Saving Lives in Sierra Leone III Consortium Programme

The Saving Lives in Sierra Leone (SLiSL) III Consortium is a 5 year £15 million GBP health-systems strengthening programme led by Concern Worldwide and funded by FCDO in Sierra Leone, primarily focused on responding to interconnected issues related to women’s, girls’ and children’s lives and health outcomes.

The Consortium comprises of 5 humanitarian NGO’s: Concern Worldwide (Concern); Helen Keller International (HKI); Humanity Inclusion (HI); Kings Global Health Partnerships (KGHP) and Send Sierra Leone (SEND), alongside 2 technical specialist partners: Welbodi Partnership (WB) and Italian Association for Solidarity among People (Associazione Italiana per la Solidarietà tra i Popoli/AISPO).

Collectively, members bring over 130 years of combined experience in Sierra Leone, working in partnership with the Ministry of Health to deliver impactful programmes that contribute to national strategy achievement and progress towards the Sustainable Development Goals.

Together the Consortium will implement a whole-of-system approach in 6 districts of Sierra Leone, building on learnings from the two previous SLiSL programmes. The approach will focus on 4 main areas of intervention: District Support; Community Level Interventions; Health Workforce Development and Accountability and Clinical Services. 

Sierra Leone has one of the highest maternal mortality rates in the world despite an estimated 74% decline since 2000. Although there has been significant progress in reducing maternal deaths from preventable causes, an estimated 1,200 women died of maternal causes in 2020. The under-five child mortality rate fell from 168 deaths per 1000 live births in 2009 to 109 deaths per 1000 live births in 2019. However, this remained the fifth highest rate in the world and, according to the Child Survival Action Plan, is not meeting its commitment to the Sustainable Development Goals (SDG).

• Human resources for health generally, including maternal and neonatal health, are limited, and unevenly distributed in the country. Malaria, anaemia, and maternal undernutrition are prevalent. Early age pregnancy is a challenge across Sierra Leone, with heightened risks of morbidity and mortality. A significant number of maternal deaths in the country are due to preventable causes, for example, in 2023, obstetric haemorrhaging was the leading direct cause of maternal deaths.
• Sustainable and quality blood services play a critical role in saving lives. In addition to supporting women with complications during childbirth, safe blood services are essential in emergency services, surgery, and the treatment of anaemia and malaria, which continue to be among the most common underlying causes of death in children.
• Furthermore, the quality and availability of sexual and reproductive health (SRH) services in Sierra Leone remain an ongoing challenge. Contraception access and consistent use are still limited, with specific and heightened difficulties for adolescents including, knowledge and education, healthcare provider attitudes, and stigma.
• There are also important gaps in safeguarding systems in healthcare in Sierra Leone, with implications for quality of care, health-seeking behaviour, and health outcomes. Protecting an individual’s health and human rights, and enabling them to live free from harm, abuse and neglect is an integral part of providing high-quality healthcare. Lack of awareness and an absence of adequately trained personnel represent significant risks to sustainable quality improvement. If unaddressed, they will continue to create and reinforce barriers to accessing care.
• Gender inequities are deeply embedded in Sierra Leone, with significant negative impacts on the lives and health outcomes of women, girls, and children, especially for those living with a disability. These can limit decision-making power regarding access to healthcare, including SRH services for example. The continuation of harmful gender norms also has damaging implications for men and boys with their participation in family planning limited due to barriers such a lack of knowledge knowledge about contraception, poor access to SRH services and the gender norm that family planning is a woman’s responsibility.

1. Increased availability, access, and utilisation of quality Reproductive, Maternal, Neonatal Child and Adolescent Health and Nutrition (RMNCAH-N) services.
2. The Ministry of Health at district level has improved capacity to deliver accountability, respect, responsive and people-centred health services.
3. The Ministry of Health at the district level has improved capacity to consistently operationalise national policies and strategies.

These are intended to be achieved through 11 different outputs which focus on:

• Community interventions (access to contraceptives; back yard gardens; literacy classes; protection).
• Mentorship of the health workforce (at both primary and secondary level).
• Last mile distributions (GPS tracking; fuel for vehicles and boats; stock management).
• Management and leadership training.
• Innovative technology (smart phone-based ultrasound; CRADLE VSA and anti-shock garments).
• Safe and rational blood use.
• Community-led accountability (mystery client visits; community score cards and conversations).

Across all outputs and activities, the Consortium will deliver and provide capacity strengthening to ensure that the barriers preventing persons with disabilities to access health care facilities and information are identified, addressed and removed