Who is to blame for high infant death rate in Sierra Leone

The country of Sierra Leone has the second highest child mortality rate in the world. The medical professionals in the country blame the high death rate on midwifes or traditional birth attendants.

The health professionals say that midwifes do not have the proper training if pregnancies get complicated. However, the midwifes way that they are needed to reach remote villages where there is no access to medicine.

From the Voice of America, writer Chinedu Offor frames the debate in this story.

Sierra Leone has the second highest child mortality rate in the world, according to a recent survey by UNICEF and the World Health Organization (WHO). The report found that more than one out of four children die before their fifth birthday.

The death rate among newborns in Sierra Leone is above the average for Africa, at 56 per 1,000 live births, says the WHO.

Doctors in government hospitals blame traditional birth attendants (TBAs) for the high death rate. They’re blamed for not being able to handle problem births, including hemorrhaging.

But the attendants say they have a major role to play, especially in a country where poverty, poor transportation and cultural practices keep many women from going to the hospital.

Dr. Ibrahim Thorlie is the chief medical officer of the Princess Christian Maternity and Child Health clinic in East End, Freetown. .

“In my own opinion, the TBAs have no role to play in the reduction of maternal mortality because they deal with the normal case that does not cause maternal mortality. Therefore, we should stop training them.”

A traditional birth attendant supervisor, Mohammed Masere, disagrees. He says Dr. Thorlie’s views are extreme.

“At (the) primary healthcare level, TBAs have a role to play because they are closer to the people in the community. They do deliveries, cases that are unable to reach the health facilities on time.”

Television personality Woteh Camera was delivered by a TBA, and she agrees. With most of the population living in rural areas and unable to access hospital services, she says, traditional birth attendants remain relevant. But they should be trained in modern methods of delivery, she adds.

“Though they are not well trained, I think they are doing a good job, as most people will say, [in view of the fact] that we don’t have qualified people in our rural areas, most especially the remote villages where…the roads are bad and it (the clinic or hospital) is far.”