Politicizing Free: Maternal and Reproductive Health Policy in Sierra Leone

Background/Purpose: On April 27, 2010, Sierra Leone implemented the Free Health Care Initiative (FHCI) for its most vulnerable populations: pregnant women, lactating mothers and children under the age of five, to address dire mortality rates. Anecdotal data from the previous study supported newspaper and documentary reports suggest that the delivery of quality care is still a problem and that there is lack of professionalism in service delivery. Study examines the services provided as a result of the free health care policy from the perspective of the professional health worker, lay health volunteer and women beneficiaries.

Method: This was a mixed method design. Data were gathered from a satisfaction survey and focus groups discussions with beneficiaries and interviews with health care workers and volunteers. As the study was conducted during the outbreak of the Ebola crises, travel around the country was restricted so two districts and Western Area were used in the study.

Analysis/Results: Data were collected from thirteen communities out of the 20 communities initially selected for the study. The majority of participants lived in rural environments. Three of the communities had a clinic present on site. The perspectives of the Free Health Care Initiative implemented by the Government of Sierra Leone were mixed.

Conclusions: Perceptions of the government provisions and availability of services were mixed for drugs availability, accessibility to health providers, and services delivery, including contraceptives.