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Title
Sierra Leones decentrale sundhedssystem - med særlig fokus på Free Health Care Initiative Sierra Leone's decentralized health system |
Full text
http://rudar.ruc.dk/handle/1800/10211 |
Date
2013 |
Author(s)
Thordal Jensen, Sara |
Contributor(s)
Prag, Ebbe; Dybbroe, Betina |
Abstract
The option to receive healthcare at a facility in Sierra Leone is very limited, a fact also reflected in the statistics. The country has some of the highest maternal and child mortality rates in the world. The government therefore launched the Free Health Care Initiative for children and pregnant women in 2010 and as a result, healthcare became free for these groups. However, there have been several issues with the implementation of this initiative. This thesis seeks to explore a decentralised healthcare system in the Tonkolili district in Sierra Leone. By observing and analysing the different aspects of the current decentralised healthcare system the thesis will investigate why the implementation of the Free Health Care Initiative is proving to be difficult. It will further highlight the health strategies pregnant women and children take when they experience difficulties with the Free Health Care Initiative. The methodology for exploring the complexity of the current healthcare system is based on a comprehensive collection of empirical data from the Tonkolili district, conducted in June 2012. To analyse and understand the interviews from this empirical data, the concept of empowerment in health promotion is used. Furthermore, Olivier de Sardan and Christian Lund's theories on decentralised systems in an African context are used as the theoretical framework. The key findings of this thesis reveal that the public healthcare system within the Tonkolili district is relatively weak and cannot provide the healthcare required by the national and international influencers. Public healthcare within the district is challenged by competition from pharmacies and a NGO hospital located in the district. It is also influenced by a number of corrupt local practices which all interfere with the effort of monitoring and coordinating the Free Health Care Initiative. When the public healthcare system does not provide the service that pregnant women and children need they are forced to use other health strategies, such as seeking help at pharmacies or at the NGO hospital. In extreme cases pregnant women and mothers of children under the age of five can lose control of their health situation which may due to the failure of implementing the Free Health Care Initiative. However, it is interesting to note that the initiative has resulted in a drop of maternal and child mortality rates. |
Subject(s)
Sierra Leone; distrikt; Sundhedssystem; decentral; Free Health Care Initiative; Masanga; Health system; Tonkolili district |
Language
da_DK |
Type of publication
Thesis; IU-studier / International Development Studies - Master thesis; Sundhedsfremme og sundhedsstrategier / Health Promotion and Health Strategies - Master thesis |
Repository
Roskilde - Roskilde University Digital Archive (RUDAR)
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Added to C-A: 2014-02-10;13:22:25 |
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