NIHR Global Health research projects improving health in Sierra Leone

NIHR funded health research projects are working in the West African state of Sierra Leone to improve health services in response to major challenges in recent years. These equitable partnerships between Sierra Leone and the UK seek to share medical understanding and knowledge between the teams in both countries. 

It’s really encouraging to see how these great partnerships between leading hospitals and universities in the UK and Sierra Leone, working closely with the Department of Health and Sanitation, are delivering not just excellent research but also, more importantly, innovation.

Funded by the NIHR through official development assistance, this vital work is contributing to efforts to tackle urgent challenges such as COVID-19, as well as chronic diseases and injury. As part of our global development strategy, with research and innovation at the forefront, we want to help build and sustain resilient health systems in Sierra Leone and around the world, to the benefit of all.

Lisa Chesney, British High Commissioner to Sierra Leone

King's Global Health Partnerships

The Kings Health Partnership capitalises on the long standing collaboration between King’s College London and Sierra Leone’s Ministry of Health and Sanitation established before the Ebola epidemic of 2014/15. The King’s team is embedded at Connaught Hospital, the main tertiary referral hospital in Freetown. Here they work with partners to help strengthen the health system, through applied research and clinical capacity-building. King’s and their partners manage two NIHR-funded research projects in Sierra Leone:

Stroke in Sierra Leone (SISLE)

Stroke is the second leading cause of adult death in sub-Saharan Africa. It affects not only older people but also working parents, and can have devastating effects on families. The SISLE project improves outcomes for stroke patients by establishing a stroke register at Connaught Hospital, the principal teaching hospital in Sierra Leone, and is strengthening clinical capacity to manage and care for stroke patients.

The Stroke in Sierra Leone (SISLE) project has significantly facilitated and highlighted the importance of evidence-based practice especially in a low resource setting like Sierra Leone. Through timely investigation and accurate diagnosis, the management and care of stroke patients at Connaught Hospital has significantly influenced patient’s outcome. This has been a life changing experience for both physicians and stroke survivors. Dr. M. Baldeh, Clinical Research Fellow, SISLE.

Health System Strengthening in Sub-Saharan Africa (ASSET)

In the wake of Ebola and Covid-19, the King’s team worked with partners to gather epidemiology data from health facilities across the country. The research has revealed that, whilst the use of many vital health services has decreased during the pandemic, the situation was far less severe than during Ebola. 

There is particular room for optimism in that mothers and children under 5 have benefited from the recent Free Healthcare Act. Despite the challenges presented by Covid-19, the access to healthcare for these members of the community has improved. 

Reductions in healthcare utilisation due to Covid-19 have been reported in some countries, but little is known about the effects on healthcare utilisation in SSA, including Sierra Leone. Due to the long-term collaboration between King’s and the Ministry of Health & Sanitation in Sierra Leone, and support over two outbreaks (Ebola and Covid-19) this important research process was developed. The research was conducted by a team from 34 Military Hospital, King’s College London, College of Medicine and Allied Health Sciences, Norwegian University of Science and Technology, Trondheim, CapaCare and University of Birmingham.

Global Health Surgical Technologies Research Group

The Surgical Technologies Group is working with partners in Sierra Leone to improve outcomes following lower limb trauma such as broken bones. Broken legs are a common problem in Sierra Leone due to high rates of road traffic accidents and accidents at work. 

 Amputee rehabilitation services were found to be low priority. Other barriers, such as poor transportation access, high service fees, rural living and gender, were found to prevent access to such services. 

The research group has successfully adapted Ilizarov frame technology to treat fractures of the lower limb, reducing the time patients spend in hospital and limiting long-term disability, and virtual reality VR training for surgeons to improve functional outcomes following leg amputation. These technologies to improve outcomes will have economic benefits, social and well being benefits for these communities. 

Research Unit on Health in Situations of Fragility

The NIHR Global Health Research Unit on Health in Situations of Fragility works on the treatment and prevention of chronic conditions such as diabetes, heart disease and hypertension. The team has been working with communities to improve dietary habits by setting up group sessions to educate about the benefits of a good diet and reducing salt intake to prevent such illnesses. Find out more about the project.