Wednesday, March 14, 2012

Small Sierra Leone Hospital Tackling Big Health Care Challenges

"The hospital is expanding its services to achieve a measurable decrease
in the infant and maternal mortality rates in Sierra Leone by providing
holistic, community focused care, regardless of ability to pay."

Mercy Hospital in Bo, Sierra Leone's second largest city, is addressing three main health challenges that exist globally, even in the United States: can't get to a doctor, can't afford to get treated, not enough doctors.

People in developing countries receive significantly less primary health care than in developed countries. According to the 2010 WHO Health Statistics the percentage of births attended by skilled health personnel is 92% in the Americas and only 47% in Africa. Mother's visited at least once during pregnancy in the Americas is 94% and in Africa 73%. Africa lags behind in its ability to deliver even the basics.

There is a significant shortage of specialized health resources and infrastructure in Africa that will take years to address. There are 23 physicians for every 10,000 people in the Americas, compared to 2 physicians for every 10,000 people in Africa, according to WHO Health Statistics for 2010.

One of the UN Millennium Development Goals is to reduce the maternal mortality rate three quarters by 2015. Throughout sub-Saharan Africa, a woman's maternal mortality risk is 1 in 30, compared to 1 in 5,600 in developed regions. Every year more than 1 million children are left motherless in the world.

In Sierra Leone, which is still recovering from a long civil war, there are only about 200 doctors for a population of 5.7 million. Where conflict once ruled, there is peace and stability, and the government is making significant progress in socioeconomic development. In spite of the advances, however, 1 in 21 women will not survive child birth, one of the highest rates in the world.

Enter Mercy Hospital--a 26 bed primary care hospital that provides vital, life saving care to over 10,000 patients each year--and the Sierra Leonean United Methodist Church (UMC) health network. Together, Mercy and UMC are looking for opportunities to improve impact and efficiency to reduce maternal and child mortality.

As one local health care expert put it, "It's not about just bringing more equipment, better microscopes and more doctors to Bo--it's about empowering those whom we have to be more efficient and effective in their work.

"Ultimately, it’s about saving lives."

Holistic, Community-Focused Care

The hospital's vision is to achieve a measurable decrease in the infant and maternal mortality rate in Sierra Leone by providing holistic, community-focused care regardless of ability to pay. To accomplish this, Mercy will be transformed into a world-class center of medical excellence supported by intensive community outreach, health worker training and research in maternal and child health.

The transformation--a model for Africa--will occur in several stages, with the first stage focusing on Community Based Primary Health Care. Involving community partners enables a greater impact on the infant and maternal mortality rates. In this regard, Mercy is currently providing community educational programs for HIV/AIDS, malaria, prenatal care, and nutrition, bringing hospital services out into the villages to thousands of people every year.

In the first phase, Community Health Volunteers from outlying villages will be trained. Community Health Volunteers are respected, local villagers that can provide care and referrals within their village to those unable to go to Mercy Hospital, acting as a liaison between Mercy and the village. Community Health Volunteer training involves education around nutrition, dietary supplements, breastfeeding, hand washing, the importance of using clean water, how malaria is contracted, how bed nets are used, how HIV is spread from person to person, and many other basic health topics.

"The Community Health Volunteer is the first line of defense in the fight against infant and maternal mortality," a Mercy spokesperson says.

A program of Helping Children Worldwide, Mercy's record is impressive. The hospital has decreased the prevalence of malaria in the community and is currently working to prevent mother to child transmission of HIV and AIDS.

Mercy is also expanding its services to achieve a measurable decrease in the infant and maternal mortality rates in Sierra Leone by providing holistic, community focused care, regardless of a patient's ability to pay.