Research for stronger health systems during and after crisis

The Free Health Care Initiative in Sierra Leone: six years on, six lessons

Posted on Thursday, 02 Jun 2016

Six years on from the introduction of the Free Health Care Initiative in Sierra Leone, ReBUILD's Sophie Witter has led a team in an evaluation of the initiative. In a blog just published in the Lancet Global Health, she gives an overview of what the review found: how that policy was implemented, what it achieved, and what we can learn from it.

Most countries want to move towards universal health coverage – people being able to access quality essential health care without financial barriers or adverse consequences. If you can’t provide the full range of services to all – which is the case for all low income countries – then one approach is to offer free care for high priority users. This is what was done in Sierra Leone in 2010, when the Free Health Care Initiative (FHCI) was launched, offering free care in public facilities for pregnant and lactating women and under-fives, in a context of one of the highest maternal mortality ratios in the world. Six years on, we report on how that policy was implemented, what it achieved, and what we can learn from it.

You can read the Lancet Global Health blog here.

And you can access the full evaluation report here.

Sophie Witter is an associate with Oxford Policy Management and led the OPM evaluation of the Free Health Care Initiative. She is also Professor of International Health Systems at Queen Margaret University, Edinburgh, UK, and part of the ReBUILD Research Consortium (research for stronger health systems post-conflict).