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Free Health Care Initiative: Unfpa Support in Sierra Leone

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Free Health Care Initiative: Unfpa Support in Sierra Leone UNFPA Sierra Leone FREE HEALTH CARE INITIATIVE: UNFPA SUPPORT IN SIERRA LEONE United Nations Population Fund Sierra Leone Country Office FEBRUARY 2013 FREE HEALTH CARE INITIATIVE: UNFPA SUPPORT IN SIERRA LEONE United Nations Population Fund Sierra Leone Country Office FEBRUARY 2013 Our Mission UNFPA, the United Nations Population Fund, is an international development agency that promotes the right of every woman, man and child to enjoy a life of health and equal opportunity. UNFPA supports countries in using population data for policies and programmes to reduce poverty and to ensure that every pregnancy is wanted, every birth is safe, every young person is free of HIV/AIDS, and every girl and woman is treated with dignity and respect. ACKNOWLEDGEMENTS Sincere gratitude goes to the numerous UNFPA staff members in the Sierra Leone Country Office, for the inputs provided and information shared. Dr. Jarrie Kabba-Kebbay, Dr. Peter Sikana, Mr. Taiwo Oluyomi, and Mrs. Isatu KaJue are specially noted for their valuable contribution. Special appr eciation goes to Mrs. Ratidzai Ndhlovu, UNFPA Representative in Sierra Leone, for providing oversight and guidance in completing this publication. Particular appreciation also goes to Government of Sierra Leone especially Ministry of Health and Sanitation and all of UNFPA’s implementi ng partners for tirelessly working to ensure the success of Free Health Care Initiative. The contribution of various development partners who partnered with UNFPA and provided funds that supported Free Health Care Initiative in different ways is also duly noted. Finally the Principal author of this document, Ms. Mirai Maruo and Editors Ms. Fiona C. Kaikal and Mr. Sriram Haridass deserve special appreciation for a Job well done. i TABLE OF CONTENT ACKNOWLEDGEMENTS................................................................................... i TABLE OF CONTENT........................................................................................ ii LIST OF ACRONYMS AND ABBREVIATIONS................................................... iv EXECUTIVE SUMMARY.................................................................................... vi INTRODUCTION................................................................................................ 1 SECTION 1: BUILD-UP TO THE FREE HEALTH CARE LAUNCH..................... 4 1.1: Assessment Tour of Sierra Leone by the President....................... 5 1.2: Sierra Leone Chapter of CARMMA launch...................................... 5 1.3: UNFPA Interviews the President...................................................... 7 SECTION 2: LOGISTICS AND SUFFICIENT SUPPLY OF DRUGS AND EQUIPMENT 9 2.1: The Global Programme to Enhance RH Commodity Security (GPRHCS) 9 2.2: Procurement of Drugs, SuPPlies and EquiPment............................ 9 2.3: Logistics and SuPPly Chain Management....................................... 10 SECTION 3: FACILITIES IMPROVEMENT......................................................... 14 3.1 SuPPort to the Solar Suitcase Programme...................................... 15 3.2: Enhancing CEmOnC Facilities throughout the Country................. 17 3.3: Strengthening District Health Services........................................... 18 SECTION 4: INVESTMENT IN HUMAN RESOURCES FOR HEALTH................ 20 4.1: Training of Nurse Anaesthetists....................................................... 20 4.2: Training of Midwives and Recruitment of Retired Midwives............ 21 4.3: Training of Obstetricians and Gynaecologists................................. 22 4.4: Training of SPecialist Paediatricians................................................ 23 4.5: Strengthening District Health Service Project - Human Resources 24 SECTION 5: STRENGTHENING OVERSIGHT, COORDINATION AND MANAGEMENT 27 5.2: Multisectoral Programme on the Sexual and ReProductive Health of Adolescents and Young PeoPle................................................... 27 5.3: Scaling uP Family Planning and the Sierra Leone Family Planning Week (07-14 July 2012)............................................................................... 28 5.4: Key Messages on the International Day of the Girl Child (11 October 2012) Key Day............................................................... 30 ii SECTION 6: COMMUNICATION OF THE POLICY AND DEMAND CREATION 32 6.1: Community Wellness ADvocacy Groups (CAGs)............................ 32 6.2: Male PENs (Male Peer-EDucator Network)...................................... 34 6.3: Volunteer Peer EDucators (VPEs) for Young People....................... 35 6.4: RaDio Drama - Saliwansai................................................................ 36 6.5: Collaboration with Local Musicians................................................ 36 SECTION 7: CONCLUSION............................................................................... 38 iii LIST OF ACRONYMS AND ABBREVIATIONS AfDB African Development Bank BEmOC Basic Emergency Obstetric Care CAG Community Wellness Advocacy Group CARMMA Campaign for Reducing Maternal Mortality and Morbidity CEmONC Comprehensive Emergency Obstetric and Newborn Care CHC Community Health Centre CHP Community Health Post CIDA Canadian International Development Agency CMS Central Medical Store DFID Department of Foreign International Development DMS District Medical Store EmOC Emergency Obstetric Care EU European Union FGM/C Female Genital Mutilation/Cutting FHCI Free Health Care initiative GBV Gender-Based Violence GPRHCS Global Programme on Reproductive Health Commodity Security HIV/AIDS Human Immuno-Deficiency Virus/Acquired Immuno-Deficiency Syndrome HDP Health Development Partners ICE/BCC Information, Communication and Education/Behaviour Change Communication ICPD International Conference on Population and Development MCHP Maternal and Child Health Post MDGs Millennium Development Goals MHTF Maternal Health Trust Fund MICS Multiple Indicator Cluster Survey MMR Maternal Mortality Ratio MOHS Ministry of Health and Sanitation MSWGCA Ministry of Social Welfare, Gender and Children's Affairs NGOs Non-Governmental Organizations PCMH Princess Christian Maternity Hospital PEN Male Peer Educators Network PHC Primary Health Care Complex iv PHU Peripheral Health Unit PMC Population Media Center PMTCT Prevention of Mother-to-Child Transmission PRSP Poverty Reduction Strategy Paper SBCU Special Baby Care Unit SLDHS Sierra Leone Demographic and Health Survey SRH Sexual and Reproductive Health STIs Sexually Transmitted Infections TBAs Traditional Birth Attendants TOT Training of Trainers UNFPA United Nations Population Fund UNJV United Nations Joint Vision VPE Volunteer Peer Educator WHO World Health Organisation Y.E.S. Youth, Empowered, Safe v EXECUTIVE SUMMARY The Government of Sierra Leone placed significant weight on reproductive health, particularly on maternal health in the country's development agenda, when the President launched the five-year Poverty Reduction Strategy Paper called "Agenda for Change (2008-2012)," which gave priority to the reduction of maternal and child mortality. In light of the high rate of maternal and neonatal mortality of 857/100,000 and 36/1,000 respectively, on 27 April 2010, the Government launched the Free Health Care Initiative (FHCI) that enabled pregnant women, lactating mothers and children under five to access free-of-charge medical care and services The Initiative was, in a way, a grand sum of Sierra Leone's efforts, as it addressed all dimensions related to reproductive health from quality service delivery to ensuring access and utilization through demand generation. UNFPA Sierra Leone, with the mandate to accelerate progress on the ICPD agenda and the Millennium Development Goal 5, supports the Government in promoting seXual and reproductive health and rights in a comprehensi ve manner. In fact, UNFPA's role in preventing maternal mortality and morbidity, promoting sexual and reproductive health and rights and strengthening the overall health system in Sierra Leone intensified with the introduction of the Free Health Care Initiative. This document summarizes UNFPA's support to the Free Health Care Initiative from the planning stage to the launching and operationalizat ion. Main areas of UNFPA interventions include procurement and distribution of drugs and equipment, strengthening of the logistics system, improvement of CEmONC, capacity building of health related human resources, empowerment for effective and sustainable demand creation. This document attests UNFPA's role in promoting family planning, paying special attention to teenagers and young people and emphasizing the need to achieve gender equality. It also validates that UNFPA’s interventions were carefully planned through using the result-based framework and placed strategically to ensure effectiveness and efficiency. vi INTRODUCTION Eleven years after the end of a protracted civil war, which destroyed the country's socio-economic infrastructure and human capacity, Sierra Leone has progressed from an emergency and transitional phase to development stage. The Government of Sierra Leone has demonstrated untiring effort to improve and strengthen governance, institutional capacity and socio-economic sectors so that the country can effectively rise above its development challenges. Together, with the support of its development partners, Sierra Leone has gradually gained politic al stability, consolidated peace, improved security and has demonstrated growing maturity in democracy as evidenced by the 2012 elections.
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