First NICU Opens in Sierra Leone

Thirteen minutes after the doors of Sierra Leone's first-ever neonatal intensive care unit (NICU) opened in Kono District, 19-year-old Phebian Baningo arrived carrying her newborn daughter, Grace, who was struggling to breathe.

In February 2026, the NICU within the Paul E. Farmer Maternal Center of Excellence (MCOE), began treating patients.

Several years ago, babies needing specialized care, like Grace, had slim chances of survival at Koidu Government Hospital (KGH). Although staff were well-trained and qualified, they simply did not have the resources needed to save babies facing complications.

This drastically changed with the establishment of the Partners In Health (PIH)-supported special care baby unit (SCBU) in 2020, which was equipped with modern technology and resources, at KGH.

But challenges remained: there was no space for mothers to stay overnight, limited medications for discharge, and a growing influx of patients referred from other facilities.

Now the MCOE's NICU offers a level of care that has never existed in the country before.

Cutting-Edge, Modern NICU

After discovering her pregnancy, Baningo moved closer to Koidu, Kono District, with her mother, Marta Lebbie, and her 4-year-old brother, Abdulloh, in search of better maternal care.

Last year, Abdulloh spent five days at KGH receiving treatment for malaria. Remembering the comprehensive care her son received, Lebbie suggested the family relocate.

Throughout her pregnancy, Baningo attended prenatal appointments at KGH and hoped to deliver at the MCOE.

"I heard the good news and was hoping one day I would see it for myself," she says.

However, when her grandfather died, Baningo needed to travel to a village several hours away for the funeral. While there, she unexpectedly went into labor and was too far away from any health facility to reach care in time. With the help of a traditional birth attendant, she gave birth at the home of a family member.

When Grace was born, she did not cry-a silence that immediately signaled something was wrong. Baningo and Lebbie rushed to the MCOE.

At the NICU, Grace was swiftly placed on oxygen support and laid in an infant warmer to regulate her temperature, interventions that had not been possible in the same way just a few years earlier.

Phebian Baningo (right), 19, and her newborn daughter, Grace, in the NICU at the MCOE in Kono District, Sierra Leone. Photo by Caitlin Kleiboer / PIH

Incubators, or infant warmers, are one of the requirements to qualify as a NICU. These portable beds allow clinical staff to bring babies directly from the operating theater to the NICU in a temperature-controlled environment.

"Before, we would just carry a baby in a blanket from the theater to the SCBU," says Princess Sia Fatorma, a PIH Sierra Leone nurse who began volunteering at KGH in 2015 before later becoming a registered nurse.

The space itself has also vastly improved. Capacity has expanded from 48 beds at KGH's previous maternity ward to 120 beds at the MCOE, with 39 in the NICU. Like the SCBU, the NICU is divided into separate rooms for babies born at KGH and those referred from elsewhere-a key measure to strengthen infection prevention and control.

"It was such a squeeze before," recalls Fatorma. In the former SCBU, multiple babies would sometimes share a single bed.

Safe Housing for NICU Mothers

There is also now a dedicated dormitory for mothers.

Baningo stayed in these sleeping quarters, located in the same building as the NICU, while Grace received care. When she first saw the 17-bed dormitory, complete with a communal kitchen, she thought, "It looked like America."

The MCOE, a cutting-edge 25-million-dollar facility, was designed in collaboration with Sierra Leone's Ministry of Health and Build Health International.

Since opening, many patients have expressed the same reaction, says Isata Dumbuya, director of nursing and midwifery for the reproductive, maternal, neonatal, child and adolescent health program.

"That is the difference that even the space itself says," says Dumbuya. "For people who use the space to know that you're valued, you're treasured, and you mean something ... that's why we we've created this space."

Every day, Baningo walked between the dormitory and the NICU, returning again and again to her daughter's bedside, watching for even the smallest signs of progress as nurses monitored Grace's breathing, temperature, and nutrition closely.

Phebian Baningo feeds her daughter, Grace, by nasogastric tube in the NICU at the MCOE on Feb. 17, 2026. Photo by Caitlin Kleiboer / PIH

In the SCBU, staff often needed to remain beside each patient after administering medication, monitoring for signs of distress. But in the NICU, modern equipment tracks patients continuously and alerts staff to any changes, allowing them to safely care for more newborns at once.

There were 922 newborns treated in the SCBU between July 2024 and June 2025. With the new NICU, that number is expected to increase significantly. Already, 228 babies were admitted to the NICU between Feb. 14 and May 1, 2026.

Healthy Food for Mothers and Babies

Grace's condition steadily improved, and by the fourth day, she was taken off all support equipment.

That same day, Baningo breastfed her for the first time.

"It was discouraging because she was not breastfeeding," says Baningo. "But I'm happy now. That's the only food she needs, the breast milk."

Parents learn from NICU staff about the importance of breastfeeding and kangaroo care-skin-to-skin contact that supports a baby's growth and development.

What was once known as kangaroo mother care at the SCBU has expanded in the NICU to include fathers as well, signifying a more inclusive approach to newborn care.

Though single, Baningo had staff by her side supporting her every need. They advised her to continue breastfeeding and practicing kangaroo care regularly, explaining that once discharged, she would need to continue for two to three hours each day to regulate Grace's temperature.

As she recovered from childbirth, Baningo received nutritious meals three times a day, part of a newly introduced feeding program at KGH.

Previously, families crowded the wards at KGH to deliver food to loved ones who were receiving care, making hygiene difficult to maintain across the hospital. Now, meals are prepared centrally, with nutritionists ensuring they meet hospital standards. Clean water dispensers have also been installed throughout the wards to support hydration.

"The cooks are very good," says Baningo. "It was a surprise to me. It's good for mothers because the food has enough protein. The cooks will put it on a tray and come and distribute it."

Phebian Baningo holds her daughter Grace on April 17, 2026. Photo by Ibrahim John Kamara / PIH

'Going home happy and smiling'

On February 22, Baningo and Grace were discharged. After days of uncertainty, they left the NICU healthy, together.

Baningo decided to remain living near Koidu, as she had grown to feel at home there. Her younger brother enrolled at a local school, and her mother began settling into life in the town.

For Dumbuya, seeing mothers' "sense of relief and joy" as they leave the NICU has been a highlight of the past few months since the MCOE opened.

"They're going home happy and smiling," Dumbuya says.

Sierra Leone's NICU

Learn more about the first NICU in Sierra Leone, based at the Maternal Center of Excellence in Kono District.

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