Manjama Health Centre located in the southern province of Sierra Leone, is among the health facilities in a country with basic immunization coverage of 78% DPT3 coverage for children under-five’s which is below national target. Despite the mass distribution of bed nets two years ago, to pregnant women and children under-five’s, utilization of bed nets for malaria is still 49% which predisposes the vulnerable population to malaria, anemia, low birth weight babies, still birth, and the persistent high rate of infant and maternal mortality 156/1000 and 1165/100,000 respectively (BPHS, 2015).This health facility covers a catchment area of 15 communities with an estimated population of 10,850 persons. The center is operated by 3 trained health staff (1CHO, 1 SECHN, &1 MCH Aide) which is very inadequate in providing routine and outreach services. The under-staffing is currently as result of inadequate funds to support staff salary and allowances. Due to lack of mobility, the health workers most times walk on foot or pay from their pocket transportation cost for reaching hard to reach communities. Providing Expanded Program on Immunization (EPI) is limited as the health facility lack an efficient Cold Chain system (refrigerator for keeping vaccines at the required temperature), and its leads to under-five children missing timely vaccination schedule. Previously, INM project used to supports Manjama facility with anti-malaria drugs and test kits for the diagnosis and treatment of malaria which is not forthcoming now, the widening gaps that exist now are provision of adequate anti-malaria drugs and test kits, Long lasting Insecticide treated Nets for malaria prevention, and most important community sensitization on the use of the LLINs especially for pregnant women and lactating mothers/children under-fives. Knowledge and skills on the use of Partograph is very limited among the available staff for skilled delivery as a result Manjama facility still contribute to the data on still birth and maternal deaths in the country.