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


Global report on urban health: equitable, healthier cities for sustainable development

  This report presents new data on the health of urban residents from nearly 100 countries, updating the first joint WHO-UN Habitat global report on urban health titled Hidden cities: unmasking and overcoming health inequities in urban settings. The new Global Report deconstructs the complex challenges of health and health inequity in cities everywhere. It presents… Read more


How equitable are community health worker programmes?

There are dramatic differences in mortality and life expectancy between and within countries. Disadvantaged groups have poorer survival chances and use facility-based services less than other groups. Community health services are an opportunity to improve this situation and create a pathway to Universal Health Coverage (UHC). Community Health Workers (CHWs) can improve equitable child survival,… Read more


How equitable are community health worker programmes and which programme features influence equity of community health worker services? A systematic review

Community health workers (CHWs) are uniquely placed to link communities with the health system, playing a role in improving the reach of health systems and bringing health services closer to hard-to-reach and marginalised groups. A systematic review was conducted to determine the extent of equity of CHW programmes and to identify intervention design factors which… Read more


Going universal: how 24 developing countries are implementing universal health coverage reforms from the bottom up

This publication is about 24 developing countries that have embarked on the long journey toward universal health coverage (UHC) following a bottom-up approach, with a special focus on the poor and vulnerable. The publication documents and analyses the experiences of these countries based on a systematic data collection effort that sought to capture in great… Read more


Ten arguments for why gender should be a central focus for universal health coverage advocates

To make universal health coverage (UHC) truly universal we need an approach which places gender and power at the centre of our analysis. This means we need a discussion about who is included, how health is defined, what coverage entails and whether equity is ensured. To celebrate Universal Health Coverage Day RinGs has put together… Read more


Universal access: making health systems work for women

Universal coverage by health services is one of the core obligations that any legitimate government should fulfil vis-à-vis its citizens. However, universal coverage may not in itself ensure universal access to health care. Among the many challenges to ensuring universal coverage as well as access to health care are structural inequalities by caste, race, ethnicity… Read more


Gender equity and universal health coverage in India

This article introduces a Series in The Lancet in which Srinath Reddy and colleagues call for universal health-care coverage in India, and outline why the development of national health provision is both timely and necessary. Without question, India has reached the right point in time to undertake universal health-care coverage, a move that is likely to… Read more


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