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CHAMPS Sierra Leone introduces Child Death Audits into hospital health service delivery to prevent deaths of children under five /

According to reports of the World Health Organisation (WHO) in 2024, the current infant mortality rate in Sierra Leone in 2024 is approximately 68.4 deaths per 1000 live births, which represents a decline from 2023. In 2023, the infant mortality rate was 70.1 deaths per 1000 live births. Top causes of child deaths are malaria, lower respiratory infections, neonatal conditions. The under-five mortality rate is estimated to be 114 deaths per 1000 live births, meaning that approximately 1 in 9 children do not survive beyond their fifth birthday.

As part of efforts to support Sierra Leone’s Ministry of Health (MoH) address the above challenges, the Child Health and Mortality Prevention Surveillance (CHAMPS) programme recently supported the establishment of weekly Child Death Audits at the Regional Hospital (MRH) in Makeni through the Directorate of Reproductive, Maternal, Child and Adolescent Health at the Ministry of Health. As a result, the MRH Child Death Audits successfully reviewed  over 90 child death cases and comprehensively documented recommendations and action plans to help minimise child deaths.

The recommendations and action plans include training and monitoring of healthcare professionals on vitals monitoring, swift referral of critically ill children, accurate health records keeping, provision of additional resuscitation devices such as suction and nebulizers, oxygen delivery equipment such as nasal prongs, face masks, non-rebreather masks, Y-connectors, and CPAP.

As a result of the findings, the programme is advocating for  sustainable inclusion of child death audits into the hospital health service delivery to prevent deaths of children under 5. It also recommended to stakeholders including the District Medical Officer, Paramount Chiefs, Mayor of Makeni city, Chairman of Bombali District Council, and public health leaders to establish a joint improvement team responsible for the implementation of action plans and recommendations from previous and subsequent audits such as regular provision of oxygen canisters, sensitising communities to regularly visit healthcare facilities and discourage use of traditional herbs/self medication at home when sick.


Implemented in Sierra Leone by Crown Agents, FOCUS1000, and World Hope International since 2017, CHAMPS is a global network that transforms data into action, working at the local, national and global levels to ensure sustainable changes in policies, and health interventions to accelerate improvements in child and maternal health.