gms | German Medical Science

Sierra Leone is one of the poorest countries in the world with a Human Development Index ranking 181 out of 195 countries. The devastating civil war from 1990 until 2002 and the Ebola epidemic in 2014 disrupted the basic healthcare functions and infrastructure in such a way that the population still has poor access to safe and affordable health care services, especially to specialized health care services such as pediatric and neonatal care. Sierra Leone has amongst the highest neonatal and under five mortality rates with 31 and 108 deaths per 1,000 live births, respectively. Lack of healthcare professionals is one of the main contributing factors. The most recent data from the WHO documents 566 physicians in the country, representing a physician density of 0.74 per 100,000 population. In October 2021, the Ministry of health and Sanitation (MOHS) of Sierra Leone together with German Doctors and Swiss Doctors agreed to start a specialized Pediatric Training Program (PTP) for clinical officers (COs) at the School of Clinical Sciences in Makeni (SCSM). Students can enter this program after obtaining their diploma in clinical medicine at the SCSM. German Doctors and the SCSM closely collaborate in this project with two other international NGOs: CapaCare and Partners in Health (PIH), respectively responsible for the specialties surgery/obstetrics and internal medicine. The 3-year bachelor pediatric specialization training program is a task sharing project with the aim to increase the number of clinically trained professionals in order to reduce child and neonatal mortality, comparable to other successful programs in Sub-Saharan Africa. The program consists of four clinical rotations of half a year in various partner hospitals, alternated by advanced theoretical modules of a month taught by national and international trainers. The last year of the 3-year program consists of a housemanship year. Twenty one students are currently enrolled in the program.

Lessons learned: The PTP is a recognized bachelor degree in Sierra Leone. Both the initiative for the program coming from the MOHS and the collaboration with the SCSM which is affiliated with the University of Sierra Leone were key for this. Despite the great interest of national stakeholders in the future COs, the involvement of national trainers is challenging. One reason for this could be the fact that there are few doctors and the country has long relied on foreign expertise. However, with the increasing number of students enrolled and involvement of partner hospitals, local physicians show more interest and the acknowledgement of the additional value of specialized pediatric COs to the healthcare system is increasing to. To support this process, it is important to gain further experience and promote the program. Further study on the program and its impact are planned.