Project 9

Other Health Challenge #1: Maternal Health

Other Health Challenge #2: Mental Health

Other Health Challenge #3: Nutrition

Incidence

The maternal mortality rate in Sierra Leone is one of the highest in the world at 1,360 per 100,000 live births. (Trani et al.,2011).

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Many people in Sierra Leone have suffered trauma, which has been linked to poor mental well-being. The ten-year civil war that concluded in 2002, the Ebola epidemic that began in 2014, and the devastating mudslide that occurred in August 2017 due to heavy rains are just a few examples. Drug abuse problems, notably marijuana and tramadol, are on the rise, and alcohol consumption is much greater than the area norm (Harris et al., 2020).

Nearly half a million children under the age of five are stunted, and another 30,000 are malnourished and in danger of dying soon because of poor food and the prevalence of preventable childhood diseases. (Keeley, Little and Zuehlke, 2019).

Prevalence 

With 1,360 maternal deaths for every 100,000 births, Sierra Leone has the highest maternal mortality rate in the world. (Trani et al.,2011).

 After the end of the civil conflict in 2002, a survey conducted by the Ministry of Health and Sanitation found that the prevalence rates for various mental health disorders were as follows: 2 percent for psychosis, 4 percent for depression, 4 percent for severe substance abuse, 1 percent for mental retardation, and 1 percent for epilepsy. The civil war that raged from 1991 to 2002, economic difficulties, gender-based violence, poor health outcomes (such as high rates of maternal and infant mortality), and the current Ebola outbreak are all factors that may have contributed to the country's high proportion of mental health disorders [12–16]. There was a treatment gap of 98.0 percent in 2009, as just 2058 of an anticipated 102 000 patients with serious mental illness got help. The Sierra Leone Psychiatric Hospital in Freetown was the country's only hospital for treating MOHS until very recently.

The regional average for obesity is 20.7 per cent for women and 9.2 percent for men. However, the rates in Sierra Leone are lower. However, 7.6 percent of adult women and 8.3 percent of adult males are predicted to have diabetes.

(Maust et al.,2015). .

Presentation

Premature death, defined as dying before 70, affects around 63 percent of Sierra Leoneans (Trani et al.,2011).

The WHO estimates that 10% of Sierra Leoneans deal with mental health issues daily. There may be many more incidents that have not been reported to authorities. As a consequence of severe poverty, "daily hardships and misery can turn into what scientists call "toxic stress" and trigger or amplify mental health problems," as one author puts it. There has been a long history of inadequate political attention to mental health issues in Sierra Leone. (Jalloh et al.,2018).

More than half, that is 57 percent , of all deaths in children under five in Sierra Leone can be attributed to malnutrition. Still, the country's health ministry and government officials have begun working to reduce this horrifying statistic by signing the Nutrition for Growth agreement and becoming part of the Scaling Up Nutrition initiative.

Social Determinants 

Transportation, housing, and education are all examples of social determinants of health (SDOH) that may affect individual and population health. Differentiating SDOH using Z Codes may enhance the precision of therapy and healthcare access.

Family conflict, difficulty to purchase essentials, and the breakdown of a marriage or partnership are the three causes of psychological suffering. Indicators of men's psychological suffering included poor physical condition, financial difficulties, and illiteracy. Incapability to afford basic requirements, poor health, the termination of a marriage or partnership, and family conflict were predictors for women. The research reveals that initiatives aimed at increasing income-generating and job possibilities, improving access to education, and strengthening families have the potential to improve mental health in Sierra Leone.

Cultural beliefs,  traditions and taboos hinder the supply and consumption of certain nutritious foods that might otherwise aid in enhancing the nutritional intake of young children, even though food poverty is believed to be the greatest obstacle to dietary variety throughout the nine-month-long rainy season.

Inequities 

Women in higher-income families, those with higher levels of education, and those living in metropolitan areas tend to get preferential treatment from the healthcare system. While delivery service disparities have narrowed over time, they remain considerable.

The Sierra Leone Psychiatric Hospital is the only in-patient institution in the country and can only accommodate up to 150 patients at once(Horn, 2021). Aside from the widespread negative connotation attached to SLPH, the disorder is also notoriously underfunded, understaffed, lacking essential infrastructure, and often short on necessary medications.

Malnutrition in Sierra Leone is a relatively new health issue brought to light by the country's recent civil war. One of the country's most ignored problems is hunger.

Programs, Policies, or Legislation

The goal of the Sierra Leonean government's National Reproductive, Maternal, and Adolescent Health (RMNCAH) strategy is to reduce maternal mortality to 650 per 100,000 live births, neonatal mortality to 23 per 1,000 live births, and under-five mortality to 71 per 1,000. (SOPs)

The Office of Population and Reproductive Health at USAID sponsored and oversaw the Advancing Partners initiative, which the MOHS collaborated with for two years. The Ministry of Health and Sanitation (MOHS) framework is being put to use in Sierra Leone to help the government execute health services as part of the country's ongoing post-Ebola recovery efforts. Through raising public awareness, preparing healthcare professionals to provide excellent treatment, and strengthening mental health governance, the initiative is helping to manage mental health in the community better.

UNICEF will help the country's young children eat healthier by bolstering the quality of essential nutrition services at the facility and community levels and better integrating nutrition programs into the country's broader health infrastructure.

Other 

Malaria is the single most lethal communicable illness in Sierra Leone, responsible for 38 percent of all hospital admissions. There are around three new tuberculosis cases per year for every one thousand individuals, making it another major public health concern.

In the past, Sierra Leone did not prioritize its citizens' mental health. Unemployment persists, and as a result, the country's economic situation remains dire. Its 11-year civil conflict left the country devastated, and an Ebola epidemic in 2014 only worsened things. Many individuals in our nation are still reeling from the effects of their history. That pain was ignored for a very long time. Nonetheless, the World Health Organization and the Ministry of Health and Sanitation have made significant strides in improving mental health in Sierra Leone

(Horn, 2021).

The life expectancy in Sierra Leone is among the lowest in the world. Sierra Leone had a 54.3-year median life expectancy in 2018. Accordingly, the country is ranked in the worst five globally. The average lifespan throughout the globe is 72.6 years, by contrast.