Sierra Leone has one of the highest maternal mortality ratios in the world, with 1,165 maternal deaths per 100,000 live births. The main cause of maternal mortality is postpartum haemorrhage, which accounted for 33% of all deaths and unsafe abortion among adolescents (10%). The Government of Sierra Leone has outlined strategic priorities for development in its new direction. Specifically, the strategic objective of the health sector is to transform the under-resourced, ill-equipped, dysfunctional and inadequate health infrastructure and healthcare delivery system to make it high quality, efficient, reliable, cost-effective, affordable and sustainable. This will increase access for all the population (particularly mothers, children and the elderly).

The National Nursing and Midwifery Strategic Plan 2019–2023 for Sierra Leone was developed in line with this new direction. The process of development was based on a systematic approach to determine the strengths and challenges of the nursing and midwifery systems. It was also to outline service provision strategies within the wider remit of the relevant policies of the MoHS and global provisions. Preceptorship systems development was identified as a key focal area for competency building for quality improvement in midwifery education.

UNFPA is currently implementing the DFID supported Saving Lives Programme which is aimed among others to improve the lives of children, adolescents, and women and reduce preventable maternal and newborn morbidity and mortality. A key component of this is the deployment of skilled providers especially midwives for the implementation of a quality of care package for women, mothers and their newborn.