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Ernest Bai Koroma

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The Free Health Care Initiative is Making a Difference in Sierra Leone

Posted: 04/05/2012 00:00

Just two years ago, our country had one of the worst maternal and infant death rates in the world. Arising out of conflict, Sierra Leone was a grim place to be a mother, and especially a mother with a young child. United Nations and World Health Organisation figures were stark. Out of every one thousand babies born, almost 200 would die before reaching their fifth birthday.

Widespread poverty, one of the many legacies of our terrible civil war, meant that more than half of our people earned less than $1 a day, with 84% unable to afford to see a doctor or visit a clinic.

We knew something had to be done. A bold move was required and fast. We couldn't allow this situation to continue.

In September 2009 we started the change with the announcement that all health user fees would be removed for pregnant and lactating women and children under the age of five. We introduced the Free Health Care Initiative in April 2010, which would give around 460,000 women and a million children a much better chance of having a longer and happier life.

And I'm delighted to say that the latest statistics have shown we are succeeding. The FHCI has had an incredible affect on the awful health indicators of just a few years ago.

In the first year alone, there was a 214% increase in the number of children attending outpatient units. More women who needed care most were attending facilities, and we reduced - by an amazing 61% - the number of women dying from pregnancy complications at facilities. We are delighted, encouraged and proud of what has been achieved in so short a time.

It has not been easy. As President, I believed it was essential for me to take leadership of this from the outset, planning and overseeing its implementation. We had to make sure the health care was not just available to our country's women and children, but that the quality of care would also improve.

To help with this, we increased the number of health workers and ensured they were given big salary rises to reflect the importance of their positions. Nurses who used to get just $50 a month, now earn $200 and doctors have had their pay increased from $250 to $1000.

Of course there is much to be done still, but we have made a fantastic start. This year we are developing our health financing policy, which we hope will ensure that all our people are protected from the financial burden of accessing health care, so that we move towards universal health coverage.

But the Free Health Care Initiative has not happened without challenges, the greatest of which are the aspects of sustainability of this plausible scheme and also the enhancement of the quality of services offered in the health facilities.

We have ensured that more of our resources are allocated to health, but to do this, and to continue to spend more year on year, we must rely on the continued support of international development partners. This is essential and greatly appreciated.

We were given vital technical assistance and financial support from the United Kingdom. This was pivotal in making the FHCI happen.

I would urge our partners, governments, aid agencies, charities like Save the Children, to continue supporting us, and all the other developing nations, on the world stage. We are delighted about what has been achieved already, but there is so much more to do.

Our wider programme for the socio-economic transformation of Sierra Leone fully takes on board all the United Nations Millennium Development Goals announced in 2000. The recent global food and financial crises have stalled our progress across some sectors, but our determination to overcome these challenges is unshakeable. Goals 4 and 5 are clear: Reduce child mortality and improve maternal health.

In order to ensure that we hit these targets, the British Government and the leaders of the other big industrialised G8 nations - who meet next month at Camp David - must ensure the world prioritises efforts to reach the most poor and vulnerable in world society.

​Two years on, we must sustain progress and I will do my best to ensure that the progress we have made is accelerated so that we can reach our common goals.

 
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