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Innovations to reduce maternal mortality and build research capacity in Sierra Leone

In this blog Cristina Fernandez Turienzo, senior research fellow at King’s College London, shares the progress of research which aims to reduce maternal mortality and build capacity in Sierra Leone, on behalf of the Capacity Research Innovation Building Maternity Systems (CRIBS) group.

Dr Cristina Fernandez Turienzo

Senior research fellow, King’s College London. Writing on behalf of the CRIBS (Capacity Research Innovation Building Maternity Systems) group.

CRIBS is a multidisciplinary global health research group funded by the NIHR that builds on research partnerships spanning the last decade, and that has formalised collaborations between King’s College London and the University of Sierra Leone, with strong support from:

• Ministry of Health and Sanitation, Sierra Leone
• iNGO Welbodi Partnership
• National Emergency Medical Services (NEMS) — the national ambulance service
• Community-based solutions NGO Lifeline Nehemiah Projects
• Midwifery schools across Sierra Leone

The overall aim of this research group is to develop and implement simple, scalable innovations to reduce maternal mortality and exchange and build research capacity and expertise in Sierra Leone. Core workstreams include: CRADLE 5, SIPHRE, APRICOT, PINEAPPLE and 2YoungLives, with cross-cutting workstreams on community engagement and involvement and research capacity strengthening.

CRADLE 5

CRADLE-5 is a hybrid cluster stepped wedge trial evaluating the implementation and effectiveness of the real-world national scale up of the CRADLE Vital Signs Alert device and obstetric emergency training across rural Sierra Leone. This trial follows a pilot implementation rollout which targeted half of the country.

It is anticipated that more than 230,000 women will benefit from CRADLE over the course of the year, once national scale up is achieved.

SIPHRE, APRICOT and PINEAPPLE

SIPHRE, APRICOT and PINEAPPLE are three ongoing observational studies taking place at one of the main hospitals in Freetown, the capital of Sierra Leone.

2YoungLives (2YL)

2YoungLives (2YL) is a locally developed community-based mentoring scheme for adolescent pregnant girls for up to one year after birth. It has been piloted in a few areas since 2017, and is now being assessed through a pilot cluster trial to formally evaluate the feasibility and implementation of the mentoring scheme in other communities. Since July 2022, more than 250 girls have been recruited from the twelve trial clusters (rural and urban) in five districts.

Participants in the 2YoungLives programme, Sierra Leone.

There has been lots of learning from the programme, including on community engagement and involvement, the under-reporting of age at health facilities and relocation, expectations from parents, and the positive effect of 2YL on mentors and coordinators.

The programme has attracted national and international attention, being featured in:

• 2022 UNFPA State of the World Population Report
• BBC World Service ‘People Fixing the World’
• Evening Standard — Let Girls Learn section
• Lancet Child & Adolescent Health

Gi4SaveLife

Linked to 2YoungLives, Gi4SaveLife is a community-hospital partnership project funded by the ESRC, which aims to maximise expertise in community-led voluntary blood donation, and the hospital’s well-functioning and adequately equipped blood bank. Since July 2022, the team have conducted six sessions in each of three communities.

Recently, Lifeline Nehemiah Projects (LNP) received the Sierra Leone NGO Award 2022 for Outstanding Performance in the NGO Sector. They have extensive experience in community engagement, and their work guides decisions within ongoing and evolving workstreams with all community stakeholders, to ensure the different programmes are built and owned by those who will ultimately benefit from them.

Building research capacity

Exchanging and building research capacity and expertise at individual, institutional and national level is crucial for CRIBS. The group is currently supporting:

Activities include:

• A co-developed 3-day practical course ‘Designing clinical research’ with an opportunity to develop local ideas into a research proposal
• A journal club for local early career researchers
• Basic IT skills learning
• Hands-on sessions to share experiences from conducting qualitative research and photovoice in Sierra Leone

Capacity building activities with researchers in Sierra Leone.

Maternal health policy lab

A ground-breaking maternal health policy lab has been co-organised in Sierra Leone, bringing together clinicians, researchers, key stakeholders from government and communities to collaborate in providing improved care and clinical outcomes for pregnant women with pre-eclampsia and their babies. The meeting brought together nearly 40 participants including:

• Government members and programme managers
• NGO project leaders and academics
• Healthcare workers including community health workers, nurses, midwives, clinical officers and senior obstetricians and paediatricians
• Community representatives from different religious groups and vulnerable populations

Group discussions and feedback sessions centred around tailored interventions to sustainably improve care for pre-eclampsia, integrate novel evidence into policy (including integrated public health education campaigns and a dedicated ‘Centre for Pre-eclampsia Care’), and commitment strategies for implementing this approach.

Find out more

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  CRIBS Global Health Research Group website
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  Read about the CRIBS Sierra Leone policy lab for pre-eclampsia
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  2YoungLives project website
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  CRIBS project page — ARC South London
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  Community-based mentoring in Sierra Leone doubles survival rate — ARC South London news (June 2025)
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  CRIBS and PAPAGAIO teams highly commended in NIHR Impact Prizes 2025

Original source: arc-sl.nihr.ac.uk — NIHR ARC South London legacy content archived May 2026.