By Christian.conteh@awokonewspaper.sl
Freetown, Sierra Leone- The world has made remarkable progress in saving young lives, with global under-five mortality falling by more than 50% since 2000, according to the latest estimates from the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). The global stillbirth rate has also dropped by over one-third during the same period.
But while these figures reflect real gains, the report warns that progress is slowing and in countries like Sierra Leone, it may even reverse, as funding cuts to maternal and child health programmes take a growing toll. Between 2015 and 2023, the era of the Sustainable Development Goals (SDGs) the annual rate of decline in under-five mortality globally slowed by 42% compared to the earlier Millennium Development Goal period. Similarly, the pace of stillbirth reduction has dropped by 53%.
In Sierra Leone, which still carries one of the highest under-five mortality rates globally, any slowdown in progress is deeply concerning. Health experts warn that ongoing cuts in global health financing could severely affect local programmes that provide life-saving services to mothers and children. Already, many health facilities in rural Sierra Leone face shortages of essential drugs, vaccines, and trained health worker’s problems likely to worsen as funding shrinks.
Sierra Leone has made some progress in child survival since the end of the civil war, but the country still records some of the highest maternal and child mortality rates in sub-Saharan Africa.
According to the last Demographic and Health Survey, over 100 children under five die for every 1,000 live births in Sierra Leone. Neonatal and infant mortality also remain high, with limited access to antenatal and postnatal care. Healthcare spending per capita is still among the lowest in the region, despite heavy dependence on donor funding. Health officials now fear that cuts to international support could reverse modest gains, especially in hard-to-reach and underserved districts.
The UN also warns that budget cuts are affecting countries’ ability to monitor child health trends, including in Sierra Leone. With reduced funding for household surveys and routine data systems, critical insights needed to improve health services are being lost.
“Without timely and accurate data, we’re flying blind,” said Aminata Kamara, a public health worker based in the capital Freetown.
Despite the challenges, there are success stories. Countries like Malawi, Cambodia, Rwanda, and Uzbekistan, all low- or lower-middle-income nations have managed to cut under-five deaths by over 75% since 2000. Their success lies in delivering high-impact interventions to the most vulnerable: skilled birth attendance, immunizations, nutrition, and timely treatment of childhood diseases.
Sierra Leone has the potential to replicate these results but it will require consistent investment, both from international partners and national leadership. Health advocates are urging renewed global and national commitments to maternal and child health. The evidence is clear: with the right support, even the most resource-constrained countries can achieve dramatic improvements.
“In Sierra Leone, every Leone spent on child survival saves lives,” said a Ministry of Health official. “This is not the time to cut back, it’s the time to double down.” CC/7/4/2025
