“Women used to die … either because of lack of experience on the part of the nurses or poor facilities.” “A very important improvement in our community is that [now] most women comfortably give birth without undergoing operations because of the regular checkups they do in the health facility at the time of pregnancy, and delivery is done without requesting money…”
That’s the difference before the Epidemic Control and Reinforcement of Health Services project. Women used to die in childbirth, and now they don’t. It doesn’t get more important than that.
The Epidemic Control and Reinforcement of Health Services (ECRHS) Program operated in Sierra Leone from 2015 to 2018 with $11.6 million in support from Germany’s Kreditanstalt für Wiederaufbau (KfW).
What did we accomplish?
- Health centers are stronger: 68% more health centers are offering basic services, and they are 5.9 times more likely to offer HIV counselling and testing.
- Systems are stronger: the national supply chains for critical drugs got stronger, so health centers are 5 times more likely to have medications for women coming in for pre-natal visits. They are also 58% more likely to have the supplies and equipment they need.
- Families have cleaner water: people are 3 times more likely to have access to safe drinking water.
- People have more food: there was a 94% decrease in the number of families who were hungry.
- Women have more power: women are twice as likely to make their own decisions about using contraceptives.
- People have more faith in health care: 93% of people say that the quality of services have improved. They are also 3 times more likely to give birth in a health center than before.
- Families bounce back faster: Families are 17% less likely to be coping in ways that hurt them in the long term, and they are moving forward after crisis. As one woman says, “most of us have used the returns from our investments to pay school/college fees for our children and pay medical bills, etc. We also reinvest it in the same farm work to generate more revenue and food for our household…”
How did we get there?
- Get communities involved: ECHRS worked with community members to track disease outbreaks (especially Ebola) and report them so the health system could respond.
- Focus on supply chains: Community volunteers conducted supply audits at health centers to track which centers were having trouble keeping enough medicine available to treat patients, and develop a plan to fix it.
- Make data visible: The project helped health centers track patient and supply data so they could track supply and demand patterns and order medicines. It also made it easier for health inspectors and communities to hold centers accountable.
- Help fill gaps in emergencies: ECHRS provided seeds to 10,039 people so they could replant and rebuild after the Ebola crisis. One participant called it, “indeed a real life-changing idea.”
- Work with national and local governments: the project worked to convince the government to increase it’s health budget and get local governments more invested in the quality of health centers.
Want to learn more?
Read the final evaluation.
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