Sierra Leone: On the Beat With a Community Health Worker in Sierra Leone

By Indrias G. Kassaye

Bombali District — Osman Koroma is on a mission to save lives. Like almost everyone else in the village of Kathirie in Sierra Leone’s Bombali District, Osman is a farmer. But four years ago, he added a new set of skills when he was trained to join the ranks of Sierra Leone’s cadre of Community Health Workers (CHWs).

Today, Osman is on the front lines of efforts to protect the lives of children and women in a country that has the highest levels of maternal mortality in the world, and one of the highest rates of child mortality.

“I do this community work early in the morning before going anywhere, and also at times I do it in the evening hours,” says Osman, who knows everyone in the village, which has a population of close to 500 people.

He works alongside the village Mothers’ Support Group and Village Development Committee (community organizations that support the needs of the village) to identify pregnant women, breastfeeding mothers and children under 5 years old, whom he then visits on a regular basis.

Critical advice

On this day, Osman’s first stop is at the home of Rahmatou Sesay, who is sitting outside as she nurses her one-month-old baby, Mariatu Kamara.

“I came to Rahmatou the morning after she delivered to see how she and the baby were doing,” Osman says. “I gave her advice on how to take care of her baby and not to put native medicines on the umbilical cord. She must wash her hands with soap before touching the baby. I advised her to breastfeed exclusively for six months.”

After filling out Rahmatou and Mariatu’s details on his CHW register, Osman makes his way to the home of 25-year-old Margaret Sesay, who is nine months pregnant with her third child. Margaret and her mother were busy peeling cassava recently harvested from her family’s farm.

Osman used the illustrated ‘National Counselling Cards for Community Workers’, developed by UNICEF and the Ministry of Health and Sanitation, to advise Margaret about what, how and when she should be eating during pregnancy.

They are soon joined by Kadiatu Tarawalie, leader of the Kathirie Mothers’ Support Group. Together they continued the discussion on what Margaret should do when the time comes for her to give birth and how she should feed and care for the new baby. Osman advises her to deliver at the Binkolo Peripheral Health Unit (PHU), and to start preparing money for transport, food and clothing and other things she will need.

“I am happy with the work that Osman is doing,” says Margaret, who has developed a good rapport with him. Osman counselled and followed up on her during her previous pregnancies. His advice was critical to her decision to give birth at the PHU rather than at home, and all her pregnancies have gone well.

“Today we discussed the things that I should be eating while I am pregnant and when I am breastfeeding, including bananas, cucumber and chicken,” Margaret says. “The pregnancy is going well. I have been to the PHU four times for check-up. I have also been vaccinated. I delivered my first two children at the PHU, and my plan is to give birth there this time as well.Making the difference

Margaret’s decision to give birth at a health facility, where trained health professionals can provide appropriate care, is essential for improving her chances of safely delivering her new baby. In Sierra Leone, only one out of two pregnant women deliver at a health facility, which is one of the contributing factors in the country’s high rate of maternal mortalityCommunity Health Workers like Osman, working in collaboration with the Mothers’ Support Groups, provide direct and continuous counselling to expecting mothers. Even in remote rural areas, creative community action facilitated by CHWs like Osman is making the difference.

All Africa 25 May 2016

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