Sierra Leone – March 2025 – In a concerted effort to eliminate mother-to-child transmission of HIV, syphilis, and hepatitis B (Triple Elimination), Sierra Leone strengthened its healthcare workforce through targeted training of frontline health workers in Makeni and Bo. Held from March 10th to 14th, 2025, the training equipped healthcare providers with the knowledge and skills needed to deliver integrated EMTCT (Elimination of Mother-to-Child Transmission) services within maternal and child health (MCH) platforms.

A total of 80 participants—including Maternal and Child Health Aides, Senior Enrolled Community Health Nurses, Midwives, Community Health Officers, and HIV Counselors—took part in the training across the two locations, with 40 participants in each. Funded by the Global Fund, the training addressed critical gaps identified in a recent rapid EMTCT cascade analysis conducted in June 2024 which revealed key service delivery challenges: only 77 out of every 100 newly diagnosed women living with HIV were initiated on ART during their first antenatal care (ANC) visit; only 36 out of every 100 HIV-positive women delivered in health facilities; and up to 30 out of 100 infants tested positive at 18 months. Additionally, stock-outs of HIV and syphilis testing kits, data integrity challenges, and weak laboratory systems further compounded these issues, weakening the overall performance of the Triple Elimination program.

Participants were equipped with practical skills to provide integrated services for EMTCT of HIV, syphilis, and hepatitis B. This included screening and treatment of pregnant women and timely testing and treatment for exposed infants. Additionally, participants learned about hepatitis B vaccination and how to ensure effective linkage to care. This training enhanced healthcare workers' ability to offer comprehensive and essential EMTCT services.

The World Health Organization (WHO) provided technical support, ensuring the training aligned with global best practices. WHO’s contributions included reviewing training materials, facilitating sessions, and offering expert guidance on effective EMTCT strategies, clinical case management, and service integration.

This initiative reinforces Sierra Leone’s commitment to global EMTCT targets and maternal-child health improvement goals. Immediate outcomes from the training include an enhanced capacity of frontline healthcare workers to deliver integrated triple elimination services, stronger coordination between MCH and disease-specific programs to optimize service delivery, and improved preparedness in healthcare facilities to provide timely testing, treatment, and prevention interventions.

Reflecting on the impact of the training, Sr. Roberta Macauley, the District Health Sister (DHS1) in Falaba District, shared: "This training has enhanced my knowledge and skills, providing up-to-date information on prevention, transmission, and care. Though I don’t work directly with patients, I now have a stronger foundation in counseling, understanding the necessary steps before treatment, and strengthening prevention strategies. When I'm in the field for supervision, I will definitely know what to look for."

Similarly, Annie Morlai, SECHN at Kombayandeh Community Health Centre in Kono District, emphasized the importance of sustained support: "If we, as health workers, do the right thing at our facilities for all HIV-positive women, we can build a future with an HIV-negative population and a healthier nation. To achieve this, we need regular support from our national and district teams to monitor our progress and ensure the consistent availability of essential medicines and test kits."

To maintain the gains achieved from this training, ongoing mentorship and supportive supervision for trained healthcare workers will be essential. Strengthening supply chain management to ensure the continuous availability of HIV test kits, ART, and other essential commodities remains a priority. Additionally, robust monitoring and evaluation mechanisms will be critical for tracking progress, identifying gaps, and informing future policy and programmatic decisions.

Investing in healthcare workforce development remains a key priority for WHO, the Ministry of Health, and partners. Strengthening human resource capacity will be crucial to sustaining progress toward EMTCT and improving long-term health outcomes for women and children in Sierra Leone.