In response to the alarming rise in maternal deaths, health and local authorities in Kenema have introduced a set of by-laws aimed at curbing the trend. The move comes as the district grapples with one of the highest rates of maternal mortality in the country, primarily attributed to home deliveries and delays in seeking medical assistance.

The signing of the by-laws occurred during a significant one-day engagement held at the Kenema Government Hospital in October this year. Key stakeholders, including the District Health Management Team (DHMT) and Chiefdom authorities, gathered to address the issue collectively. The event witnessed Chief Ismail Koroma, Chiefdom Speaker of Small Bo Chiefdom, signing the document alongside District Medical Officer Dr. Donald Grant.

The newly enacted by-laws prohibit home deliveries and discourage other harmful practices during pregnancy. One of the main challenges faced by the region is the prevalence of home deliveries, often facilitated by untrained individuals known as Traditional Birth Attendants (TBAs). Complications during these deliveries, such as excessive bleeding, pose significant risks to both the mother and the baby due to the lack of appropriate medical equipment and expertise.

Dr. Grant, during his presentation at the stakeholders’ engagement, highlighted that most maternal deaths in the district occurred among women aged 20 to 29. He emphasized that home deliveries and delays in referrals to major government health facilities were the primary causes of the high maternal mortality rate. In 2022, 42 women died during childbirth in Kenema, with specific chiefdoms like Lower Bambara and Nongowa recording the highest number of cases. Between January and September 2023, 20 maternal deaths were reported, with April seeing the highest incidence.

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To address this crisis, the authorities have been working to incorporate TBAs into the formal healthcare system by providing them with training. However, progress has been hindered by factors such as poor service delivery, and discouraging people from seeking assistance from healthcare facilities.

In response, the newly introduced by-laws aim to change this trajectory by prohibiting home deliveries and encouraging timely referrals to medical facilities. All 16 Paramount Chiefs of the District and their sub-chiefs have committed to enforcing these laws, signaling a united effort to combat the issue. The enforcement of these by-laws also relies on the collaboration of community leaders, health authorities, and partners.

Chief Francis Musa Kallon, Kenema City Town Speaker, praised the initiative but stressed the need for collaboration at higher levels, including the involvement of Members of Parliament in the enforcement efforts. He also urged district health authorities and partners to provide birth waiting homes at Peripheral Health Units (PHUs) across the district.

Nurse Hannah Tommy, in charge of the Samai Town II Community Health Center in Nongowa Chiefdom, expressed her readiness to tackle the situation with the available support. She noted that maternal deaths and complications during pregnancy, including chronic colds and Sexually Transmitted Infections, remained significant challenges at their facility. Additionally, common childhood illnesses like Malaria, pneumonia, and the common cold were prevalent among children under five.

The introduction and enforcement of these by-laws mark a significant step toward addressing the pressing issue of maternal mortality in Kenema. The united efforts of local authorities, healthcare professionals, and community leaders are crucial in ensuring the well-being of expectant mothers and their newborns, ultimately leading to a healthier future for the district.