however, the country still faces critical shortage of midwives, doctors, laboratory technicians and health information officers over and above the trained and qualified nurses available. To this end too, the health sector has embarked on innovative schemes, such as creating alternative cadres like nurse anesthetists, cataract surgeons, Maternal and Child Health aides as well as contracting doctors and midwives abroad through the South-South Corporation scheme. 255. The MoHS will continue to increase the number of medical doctors, nurses, midwives and maternal and child aides to be trained, equitably deployed and retained in health facilities across the country. The quality of training will continue to be improved through a review of curriculum as well as rehabilitating and constructing training institutions. Given the challenges of geographical access for hard-to-reach communities, priority will be given to training, deployment and supportive supervision of community health workers. 256. Ongoing challenges in relation to monitoring and supervision of the provision of services and procurement of supplies down to a centralised level will be further addressed through increased civil society monitoring and reporting to the MoHS as well as the deployment of the ministries’ own additional supervisors which form part of the District Health Management Teams in the field. 7.2.3 Maternal, infant and child health 257. Sierra Leone has, with the support of key development partners, taken numerous steps to improve the health and well-being of its youngest children from as early as possible through the provision of ante- and post-natal preventative and curative health services for pregnant and lactating women, infants and young children. Its relevant policies and programmes have targeted the social, economic and leading medical causes of infant, child and maternal morbidity and mortality as well as key access barriers. Responses to the leading medical causes focussed on malaria, respiratory and diarrhoeal diseases (which account for 75 percent of under-five mortality) and malnutrition (which is linked with 57 percent of child deaths) (Statistics Sierra Leone and UNICEF, 2011). So too, programmes have sought to address the underlying causes of poor access to unsafe drinking water, poor sanitation, hygiene and nutrition. Key access barriers addressed include distance to services, the cost of services, low levels of knowledge and harmful attitudes practices and attitudes. 258. The various initiatives and programmes, described in more detail in the following paragraphs, have made a substantial difference in the health and well-being of mothers, infants and young children. At the time that Sierra Leone ratified the ACRWC, maternal, infant and child mortality rates were extremely high. In 2001, the maternal mortality rate was an estimated 1,800 per 100,000 live births, and infant and under-five mortality rates were 170 and 286 per 1,000 live births (Government of Sierra Leone, 2006) (Government of Sierra Leone: Agenda for Prosperity, 2013). The survival of mothers and their children has steadily improved over time as indicated in the following table, with the most recent rates indicating a drop of more than 50 percent in maternal mortality rates down to 857 per 100,000 live births (in 2008), in infant mortality rates to 92 and under-five mortality rates of 156 per 1,000 live births (in 2012) (Statistics Sierra Leone and UNICEF, 2011) (Statistics Sierra Leone, 2014). The GoSL recognizes that there is still much work to 70  Government of the Republic of Sierra Leone Initial Report on the African Charter on the Rights and Welfare of the Child 2002-2014