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Focus: Sierra Leone – Free Healthcare

On Independence Day (27th april), the country with one of the worst death rates in the world among women in childbirth launched free healthcare for those who are pregnant or breastfeeding and for the under-5s. It should save thousands of lives

Tony Blair’s Africa Governance Initiative (AGI) has been working with the Sierra Leone government since October 2008. The AGI has set up sub-committees on infrastructure, communications, finance, drugs and logistics, human resources and monitoring and evaluation and provided strategic advice and support to the chief medical officer and senior health officials.

DfID has given $8.8 million for new drugs, as well as other help. Weekly meetings have brought together government and donors and aid agencies so that everybody has been in the loop and performed their own specific tasks

Outside help has been important, but the greatest credit of all goes to ministers and staff who have been working 12 hours a day, seven days a week.

There have been some major issues. The health minister was sacked last year for corruption. Junior doctors went on strike recently, worried about the impact the reforms would have on their lives. Health workers have been given large pay rises, from three-fold to six-fold, to compensate for the money they will lose when they can no longer charge fees. And there are still considerable worries over the shortages of staff – 50% of the healthcare staff Sierra Leone trains leave for Ghana, the UK or somewhere else where life is not so hard.

But the whole country is excited at the move and the expectation is that the community will help keep things on track. There is a toll-free number for people to call if doctors try to levy charges where there shouldn’t be any, or try to charge men extra to make up for lost revenue from women, or if healthcare staff don’t turn up for work or the drugs inexplicably run out. There is a real determination to make it work. This is not about political reputations in Sierra Leone or the UK. The lives of thousands of women and small children are at stake.

Congratulations to Sierra Leone.

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