In Sierra Leone, Africa, maternal mortality is among the highest in the world, with about one in 20 women dying as a result of pregnancy or childbirth, according to the latest United Nations estimate.

To help improve that dismal reality, faculty with Johns Hopkins’ departments of pediatrics and gynecology and obstetrics worked with the West African College of Physicians and the University of Sierra Leone Teaching Hospitals Complex to establish that nation’s first residency programs in pediatrics and obstetrics/gynecology in 2021, in collaboration with the Mama-Pikin Foundation, a Sierra Leone-based nongovernmental organization.

Now two Johns Hopkins faculty members are overseeing efforts to strengthen the curriculum in simulation-based education, “which is still in its infancy in West Africa,” says Nicole Shilkofski, pediatric residency program director at Johns Hopkins Children’s Center.

Using funding from a two-year health equity grant from Johns Hopkins’ Alliance for a Healthier World, she and Toni Ungaretti, director of the Master of Education in the Health Professions (MEHP) program at Johns Hopkins, are working to help equip a clinical skills center by purchasing teaching and simulation equipment. The program also will bring Johns Hopkins medical fellows and residents, as well as a student and instructional designer from the MEHP program, to Sierra Leone to teach. 

Shilkofski and Ungaretti are working on implementing the program, and in the second year will focus on data collection about the program’s impact on maternal and child health equity and public health outcomes locally. This includes developing an advisory board of women who have been cared for at local hospitals and whose children have been patients at the Ola During Children’s Hospital in Freetown, the capital. The advisory board will help to inform the prioritization of clinical education needs within the training programs. The first trip likely will be in early 2023.

Shilkofski, a champion of the “train-the-trainer” model of health care capacity building, says, “We’re excited about this opportunity and the grant funding because we really feel like we can help to start something from the ground up that I hope will have a huge impact on maternal and child health.”