Fiscal space analysis in Sierra Leone: the free health care initiative and universal health coverage

This brief highlights how Sierra Leone can improve the sustainability of the free health care initiative (FHCI) financing, lower household out-of-pocket (OOP) payments on health care, and decrease its dependence on donors. A secondary analysis provides insights into how Sierra Leone could work towards achieving its longer-term health goal of Universal Health Coverage (UHC). If… Read more




Monitoring and evaluation in Sierra Leone’s health sector

As part of the review of Sierra Leone’s Free Health Care Initiative (FHCI), researchers assessed its monitoring and evaluation (M&E) system, strengths and weaknesses, and the changes that took place as a result of the FHCI. This brief notes that a strong M&E system is crucial to help improve performance and achieve results. Several key… Read more




The free health care initiative (FHCI) in Sierra Leone: real gains for mothers and young children

In 2010, the Free Health Care Initiative (FHCI) abolished health user fees for pregnant women, lactating mothers and children under five. This was a response to very high mortality and morbidity levels among mothers and children and reports that financial costs were a major barrier to health service uptake and use by these groups. This… Read more




Sierra Leone’s free health care initiative: financing implications

In 2010, the Government of Sierra Leone (GoSL) took steps towards establishing the Free Health Care Initiative (FHCI). At its core, this was the removal of user fees (on drugs and consultations) for pregnant women, lactating mothers and children under five. This brief is based on an independent review of FHCI completed in 2016, which looked… Read more




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