RIGHTS GROUPS EXPOSE ROTS IN MATERNAL HEALTH SYSTEM
By Ibrahim Alusine Kamara
A new joint report by Amnesty International and Human Rights Watch (HRW) has laid bare shocking levels of neglect, abuse, and corruption in Sierra Leone’s public maternal healthcare system — a crisis that continues to claim the lives of women and newborn babies despite years of government promises under the Free Healthcare Initiative.
Titled “No Money, No Care: Obstetric Violence in Sierra Leone,” the report paints a grim picture of systemic failures and deep-rooted corruption within public hospitals. It documents how countless women are denied care during childbirth because they cannot afford informal payments — even in facilities supposedly covered by the government’s Free Healthcare policy.
According to the report, health workers routinely demand bribes before providing basic medical attention, leaving many poor expectant mothers to suffer or die while seeking help. Some women interviewed described being verbally abused, neglected during labour, or detained in hospitals for failing to pay illegal charges.
“The Free Healthcare Initiative was meant to save lives, but for many women in Sierra Leone, childbirth remains a life-threatening ordeal,” said one of the researchers quoted in the report. “The reality is that without money, there is no care.”
A Humanitarian and Governance Crisis
The findings have triggered widespread concern among human rights advocates and citizens alike. Amnesty International and HRW argue that the government’s failure to regulate hospital management, ensure accountability, and discipline abusive or corrupt health officials has turned public maternity wards into spaces of fear, humiliation, and loss.
The report also highlights how maternal mortality remains one of the highest in the world. According to global health statistics, Sierra Leone records over 700 maternal deaths per 100,000 live births — a figure worsened by poor infrastructure, shortages of medical supplies, and limited oversight.
Corruption Undermines Free Healthcare
Despite government claims of investing heavily in maternal and child health, the report found that corruption and mismanagement are choking the system from within.
Funds meant for essential drugs and medical supplies often go missing, and patients are forced to pay out-of-pocket for services that should be free.
Amnesty and HRW warn that the widespread practice of demanding illegal payments not only violates women’s right to healthcare but also erodes public trust in the state’s Free Healthcare Initiative — one of the Bio administration’s flagship social programs.
Calls for Accountability and Reform
Both organisations urged the Government of Sierra Leone to act decisively to end what they describe as “obstetric violence” — the abuse, neglect, and mistreatment of women during pregnancy and childbirth. They recommended:
Strict enforcement of anti-corruption and disciplinary measures in the health sector;
Adequate training and supervision of health workers;
Strengthening oversight mechanisms within the Ministry of Health; and
Immediate investigation into reported cases of abuse and deaths in public hospitals.
They also called for compensation and justice for families of women who died as a result of negligence or corruption in maternal facilities.
Government Reaction
While the government has yet to issue an official response to the report, officials from the Ministry of Health and Sanitation and the Anti-Corruption Commission (ACC) have in the past acknowledged challenges in managing the Free Healthcare system, including the misuse of drugs, poor staff attitudes, and lack of accountability in hospital administration.
Observers, however, say the revelations by Amnesty International and Human Rights Watch should serve as a wake-up call to the authorities to confront the deep-rooted problems that continue to put women’s lives at risk.
A Call for Urgent Change
The report’s title — “No Money, No Care” — captures the stark reality for many Sierra Leonean women: that childbirth, instead of being a moment of life and joy, too often becomes a deadly gamble.
As international rights groups and local advocates intensify calls for reform, one message echoes across the country — Sierra Leone’s mothers and newborns deserve better than corruption, neglect, and silence.