Sierra Leone Cuts Maternal Deaths Two-Thirds

Why this is here: In 2023, non-physician clinicians trained by CapaCare performed 41% of all surgical procedures nationwide in Sierra Leone, becoming the primary surgical providers in rural areas.

Håkon Bolkan and CapaCare trained 113 community health officers in Sierra Leone to perform life-saving surgeries. The non-profit organization’s program began in 2008 and now accounts for nearly 60% of all cesarean sections performed in the country. This training has contributed to a near threefold reduction in Sierra Leone’s maternal mortality ratio—one of the most significant declines in Africa over the last decade.

Emergency obstetric care is now available nationwide, largely due to these trained officers filling a critical gap in surgical access. The program expanded to Liberia in 2021, though that country prioritized specialist training over task-sharing.

Roughly half of the earliest-trained health officers still lack full legal recognition, creating obstacles to career advancement. Despite this, the initiative’s success is prompting a broader focus on balanced surgical training within Sierra Leone, supporting both community health officers and specialist surgeons. The work continues to improve surgical access for a population that once had only one surgeon per 700,000 people.