What women and newborns need (2012)

382,000 PREGNANCIES A YEAR = HOW MANY EPISODES OF CARE ?
Sierra Leone - Number and distribution of pregnancies (2012)
Number and distribution of pregnancies (2012)
0
<0.09
0.10-0.19
0.20-0.49
0.50-0.99
1.00-1.49
1.50-1.99
2.00-2.49
2.50-10.00
>10.00
APPROX
PRE-PREGNANCY
(all women of reproductive age)
=
2,329,000
family planning visits
ANTENATAL
(pregnancies x 4)
=
1,527,000
routine visits
BIRTH
=
229,000
skilled birth attendance
POST-PARTUM
(births x 4)
=
918,000
routine visits
POSTNATAL
(newborns x 4)

Workforce availability (2012)

Country classification of staworking in MNH
Time spent on MNH %
Midwives
286
90
Midwives, auxiliary
2,376
90
Nurse-midwives
na
na
Nurses
na
na
Nurses or nurse- midwives, auxiliary
1,018
-
Clinical ocers & medical assistants
65
50
Physicians, generalists
45
-
Obstetricians & gynaecologists
7
51
PRE-PREGNANCY
ANTENATAL
BIRTH
POST-PARTUM
POSTNATAL
ESTIMATED MET NEED=
24%
workforce time available
workforce time needed
Estimate of met need (national aggregate) based on available data

Geographic accessibility

Number of births with a skilled birth attendant (SBA) 2

Accessed a SBA
Did not access a SBA
No data on rural/urban SBA

MIDWIFERY EDUCATION 3

Minimum high-school requirement to start training
Grade 12 and above
Years of study required to qualify (rounded)
2
Standardized curriculum? Year of last update
Yes, 2010
Minimum number of supervised births in curriculum
20
Number of 2012 graduates/as % of all practising midwives
121/42
% of graduates employed in MNH within one year
99

MIDWIFERY REGULATION

Legislation exists recognizing midwifery as an autonomous profession
Yes
A recognized definition of a professional midwife exists
Yes
A government body regulates midwifery practice
Yes
A licence is required to practise midwifery
Yes
A live registry of licensed midwives exists
No
Number of EmONC basic signal functions that midwives are allowed to practise (out of a possible 7)
7
Midwives allowed to provide injectable contraceptives/intrauterine devices
Yes/Yes

PROFESSIONAL ASSOCIATIONS 4

Year of creation of professional associations
1969
Roles performed by professional associations:
Continuing professional development
Yes
Advising or representing members accused of misconduct
Yes
Advising members on quality standards for MNH care
Yes
Advising the Government onpolicy documents related to MNH
Yes
Negotiating work or salary issues with the Government
Yes
na = not applicable; - = missing data

PROJECTED NUMBER OF PREGNANCIES BY YEAR: URBAN VS. RURAL

ESTIMATES AND PROJECTIONS TO 2030

WHAT IF... Estimates of met need based on available data.

1
The number of pregnancies was reduced by 20% by 2030?
0.4 million
CURRENT
0.32 million
SCENARIO

Immediate increase in met need for pregnancy, birth, post-partum/postnatal care. Acceleration in met need for pre- pregnancy services from 2028 onwards.

2
The number of midwife, nurse and physician graduates doubled by 2020?
CURRENT
42 % MET NEED 2030
SCENARIO
62 % MET NEED 2030
3
Efficiency improved by 2% per year until 2030?
CURRENT
42 % MET NEED 2030
SCENARIO
52 % MET NEED 2030
4
Attrition was halved in the next 5 years (2012-2017)?
10 % leak
CURRENT
42 % MET NEED 2030
5 % leak
SCENARIO
49 % MET NEED 2030

CURRENT TRAJECTORY

42 % MET NEED 2030

WHAT IF... TRAJECTORY

100 % MET NEED 2030
1. These health worker categories include the following country titles - Midwives: includes midwives; Auxiliary midwives: includes maternal and child health aides (MCHAs), nursing aides; Auxiliary nurse-midwives: includes state enrolled community health nurses (SECHNs); Generalist physicians: includes medical officers; Obstetricians & gynaecologists: includes obstetricians & gynaecologists, physician specialists; Clinical officers & medical assistants: includes community health officers (CHOs). Source: SoWMy 2014 or secondary sources (WHO Global Health Observatory; government policy documents).
2. Year of data is as per most recent data available in STATCOMPILER.
3. Information refers to the midwife cadre category.
4. National associations for midwifery and nursing.

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