Sierra Leone

MDG Goal 5 - Improve Maternal Health

 Background

 

Goal	Relevant Target
Goal 5: Improve Maternal Health	Target 6: Reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio

The state of Reproductive Health is epitomized by high maternal mortality, the very low contraceptive prevalence rate, and low rates of skilled attendance at delivery and of institutional deliveries. The maternal mortality rate in Sierra Leone, 1600/100,000 live births, is among the highest in the sub-region. Although maternal mortality stabilized in 2004-2005 at 1600, from 1800 previously, a lot more effort is needed to put the trend back on track in the coming years.

The clinical causes of maternal mortality are mainly complications of pregnancy and childbirth, such as haemorrhage, anaemia, eclampsia, obstructed labour, and unsafe abortion; non-clinical reasons are related to delays in decision making about seeking medical care, delays in reaching the health care facility, and delays in receiving prompt and appropriate care at the health facility. The low status of women in households and the community in general, and their limited access to resources particularly in times of emergency, contribute to the barriers to seeking health care.

Fertility rates remain high, estimated at 6.5 for women for 2000-2005. High fertility rates are closely related to rural residence and low socio-economic status, with age at first childbirth being low. The contraceptive prevalence rate between 1995 and 2001 was extremely low at 4%; there has since been some improvement, with 5.6% of household survey respondents in 2004-05 reporting that they were taking some action to prevent pregnancy, the preferred method being the pill, 48.1%, followed by injectables, 25.9% (Sierra Leone Integrated Household Survey, 2004-05).