Health services improving for hard-to-reach communities

Surrounded by rocky hills, forests and with very poor roads, Bafodia, in Koinadagu district, is a remote community in northern Sierra Leone.

A local community health centre (CHC) serves eight nearby villages, but has suffered a staff shortage – until recently there has been only one qualified community health officer and one traditional birth attendant. This has led to serious challenges in providing vital medical services, particularly for pregnant woman – most births had been happening at home – and very young children.

Due to supply challenges, the CHC has also struggled to provide free drugs to those who need them. Community members have had no choice but to buy poor quality, sometimes expired, medicines from informal drug sellers.

Low levels of literacy have also been a serious challenge in this community of around 5000 people – made up mostly of children, young people, women and elderly people – hindering the community in seeking and securing development packages from the district councils or central government. They have often missed out because the community is simply too hard to reach.

SABI and its partner Sierra Leone Social Aid Volunteers (SLSAV) has been working with people in Bafodia to address some of these challenges.

SLSAV has carried out sessions and meetings with the community to explain Presidential Recovery Priorities (PRP) plans and targets around education, health and social protection. The community highlighted challenges around healthcare, also raising the long distances some families had to travel to the CHC and reporting that the centre had been closed for four weeks, when a nurse was off sick.

Following the sessions, the community – alongside the SLSAV team and a local ward councillor – has brought these key issues to the attention of the district health authorities, who have promised to send an additional nurse to ensure the CHC operates properly.

The ward councillor and community members are working together to support CHC staff to ensure the facility is constantly staffed and drugs don’t run out. The councillor has also been encouraged to report back regularly to Koinadugu District Council and the district health medical team about ongoing issues.

Inatorma Coomber, SABI programme officer, says: ‘Citizens’ knowledge has increased on how to demand services and who to engage to improve service delivery.’

SABI has raised community awareness of their roles and responsibilities and how they can take action to make district authorities listen and respond to their needs.

In a follow-up community meeting, the Section Chief said: ‘I thank the programme for its efforts in letting the community understand the channels to demand for services.’

He promised he would also actively encourage pregnant women, new mothers and young children to regularly visit the health facility.

Health Centre, Port Loko District, Sierra Leone

Other recent progress in Bafodia includes:

  • Community health committee members helping to promote quality health services, ensuring community people attend clinics regularly and reporting issues around the management of the facility to the ward councillor.
  • The ward councillor is now required to always attend district sector meetings on education, health and social protection to update the district council on developments in the ward.
  • A school management committee is working to support the provision of quality primary education in the area.
  • Frontline service providers (teachers, healthcare workers and social workers) supporting each other and improving collaboration.

Inatorma Coomber adds: ‘People are taking the lead in their own development, advocating for better services and holding duty bearers accountable. They are getting themselves into working groups, developing action plans and following them up with local authorities.

‘They are also holding themselves accountable for their own community development.’