Sierra Leone

En français

HKI provides technical assistance to the Ministry of Health and Sanitation and NGOs for the implementation of programs for the reduction of malnutrition and improvement of eye health through integration and partnership. HKI also works to improve the capacity to monitor and evaluate nutrition and eye health programs and encourages networking in order to improve the coherence of interventions. Current activities include:

• Vitamin A Supplementation >>more
• Anemia control for pregnant women >>more
• Nutrition programs for people living with HIV/AIDS >>more
• Essential Nutrition Actions to reduce malnutrition >>more
• Onchocerciasis and Lymphatic Filariasis control >>more
• Control of Neglected Tropical Diseases >>more

Program Descriptions:

Vitamin A Supplementation (VAS): Recent analyses estimated that 57% of children under-five deaths are attributable to malnutrition in Sierra Leone and an estimated 40% of children under-five are vitamin A deficient . HKI’s nutrition program is primarily geared towards supplementing children under-five with vitamin A; 23-34% of child death could be averted by VAS.

HKI supports the Sierra Leone government and partner organizations in institutionalizing micronutrient supplementation including integrating biannual VAS into routine health care services for children and post partum women . Efforts are being made to collaborate with the private sector including faith-based clinics and hospitals, and to establish VAS through community-based Traditional Birth Attendants (TBAs) since 70% of deliveries are done by TBAs. Thirteen private sector organizations are now distributing vitamin A to post partum women and sick children in their clinics and peripheral health unit staff in the Kambia district. VAS has been distributed since 2004, by various different means. One such manner was with the introduction of Micronutrient Week in 2006, which included other child survival interventions; 96% of the target populations were reached with vitamin A and other life saving interventions.

VAS activities were enhanced through HKI’s coverage surveys, the production of VAS guidelines, and the dissemination of Information, Education and Communication (IEC) materials including the airing of jingles. HKI also provided training of health workers on vitamin A and other key micro-nutrients, and developed a training manual for use by health workers in Sierra Leone.

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Anemia Control: Based on health statistics from the Ministry of Health and Sanitation, 15% of the high maternal mortality in Sierra Leone is attributable to anemia in pregnant women. Anemia affects approximately 86% of children under five years of age, and 68% of women of childbearing age.

These statistics led to the formulation of a national policy that every pregnant woman should take iron pills every day throughout pregnancy. This policy change would have had a major impact if women attended clinics regularly while pregnant but most start going either very late in their pregnancy or not at all. In response, HKI in collaboration with the Kambia District Health Management Team, established a pregnant women support group program to control anemia in pregnant women in the Kambia district.

HKI has been advocating for this strategy to be adopted by other organizations; CARE International has already begun implementing the program and Catholic Relief Service will start in January 2008. Key information about iodine has also been incorporated into the IEC materials which have been produced and disseminated throughout the country for the use of health workers.

People living with HIV/AIDS: People living with HIV/AIDS can prolong their lives with good nutritional practices. In the past HKI has addressed this problem in the area of child feeding with mothers who are HIV positive. The infant and young child feeding guidelines developed in 2005 provide a variety of options on feeding of infants whose mothers are HIV positive without transferring the virus and ensuring rich vitamins and minerals were still provided.

HKI is exploring the need to offer nutritional support (training and capacity development) to people living with HIV/AIDS in Sierra Leone. In April, 2007, HKI met with stakeholders to discuss key issues.

Essential Nutrition Actions: HKI intends to take the leadership role in engaging other nutrition stakeholders to take to scale the Essential Nutrition Actions (ENAs) in reducing malnutrition in the country as well as the establishment of community-based program for the treatment of severely malnourished children in the Kambia district.

ENA framework is an integrated package of 7 proven community based actions linking health, nutrition, agriculture and education. They include: optimal breast feeding, complementary feeding with breast feeding, nutritional care of sick children, women’s nutrition, control of VAD, control of anemia, and control of iodine deficiency disorders . These actions have already been implemented by various organizations but they are done in isolation so it is difficult to see the total impact. If these actions are implemented on a large scale, they could contribute to the achievement of the Millennium Development Goals, as happened in Ethopia and Mozambique where they had great success in drastically reducing malnutrition.  

HKI's intention is to bring together all nutrition stakeholders in the country to determine a plan to implement all of the ENAs. HKI participated in a national training including national health staff and NGOs and intends to work with the Kambia DHMT to set up pilot sites in the district.

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Onchocerciasis: HKI plays a leadership role in Onchocerciasis (river blindness) control; Sierra Leone belongs to the Special Intervention Zones. HKI focuses on reinforcing IEC strategies and surveillance systems, and Community Directed Treatment with Ivermectin (CDTI) programs through the support of the Nippon Foundation.

With support from Merck & Co, Inc., HKI continues to provide technical assistance to the National Onchocerciasis Control Programme to strengthen CDTI in northern Sierra Leone, a region where over 1,064,022 people are at risk. Since a large proportion of the rural communities are endemic, HKI is trying to to integrate our VAS training into current CDTI activities.

Lymphatic Filariasis: The treatment of Lymphatic Filariasis (LF) will also be integrated into CDTI nationwide. Over 17,902 Community Directed Distributors (CDDs) have been trained on the basic concept of CDTI as well as the integrated management of LF into CDTI in all the endemic Oncho and LF communities. Six districts were selected to pilot test the integration of LF treatment into CDTI during the 2007 Ivermectin distribution. Reports so far have shown positive results.

Neglected Tropical Diseases: HKI has also been working to integrate management of Neglected Tropical Diseases (NTDs) which include onchocerciasis, LF, soil-transmitted helminthes, schistosomiasis and trachoma. In 2008, HKI’s programs will build on the CDTI programs currently underway by engaging CDDs in the distribution, and providing training and education to endemic communities. This approach will enable HKI to support control of all five major NTDs.

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Program Partners

• Africare
• Canadian International Development Agency (CIDA)
• CARE
• Catholic Relief Services (CRS)
• The Christian Health Association of Sierra Leone (CHASL)
• CONCERN
• GOAL
• Government of Sierra Leone
• Health Unlimited
• Merck Donations
• The Nippon Foundation
• PLAN Sierra Leone
• Sightsavers International
• Standard Chartered Bank (SCB)
• UNICEF
• USAID
• WFP
• WHO
• World Vision

Key Staff

• Jen Peterson - Country Director
• Epiphane Agossou - Administrative and Finance Manager
• Marian Bangura - HKI Program Officer
• Kaprie P. Conteh - Administrative and Finance Assistant
• Mustapha Sonnie - Onchocerciasis Program Officer