Making Maternal Health Matter in Ending FGM in Sierra Leone
I was asked by FORWARD to attend the parliamentary screening and discussion of A Matter of Life or Death: Giving Birth in Sierra Leone on 2 July 2026. Hosted by MP Bobby Dean and chaired by journalist Eliza Anyangwe of The Fuller Project, the event brought together policymakers, healthcare professionals, journalists, and advocates to examine the impact of UK aid cuts on maternal and child health in Sierra Leone.
As FORWARD’s Community Outreach and Advocacy Coordinator—and as a Sierra Leonean woman—the event resonated with me on both a professional and deeply personal level. Watching the documentary was emotional because it reflected the realities that many women, girls, families, and healthcare workers continue to face every day in Sierra Leone.
The film powerfully illustrated how reductions in international aid have placed even greater pressure on an already overstretched healthcare system. Sierra Leone’s Chief Medical Officer, Dr Mustapha S. Kabba, acknowledged the significant challenges facing the country while also highlighting examples of progress and innovative approaches to improving maternal healthcare. His reflections demonstrated both the scale of the challenge and the determination of healthcare professionals who continue to deliver life-saving care despite shortages of staff, equipment, medicines, and funding.
Behind every statistic is a woman risking her life to give birth. Behind every maternal death is a family forever changed. Behind every new born is the hope of a healthier future that depends on access to safe, quality healthcare and safe delivery.
While the documentary focused on the impact of aid cuts, it also reinforced something that cannot be ignored: improving maternal health must include addressing harmful practices such as female genital mutilation (FGM). Although FGM was not a central focus of the film, the filmmakers acknowledged during the discussion that they were aware of its prevalence and the serious complications it causes for women and girls in Sierra Leone.
FGM remains a grave violation of human rights and a significant public health issue in Sierra Leone. Prevalence rates by UNFPA show that 83% of women aged 15–49 in Sierra Leone have undergone FGM. Girls who undergo FGM face increased risks during pregnancy and childbirth, including prolonged and obstructed labour, severe tearing, excessive bleeding, infection, obstetric fistula, and, in some cases, maternal and new born deaths. These preventable complications place additional strain on healthcare systems that are already operating with limited resources.
Maternal health does not begin in pregnancy—it begins in childhood. Protecting women during childbirth means protecting girls from harmful practices long before they become mothers.
As someone working with FORWARD to end FGM and violence against women and girls, I remain deeply concerned by reports suggesting that FGM is increasing in Sierra Leone. Equally concerning is the continued public recognition and celebration of women who perform FGM. Many of these women also serve as traditional birth attendants within their communities.
Traditional birth attendants have long played an important role in supporting women, particularly in rural areas where access to formal healthcare remains limited. Their contribution to maternal care should not be overlooked. However, when those entrusted with supporting women through pregnancy and childbirth are also carrying out FGM, it creates a profound contradiction. It sends conflicting messages about women’s health, bodily autonomy, and the fundamental right of every girl to grow up free from violence.
Continuing to endorse practitioners who perform FGM risks legitimising a practice that causes lifelong physical and psychological harm. At a time when Sierra Leone is striving to reduce maternal mortality and strengthen its healthcare system, efforts to improve maternal health must go hand in hand with meaningful action to end FGM.
The discussion following the documentary highlighted the importance of sustained investment in maternal and child health, stronger local leadership, and equitable international partnerships. While financial investment in healthcare is essential, lasting progress also requires investment in prevention, education, community engagement, and the protection of the rights of girls and women.
At FORWARD, we believe sustainable change comes from working alongside communities, supporting survivors, engaging traditional and religious leaders, empowering young people, and advocating for policies that protect women and girls from harmful practices. Ending FGM is not separate from improving maternal health—it is fundamental to it.
As a Sierra Leonean, I know the resilience, compassion, and strength of our communities. As an advocate, I also know that change is possible when governments, civil society organisations, healthcare professionals, community leaders, and international partners work together with a shared commitment to protecting the rights, dignity, and health of women and girls.
Attending this event reaffirmed my belief that every woman deserves to experience pregnancy and childbirth safely, and every girl deserves to grow up free from violence. We cannot reduce maternal mortality without confronting the inequalities and harmful practices that place women and girls at risk. The fight for safer motherhood and the fight to end FGM are inseparable—and both demands sustained commitment, investment, and action.
Alimatu Dimonekene MBE, Community Outreach and Advocacy Coordinator
Photo Credit: Chiara Ceolin
