The Well Woman Clinic’s antenatal/postnatal clinic, funded by the Heineken Africa Foundation (HAF), and supported by Sierra Leone Brewery Ltd, officially opened on Friday 21st February 2020. An extension of the Clinic’s Prenatal Equipment Project Outreach (PREPO) which was sponsored by Heineken Africa Foundation with support from UNFPA, the Government of Sierra Leone and the MEPS Trust, it is a project in line with the Government’s determined efforts to lower Sierra Leone’s infant mortality rate which, at 1,120 per 100,000 live births, ranks amongst the highest in the world.
With the permission of the Ministry of Health, we used Government hospitals in Bo, Kenema and Makeni, and PHUs in Sussex and Waterloo to screen women free of charge 2-3 times during their pregnancy. Peer educators encouraged women in those areas to come forward for screening. The results were encouraging. Of the abnormal scans of 4,500 women screened in Bo, Kenema, Makeni, Sussex, and Waterloo there were no maternal deaths but sadly, 4 neonatal deaths occurred. Results also showed that the Clinic itself registered women from 20 other Clinics, PHUs and CHUS for ultrasound scans, thus highlighting the need for an antenatal/postnatal clinic at the Clinic itself where women would receive comprehensive antenatal care.
Description of the Project
The total cost of this Project is based on a very conservative budget of $319,000 for 3 years of which the Heineken Africa Foundation is funding 71% ($226,500 or Eur209,722). 29% ( $92,500 or Eur85,100) is being funded by the MEPS Trust and donations from the general public. The project has a two-pronged strategy - clinic based, as well as an outreach to Sussex and Waterloo.
A) The clinic based strategy
The Clinic is a fully functional antenatal clinic with ultrasound screening and lab services under one roof. The original plan was to cover women in the Congo Town, Murray Town, Brookfields, Wilberforce, Hill Station and Lumley areas, but those target areas had to be quickly revised following a rush
on the services as word went round.
Objectives of the Antenatal Clinic (Clinic based)
Objective 1: To provide free or affordable access to quality antenatal care and ensure access to safe delivery for approximately 10,000- 15,000 low income women with 20,000-25,000 encounters over a period of three years.
Objective 2: To provide education for the women on nutrition, breast feeding, general wellness care, HIV infections, family planning as well as on the advantages of registering in a proper antenatal/postpartum setting, and delivering their infants in approved clinics, centres or hospitals.
Objective 3: To provide preventive health care to both mother and baby in the post partum period (that is up to 42 days after delivery).
94% live births and a 2% maternal mortality rate of those who receive care from the Well Woman antenatal/postnatal facility. This translates as follows as per the postnatal facility:
a) Healthy babies: Improved health for babies, 0% stunting, better infant health and decreased infant mortality;
b) Healthy mothers: Improved health (physical & emotional) for mothers through counselling, with
thorough physical examinations of their reproductive organs -uterus, cervix, ovaries and vaginal muscle tone.
B) Outreach strategy to Antenatal Clinics in Waterloo and Sussex
This is a mobile ultrasound outreach which offers 2-3 ultrasound scans (Dating scans at 6-14 weeks, Anomaly scans 18-22 weeks, and Wellbeing scans from 32 weeks to term) to each woman, depending on when they first access the Clinic. It gives us the opportunity to assess the development of the pregnancy and, if necessary, refer mothers for management of the pregnancy. It also prepares mothers for birth knowing that their babies are fine.
The Well Woman Clinic realizes that there are other factors which contribute to maternal, neonatal and infant mortality and also that it lacks the capacity to provide all the answers. However, what it does have is a team of well trained and highly motivated health workers committed to the cause of improving maternal and neonatal health.
Sustainability: How this service can be sustained once the project ends.
➢ with the continued sponsorship of our “Partner for life,” HAF;
➢ with the Government’s continued support in providing the basic package;
➢ Collaboration with partners;
➢ the Well Woman Clinic’s critical success factors which include:
a) committed staff, most of whom have been with the Clinic since its inception, 14 years
ago, and others for at least 8 years;
b) Job satisfaction;
c) robust management structure;
d) excellent financial management; and
e) integration of projects into the Clinic’s main programme.
The Well Woman Clinic is grateful to the Heineken Africa Foundation for its sponsorship, to the Government of Sierra Leone for its invaluable assistance and the Trust as it tackles the huge problem of high maternal and neonatal mortality.