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Update Sierra Leone September 2013

A PROMISE RENEWED: ACCELERATING RESULTS FOR CHILD AND MATERNAL SURVIVAL IN SIERRA LEONE

On 11 September UNICEF released the 2013 Report on Committing to Child Survival: A Promise Renewed. It examines trends in child mortality since 1990, analyses the main causes of under-five deaths, and highlights national and global efforts to save children's lives. Globally, UNICEF and other UN agencies together with partners from the public, private and civil society sectors reach out to intensify their action to fulfil their promise to the world's children and mothers: A Promise Renewed represents a global movement to revitalize action and double efforts in the fight for child and maternal survival so that more countries will achieve the Millennium Development Goals (MDGs) 4 and 5 by 2015. The new UNICEF report shows that if current trends continue, the world will not meet Millennium Development Goal 4 to cut the rate of under-five mortality by twothirds by 2015. Worse, if current trends continue, the goal will not be reached until 2028. In Sierra Leone, development partners recognize that the country has taken a very important step to reach the MDGs with the launch of the Free Health Care Initiative in 2010. The initiative provides health services free of charge for children under five years as well as for pregnant and nursing women. In February 2013, the Government of Sierra Leone renewed its promise to accelerate child survival and the EU and UNICEF signed an agreement to increase support to the Free Health Care Initiative with Euro 20 Million. Other donors such as the UK Government and Irish Aid also contribute to the initiative. Working hand in hand with the Ministry of Health and Sanitation and partners, UNICEF Country Representative Roeland Monasch welcomed the government's renewed promise to make child and maternal health a priority, also in its new Poverty Reduction Plan, the Agenda for Prosperity. In many cases, simple solutions can save lives. The Maternal and Child Health Week (MCHW) is an example for how UNICEF Sierra Leone works around the clock to

UNICEF Sierra Leone/2013/Asselin

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boost the provision of life-saving services and information for mothers and children. During the bi-annual campaigns organized by the Ministry of Health with support from UNICEF and other partners, health workers vaccinate children on a large scale, deliver mosquito nets, provide Vitamin A and de-worming tablets. The intervention is also being used for HIV/ AIDS testing during pregnancy. A Promise Renewed is about accelerating results, it is about scaling up efforts. It is a promise which needs to be fulfilled as its major implication means: "To be or not to be" for millions of children and mothers in Sierra Leone. Therefore, we cannot forget our obligation: UNICEF Sierra Leone pledges to support the goal of A Promise Renewed and calls upon partners to fulfill the promise the world made to children in MDG 4 and 5: Give every child the best possible start in life!, says UNICEF Representative in Sierra Leone, Roeland Monasch. For more details: http://www.apromiserenewed.org
By Rosmarie E. K. Jah, Reports Officer, UNICEF Sierra Leone

THE DAY OF THE AFRICAN CHILDA CALL TO END HARMFUL PRACTICES TO REACH PROSPERITY
On 16th June, Sierra Leone joined other countries in Africa to celebrate the Day of the African Child, to draw attention on the condition of children on the continent and to unite the efforts of all actors to combat the ills that plague the daily lives of children. This year's theme was Eliminating harmful social and cultural practices affecting children: our collective responsibility.

Harmful social and cultural practices are among the many factors that continue to hamper Sierra Leone's development and prevent it from reaching the Millennium Development Goals. For the government's Agenda for Prosperity, the new Poverty Reduction Strategy, to reach its full potential and lead the country out of poverty and bad health, these practices must be addressed. To mark the day, children from all districts in Sierra Leone met and discussed harmful practices affecting their lives such as the low rate of exclusive breastfeeding, teenage pregnancy, prejudice against children with disabilities, HIV/AIDS and more. Two children from each district then travelled to Freetown to declare what they expect from the government , reminding adults that only joint responsibility by communities, the private sector and civil society will ensure that children do not become victims of harmful social and cultural practices. Malnutrition is the underlying cause of 37% of children's death in Sierra Leone. Exclusive breastfeeding during the first six months of an infant's life is the safest and cheapest way of preventing malnutrition and other illnesses. Yet in Sierra Leone only 31% of women exclusively breastfeed their children for six months. Addressing the myths and cultural practices preventing proper feeding practices entails comprehensive behaviour change activities and engagement of communities in improving child care and feeding. Teenage pregnancy is the reason for about 40% of maternal deaths and the leading cause of death for adolescent girls. Among the multiple causes behind this problem are lack of knowledge on reproductive health and inhibiting attitudes towards contraceptives. Acknowledging that this phenomenon poses a serious
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barrier to development, the Government of Sierra Leone launched a strategy to prevent teenage pregnancy, in May 2013. Another harmful practice affecting the girls in Sierra Leone is Female Genital Cutting (FGC). FGC in Sierra Leone is associated with becoming a full member of society and eligibility for marriage. Questioning the practice means questioning the social and spiritual system, making the very sensitive issue difficult to address. UNICEF is supporting a coalition of local organisations which work in communities and trigger dialogues on the issue, with different groups of stakeholders and across generations. This will inform strategies working towards abandonment of the practice.
By Charlris Okafor, Communication Officer, UNICEF Sierra Leone

UNICEF Sierra Leone/2013

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UNICEF Sierra Leone/2013

SIERRA LEONES PREPARATIONS TO PREVENT ANOTHER CHOLERA OUTBREAK DURING THE RAINING SEASON
In Sierra Leone two seasons determine the annual cycle: the rainy season from May to October, and the dry season from November to May. During the rainy season the risk of a cholera outbreak is increased. Especially in densely populated areas with poor hygiene and sanitation conditions, cholera can spread very fast. According to the Ministry of Health and Sanitation, Cholera ranks among the five most important epidemic-prone diseases in Sierra Leone. Last year, Sierra Leone's President Ernest Bai Koroma had to declare a national state of emergency because of the worst cholera outbreak in over 15 years with over 20,000 people infected and 300 killed. This year the credo for Sierra Leone is: Cholera Preparedness! In June the Ministry of Health and Sanitation called on Sierra Leone's population to take precautionary measures to prevent another cholera outbreak. Cholera can be prevented and cured. UNICEF Sierra Leone works together with the Government and the National Cholera Task Force to raise awareness and to provoke behavioral change. Cholera prevention demands practicing proper hygiene behavior such as using only safe water and clean toilets, washing hands before eating and after using the toilet. Many people are not aware of these simple measures, and many have no chance to put them into practice. Only 32% (rural) and 58% (urban) of people in Sierra Leone have access to sanitation facilities and 57% have access to safe water supply. UNICEF Sierra Leone is supporting the Ministry of Health and Sanitation in distributing hygiene messages, in the implementation of Community Led Total Sanitation
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(CLTS), and in rehabilitating water wells. CLTS is a community empowerment approach that encourages changes in behavior through triggering and mobilizing communities for the construction, proper use and maintenance of latrines and sanitation facilities. With the financial support from the governments of the UK and the Netherlands, to date over 3,900 communities have been declared open defecation-free in Sierra Leone after they became part of the CLTS program. Funded by the Japanese government and the African Development Bank UNICEF is in the process of rehabilitating 80 wells in diarrhea hot spots across the country, and of installing solar-powered water systems for larger communities that have been previously affected by high levels of diarrheal diseases. Together with six implementing partners, UNICEF is operating in eight cholera high risk districts in Sierra Leone, targeting a population of 1,011,686 people out of an estimated national population of 6 million. The project is being implemented in 31 chiefdoms and/or city sections.
By Rosmarie E. K. Jah, Reports Officer, UNICEF Sierra Leone

UNICEF Sierra Leone/2013/Asselin

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MOTHERS CLUBS AS AN OPPORTUNITY FOR THE NEXT GENERATION

Gender gaps have nearly disappeared in primary education in Sierra Leone. UNICEF initiated the Mothers Clubs to promote family and community participation in the education of their children. This creates special opportunities for women in particular in the promotion of access, retention and performance of their daughters, in school. For many children in Sierra Leone, education is just a dream. The major barrier to education is poverty. Many people cannot afford the indirect costs of uniforms and school materials. Children, particularly girls, often have to work on the farm or look after younger siblings instead of going to school. Additional factors which contribute to the high number of out of school children include a low level of female literacy; and cultural practices, such as child marriage. To ensure increased enrolment rates for girls and reduced incidence of their withdrawal from school UNICEF initiated Mothers Clubs. Each club comprises 20 women. The members of the club embark on school visits to monitor attendance and ensure that parents in the community send their children to school every day. UNICEF provides training for the women in counseling, mediation and raising awareness for them as duty bearers on rights of their children. UNICEF provides the Mothers Clubs with seed money of 500,000 Leones (about USD$116) to start small businesses. The profits from these ventures are used to identify and support the education of vulnerable children within the community. Some groups enrich their children's nutrition through vegetable gardens. Others learn to read and write. Most engage in income-generating activities.
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Hawa Kamara, 12 years old, attends the Islamic Primary School in Gbense Chiefdom, in Sierra Leone's eastern Kono District. Her father is both blind and ill. After her mother died two years ago, Hawa dropped out of school to sell small cakes in town to support her family, including her three year old sister and elderly grandmother. The family could not afford to send Hawa to school. When the local Mothers Club found out about Hawa's situation, they provided a school fund. By contributing 2000 Leones (about USD$ 0.5) a month each, they have been able to pay for the extra costs for her schooling. The Gbense Mothers Club actively monitored her case and provided encouragement. They also convinced her family that education is the only way for a brighter future. Hawa is now happily completing her class five education, unburdened with being the sole provider for her family. Special efforts are needed to reach Universal Primary Education in Sierra Leone by 2015. Some positive indicators include the development of an Education Sector Plan for 2015 to 2018 and the commitment by the Government of Sierra Leone, to allocate 20 per cent of the national budget to education annually.
By Charlris Okafor, Communication Officer, UNICEF Sierra Leone

UNICEF Sierra Leone/2013

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NEW EDUCATION SECTOR PLAN ENDORSED

On 3 September the Ministry of Education and Education Development Partners group endorsed the new Education Sector Plan 2014-2018. UNICEF is co-chair of the Education Development Partners Group and Coordinating Agency of the Global partnership of Education. The implementation of the previous Education Sector Plan has resulted in tangible improvements. The latest national survey data indicate that literacy rates among 15-19 year olds have increased from 55 to 71% between 2008 and 2013. The percentage of teenagers that have accessed at least some secondary education had increased by 50% during the same period from 40 to 62%. However, still too many children are not accessing quality basic education. They are either out of school or not learning much in the classroom. A new Education Sector Plan (2014-2018) has been developed to address the existing challenges. UNICEF is supporting the dialogue between donors, education sector partners and the Ministry of Education and the new Education Sector Plan. The new Education Sector Plan describes how the Ministry of Education will advance the progress already made in the areas of access, equity, completion, quality and system strengthening. This is to achieve its desired goals for the sector over a period of five years from 2014 to the end of 2018. Goals, strategies, interventions and costs of the Education Sector Plan are aligned with the Poverty Reduction Strategy Paper, the Agenda for prosperity, which has been launched on Friday, 12 July. The endorsement of the plan was a requirement for the application for a 17.9 million grant from the Global Partnership for Education earmarked for the basic education programme in Sierra Leone. The grant complements contributions to the implementation of the plan by the Government of Sierra Leone and donors and partners in education. UNICEF is the lead coordinating

agency of the education development partners. Education is a human right. In 2013, every child in Sierra Leone should be able to go to school. Government and partners will need to double their efforts and work closely together to make sure parents can claim the right of their children to go to school and learn, says UNICEF Representative Roeland Monasch.
By Miriam Mareso, Education Specialist, UNICEF Sierra Leone

UNICEF Sierra Leone/2013

UNICEF Sierra Leone/2013

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1.2 MILLION UNDER-FIVE CHILDREN BENEFIT FROM THE MAMIE EN PIKIN WELBODI WEEK
The Ministry of Health and Sanitation, in collaboration with UNICEF, WHO, Rotary International, Helen Keller International, the Sierra Leone Red Cross and other partners, on May 23rd 2013 launched the 8th round of the Integrated Maternal and Child Health Week that is locally referred to as the Mamie en Pikin Welbodi Week (maternal and child health week) with a health fair in Kailahun town, eastern Sierra Leone. The Mamie en Pikin Welbodi Week is a week-long integrated biannual health intervention that seeks to reduce illness and deaths among pregnant women, nursing mothers and children who are under the age of five. It usually takes place every May and November. This May, about 1.2 million under-five children were targeted with polio vaccination, vitamin A and de-worming tablets. Other health interventions included growth monitoring of children; immunization; demonstration of good nutritional practices including exclusive breastfeeding; HIV counseling and testing, family planning services, health education on the importance of using mosquito nets to prevent malaria; information on cholera prevention and demonstration of hand washing with soap. Baindu, a mother of four in Kailahun who strapped her three year old baby on her back attended the health fair
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and felt very pleased and self-fulfilled. She said: I have learnt so much today and my baby has received the polio vaccination for the fourth time! I am particularly impressed with the information I received on exclusive breastfeeding, malaria and diarrhoea /cholera prevention. The Maternal and Child Health Week provides an important opportunity to reach those children and women who have been missed out by routine health interventions. In this regard, the next round of the Mamie en Pikin Welbodi week is planned for 1st week of December and a polio immunization campaign will run from 25th to 28th October, this year.
By Issa Davies, Communication Officer, UNICEF Sierra Leone

UNICEF Sierra Leone/2013

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CONSTRUCTING AND REHABILITATING MATERNITY WARDS IN SIERRA LEONE

Since the end of the war in 2002, Sierra Leone has been struggling with a severe lack of properly equipped health facilities, both in regards to technical equipment and in human resources. To tackle that problem, UNICEF has been supporting the government of Sierra Leone in constructing and rehabilitating paediatric and maternity wards at district hospitals as well as peripheral health units. In 2008, a nationwide needs assessment on the provision of health services concluded that the provision of quality health services in Sierra Leone was highly insufficient. Not a single health center was able to provide Basic Emergency Obstetric and Neonatal Care (BEmONC). But not only the small health centers lacked adequate equipment and human resources; six out of 13 district hospitals had no capacity to provide comprehensive EmONC. Many were in bad condition without running the district hospitals in Koinadugu, Kenema, Kono and Pujehun have been rehabilitated and fully equipped. The maternity ward in Kailahun district hospital is under construction. Funding for the construction of the maternity ward in Kambia district hospital is expected soon. Four health centers have been renovated and upgraded to provide Basic Emergency Obstetric and Newborn Care (BEmONC) services. Furthermore UNICEF provided technical and financial support for the equipment of 65

water and with limited electricity supply. The rehabilitation of the health infrastructure to ensure quality health care has therefore been a priority for the Government of Sierra Leone. With the start of the Free Health Care Initiative in April 2010, the government with support of its partners started the process of rehabilitating 65 health centers, five in each district, to be able to provide Basic Emergency Obstetric and Neonatal Care (BEmONC), and maternity and paediatric wards in district hospitals. Another focus is the renovation of district medical stores and district hospital pharmacy stores. With technical and financial support provided by UNICEF
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BEmONC health centers and 12 district hospitals. Three new paediatric wards are currently being constructed in the district hospitals of Kono, Moyamba and Tonkolili. The inauguration of the new structures is expected in the fourth quarter of this year. UNICEF has recently supported the Ministry of Health in an infrastructure survey, mapping all BEmONC facilities, District Hospitals, District Medical Stores and Maternal and Child Health Aide District Medical Schools. The results of the survey will be used for planning and prioritization for the continued rehabilitation/construction work in the coming years.
By Angela Griep, Communication Specialist, UNICEF Sierra Leone

UNICEF Sierra Leone/2013/Sara Aagai

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LET GIRLS BE GIRLS, NOT MOTHERS! SIERRA LEONE FIGHTS AGAINST TEENAGE PREGNANY
With support from UNICEF and UNFPA, the President of Sierra Leone, Ernest Bai Koroma, launched a National Strategy for the Reduction of Teenage Pregnancy in Sierra Leone on May 13th 2013 in Freetown. The theme of the launch was: Let girls be girls, not mothers! In Sierra Leone, teenage pregnancy is one of the pervasive problems affecting the health, social and economic progress and empowerment of women and girls. The statistics are alarming as 34 per cent of all pregnancies occur amongst teenage girls (SLDS 2008); 26 per cent of women between the ages of 15 and 19 have already given birth and 40 per cent of maternal deaths occur as a result of teenage pregnancy (MICS 2010). Teenage pregnancy is the third most common factor for girls dropping out of school. In order to tackle the problem, UNICEF and UNFPA supported the government to set up a multi-sectorial committee that comprises key line ministries, the UN, NGOs and civil society representations to come out with a strategy that addresses social protection, health, gender and poverty issues. I dropped out of school in the third grade of my secondary education when I was impregnated by a man who was basically taking care of my needs since my parents cannot afford to do so, said 15 year old Isatu in Freetown. I regretted being pregnant at that early age and wish to go back to school and continue my education. This cannot be the future that we want for our daughters, said President Koroma as he launched the strategy. Our girls should read their books and not change napkins. The three-year strategy entails improving policy and legal environment to protect adolescents and young people's rights; improving access to quality sexual reproductive health, protection and education services; providing comprehensive age appropriate information and education and empowering communities to prevent and respond to teenage pregnancy. Setting up coordination, monitoring and evaluation mechanisms for the proper management is also a key component of the strategy. UNICEF is rendering technical and financial support these mechanisms for the successful roll out of the strategy.
By Issa Davies, Communication Officer, UNICEF Sierra Leone

In 2013 UNICEF Sierra Leone received contributions from: The Governments of Canada, Ireland, Japan,Netherlands, Norway, The European Union, United Nations; African Development Bank, GAVI Alliance, Global Fund against AIDS/TB/Malaria, Bill & Melinda Gates Foundation, Micronutrient Initiative, and United Nations Foundation. United Kingdom, United Arab Emirates, and USA

For more information please contact: Angela Griep Head External Relations, Advocacy and Leveraging Resources, UNICEF Sierra Leone Telephone: +232 22 235 730/735 Mobile: +232 76 912 059 Facsimile: +232 22 235 059 E-mail: agriep@unicef.org URL: http//www.unicef.org www.facebook.com/unicefsierraleone Follow us on twitter:@UNICEFSierraLeo

UNICEF National Committee of: Australia, Austria, Belgium, Germany, Iceland, Italy, Japan, Luxembourg, Netherlands, Norway, Poland, Sweden, Switzerland, United Kingdom, and USA.

UNICEF Sierra Leone/2010/Asselin