Sierra Leone Free Health Care Initiative

A Sierra Leonean government program introduced by the president in 2010 that abolished health user fees for pregnant women, lactating mothers and children under five years old, groups that had faced some of the highest mortality and morbidity rates in the world and for whom cost had been identified as a major barrier to using health services. Under the Free Health Care Initiative, an estimated 1.5 million children and their pregnant or lactating mothers became entitled to free essential services in government and government-contracted facilities, including antenatal, delivery and postnatal care for mothers and preventive and curative care for common childhood illnesses, with consultation fees, medicines and medical supplies waived for the covered groups. Evaluations found sharply increased numbers of women and children seeking care after the policy took effect, including a rise of more than 200 percent in facility use for paediatric surgical cases and common childhood infections such as malaria, diarrhoea and pneumonia, alongside more women attending facilities for urgent care during childbirth.