Midwives distribution, urban status and provision of midwifery services to the rural dwellers in Sierra Leone

Margaret Titty Mannah-Macarthy, United Nations Population Fund (UNFPA)
Austin Olufemi Adeyemo, University of Liverpool
Mohammed A. M. Elhassein, United Nations Population Fund (UNFPA)
Hossinatu Mary Kanu, Ministry of Health and Sanitation, Sierra Leone

Introduction: Year after year, Sierra Leone’s Maternal Mortality Rate ranks highest globally, with 1,165 deaths per 100,000 live births. Improvement involves provision of care, enabled by skilled midwives, nationally. Objective: This study examines the distribution of midwives in Sierra Leone and its effects on provision of midwifery service in rural settings of Sierra Leone Methods: Conducted May-June 2014 nationally, the mixed methods study used survey design (questionnaire) and as well as purposive administration to all 298 midwives surveyed. Results: In Freetown City, there is 1 midwife for every 9,200 populations (in nearest hundred), with 1 midwife for every 53,000 pregnant women in rural areas. Midwives in Freetown were primarily married (72.3%) and younger (30-40s at 60.9%) than their older, divorced rural-based counterparts. Conclusions: Midwives with less marital responsibility are more likely to stay in rural settings. Young and unmarried midwives posted to rural settings should be provided with an enabling environment to support retention.