Sierra Leone has just recently wrapped up its final Maternal and Child Health Week campaign for 2016, known locally as 'Mami en Pekin Welbodi Week', which targeted 95 percent children under five with lifesaving vaccines. Earlier campaign rounds achieved up to 97 percent coverage to protect children against polio, measles and other major childhood diseases. 
Such a result is remarkable when reflecting on the situation just a year ago. Even after the end of the major Ebola outbreak in 2015, many families remained scared to visit the health facilities, and suspicion of heath workers had escalated. Some areas continued to report high levels of resistance to vaccinations and other health programs.

Esther Ngegba is a Community Engagement Officer with the WHO in Port Loko, which was one of the districts hardest hit by Ebola. She recalls that families in the comunities she visited last year feared the routine vaccines actually contained the Ebola virus. “Community members actively fled when they saw health worker teams arriving into the villages.”

Taking health services back to the communities

Against this backdrop, the Ministry of Health and Sanitation and partners launched immense door-to-door campaigns which engaged health workers to visit communities up and down the country. Some walked miles to talk to remote communities about available health services, promote the clinics, and deliver lifesaving vaccines and medicines to all children under five years of age.

These efforts have paid off. Today, more than 1.5 million children have received vaccines against major diseases, anti-worming medicines and Vitamin A, helping to provide them with a healthier start in life, and pregnant women have also been targeted and encouraged to go the clinic for critical antenatal care.

Engaging communities to rebuild trust in the health system

Increasing coverage of the key vaccines has required sustained community engagement at every level to ensure communities and families understand the importance of immunization to protect their children’s health, and build support from key stakeholders including community and religious leaders, school teachers, women’s groups and others.

This is part of a much broader process which focuses on increasing engagement with the health system, driven from the ground up. It is not just one way. Trainings have also been conducted with frontline health workers in compassionate communications, so as to enable them to more effectively engage with communities and address their fears.

“For the first five months after Ebola we were doing continuous community engagement, setting up structures everywhere. The more we engaged them, the more we bridged the gap,” says Richard S. Gborie, Deputy Social Mobilisation Coordinator in Port Loko District. “Now we know how important it is to engage the people and ensure they have a serious role to play in addressing the health issues in the country.“

Promoting sustainable health-seeking practices

Vaccination campaigns are a beginning, adds Gborie. They are saving lives, and they are helping to reconnect people with their health services at an important juncture. 

The focus now he says, must be harnessing this momentum to build sustainable health-seeking practices, with men, women and children engaged with their healthcare system: going to the clinic as soon as they are sick; taking preventive actions to protect against diseases, and going for routine checkups and vaccines. 

This is a longer-term vision which will engage many partners, within communities and in the health sector, towards building a strong, participatory health system that delivers for all in Sierra Leone.

Maternal and Child Health Week and immunization programs have been led by the Ministry of Health and Sanitation with support from a range of partners including WHO, UNICEF, Helen Keller International and many community organizations.