by Rosanna Niosi
As a region that has historically lacked comprehensive health services, Sierra Leone has entered a new era. The completion of a new maternal and newborn health facility, the Maternal Center of Excellence (MCOE), at Koidu Government Hospital represents more than just an achievement in architecture, engineering, and construction efforts within a resource-constrained context. Rather, it is a remarkable shift into high-quality care.
Sierra Leone experiences some of the highest maternal mortality in the world, with country officials reporting 184 deaths per 100,000 live births in 2024. Thankfully, comprehensive investments in health programs, as well as a steadfast commitment from the government to invest in its healthcare workforce, have steadily reduced the number of maternal deaths over recent years. However, health programming and training efforts are not enough. Without reliable infrastructure, such as safe, accessible healthcare facilities to give birth, reversing maternal deaths has been challenging.
Equipped with 120 beds, the MCOE has been classified by those who built it as a “beacon of hope” for mothers and their families. Designed and constructed by Beverly-based Build Health International (BHI) in partnership with Partners In Health and the Sierra Leonean Ministry of Health, the MCOE includes a birthing center, neonatal intensive care unit (the first in the country), maternal waiting areas for expectant mothers, and designated administrative spaces for healthcare personnel. Most impressively, the facility was constructed by a majority-women workforce, many of whom will utilize the facility for their own healthcare needs in the future.
Mariama Nguajah, Diana “Success” Kumba, and Isatu Jalloh all hail from the community of Kono and were hired and trained on site of the MCOE construction.
Because Sierra Leone lacks construction resources, the MCOE took many years of planning, collaboration, and above all, innovation. BHI and its team of architects, engineers, project managers, and global health experts integrated multiple stakeholder inputs to develop a dignified space, prioritizing details to promote trust and comfort. For example, family members who often accompany expectant mothers can use the spacious courtyard to relax and wait. Most of the facility signage features icons to overcome literacy barriers. A peaceful garden provides serenity to patients and healthcare personnel alike.
Rosanna Niosi
The design is also environmentally responsive and sustainable, with sensible strategies that address climate effects. For example, extensive air conditioning systems would quickly overwhelm the region’s electrical grid and induce power outages. Instead, BHI architects developed passive cooling systems through the strategic placement of fans to promote airflow. Additionally, long covered passageways offset the effects of the country’s extensive rainy season, allowing patients and clinical staff alike to quickly access different areas of the facility.
The concerted efforts to create a welcoming environment have paid off. Since opening on Feb. 14, the MCOE has already received over 3,300 patients. As BHI completes final touches on the outpatient facility, which is due to open in June, the MCOE’s beacon of hope shines for Sierra Leone and beyond.
Rosanna Niosi is communications and marketing manager at Build Health International.
