Injustice has a cure
In Sierra Leone, women face a 1 in 74 lifetime risk of dying in childbirth. The Maternal Center of Excellence is changing that.
For more than a decade, Partners In Health and Sierra Leone's Ministry of Health have worked side by side to strengthen maternal care at Koidu Government Hospital in Kono District. This partnership took a bold step forward with the creation of the Paul E. Farmer Maternal Center of Excellence (MCOE). Built in partnership with Build Health International (BHI) and Sierra Leone’s Ministry of Health, this state-of-the-art facility is designed to dramatically expand maternal services and set a new standard for care.
Koidu Government Hospital serves as a vital referral center for high-risk pregnancies and obstetric emergencies. Through innovative design and advanced medical training, the MCOE is raising the standard of maternal health in Sierra Leone, ensuring that every mother and baby has access to safe, dignified, and high-quality care.
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The MCOE Timeline: Building a Legacy of Care
From vision to reality, the MCOE has been years in the making—built through partnership, innovation, and community leadership to transform maternal health in Sierra Leone. The MCOE includes a NICU, a piped medical gas system including oxygen, and healing spaces. From early planning in 2017 to the center’s opening in 2026, each milestone reflects a shared commitment to dignified, high-quality care for every mother and newborn.
Built in Partnership
Planning for the MCOE began in 2017 at Koidu Government Hospital—once short on power and supplies, now equipped with 24/7 electricity, stocked pharmacies, and skilled staff.
The Greens Join the Fight
A 2017 New Yorker story lit the spark. After visiting Kono, John and Sarah Green—along with Hank and Katherine—committed to advancing maternal health through advocacy.
A Facility Unlike Any Other
In partnership with Build Health International, every detail was designed for dignified, high-quality care. The MCOE includes a NICU, piped oxygen, and healing spaces.
Breaking New Ground
Construction began in April 2021 with a promise: to build a place where mothers and newborns receive the care they need—and the future they deserve—built by local hands.
Doors Open to Patients
In 2026, the MCOE began providing inpatient care—expanding services to save lives and strengthen Sierra Leone’s maternal health system for generations to come.
Shaping the Future
This isn’t just a new facility—it marks a new era for Kono District, where data, evidence, and community care drive lasting progress in maternal health year after year.
The Greens: Fueling a Movement for Mothers
With the support of PIH trustee and bestselling author John Green, his brother Hank, and their global community, PIH continues to expand lifesaving work in Sierra Leone. After visiting Koidu Government Hospital in 2018, John and his wife, Sarah, were inspired by the vision for the Maternal Center of Excellence and pledged to raise $25 million to help make it a reality.
Together, John and Hank launched a grassroots campaign to rally millions around health equity, using storytelling and creativity to spotlight preventable maternal deaths. Through their advocacy and ventures like the Good Store, they’ve turned compassion into lasting impact—showing that long-term challenges demand long-term solutions. Joining as a monthly donor helps carry that same vision forward, month after month.
Five Essential Elements of Care
Built on PIH’s “five S’s” (staff, stuff, space, systems, and social support) the MCOE reflects decades of investment in maternal care and the belief that lasting health systems require every element working together for all.
Staff: The People Who Make It All Possible
At the MCOE in Sierra Leone, PIH is investing not only in a new hospital, but in the health workers who sustain it—training midwives, expanding clinical teams, and preparing the next generation of maternal care leaders today.
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Stuff: The Tools That Make Treatment Possible
At Sierra Leone’s MCOE, lifesaving equipment—from NICU incubators to piped oxygen—is transforming maternal care. But clinicians say the technology only matters because trained health workers now have the tools to save lives.
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Space: Where Healing Happens
Built to replace an overcrowded maternity ward designed for scarcity, Sierra Leone’s MCOE now provides 120 beds, operating theaters, isolation rooms, and healing spaces rooted in dignity. Many women from Kono helped build it themselves.
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Systems: The Invisible Infrastructure That Saves Lives
At Sierra Leone’s MCOE, lifesaving care depends on systems working together—from ambulances and referral networks to triage, electronic records, and reliable power. When systems fail, clinicians say, lives are at risk.
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Social Support: Closing the Distance Between Home and Hospital
Social support helps women reach care and recover safely, from birth waiting homes and free meals to transportation support and community health workers. Clinicians say trust in the health system is growing.
Read MoreBigger Than a Building: The MCOE
In Sierra Leone, Partners In Health staff are confronting painful realities with radical hope, transforming maternal care through skilled midwives and modern facilities like the MCOE. Across PIH-supported facilities, the number of mothers receiving care has risen by 73 percent—a sign of lasting progress and a growing movement to reduce maternal mortality.
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