The infant and maternal mortality rates in Sierra Leone are among the highest in the world. But data from the 2019 Sierra Leone Demographic and Health Survey report (SLDHS) done by Statistics Sierra Leone, which was launched by the Vice president Dr. Mohamed Juldeh Jalloh on Friday, shows that the country had been making steady progress in reducing infant and maternal mortality rates.
The 2019 Demographic and Health Survey Report shows that maternal mortality – deaths associated with pregnancy and childbearing, has reduced from 1,165 in 2013 to 717 deaths per 100,000 live births for the seven-year period before the survey.
Infant mortality has decreased from 92 to 75 deaths per 1,000 live births in 2019. During the same time period, under-5 mortality has declined from 156 to 122 deaths per 1,000 live births; and neonatal mortality has slightly decreased, from 39 to 31 deaths per 1,000 live births, according to the report.
The report shows that more women in Sierra Leone are receiving antenatal care (ANC) in the first trimester and making 4+ ANC visits since 2008 but since the 2013 survey the progress has stalled.
“More than 8 in 10 births (83%) are delivered in a health facility, primarily in public sector facilities (81%). Sixteen percent of births are delivered at home. Births are more likely to be delivered in a health facility in urban areas than rural areas. Overall, 1 in 5 births in rural areas is delivered at home,” the report indicates.
According to the study, health facility deliveries have markedly increased since 2008 when only 1 in 4 (25%) births were delivered in a health facility. Skilled assistance during delivery has steadily increased from 42% in 2008 to 87% in 2019.
Some of the improvement of the health indicators can be attributed to the free healthcare program which was launched in 2010. With its launching in 2010, the Free Health Care Initiative (FHCI) abolished health user fees for pregnant women, lactating mothers and children under five.
This was a response to very high mortality and morbidity levels among mothers and children and reports that financial costs were a major barrier to health service uptake and use by these groups.
The report shows that childhood stunting has decreased from 36% in 2008 to 30% in 2019. “During the same time period, the proportion of children underweight has declined from 21% to 14%. Childhood wasting has remained stagnant since 1992.”
The 2019 SLDHS tested children age 6-59 months for Anaemia. Overall, 68% of children age 6-59 months is Anaemic, with 3% of children experiencing severe Anaemia, according to the report.
The report indicates: “There has been a steady decline in fertility rate since 2008 from 5.1 children per woman to the current level of 4.2 children per woman. A similar trend is shown to women in rural areas (5.8 to 5.7 and 5.1 respectively) and urban areas (3.8 to 3.5 and 3.1) during the same period.”
More than 7 in 10 women (72%) report at least one problem accessing health care for themselves. More than 4 in 10 women are concerned about the distance to the health facility, while 1 in 4 are concerned about getting permission to go for treatment; and more than two thirds of women are concerned about getting money for treatment, and 22% are concerned about going alone, according to the report.
The report further shows that, basic vaccination coverage has increased since 2008 when 40% of children had received all basic vaccinations, it has decreased from 68% in 2013 to the current level of 56%. “The proportion of children who have received no vaccinations has declined from 16% in 2008 to 2% in 2019.”
The data shows that overall, 1.7% of adults age 15-49 in Sierra Leone are HIV positive. HIV prevalence is higher among women than men (2.2% versus 1.1%).
“Among adults, HIV prevalence is twice as high in urban areas (2.3%) than in rural areas (1.2%). Similarly, HIV prevalence is higher among urban women and urban men than their rural counterparts. N.B. The increase in the rate of HIV prevalence is not a statistically significant increase from the rate reported in 2013.”
The report shows that Insecticide Treated Net (ITN) ownership has increased from 37% in 2008 to 68% in 2019. Full household ITN coverage has also increased from 7% to 25% during the same period.
SLDHS data are needed to understand the demographic and health status of the people who should be protected by providing health for all of them.
The report informs policy and provide data for planning, implementation, monitoring, and evaluation of national health programmes such as the Universal Health Coverage (UHC).
It is designed to provide up-to-date information on health indicators nutritional status of children, early childhood and maternal mortality, maternal and child health, fertility levels, nuptiality, sexual activity, fertility preferences, awareness and use of family planning methods, breastfeeding practices, awareness and behaviours regarding HIV/AIDS and other sexually transmitted infections, and prevalence of HIV.
By Alusine Sesay
14/12/2020. ISSUE NO: 7966