The planned increase of Sierra Leone’s government health budget from 7.4 per cent of the total national budget to 10.5 per cent is good news to the Child Health Now campaign and its partners in the country, who had strongly lobbied the government for this move which affects the lives of millions. This is a step forward after the budget decreased from 11 per cent in 2012.
WV Sierra Leone worked with partners including Save the Children, Oxfam and local organisations to respond to the decrease and to track how healthcare money is being used. The coalition showed the government how other countries have helped to reduce child and maternal deaths by making sure that the right people with the right training are in the right places.
Sierra Leone’s mortality statistics for young children are among the world’s highest, and may even be on the increase. In 2011, UNICEF estimated that it was as high as 217 per 1000 live births due largely to preventable causes including disease, malnutrition and lack of knowledge, and access to medication. Villages experience higher rates than cities.
Leslie Scott, interim national director – WV Sierra Leone, said: "An effective health system depends on heavy investment in people—nurses, doctors and well-trained community health workers. The budget increase means more training of community health workers – this is critical to ensuring that quality health services are delivered in all parts of the country."
Rural areas a challenge
More than a quarter of health facilities in Sierra Leone are understaffed and health professionals prefer to work in cities. Many rural health facilities are staffed by nurses or midwives with only basic training.
The coalition hopes for more than just increases in national-level spending, but to increase the number of well-trained staff in the places that need it most, especially in villages. The coalition’s recent budget tracking showed that the money is often not efficiently reaching these places.
World Vision and its partners have been lobbying the Ministry of Finance and Economic Development, the Ministry of Health and Sanitation, local councils, district health ministry teams and local civil society organisations. In addition to pushing the government on the top-level budget, the coalition hopes that the government will make it top priority to adopt a recent draft Community Health Worker Policy—a framework of healthcare change that provides the right balance of numbers and skills for healthcare professionals by 2015.