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Page last updated at 11:31 GMT, Tuesday, 27 April 2010 12:31 UK

Sierra Leone starts free care for mothers and children

Baby at a hospital in Sierra Leone
Sierra Leone has one of the highest child mortality rates in the world

Sierra Leone has launched a free healthcare plan for pregnant women, breast-feeding mothers and children under five years old.

The country has some of the world's highest maternal and child death rates.

Doctors blame this partly on health service fees and the cost of medication, and hope the healthcare plan will help save lives.

But there is concern that Sierra Leone lacks the resources and infrastructure to support the new programme.

Sierra Leone is one of the world's poorest countries.

It emerged from a decade of civil war in 2002, but reconstruction is still proving to be a big struggle.

DYING IN SIERRA LEONE
Life expectancy: 46 (men), 49 (women)
One in eight women risk dying in pregnancy or childbirth
For every 1,000 children born, 140 die
Highest mortality rate in the world for children under five
Sources: UN, Amnesty International

Ratiszai Ndlovo, Sierra Leone's UN Population Fund representative, told the BBC's Umaru Fofana that although medical equipment had been ordered and some drugs distributed around the country, everything was still not in place for the launch of the healthcare plan.

"It's not perfect, it's not 100%," she said.

"But I think we cannot start the programme with everything in a perfect condition."

Free healthcare in Sierra Leone is expected to save the lives of more than one million mothers and children, at an initial cost of $19m (£12m).

Other countries in Africa, such as Burundi, have also introduced free care to new mothers and children under five in recent years.

In Sierra Leone, the programme's main donors have been the UN and the UK, who between them have helped refurbish hospitals, supply drugs and pay health workers' wages.

Pay and conditions were the main grievances in a two-week-long strike in March staged by the country's public health workers.

They feared free care would result in more patients and longer working hours.

The dispute was settled when the government offered salary increases of between 200% and 500%.

Our correspondent says there are other challenges facing the healthcare programme.

For example, Sierra Leone's bad roads and the lack of ambulances means pregnant women living in the more isolated parts of the country are often slow to receive attention.

And some question how the free healthcare will be paid for once the donor support runs out.



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