On the 20th of April, the Directorate of Noncommunicable Diseases in the Ministry of Health and Sanitation of Sierra Leone co-led a workshop with the WHO Sierra Leone Country Office to validate a multi-stakeholder proposal to the United Nations Health4Life Fund.
The workshop culminated a first-of-its-kind 10-month engagement process to co-create an aligned plan of action between NCD and mental health stakeholders in the country to address the fundamental challenge of access to services for people living with NCDs and mental health conditions. The hybrid workshop was attended by 20 participants drawing from various UN agencies, members of the national NCDs Technical Working Group and other development partners and NGOs who work on NCDs and mental health.
The problems to overcome in Sierra Leone are significant. A 2017 Service Availability and Readiness Assessment survey found that only 11%, 20%, 15% and 3% of health facilities in the country provided services for diabetes, cardiovascular, chronic respiratory and cervical cancer, respectively. Where available, NCDs services were concentrated in tertiary facilities in urban areas, with almost no services available in primary care settings in the country’s rural areas. The situation is more dire for mental health, with an estimated treatment gap exceeding 95% for severe illness.
In his opening remarks, The Director of Noncommunicable Diseases, Dr. Sesay Santigie opened the workshop expressing gratitude to partners for support in moving forward the country’s NCD agenda, and specifically highlighted the successful passing of alcohol and tobacco control acts which Sierra Leone’s President had signed into law one week earlier.
He made an urgent appeal to the UN and to development partners in attendance to increase their support to enable the scale up of the implementation of the national NCDs and mental health action plans. Dr Sesay called attention to the limited resources allocated to NCDs in the country and the consequent constraints in access to health services. In addition, he highlighted the near total absence of data on NCDs and mental health to support resource allocation and planning and requested support to undertake a nationally representative STEPwise survey.
The proposal provides a coherent, coordinated roadmap for a multi-stakeholder approach towards scaling up access to services for NCDs and mental health in the country. It focuses activities along four components: i) increasing resource flows to NCDs and mental health from domestic, bilateral, and multilateral sources; ii) generating baseline data and strengthening data systems; iii) scaling up service delivery through implementation of PEN and PEN Plus; and iv) implementation research and learning. Delivery of these components will be supported by various partners who will work together to ensure complementarity, efficiency, avoiding duplication, and importantly, overcoming the limitations of “piloting”.
The implementation of the proposal will be carried out by the MOHS with technical support for various components provided by WHO, UNDP, UNICEF, Partners in Health, CHAI, CUAMM, Focus 1000, University of Sierra Leone and other international and local actors.
During the workshop, Medtronic Labs pledged support for the Sierra Leone proposal, offering a cash contribution and in-kind support for the implementation the data system strengthening component of the proposal.
The implementation of the proposal is expected to increase access to NCDs and mental healthcare services to a significant segment of Sierra Leone’s population, establishing the basis for a sustainable nationwide scale up.
To learn more about the workshop and Sierra Leone’s proposal, email Mamka Anyona at anyonar@who.int or Reynold Senesi at senesir@who.int.