How health workers are building community resilience

30% of health workers in Sierra Leone are working with no salary, but they still manage to save lives and prevent epidemics. Find out more.

I love my job, but I’m not entirely sure I’d keep showing up if no one paid me. But for the 30% of workers in Sierra Leone’s health system who aren’t getting paid, they’re still working to build systems that will treat patients and warn people in time to stop epidemics. Mamasu is one of these women—a nurse in a health clinic that has seen no maternal deaths since she started working with CARE’s programs. Their extraordinary commitment keeps the system running with few resources, frequent supply shortages, and the highest rate of maternal mortality in the world. In 3 years, CARE worked with the health centers to increase services by 7 times, and help centers and communities to build early warning systems for epidemics.

Epidemic Control and Reinforcement of Health Services runs from 2015-2018 with $6 million in support from the German Cooperation through a bi-lateral agreement with the government of Sierra Leone. It reached 88,000 people directly and 150,000 people indirectly.

What did we accomplish?

  • More people could get services: There was a 66% increase in the number of health units offering basic services to their patients. Health centers were seven times more likely to offer HIV support services—up to 86% of centers. They are more than 4 times more likely to have the supplies they need to offer antenatal care for patients.
  • People have safer water: The number of people who have safe drinking water went up more than 3 times, up to 63%.
  • It’s easier to wash your hands: The number of facilities where you could wash your hands in communities more than tripled.
  • Communities are more likely to spot risks: There was a 49% increase in the number of health facilities that work with communities to have disease monitoring systems so they would have early notification of potential problems (up to 91% of centers).

How did we get there?

  • Communities are more connected to centers: 91% of communities say that their community health workers are doing an effective job, and 100% of centers feel that they are connected to their communities.
  • Health staff have more skills: The project trained 92% of the health workers in the districts where they worked on Ebola prevention and control.
  • Think beyond disease: The quarantine that went with Ebola devastated local markets, and in addition to the burden of disease, people had no way to get food—so they ate all of their seed stocks for the next season. CARE got communities seed vouchers so they can prepare for having food next year.

Want to learn more?

Check out the mid-term evaluation. They’re working on a final evaluation now, and the project got renewed for a phase two, so stay tuned for more information.