Sierra Leone is DAC-1 and ranks 183/188 on UNDP HDI and is hence among the poorest countries worldwide. The country has a fragile health care system, which was even further challenges by the Ebola epidemic. According to WHO, Sierra Leone has among the highest rates worldwide concerning maternal mortality and perinatal complications. There is no data on HIP in Sierra Leone but in the Africa Region there is an estimated percentage of 10.5% HIP.
To promote the awareness, screening and care of hyperglycemia in pregnancy (HIP) in Sierra Leone
In order to improve care for pregnant women with HIP, the project will introduce universal screening for HIP and referral mechanism for detected cases at Princess Christian Maternity Hospital (PCMH) in Freetown. PCMH has a catchment area of more than 1,346,771 and the expected deliveries are about 59,258 per year, around 4,4% of population.
To improve the quality of care capacity building will be provided to PCMH staff and staff of surrounding primary/secondary ante-natal care facilities and provision of basic equipment and screening material will be provided.
Roll out of 12-month post-partum care of mother and child, incl at primary and secondary level, and through linkages with vaccination and education services will enhance the follow up of women suffered from HIP and their babies.
The development of a dedicated a patient record and data collection system at PCHM will assist in quantifying the burden of the disease.
In order to enhance HIP care and streamline access to care across Sierra Leone, the project will support the Ministry of Health and the Directorate of Research and NCDs to develop national guidelines on hyperglycemia in pregnancy through the evidence and practice generated at PCMH using an operational research approach.
In order to increase the awareness on HIP among women, the project will provide information, education and communication activities on the importance of HIP screening and on seeking appropriate care.
- 90 Health Care Personnel (mainly nurses, 10 from PCMH respectively 80 from primary and secondary care units) will enhance their knowledge on HIP
- PCMH and 16 primary and secondary facilities have implemented HIP screening, care and post-partum services.
- 10,000 pregnant women has been screened for HIP and provided improved ante-natal care
- 1,000 pregnant women has been detected with HIP and referred to PCMH for comprehensive care, and followed up post-partum.
- 59,000 pregnant women across targeted area has been reached through awareness and prevention oriented activities.
Results at completion
- 184 HCPs trained in GDM
- First GDM clinic established in Sierra Leone; Integrated Diabetes Screening (IDS) clinic created in the ANC services at PCMH
- Peripheral IDS Clinics established in 17 Peripheral Health Units (PHUs) in Western Area of Sierra Leone
- Protocol for Integrated Diabetes Screening developed and reviewed by the MoHS
- 14,231 women screened in IDS Clinic at PCMH
- 4,296 women screened in IDS Clinic in PHUs; referral system for all the positive cases from PHUs to IDS Clinic at PCMH;
- Collaboration with the only Diabetes Clinic in Freetown (in Connaught Hospital) for all the positive cases aimed to ensure specialized visits
- 76,447 women reached with information on GDM and related services through awareness raising campaigns;
- Operational research on diabetes in pregnancy, “A simplified diagnostic work-up for the detection of gestational diabetes mellitus in low resources settings: achievements and challenges” developed (yet to be published)
- First data on GDM in Sierra Leone collected