At a crossroads - Sierra Leone's free health care policy

Amnesty International 2011, anglais, 41 pages

Pregnant women and girls in Sierra Leone face continuing challenges in gaining access to maternal health care services. Despite important reforms initiated over the last two years, including a free health care policy covering pregnancy and childbirth, the health care system is dysfunctional and much remains to be done.

Health facilities are often short of essential drugs and supplies. Disparities persist between rural and urban areas, the quality of care is frequently substandard, and overwhelmingly women still have to pay for essential drugs.

A critical shortcoming within the health care system is the absence of any effective monitoring and accountability mechanisms. The existing processes are poorly resourced and focus on reviews of individual facilities rather than on monitoring obstacles women face in accessing services. There are no effective complaint mechanisms available to women and girls when their human rights are denied. In this report, Amnesty International examines how gaps in monitoring and accountability are undermining the success of the recent health care reforms, in particular free access to essential drugs in pregnancy and childbirth. Amnesty International calls on the government of Sierra Leone to strengthen and establish monitoring and accountability mechanisms so that health care is accessible to women and girls and effective remedies are available if their human rights are violated.