In June 2026, Sierra Leone’s minister of health, Dr. Austin Demby, announced a 31% drop in maternal mortality following the first 100 days of the government’s 300 Days of Activism campaign. It marks the latest effort to improve health care for pregnant women and newborns in the country, which has consistently reported the highest rates of maternal mortality worldwide. In 2000, there were 1,682 deaths per 100,000 live births. United Nations Children’s Fund (UNICEF) has reported this figure declining significantly in the years since. Digitizing antenatal care in Sierra Leone is a significant factor in this national success story.

Maternal Mortality in Sierra Leone

Maternal mortality in Sierra Leone is primarily caused by hemorrhaging, hypertension, obstructed labor and sepsis, conditions that can be prevented if caught early enough. Around 79% of maternal deaths in 2017 occurred within a health care facility.

Efforts by the Sierra Leone government to address antenatal care have significantly reduced deaths during pregnancy or childbirth. In 2010, it provided free health care to pregnant women and children to improve access to medical attention. In March 2025, it increased the number of skilled medical professionals and improved the availability of medication and treatment.

Paper-based systems previously made it difficult to track high-risk pregnancies and allow health care professionals to intervene before situations became critical. The World Health Organization recommends pregnant women attend eight antenatal contacts. In 2019, two-thirds of expectant mothers attended only four.

Rural areas experience a disproportionate lack of access to medical resources compared to their urban counterparts. In 2017, researchers reported that 90% of pregnant women in rural areas did not receive health care due to costs or distance to facilities. This compared to 59% of women living in urban centers. This highlights the urgency of digitizing antenatal care in Sierra Leone.

Digitizing Antenatal Care in Sierra Leone

In 2024, UNICEF collaborated with Sierra Leone’s Ministry for Health and Ministry for Communication, Technology and Innovation to adopt the World Health Organization’s SMART Guidelines for antenatal care. This is part of the Digital Adoption Kit process, which aims to create a digital medical system to address national health priorities. Creating a uniform, digitized administration network allows medical personnel and patients to stay informed, communicate effectively and receive care when needed.

The government launched the Pregnancy Registration and Service Tracking Application, known as PReSTrack, in July 2024. This allows expectant mothers to log their pregnancy on a centralized system and provides up-to-date tracking and monitoring of conditions that may arise. The system can partially function offline, and GPS technology enables health care providers to reach the entire country, even remote areas. PReSTrack, also referred to as the Kombra App, represents a historic development in improving access to health care for pregnant women and newborns. Digitizing antenatal care in Sierra Leone has educated women and girls on warning signs, enabling medical professionals to respond quickly to emergencies. Above all, preventable deaths are being avoided.

The 2025 Code4Health Hackathon

The work did not stop there. In 2025, the Code4Health Hackathon launched as part of digitizing antenatal care in Sierra Leone. Funded by the German Digital Innovation Pandemic Control project and the Norwegian Agency for Development Cooperation, it tasked 22 young engineers with developing online applications to reduce maternal mortality. The project lasted nine months and culminated with the top teams receiving guidance to develop their applications and integrate fully with PReSTrack.

• Team Geneline-X created an all-in-one platform that connects patients, doctors and administrators to improve care coordination.
• Team MediLink developed the Healthy Mother App, which provides weekly health tips, emergency support and features that allow pregnant women to report symptoms and issues.
• Team Medikated focused on access to pharmacies, creating a system for online consultations and e-prescriptions.
• Team Peer Pay used Digital Health ID to build a centralized system that would enable seamless referrals, patient tracking and one-tap ambulance dispatch for emergencies.
• Team Next Wave Innovators constructed Mama Care, which also seeks to reduce maternal mortality through up-to-date monitoring, centralized records and emergency call support.

Key themes of these tools are centralized systems, better information for pregnant women, the ability to track symptoms and accessibility to health care in emergencies. These features will monitor vulnerable pregnancies and react to issues quickly, helping to reduce the number of deaths from preventable causes, such as hemorrhaging.

Looking Ahead

Digitizing antenatal care in Sierra Leone still has challenges to overcome. Accessing rural areas and addressing workforce shortages remain considerable obstacles. Recent cuts in global funding have also hindered improvement. Despite being renewed in 2023, the United Kingdom government has reduced the Saving Lives in Sierra Leone program from £35 million to £1 million. The United States historically provided 14% of the funding for Sierra Leone’s reproductive health, but this has been eliminated as part of the stop-work order that significantly reduced United States Agency for International Development (USAID) projects.

Despite this, the government aims to integrate recent developments in the Electronic Medical Record rollout planned for 2026. Further steps to digitize antenatal care in Sierra Leone will help work toward reducing preventable maternal and child deaths, part of a broader national push, including the Digital Adoption Kit’s planned expansion to other national health issues, such as immunization and combating Human Immunodeficiency Virus (HIV), while strengthening infrastructure to ensure these initiatives are long-term.

– Louise Nethercott

Louise is based in Derby, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr