Access to Essential Medications and Equipment for Obstetric and Neonatal Primary Care in Bombali District, Sierra Leone

Abstract

The increased demand for basic emergency obstetric and neonatal care (BEmONC) services in Sierra Leone since the launch of the nationwide free maternity care initiative in 2010 has strained the capacity of the system to provide high‐quality care. In 2014, members of our research team visited all 97 functioning primary health‐care facilities in Bombali district in the Northern Province of Sierra Leone to evaluate gaps in access to BEmONC. Although most facilities had the equipment necessary for maternal and neonatal care, these were often not in satisfactory condition. Most of the facilities did not stock all of the essential medicines for BEmONC, and less than 10 percent of the facilities had sufficient stocks of unexpired and properly stored medications. Stronger supply chains will be necessary to improve health system performance in Sierra Leone, reduce maternal mortality, increase neonatal survival, and achieve targets associated with the Sustainable Development Goals (SDGs).

Implementing essential diagnostics-learning from essential medicines: A scoping review

“…The barriers related to the relationship with norms and standards for the EDL implementation included poor availability of diagnosis and management guidelines, noting the unavailability of diabetes guidelines in any surveyed clinics 165 . Other barriers unique to the EML included incompliance to guidelines 50,53,131,149,153,166,168,169 , incompliance to national EMLs 48,68,79,132,145,170 , lack of national EMLs in facilities 128,171 , disconnect between guidelines on treatment protocols 47,75 , disconnect between policy, guidelines and practice 46,167 , and lack of standard operating procedures 135 .…”

“…Unavailability of guidelines was the most prominent theme within the barriers related to relationship with norms and standards for the EML implementation 35,66,86,106,110,116,154,166,143,59,106,119,131,143,155,167 . Other barriers unique to the EML included incompliance to guidelines 50,53,131,149,153,166,168,169 , incompliance to national EMLs 48,68,79,132,145,170 , lack of national EMLs in facilities 128,171 , disconnect between guidelines on treatment protocols 47,75 , disconnect between policy, guidelines and practice 46,167 , and lack of standard operating procedures 135 .…”

Clinical Equipment as a Potential Impediment to Optimal Intrapartum Monitoring and Delivery for Pregnant Women in South Africa

“…Facility midwifery care services need to improve by providing equipment and supplies to increase satisfaction with services received during the intrapartum stage of pregnant women [9]. A study in Sierra Leone indicated that the checklist entries for labour regarding delivery equipment could improve optimum care during intrapartum monitoring and delivery for pregnant women [10]. Significantly, the maintenance of equipment should be prioritised to achieve optimum monitoring and delivery for a pregnant woman effectively [10].…”

“…A study in Sierra Leone indicated that the checklist entries for labour regarding delivery equipment could improve optimum care during intrapartum monitoring and delivery for pregnant women [10]. Significantly, the maintenance of equipment should be prioritised to achieve optimum monitoring and delivery for a pregnant woman effectively [10]. High-quality care is needed during labour.…”