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What has Sierra Leone's Government pledged for mothers and babies?

What commitments have the Government of Sierra Leone made to save the lives of our mothers and babies? 

Through a strong focus on evidence, MamaYe empowers communities and citizens to hold the Government accountable to its commitments and to make sure these pledges are met. Below we outline some of the public pledges made by the Government at International and national events, and assess whether these commitments have been fulfilled. 

The Abuja Declaration - a commitment to ensure 15% of the annual budget is used to improve the health sector

In April 2001, at a meeting of African leaders in the Nigerian capital, the Sierra Leonean Government pledged to support the Abuja Declaration, that at least 15% of the government's annual budget is used to improve the health sector. No deadline was set for meeting this commitment. Click here for more details.

"Of course there is much to be done still, but we have made a fantastic start. This year we are developing our health financing policy, which we hope will ensure that all our people are protected from the financial burden of accessing health care, so that we move towards universal health coverage." - President Ernest Koroma, 4th May 2012

"Sierra Leone will not be an exception to the Abuja commitment!" - Hon. Mabinty Daramy (MoFeD) Deputy Minister of Finance, at the MamaYe launch, 17 May 2013 

What has been done so far?

  • For 2014, the Sierra Leonean government had increased health sector allocation to 11.2% of the annual budget – 27.1% of the supplementary budget read by the government in July this year was allocated to the health sector which also included   response to the Ebola outbreak.
  • Mamaye welcomes this progress, yet Sierra Leone is still below the promised 15% target. The gap can be closed. Countries like Rwanda achieved 15% Abuja target before 2015.
  • Do you know how Mamaye supported this change? Click here and here to discover more about our great work with various partners in Sierra Leone. And click here to have a look at our fabulous scorecards to see in details how Sierra Leone performs on this target.

The Maputo Plan of Action - to ensure universal access to reproductive health services

In September 2006, at a meeting in the Mozambican capital, Sierra Leone pledged to support the Maputo Plan which addresses "the serious threat" to "the right to health in Africa" (with) "poor sexual and reproductive health as a leading killer." 

The Sierra Leonean Government plan to address this threat through the following means:

  • Integrating HIV/AIDS services into sexual and reproductive health and rights
  • Promoting family planning as a crucial factor in attaining the Millennium Development Goals
  • Supporting the sexual and reproductive health needs of adolescents and young people
  • Addressing unsafe abortions
  • Delivering quality and affordable health services to promote safe motherhood, child survival, and maternal, newborn and child health
  • Adopting strategies that would ensure reproductive health commodity security
  • Increasing resources for sexual and reproductive health, in alignment with the Abuja Declaration.

Taken from the "Plan of Action on Sexual and Reproductive Health and Rights" and reproduced on the UNFPA website.

The UN's Every Woman Every Child - a commitment to save the lives of women and children by 2015

In September 2010, at a summit for the UN Millenium Development Goals in New York, Sierra Leone was one of the governments that pledged to "save the lives of 16 million women and children by 2015".

Sierra Leone pledged to do this by:

  • Increasing access to health facilities by pregnant women, newborns and children by 40% through removal of user fees, effective April 2010;
  • Developing a Health Compact to align development partners around a single-country-led national health strategy
  • Insuring that all teachers engage in continuous professional development in health

Taken from the "Commitments in Support of the Global Strategy for Women’s and Children’s Health" on the UN's Every Woman Every Child, and reproduced here.

What has been done so far?

  • The Free health care initiative has been progressively implemented and the health compact has been developed. Yet more efforts and investments are needed.
  • Continuous professional development is still very much needed by health workers in Sierra Leone

Family Planning summit.

Sierra Leone committed in 2012 to increasing its annual health budget from 8% to 12% by 2013 and gradually thereafter until the Abuja target of 15% is met. Within that it is committed to increasing the family planning budget from 0.42% in 2012 to 1% by 2020, recognizing that this will be 1% of a projected increasing budget for health overall. Private sector providers and training more health workers will help scale up family planning services and community outreach to marginalized populations, including young people. Voucher schemes will be piloted with a view of enabling the poorest to get access. Civil society groups will play a key role in advocacy and monitoring availability and access to voluntary family planning.  

The Free Health Care initiative.

The President of Sierra Leone committed in 2010 that pregnant or breastfeeding women, and children under five would be entitled to free health care in public health facilities. As he committed:

“From this Independence Day, every pregnant woman, breastfeeding mother and child under five years of age will be entitled to free health care in every Government health facility in the country. From pre-natal check-ups to surgical services, drugs, vaccinations and inpatient hospital care, no pregnant woman, breast feeding mother or child under five would have to pay a single Leone.

Today, I also want to reassure the nation that I am determined to make this policy work. You may have heard hollow promises from politicians before about free services, but in the past these announcements have not been backed up by other actions. This time it will be different”.  Dr Ernest Bai Koroma, 27 April 2010.

What has been done so far?

  • The initiative has been progressively implemented
  • Yet too often, clinics lack drugs and equipment, and users can be asked to pay even when they benefit from an exemption. Out-of-pocket expenditure remains high. 

What next?

Sierra Leone needs to make health a priority and to hold to its commitments. As a Ministry of Health official said: 

"We should be proud of the enormous progress in the clinics over a relatively short time, but there is much more to be done"  - Foday Sawi (MoHS) Deputy Minister of Health at the MamaYe launch, 17 May 2013.


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