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(New York) -- More than a year after the launch of Sierre Leone's Free Health Care Initiative for pregnancy care, women continue to face serious challenges accessing treatment and drugs crucial for safe pregnancy and childbirth, Amnesty International said today.
Under the program, free treatment at government health facilities was made available to all pregnant women and lactating mothers. However, a new Amnesty International report, "At a Crossroads: Sierra Leone's Free Health Care Policy" concludes many women are being asked to pay for drugs, which they cannot afford.
"The health care system remains dysfunctional in many respects," said Erwin van der Borght, Amnesty International's Africa program director.
"Government figures show that since the introduction of the Initiative, more women are delivering their babies in health facilities. However, many women continue to pay for essential drugs, despite the free health care policy, and women and girls living in poverty continue to have limited access to essential care in pregnancy and childbirth."
The government has introduced some initiatives to address these challenges including steps to increase women's access to health services, increasing the pay of health workers and providing workers with additional training. However, much remains to be done.
"A critical shortcoming within the healthcare system is the absence of any effective monitoring and accountability systems, without which reforms cannot succeed," said van der Borght.
Existing processes focus on reviewing individual facilities rather than on monitoring the obstacles women face in accessing services. In addition, there are no effective complaint mechanisms available to women and girls.
A 23-year old woman who had just given birth told Amnesty International:
"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."
Van der Borght said effective monitoring and accountability are vital to the realization of the right to health.
"Deficiencies in the monitoring and accountability system allow poor practice and mismanagement to go unchallenged, and have provided some people with opportunities to exploit the system and plunder valuable medicines," he said.
Amnesty International is calling on the Sierra Leone government to establish and strengthen systems for monitoring and accountability to ensure health care interventions are accessible to women and girls and to guarantee effective remedies for violations of the human right to health.
In April 2010 the Sierra Leone government launched its "Free health care initiative" for pregnant women, lactating mothers and children under 5 at all government-run facilities.
Amnesty International promotes the empowerment of women and girls and the removal of barriers to the realization of their sexual, reproductive and maternal health rights through its Demand Dignity campaign.