Sierra Leone launching free health care program for mothers, children; Challenges remain

Sierra Leone is launching a program to provide free health care for mothers and children in an effort to reduce high maternal and child mortality rates, Ernest Bai Koroma, the country's president, said on Tuesday, the Associated Press reports (4/27).

During a speech marking the country's 49th independence day, Koroma said the program aims to provide a "secured future," SAPA-Agence France-Presse/IOL reports. He said the initiative requires additional health workers "because there is going to be an upsurge in the number of people reporting for the services." He continued, "For now, we will limit our activities to government hospitals but we are discussing with faith-based organisations so that we can map out a strategy on how they can come in and add to the service." Samuel Kargbo, the director of reproductive health, said the program will provide care for 1.2 million women and children. "According to the World Health Organisation (WHO), Sierra Leone has the world's highest death rate among pregnant women and children" (4/28).

The program is receiving most of its funding from the U.N. and the U.K., which has said it would donate a one-year supply of drugs and money to pay health workers fairly, BBC reports. Health workers in the country were recently on strike because of low wages and working conditions, the news service notes (Fofana, 4/27).

"The main concerns for health workers are compensation, working conditions, lack of career advancement and study opportunities and a lack of equipment," according to Frederic Coker, head of a coalition of striking doctors, IRIN reports in an article examining the country's readiness for the new program. "We know from experience in other countries that have implemented free care that the first months are critical," said Laurence Sailly, interim head of mission for Medecins Sans Frontieres-Belgium. Vidhya Ganesh, a UNICEF representative in Sierra Leone adds: "A great deal of preparation has taken place [for the launch], including getting medicines in place and communicating the policy … But by no means will all challenges to the health sector be resolved in one move" (4/27).

There have been several issues with roll out so far. "Koroma had a tough time selling the plan, which he and the ministry hoped to unveil to much fanfare next month. Details of the plan remained under wraps until health care workers and local media began asking question," GlobalPost reports, noting the recent trial of the health minister, who was convicted on charges of fraud. "Medical workers say the idea behind the health care initiative is a good one, but there is not enough equipment, supplies or even staffers available to handle the flood of women and children expected once it goes into effect" (Johnson, 4/27).

Though medical equipment has been ordered and some drugs have been given out, some things are still missing for a full launch, according to Ratiszai Ndlovo, Sierra Leone's U.N. Population Fund representative, the BBC writes. "It's not perfect, it's not 100%," she said (4/27).