures to prevent
another cholera outbreak.
Cholera can be prevented and cured. UNICEF Sierra Leone
works together with the Government and the National
Cholera Task Force to raise awareness and to provoke
behavioral change. Cholera prevention demands
practicing proper hygiene behavior such as using only
safe water and clean toilets, washing hands before eating
and after using the toilet. Many people are not aware of
these simple measures, and many have no chance to put
them into practice. Only 32% (rural) and 58% (urban) of
people in Sierra Leone have access to sanitation facilities
and 57% have access to safe water supply.
UNICEF Sierra Leone is supporting the Ministry of Health
and Sanitation in distributing hygiene messages, in the
implementation of Community Led Total Sanitation
(CLTS), and in rehabilitating water wells.
CLTS is a community empowerment approach that
encourages changes in behavior through triggering and
mobilizing communities for the construction, proper use
and maintenance of latrines and sanitation facilities. With
the financial support from the governments of the UK and
the Netherlands, to date over 3,900 communities have
been declared open defecation-free in Sierra Leone after
they became part of the CLTS program.
Funded by the Japanese government and the African
Development Bank UNICEF is in the process of
rehabilitating 80 wells in diarrhea hot spots across the
country, and of installing solar-powered water systems for
larger communities that have been previously affected by
high levels of diarrheal diseases. Together with six
implementing partners, UNICEF is operating in eight
cholera high risk districts in Sierra Leone, targeting a
population of 1,011,686 people out of an estimatednational population of 6 million. The project is being
implemented in 31 chiefdoms and/or city sections.
SIERRA LEONES PREPARATIONSTO PREVENT ANOTHER CHOLERA OUTBREAK DURING THE RAINING SEASON
In Sierra Leone two seasons determine the annual cycle: the rainy season from May to October, and the dry season
from November to May. During the rainy season the risk of a cholera outbreak is increased. Especially in densely
populated areas with poor hygiene and sanitation conditions, cholera can spread very fast. According to the Ministry
of Health and Sanitation, Cholera ranks among the five most important epidemic-prone diseases in Sierra Leone.
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For many children in Sierra Leone, education is just a
dream. The major barrier to education is poverty. Many
people cannot afford the indirect costs of uniforms and
school materials. Children, particularly girls, often have to
work on the farm or look after younger siblings instead of
going to school. Additional factors which contribute to the
high number of out of school children include a low level of
female literacy; and cultural practices, such as child
marriage.
To ensure increased enrolment rates for girls and reducedincidence of their withdrawal from school UNICEF initiated
Mothers Clubs. Each club comprises 20 women. The
members of the club embark on school visits to monitor
attendance and ensure that parents in the community
send their children to school every day. UNICEF provides
training for the women in counseling, mediation and
raising awareness for them as duty bearers on rights of
their children.
UNICEF provides the Mothers Clubs with seed money of
500,000 Leones (about USD$116) to start small businesses.
The profits from these ventures are used to
identify and support the education of vulnerable children
within the community. Some groups enrich their children's
nutrition through vegetable gardens. Others learn to read
and write. Most engage in income-generating activities.
MOTHERS CLUBS AS AN OPPORTUNITY FOR THE NEXT GENERATION
By Charlris Okafor, Communication Officer, UNICEF Sierra Leone
Gender gaps have nearly disappeared in primary education in Sierra Leone. UNICEF initiated the Mothers Clubs topromote family and community participation in the education of their children. This creates special opportunities for
women in particular in the promotion of access, retention and performance of their daughters, in school.
Hawa Kamara, 12 years old, attends the Islamic Primary
School in Gbense Chiefdom, in Sierra Leone's eastern
Kono District. Her father is both blind and ill. After her
mother died two years ago, Hawa dropped out of school to
sell small cakes in town to support her family, including
her three year old sister and elderly grandmother. The
family could not afford to send Hawa to school.
When the local Mothers Club found out about Hawa's
situation, they provided a school fund. By contributing
2000 Leones (about USD$ 0.5) a month each, they havebeen able to pay for the extra costs for her schooling.
The Gbense Mothers Club actively monitored her case and
provided encouragement. They also convinced her family
that education is the only way for a brighter future. Hawa
is now happily completing her class five education,
unburdened with being the sole provider for her family.
Special efforts are needed to reach Universal Primary
Education in Sierra Leone by 2015. Some positive indicators
include the development of an Education Sector Plan for
2015 to 2018 and the commitment by the Government ofSierra Leone, to allocate 20 per cent of the national
budget to education annually.
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The implementation of the previous Education Sector Plan
has resulted in tangible improvements. The latest
national survey data indicate that literacy rates among
15-19 year olds have increased from 55 to 71% between
2008 and 2013. The percentage of teenagers that have
accessed at least some secondary education had
increased by 50% during the same period from 40 to
62%.
However, still too many children are not accessing quality
basic education. They are either out of school or not
learning much in the classroom. A new Education Sector
Plan (2014-2018) has been developed to address the
existing challenges. UNICEF is supporting the dialogue
between donors, education sector partners and the
Ministry of Education and the new Education Sector Plan.
The new Education Sector Plan describes how the Ministry
of Education will advance the progress already made in
the areas of access, equity, completion, quality andsystem strengthening. This is to achieve its desired goals
for the sector over a period of five years from 2014 to the
end of 2018. Goals, strategies, interventions and costs of
the Education Sector Plan are aligned with the Poverty
Reduction Strategy Paper, the Agenda for prosperity,
which has been launched on Friday, 12 July.
The endorsement of the plan was a requirement for the
application for a 17.9 million grant from the Global
Partnership for Education earmarked for the basic
education programme in Sierra Leone. The grant
complements contributions to the implementation of the
plan by the Government of Sierra Leone and donors andpartners in education. UNICEF is the lead coordinating
NEW EDUCATION SECTOR
PLAN ENDORSED
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agency of the education development partners.
Education is a human right. In 2013, every child in Sierra
Leone should be able to go to school. Government and
partners will need to double their efforts and work closely
together to make sure parents can claim the right of their
children to go to school and learn, says UNICEF
Representative Roeland Monasch.
On 3 September the Ministry of Education and
Education Development Partners group endorsed the
new Education Sector Plan 2014-2018. UNICEF is
co-chair of the Education Development Partners Group
and Coordinating Agency of the Global partnership of
Education.
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By Miriam Mareso, Education Specialist, UNICEF Sierra Leone
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The Mamie en Pikin Welbodi Week is a week-long
integrated biannual health intervention that seeks to
reduce illness and deaths among pregnant women,
nursing mothers and children who are under the age of
five. It usually takes place every May and November. This
May, about 1.2 million under-five children were targeted
with polio vaccination, vitamin A and de-worming tablets.
Other health interventions included growth monitoring of
children; immunization; demonstration of good nutritional
practices including exclusive breastfeeding; HIV counseling
and testing, family planning services, health education on
the importance of using mosquito nets to prevent malaria;
information on cholera prevention and demonstration ofhand washing with soap.
Baindu, a mother of four in Kailahun who strapped her
three year old baby on her back attended the health fair
1.2 MILLION UNDER-FIVE CHILDREN BENEFIT
FROM THE MAMIE EN PIKIN WELBODI WEEK
and felt very pleased and self-fulfilled. She said: I have
learnt so much today and my baby has received the polio
vaccination for the fourth time! I am particularly
impressed with the information I received on exclusive
breastfeeding, malaria and diarrhoea /cholera prevention.
The Maternal and Child Health Week provides an
important opportunity to reach those children and women
who have been missed out by routine health
interventions.
In this regard, the next round of the Mamie en Pikin
Welbodi week is planned for 1st week of December and a
polio immunization campaign will run from 25th to 28thOctober, this year.
The Ministry of Health and Sanitation, in collaboration with UNICEF, WHO, Rotary International, Helen Keller
International, the Sierra Leone Red Cross and other partners, on May 23rd 2013 launched the 8th round of the
Integrated Maternal and Child Health Week that is locally referred to as the Mamie en Pikin Welbodi Week (maternal and
child health week) with a health fair in Kailahun town, eastern Sierra Leone.
By Issa Davies, Communication Officer, UNICEF Sierra Leone
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the district hospitals in Koinadugu, Kenema, Kono and
Pujehun have been rehabilitated and fully equipped. The
maternity ward in Kailahun district hospital is under
construction. Funding for the construction of the maternity
ward in Kambia district hospital is expected soon.
Four health centers have been renovated and upgraded
to provide Basic Emergency Obstetric and Newborn
Care (BEmONC) services. Furthermore UNICEF provided
technical and financial support for the equipment of 65
BEmONC health centers and 12 district hospitals. Three
new paediatric wards are currently being constructed in
the district hospitals of Kono, Moyamba and Tonkolili. The
inauguration of the new structures is expected in the
fourth quarter of this year.
UNICEF has recently supported the Ministry of Health in
an infrastructure survey, mapping all BEmONC facilities,
District Hospitals, District Medical Stores and Maternal
and Child Health Aide District Medical Schools. The
results of the survey will be used for planning andprioritization for the continued rehabilitation/construction
work in the coming years.
CONSTRUCTING AND REHABILITATING MATERNITY WARDS IN SIERRA LEONE
Since the end of the war in 2002, Sierra Leone has been struggling with a severe lack of properly equipped health
facilities, both in regards to technical equipment and in human resources. To tackle that problem, UNICEF has been
supporting the government of Sierra Leone in constructing and rehabilitating paediatric and maternity wards at
district hospitals as well as peripheral health units.
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By Angela Griep, Communication Specialist, UNICEF Sierra Leone
In 2008, a nationwide needs assessment on the provision
of health services concluded that the provision of quality
health services in Sierra Leone was highly insufficient. Not
a single health center was able to provide Basic
Emergency Obstetric and Neonatal Care (BEmONC).
But not only the small health centers lacked adequate
equipment and human resources; six out of 13 district
hospitals had no capacity to provide comprehensive
EmONC. Many were in bad condition without running
water and with limited electricity supply.
The rehabilitation of the health infrastructure to ensure
quality health care has therefore been a priority for the
Government of Sierra Leone. With the start of the Free
Health Care Initiative in April 2010, the government with
support of its partners started the process of
rehabilitating 65 health centers, five in each district, to be
able to provide Basic Emergency Obstetric and Neonatal
Care (BEmONC), and maternity and paediatric wards in
district hospitals. Another focus is the renovation of
district medical stores and district hospital pharmacy
stores.
With technical and financial support provided by UNICEF
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In Sierra Leone, teenage pregnancy is one of the
pervasive problems affecting the health, social and
economic progress and empowerment of women and
girls. The statistics are alarming as 34 per cent of all
pregnancies occur amongst teenage girls (SLDS 2008);
26 per cent of women between the ages of 15 and 19 have
already given birth and 40 per cent of maternal deaths
occur as a result of teenage pregnancy (MICS 2010).
Teenage pregnancy is the third most common factor for
girls dropping out of school.
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LET GIRLS BE GIRLS, NOT MOTHERS!
SIERRA LEONE FIGHTS AGAINST TEENAGE PREGNANY
In order to tackle the problem, UNICEF and UNFPA
supported the government to set up a multi-sectorial
committee that comprises key line ministries, the UN,
NGOs and civil society representations to come out with a
strategy that addresses social protection, health, gender
and poverty issues.
I dropped out of school in the third grade of my
secondary education when I was impregnated by a man
who was basically taking care of my needs since my
parents cannot afford to do so, said 15 year old Isatu inFreetown. I regretted being pregnant at that early age
and wish to go back to school and continue my education.
This cannot be the future that we want for our
daughters, said President Koroma as he launched the
strategy. Our girls should read their books and not
change napkins.
The three-year strategy entails improving policy and
legal environment to protect adolescents and young
people's rights; improving access to quality sexual
reproductive health, protection and education services;
providing comprehensive age appropriate informationand education and empowering communities to prevent
and respond to teenage pregnancy. Setting up
coordination, monitoring and evaluation mechanisms for
the proper management is also a key component of the
strategy.
UNICEF is rendering technical and financial support these
mechanisms for the successful roll out of the strategy.
By Issa Davies, Communication Officer, UNICEF Sierra Leone
With support from UNICEF and UNFPA, the President of Sierra Leone, Ernest Bai Koroma, launched a National Strategy
for the Reduction of Teenage Pregnancy in Sierra Leone on May 13th 2013 in Freetown. The theme of the launch was:
Let girls be girls, not mothers!
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Angela Griep
Head External Relations, Advocacy and
Leveraging Resources, UNICEF Sierra Leone
Telephone: +232 22 235 730/735
Mobile: +232 76 912 059
Facsimile: +232 22 235 059
[email protected]:URL: http//www.unicef.org
www.facebook.com/unicefsierraleone
Follow us on twitter:@UNICEFSierraLeo
For more information contact:pleaseIn 2013 UNICEF Sierra Leone received contributions from:
The Governments of Canada, Ireland, Japan,Netherlands, Norway,
United Kingdom, United Arab Emirates, and USA
The European Union, United Nations; African Development Bank,
GAVI Alliance, Global Fund against AIDS/TB/Malaria, Bill &
Melinda Gates Foundation, Micronutrient Initiative, and United
Nations Foundation.
UNICEF National Committee of: Australia, Austria, Belgium,
Germany, Iceland, Italy, Japan, Luxembourg, Netherlands,
Norway, Poland, Sweden, Switzerland, United Kingdom, and USA.