Training Health Workers in Sierra Leone

Sierra Leone remains one of the world’s poorest countries with 60 per cent of the population living under the poverty line. Of the country’s population, it is estimated that 40-45 per cent are young people.

These adolescents face a number of specific threats to their health that, in turn, impact upon their opportunities and prospects.

High teenage pregnancy rates are a prime example. In a country with one of the world’s worst maternal mortality ratios (at 1,360 deaths per 100,000 births), 41 per cent are adolescent girls. Those girls who survive child birth are often prevented from continuing their education due to childcare commitments. High teenage pregnancy rates are undoubtedly a factor in why two-thirds of Sierra Leonean women have no formal education and only three per cent go on to higher education.

Other adolescent health concerns in Sierra Leone include the spread of sexually transmitted infections and particularly HIV and/or AIDS. Worryingly, in Sierra Leone, 0.6 per cent of adolescents have HIV, just 23 per cent have a comprehensive knowledge of HIV and/or AIDS and only 12 per cent of those with multiple partners use condoms.

All these factors reinforce how important it is for health workers to be well-versed in adolescent health and able to provide an approachable service.

Unfortunately, in Kenema this hasn’t always been the case. An alarming lack of knowledge concerning adolescent health was found amongst health workers there. The inadequate service was exacerbated by the fact that many adolescents were uncomfortable visiting health facilities because of the attitudes of health staff, meaning some young people suffer in silence rather than seeking attention.

In partnership with Irish Aid, GOAL has been delivering a comprehensive training programme for health workers in Kenema. Sessions increased health workers’ understanding of the specific risks associated with adolescent pregnancy and child birth, best practices to avoid complications during delivery, and how to make health facilities youth-friendly.

Anita Cornel (pictured), is a maternal and child health nurse at a health facility in Kenema. She took part in GOAL’s training.

‘There were around 20 nurses in my group who work at different health facilities in Kenema,” she said. “GOAL’s training was very good. We are able to treat lots of young people with adolescent health issues now.”

Maternal and child health nurse, Anita Cornel, pictured at the health facility where she works in KenemaImproved communication has been central to teaching health workers how to approach sensitive topics such as contraceptive use, allowing them to provide a service that is tailored to supporting adolescents’ needs. The training allows nurses like Anita to adopt a preventative strategy, aimed at influencing adolescents’ behaviour before they have unprotected sex.

The training focused heavily on improving the health workers’ attitudes towards adolescent health and minimising stigma in order to encourage young people to seek medical care. To Anita, the results of this have already been felt.

‘The training demonstrated how we can give effective care confidentially. The young people often don’t want people to know that they have come to us. With the training, we are open to them at any time. They will come to see us even at night.”

GOAL’s training resulted in a 33 per cent rise in participating health workers’ knowledge of adolescent healthcare, up from 46 per cent to an encouraging post-training average of 79 per cent.

GOAL staff continue to support health workers in Kenema by providing on-the-job training aimed at sustaining and strengthening standards of adolescent healthcare.

– Kaleem Luthra, Programme Intern, GOAL Sierra Leone