Abstract

Abstract
Background: Annually, Sierra Leone records approximately 23,000 preterm births affecting around 10% of
deliveries and resulting in around 2800 child mortalities. Care bundles have been shown to improve the survival
of preterm babies, but their implementation in Sierra Leone has not been well studied.
Objective: To evaluate the current practices of care bundle management for preterm babies provided in two
rural referral hospitals in Kailahun District, Sierra Leone
Methods: We conducted a mixed-methods study, including a cohort observational study of 103 mothers who
gave birth to preterm babies between June and November 2023, and focus group discussions with healthcare
workers.
Result
This study evaluated 103 pregnancies to assess the PremPrep-5 care bundle implementation. Antibiotics were
the most commonly used intervention at 77.7%, while early breast milk initiation and Kangaroo Mother Care
were less frequent at 19.4% and 16.5%, respectively. Key interventions like delayed cord clamping, magnesium
sulfate, and antenatal corticosteroids were used in fewer than 10% of cases. Limited knowledge among
healthcare workers likely contributed to this underutilization, suggesting a need for improved training to
reduce complications related to preterm births.
Conclusion
Our findings suggest that there is a need to improve care bundle implementation in Sierra Leone. This could be
achieved through training healthcare workers, improving access to resources, and addressing ethical
considerations.