Sierra Leone has one of the highest maternal mortality ratios (MMR) in the world, estimated at about 1360 per 100,000 livebirths in 2015. Poor access to maternal health services and the
low rate of skilled birth attendance make Sierra Leone one of the most unsafe places for women to deliver. One of the key strategies for averting maternal mortality is ensuring that
quality skilled birth attendance is available, accessible and used throughout the country.

A strong health care system balances clinical, prevention and intervention strategies, provides health education for its citizens and maintains an active health care workforce capable of
providing competent services for quality health. It provides sufficient resources and enabling environments for optimal health and protects public health. Consequently, investing in
strengthening the nursing and midwifery structure of a country is a must for a robust health care system.

The Sierra Leone Rapid Emergency Obstetric and Newborn Care (EmONC) Assessment conducted in 2017 revealed gaps in the quality of EmONC services provided in the country.
To address the gaps and improve the quality of EmONC services, government with support from the partners including UNFPA is planning to support selected health facilities to provide
efficient and quality health services to the people of Sierra Leone. Specifically, 2 tertiary hospitals and 4 regional hospitals have been designated Centers of Excellence. These include
PCMH and the hospitals at Jui, Kenema, PortLoko, Bo and Makeni. In addition, UNFPA is also planning to improve the quality of BEmONC services provided in selected Community
Health Centers starting with the Community Health Centre at Regent. This consultancy is aimed at providing technical assistance in the field of maternal health for quality improvement processes
as well as support specific midwifery interventions in the UNFPA country office and to the Ministry of Health and Sanitation and other midwifery stakeholders.