More than a year after the launch of the country’s “Free Health Care Initiative”, pregnant Women's rights's rightss rights's rights's rights's rights and girls in Sierra Leone continue to face serious challenges in accessing the drugs and medical care crucial for safe pregnancy and childbirth.

Under the initiative, all pregnant Women's rights's rightss rights's rights's rights's rights and lactating mothers should receive free treatment at government-run health facilities. However, a new Amnesty report, At a Crossroads: Sierra Leone’s Free Health Care Policy , reveals that many of these Women's rights's rightss rights's rights's rights's rights are being asked to pay for drugs, which they cannot afford.

Amnesty International’s Africa Programme Director Erwin van der Borght said: “The health care system remains dysfunctional in many respects.

“Government figures show that since the introduction of the initiative, more Women's rights's rightss rights's rights's rights's rights are accessing antenatal care and delivering their babies in health facilities.

“However, many Women's rights's rightss rights's rights's rights's rights continue to pay for essential drugs, despite the free health care policy, and Women's rights's rightss rights's rights's rights's rights and girls living in poverty continue to have limited access to essential care in pregnancy and childbirth.

“A critical shortcoming within the healthcare system is the absence of any effective monitoring and accountability systems, without which reforms cannot succeed.”

The government of Sierra Leone has introduced initiatives to address these challenges, including steps to increase Women's rights's rightss rights's rights's rights's rights's access to health services, increasing the pay of health workers and providing those workers with additional training. However, the existing processes are poorly resourced and focus on reviewing individual facilities rather than on monitoring obstacles Women's rights's rightss rights's rights's rights's rights face in accessing services. Meanwhile there are no effective complaint mechanisms available to Women's rights's rightss rights's rights's rights's rights and girls when their human rights are denied.

A 23-year old woman who had just given birth told Amnesty: “My baby was crying a lot and had a fever. Hospital had no drugs for him. Need to pay money. They chased me away. I don’t know how to complain.”     

Monitoring and accountability are vital to the realisation of the right to health. An effective framework of monitoring and accountability serves as the basis for promoting changes which allow Women's rights's rightss rights's rights's rights's rights and girls to enjoy their right to maternal health and give birth more safely.

Amnesty has welcomed the positive response received from Sierra Leone’s Ministry of Health and Sanitation on sharing this report with them, but the organisation insists that planned reforms must be translated into action.

Download the full report - At a crossroads: Sierra Leone's free health care policy (PDF)

• In April 2010 the Sierra Leone government launched its “Free health care initiative” for pregnant Women's rights's rightss rights's rights's rights's rights, lactating mothers and Children's rights under five at all government-run facilities.
• This report is issued as part of Amnesty’s ongoing campaign to ensure that Women's rights's rightss rights's rights's rights's rights and girls living in Sierra Leone are able to realise their maternal health and sexual and reproductive rights.
• This work is also part of Amnesty’s global Demand Dignity campaign, launched in 2009. This aims to expose and combat the human rights violations that drive and deepen poverty.
• Through its work on this issue Amnesty promotes the empowerment of Women's rights's rightss rights's rights's rights's rights and girls and the removal of barriers to the realisation of their sexual, reproductive and maternal health rights.

For more information, see our Demand Dignity campaign