Sierra Leone

The Problem

  • 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. 
  • Based on national health statistics, 15% of the high maternal mortality in Sierra Leone is attributable to anemia in pregnant women. Anemia affects approximately 86% of children under five and 68% of women of childbearing age.
  • In Sierra Leone, 2 million people are at risk for blinding and debilitating disease of onchocerciasis.

What HKI Is Doing

Helen Keller International began working in Sierra Leone in 2002 and officially opened an office in 2004. Currently, HKI‘s activities include:

Vitamin A Supplementation
Helen Keller International works with government and partner organizations in Sierra Leone, including UNICEF, to institutionalize micronutrient supplementation. HKI helps with planning at the national and district levels; trains trainers, distributors and supervisors; assists with program communications; and engages in monitoring and evaluation activities. Twice-yearly vitamin A supplementation is integrated into routine health care services for children and post-partum women as well as into Maternal and Neonatal Tetanus Eradication campaigns. De-worming treatments are also distributed during the Eradication campaigns. Last year, over 95% of the target population was reached with vitamin A supplementation, or 1,032,744 children ages 6-59 months.

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Anemia Control
Although Sierra Leone’s national policy requires that pregnant women should take iron pills every day during pregnancy, many do not attend clinics regularly to receive the pills and information about their importance. In response, HKI established a support group for pregnant women in the Kambia, Kailahun and Koinadugu districts to help control anemia.

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Control of Neglected Tropical Diseases (NTDs)
HKI currently addresses six Neglected Tropical Diseases (NTDs) in Sierra Leone: onchocerciasis, lymphatic filariasis (LF), soil transmitted helminthiasis (hookworm, roundworm and whipworm), and schistosomiasis. HKI builds on the CDTI system by providing training and education so that Community Directed Distributors can distribute multiple treatments at the same time.

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Onchocerciasis Control
Helen Keller International plays a leadership role in onchocerciasis control. With support from Merck & Co., HKI continues to strengthen Community-Directed Treatment with Ivermectin (CDTI) to prevent and treat this debilitating disease in Sierra Leone, where 2.9 million people are at risk. In 2010 over 2.2 million people received treatment in endemic communities.

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Lymphatic Filariasis (LF) Control
In order to be more effective, HKI tries to layer interventions whenever possible. In Sierra Leone, HKI has integrated the treatment of lymphatic filariasis into CDTI; 30,000 Community Directed Distributors now give out both ivermectin (Mectizan®) for onchocerciasis and albendazole (donated by GlaxoSmithKline) for lymphatic filariasis to treat both Neglected Tropical Diseases. Over 5.8 million people are at risk of lymphatic filariasis infection. In both 2010 and 2011, over 3.6 million people received treatment in 12 provincial districts, along with an additonal 1.2 million people in the Western area, including the capital Freetown.

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Schistosomiasis Control
The districts in Sierra Leone's north-east are highly endemic for schistosomiasis; 2.2 million people are currently at risk of infection. A school-based control program began in six districts in 2009, and in 2010 was scaled up to include at-risk adults and expand to seven districts. School aged children receive a free school meal on the day of treatment in order to minimize side effects. In 2011, over 1.8 million children and at-risk adults were treated with praziquantel.

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Soil-Transmitted Helminthiasis Control
Deworming activites were integrated with Schistosomiasis control in six districts in 2009. In 2010, activities were expanded to seven districts in collaboration with the Ministry of Health and Sanitation. School aged children in another five districts were included in the second round of 2010 deworming in collaboration with the Ministry of Education, Science and Technology meeting the World Health Assemblies target of reaching over 75% of vulnerable children. This level of outreach was maintained in 2011 with 1.1 million school aged children receiving a second de-worming treatment six months after the first through the lymphatic filariasis elimination program.

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