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Sierra Leone: 1st anniversary of the free healthcare system
Sierra Leone used to be the worst place in the world to give birth. On 28 April last year, the government of Sierra Leone took a huge step in the fight to reduce maternal and child deaths by making health care free for pregnant and lactating mothers and children under the age of five.
By removing health “user fees” up to 460,000 women and 1 million children each year will now benefit from free care. Progress since free health care was introduced has meant that:
- The number of women giving birth in hospitals and the number of children being treated for malaria have both tripled;
- The fatality rate for malaria in hospitals has been reduced dramatically, by approximately 90%;
- The number of children dying in the capital’s children’s hospital has halved;
- Free mosquito nets have been distributed country-wide, to help prevent malaria, saving the lives of nearly 4500 children.
Credit: Aubrey Wade/Oxfam
Credit: Aubrey Wade/OxfamHealth care costs at Princess Christian maternity hospital in Freetown, capital of Sierra Leone. LE10,000 are roughly equivalent to 2.30 US dollars, 1.55 Euros, or 1.38 British pounds.
Credit: Aubrey Wade/OxfamNurse Halimatu Kamara (26) administering a polio vaccine to Zainab Nana Sillah (6 months) who is attending the clinic at Lumley Government Hospital with her mother Abibatu Jah Saneh. Abibatu attended the clinic for free antenatal check-ups prior to delivering her baby.
Credit: Aubrey Wade/OxfamZainab Bah (34) is 8 and a half months pregnant. She heard about free maternal health care on the radio and has come to hospital complaining of back pain and bad digestion. She is also worried because she bled a lot during her first two childbirths. After her check up Zainab is given the all clear and a free prescription which she could not otherwise have afforded.
Credit: Aubrey Wade/OxfamZainab Tarawalie (20) and baby son Hassan (1 day). Before health care was free she’d have gone to a traditional birth attendant (TBA) because of the cost of treatment. During delivery Zainab’s skin was torn. This was routinely treated by the hospital staff and she had a good birth. “In hospital you are well looked after with the correct medicine. A TBA would just give you some herbs and maybe then she leaves you alone. I could have been really sick.”
Credit: Aubrey Wade/OxfamRugiattu Jalloh (20) and her son Soulayeman (18 months), who is recovering from measles and covered in a soothing lotion, at Lumley Government Hospital. Rugiatu runs a haberdashery from her house. On a good day she turns over LE30,000 ($6.90) but business right now is slow and her husband is unemployed. She has given birth to her three children with a TBA because of the cost. Soulayeman’s treatment would have cost her LE10,000 ($2.30).
Credit: Aubrey Wade/OxfamAdama Bangura (27), mother of six, didn’t want any more children. She joined a planned-parenthood program and had the Depo-Provera injection. However recently she began feeling unwell and experienced bleeding episodes. At the hospital an ectopic pregnancy was diagnosed and Adama underwent emergency surgery. Prior to free maternal health this would have cost around LE1.5m – LE2m ($345 – $460), plus LE1,000 per day for her bed fee. These costs would have been prohibitive for someone on her income.
Credit: Aubrey Wade/OxfamHawa Aruma (20) is a market trader. Her husband works in construction. “I gave birth to my first son at a health center and it cost LE80,000 ($18). My husband paid but his income is low, it was a struggle to find the money.” When she became pregnant again she was diagnosed with pre-eclampsia (raised blood pressure during pregnancy) and was referred to Princess Christian Maternity Hospital for monitoring. Everything has gone fine and she was happy all the care she received was free.
Credit: Aubrey Wade/OxfamAdama Sesay with her baby Albert, who was suffering from intestinal pain. Adama lost two of her four children, when health care was not free. “Now health care is free I came to hospital as soon as my child fell ill. Before when I had to pay I’d have left it to my husband in the hope he had money to pay. A woman could not do this on her own.”
Credit: Aubrey Wade/OxfamJariatu Bangura (20) and son Soulayman (5 months). Jariatu brought Soulayman to the hospital because he had a fever and irregular breathing. The doctors did some tests and are now giving him free treatment for pneumonia.
Credit: Aubrey Wade/OxfamWaiting room at Makeni District Hospital.
Yawa Mattia (27) and her son Alhusine, who is in Makeni Government Hospital with a fever. Yawa lost her first child and Alhusine has been in hospital 4 times already in his short life.
Adamse Koroma (18) brings her 1-year-old daughter, Isatu, for a check-up at the Makeni Government Hospital in Sierra Leone.
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