WHO · UNICEF · UN IGME 2024← All Countries

🇸🇱

Maternal & Child Mortality
in Sierra Leone

West Africa · #6 of 30 worst globally

Child Deaths Since Jan 1, 2026

0

87.2 per 1,000 live births · Sierra Leone

Deaths at Birth Today

0

est. newborns today

Infant Mortality Rate

87.2

per 1,000 · 3.2× world avg

Maternal Mortality Rate

443

per 100,000 · 2.2× world avg

West Africa

Birth Mortality Crisis

Mothers & Newborns
Dying in Sierra Leone
During Childbirth

443 maternal deaths per 100,000 — among the most dangerous places in the world to give birth.

Newborn & Infant Mortality

87.2deaths per 1,000 live births

3.2× the world average

Maternal Mortality During Birth

443deaths per 100,000 live births

2.2× the world average

👶

Newborn & Child Deaths During Birth in Sierra Leone

The 2014–16 Ebola crisis killed 14,000+ Sierra Leoneans and decimated an already fragile health system. Community distrust of health facilities continues to suppress care-seeking behaviour.

Meaningful progress — from 240 per 1,000 in 2000 to 87 today — but plateaued post-Ebola.

Leading Causes of Child Death at Birth

Malaria31%

Neonatal causes27%

Pneumonia14%

Diarrhoea12%

Other16%

* Neonatal deaths (first 28 days) represent the largest share of under-5 mortality.

What Happens in the Delivery Room

🏥

Births in a health facility~78%

estimated — lower in conflict/rural areas

👩‍⚕️

Skilled birth attendant present~34%

doctor, midwife or trained nurse

⚠️

Neonatal deaths (first 28 days)48%

of all under-5 deaths occur at birth

🩸

Most preventable with skilled care~75%

of child and maternal deaths

🤱

Maternal Mortality During Birth in Sierra Leone

The Free Healthcare Initiative (2010) improved access but was overwhelmed by demand. The 2014 Ebola crisis forced closure of many facilities during a critical window.

Improved from ~2,200 in 2000 to ~443 today — substantial reduction — but still critically high.

Causes of Death During Labour & Delivery

Haemorrhage28%

Eclampsia22%

Sepsis19%

Obstructed labour16%

Malaria in pregnancy9%

Other6%

* Haemorrhage and eclampsia together cause over 50% of deaths — both are treatable with basic skilled care.

Why Mothers Die at Birth Here

🩺

Emergency obstetric care availableLimited

few facilities can manage haemorrhage

🩸

Blood transfusion accessCritical gap

haemorrhage kills within 2 hours

💊

Magnesium sulphate (eclampsia)Often absent

costs $1 — saves lives instantly

✅

If skilled care were universal~75% fewer deaths

WHO estimate for this mortality level

⚠️

Why Is This Still Happening?

Structural Barriers to Safe Birth in Sierra Leone

11-year civil war destroying health infrastructure

2014–2016 Ebola epidemic devastating remaining health systems

High teenage pregnancy rate (28% of births to mothers under 18)

Seasonal flooding disrupting health facility access

Community distrust of formal health systems post-Ebola

🎯

SDG 3 Progress Assessment

Sierra Leone is on a positive trajectory but will not meet SDG targets without sustained investment.

💡

Prevention & Solutions

How Can We Prevent This in Sierra Leone?

📍 The Situation

Sierra Leone has never fully recovered from the destruction of its health system during the 1991–2002 civil war, or from the 2014–2016 Ebola epidemic that killed a disproportionate number of health workers. Today, it consistently ranks among the most dangerous places in the world to give birth.

🔬 How Ultrasound Helps

Sierra Leone's Directorate of Health Services has identified skilled birth attendance and antenatal care quality as the two most impactful intervention points. POCUS training for skilled birth attendants directly addresses both. A midwife who can perform a basic OB scan at the first antenatal visit can identify malpresentation (~4% of pregnancies), placenta previa (0.5%), and multiple pregnancy — all conditions requiring obstetric intervention that, undetected, frequently cause haemorrhage and obstructed labour deaths.

🎓 The Training Gap

Sierra Leone's Reproductive and Child Health Directorate has partnered with international organizations to deploy portable ultrasound devices to district health facilities. The limiting factor is consistently trained operators. GUSI's rapid-certification model is directly applicable to filling this gap.

What a trained provider can detect with a portable ultrasound device

🩸Placenta previa

🔄Malpresentation

👥Twin pregnancy

📉Fetal growth restriction

⚡Pre-eclampsia markers

🫁Childhood pneumonia

💉Internal bleeding

🧠Hydrocephalus

🧮

Interactive Model

POCUS Impact Calculator — Sierra Leone

Model based on: 600 scans/provider/year · 15% high-risk detection rate · 47% mortality reduction for detected cases (Swanson et al. 2014 · WHO POCUS in LMICs review)

Number of POCUS-trained providers deployed in Sierra Leone50

1 provider250500 providers

Scans per Year

30,000

pregnant women screened

High-Risk Detected

4,500

flagged for referral / intervention

Maternal Deaths Prevented

30

mothers saved per year

Newborn Deaths Prevented

70

babies saved per year

Total Lives Saved Per Year

100deaths prevented

2.0

lives per provider

$248

est. cost per life saved

$24,750

total training investment

* This calculator uses a conservative evidence-based model. Actual impact varies by deployment context, provider experience, and health system capacity. Training cost based on GUSI OB POCUS Essentials (~$495/provider). Mortality reduction from peer-reviewed POCUS implementation studies in low-resource settings.

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Technology & Education

A Practical Plan to Bring POCUS to Sierra Leone

🗺️ Deployment Roadmap for Sierra Leone

Baseline assessment — map existing facilities, referral pathways, blood supply, and available midwives, nurses, and physicians who could be trained.
Provider training — enrol local champions in GUSI's OB POCUS Essentials + Pediatric POCUS courses. Certify a core group to train others.
Device procurement — select appropriate portable handheld devices based on power infrastructure, connectivity, and budget (see brands below).
Protocols & referral integration — define what to scan, what findings trigger referral, and how to document scans at the point of care.
Quality assurance — regular image review sessions, outcomes tracking, and refresher training to maintain competency.

📡 Recommended Portable Ultrasound Devices

🦋 Butterfly iQ+

Website →

Single-probe whole-body device covering OB, cardiac, lung, and FAST exams. App-based platform with built-in AI guidance. Designed for low-resource environments — charges via USB and works with any smartphone.

🔵 Philips Lumify

Website →

App-based probe that plugs into Android phones. Multiple transducer heads available for OB and point-of-care use. Widely used in GUSI-supported training programs globally.

🟢 GE Vscan Air

Website →

Wireless, pocket-sized dual-probe handheld. Streams live images to a smartphone app. Excellent battery life — purpose-built for rapid bedside OB and FAST-style assessments.

🔷 Clarius HD3

Website →

High-resolution wireless handheld. Multiple probe configurations available. Strong image quality in a compact form factor — suitable for OB, lung, and neonatal scanning.

Global Ultrasound Institute · GUSI

The training that closes the gap — built for providers in settings like Sierra Leone

GUSI trains physicians, nurses, midwives, and community health workers in Point-of-Care Ultrasound. Courses are designed from the ground up for providers in resource-limited settings — short, practical, competency-based, and available online or in person. Every course maps directly to the conditions killing mothers and babies during childbirth.