Free Health Care Initiative helps to improve maternal, neonatal and child health in Sierra Leone

Making health services available for mothers and children

Tapuwa Mutseyekwa
A pregnant woman gets vaccinated against tetanus.
UNICEF Sierra Leone/2021/Mutseyekwa
23 April 2021

Goderich, Sierra Leone – Mariama Marah (17 years), has taken a ride on a public motorbike to leave her house and head to the Metchem Peripheral Health Unit (PHU) in Goderich, Western Area Rural District.  It has not been a long ride, but for a young expectant mother, who is not feeling well, the journey seemed to drag on too long.  As she disembarks from the motorbike, she walks sluggishly through the entrance of the PHU and immediately sits on the bench in the facility.

“I am glad to be at the PHU to get treatment,” says Mariama, whose laboratory results show that she has malaria and now has to commence the treatment. “I have been sick since yesterday, feeling weak and having a fever,” says Mariama as she explains the nature of the symptoms which have brought her to the PHU.

Mariama does not work and is dependent on the meagre income that her partner gets from his trading at the market.  She is therefore glad that at Metchem PHU, she will be given the malaria treatment for free, courtesy of the Free Health Care Initiative introduced nationwide by Government in 2010.  Through this initiative, Mariama can have the confidence to attend to bouts of illness that might arise during pregnancy and be rest assured that the family’s resources do not get strained.

“It was my aunt who told me about the Free Health Care Initiative.  She explained that because I am pregnant, I would not be paying for the medicines and services that I receive at the PHU,” says Mariama who during the course of her pregnancy has received a bed net, regular Ante Natal Care (ANC) checks and counselling for Prevention of Mother to Child Transmission of HIV.   

After receiving her pack of malaria treatment medicine, Mariama also got the chance to receive her first shot of the tetanus vaccine to ensure that her delivery is safe.

A pregnant woman stands outside a health facility in Sierra Leone
UNICEF Sierra Leone/2021/Mutseyekwa
A pregnant and ailing Mariama arriving at Metchem PHU for attention.

Across Sierra Leone, many pregnant women continue to lose their lives or that of their babies due to illnesses such as malaria, tetanus, sepsis, and hypertension. With a Maternal Mortal Rate (MMR) of 717 per 100,000 live births in 2019 (Sierra Leone Demographic and Health Survey 2019), Sierra Leone remains one of the countries with the highest MMR in the world. 

At Metchem PHU, more than 45 pregnant women pass through the doors of the facility per month and within the course the pregnancies, cases of malaria and Sexually Transmitted Infections and HIV are regularly attended to by the PHU nurses.   

To help reduce the risks faced by women during pregnancies and in a move to address the daunting MMR statistics, UNICEF, with funding from the UK Foreign, Commonwealth and Development Office (FCDO), has been supporting the Ministry of Health and Sanitation to improve access to quality health service across the country through the Free Health Care Initiative (FHCI).  Launched in 2010, the FHCI has been a very important channel through which free medical supplies reach pregnant women, lactating mothers, children under five, people with disabilities and survivors of Ebola, regardless of where they stay in the country.

A pregnant woman display malaria drugs she received at a health facility in Sierra Leone
UNICEF Sierra Leone/2021/Mutseyekwa
Mariama received her malaria drugs, which will help her regain her health.

UK-FCDO’s investment into the FHCI has also helped to strengthen the procurement, warehousing, and distribution of essential drugs, ensuring that there is no tardiness from the time the drugs leave headquarters to the point when mothers and children benefit from the supplies. Since 2013, Metchem PHU, which covers a total catchment of six communities and 8 000 inhabitants, has been receiving drugs on a quarterly basis.  The facility management works closely with community stakeholders to receive and account for the drugs. 

Headman Mohamed Turay is elated that the supply of drugs under the FHCI has been smooth and that there has been a very positive impact on the health of mothers and their newborns.   Most of the clients who access Metchem come from poor households, where income from the stone mining and petty trading activities they engage in, is never enough to meet the family needs for food, shelter, education, and health care. Headman Turay is therefore happy for the support with free health services and drugs which is a huge benefit to the families.

Apart from being among the stakeholders who receive the drugs, Headman Turay says he also has leeway to directly engage with the District Health Management Team to inform them of any additional needs to meet the health needs of the community.

“The people in this community are happy that they are benefiting from the Free Health Care Initiative and that the health of mothers and babies is improving a lot, ” says Headman as he expresses appreciation for the FHCI and the nurses of Metchem PHU.

A woman carries her twin babies at a health facility in Sierra Leone.
UNICEF Sierra Leone/2021/Mutseyekwa
Mabinty is happy with the support she has received through the FHCI

This testimony of safe delivery and continued good care for Mabinty and her children, serves to build Mariama’s confidence that she will also have a positive outcome of her pregnancy, thanks to services and supplies that mothers and babies are receiving through the Free Health Care Initiative.