The free health care initiative: how has it affected health workers in Sierra Leone?

Health Policy and Planning
Sophie WitterMaria Paola Bertone

Abstract

There is an acknowledged gap in the literature on the impact of fee exemption policies on health staff, and, conversely, the implications of staffing for fee exemption. This article draws from five research tools used to analyse changing health worker policies and incentives in post-war Sierra Leone to document the effects of the Free Health Care Initiative (FHCI) of 2010 on health workers.Data were collected through document review (57 documents fully reviewed, published and grey); key informant interviews (23 with government, donors, NGO staff and consultants); analysis of human resource data held by the MoHS; in-depth interviews with health workers (23 doctors, nurses, mid-wives and community health officers); and a health worker survey (312 participants, including all main cadres). The article traces the HR reforms which were triggered by the FHCI and evidence of their effects, which include substantial increases in number and pay (particularly for higher cadres), as well as a reported reduction in absenteeism and attrition, and an increase (at least for some areas, where data is available) in outputs per health worker. The findings highlight how a flagship policy, combined with high profile support and financial and techni...Continue Reading

References

Feb 22, 2003·Health Policy·Dean A ShueyAnthony B Zwi
May 13, 2008·BMC Health Services Research·Juliet Nabyonga-OremOladapo Walker
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Aug 4, 2016·International Journal for Equity in Health·S WitterUNKNOWN FEMHealth team

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Citations

Apr 8, 2016·Health Policy and Planning·Maria Paola Bertone, Mylene Lagarde
Jul 22, 2017·PloS One·Louise SigfridHelena Legido-Quigley
Nov 18, 2017·Health Policy and Planning·Alvaro Alonso-GarbayoTim Martineau
Jan 13, 2018·The International Journal of Health Planning and Management·Sophie WitterAde Renner
Feb 3, 2016·Human Resources for Health·Haja R WurieSophie Witter
Aug 17, 2018·BMC Medical Education·Aniek WoodwardAndrew Leather
Nov 9, 2019·Culture, Health & Sexuality·Hilary CornishMeghna Ranganathan
Jul 20, 2017·Health Research Policy and Systems·Manso M KoromaNamoudou Keita
Mar 9, 2019·Human Resources for Health·Barbara McPakeChristopher H Herbst
Sep 6, 2017·International Journal for Equity in Health·Ijeoma EdokaJoseph Edem-Hotah
Feb 3, 2019·International Journal of Health Policy and Management·Karen Van der VekenPeter Decat

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