Sierra Leone is currently working towards achieving the Millennium Development Goals. To achieve the targets for the reduction of child mortality, which forms MDG 4, Sierra Leone should reduce under-five deaths per 1,000 live births to 89, and increase measles immunisation to 100 per cent by 2015. In 2012, under-five mortality stood at 182 deaths per 1,000 live births and measles immunisation at 80 per cent. Given this information, it is unlikely that the under-five target will be met by 2015, although the measles immunisation target may be achieved if further progress is made. The United Nations Development Programme report of Sierra Leone’s progress towards the MDGs suggests a more holistic approach to reducing child mortality, with steps including increasing child and infant health and new-born care interventions;
using illness management techniques; using the ‘reaching every district’ approach to increase and sustain immunisation coverage of all antigens to 80 per cent and above; improved training of paediatric health care staff; infrastructure development; and raising awareness using more effective education and communication.
The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by threequarters between 1990 and 2015. When applying this target to Sierra Leone, the maternal mortality should fall to 325 cases per 100,000 live births. In the period 2007-11 Sierra Leone had a reported maternal mortality ratio of 860 deaths per 100,000 live births (this figure was estimated at 890 deaths per 100,000 by UN agencies/World Bank in 2010). Based on the data reported by the country, it is unlikely that this target will be achieved by 2015. Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional. In the period 2007-12 this figure stood at 63 per cent, so progress towards this target is also off track. The United Nations Development Programme report of Sierra Leone’s progress towards the MDGs suggests that much needs to be done to improve the maternal mortality rate in the country. Recommendations for remedial action are similar to those given for MDG 4 (above), as well as equipping district health care centres with the necessary resources to provide safe delivery services and improving training of maternal health care staff.
MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. There has been little change in HIV prevalence in Sierra Leone since 2004, with incidence of HIV having increased significantly since records began around 1990. Reported cases and deaths from malaria in the country are also high, although numbers of both cases and fatalities have fallen slightly since 2010, which is encouraging. Unfortunately, there has been an exponential increase in the estimated incidence of, and estimated mortality (when mortality data excludes cases co-morbid with HIV), from TB since 1990. Accordingly, progress towards this goal is currently off track. The United Nations Development Programme report of Sierra Leone’s progress towards the MDGs provides comprehensive suggestions for methods that can be used to reduce the prevalence of HIV, malaria and other diseases in the country. Suggestions overall include increasing awareness and education about diseases in the general population, and improving the facilities of health care centres and hospitals to allow for increased treatment of these different diseases.
