Launch Day
on Freetown Blog (Sierra Leone), 27/Apr/2010 15:07, 34 days ago
 This free healthcare issue - we need to grasp it with both hands!Yesterday was the last pre-launch Ministry Steering Group meeting, and there was much to discuss: have drug consignments reached all intended destinations? are they the right drugs? is all the equipment and renovation work completed? Are the monitoring arrangements in place? Have the messages been communicated properly? As far as HR is concerned, my boss was able to report that there are now 7077 health workers on the payroll and that all salaries (including new pay rates and back pay) have been sent from the Treasury to the banks. That is a huge achievement in itself and represents a lot of effort by a lot of people.I have just got back from the official launch event at the Childrens Hospital and it is certainly clear that the Free Healthcare message has been communicated OK.Yes, those are queues. It was predicted that on launch day many would turn up, curious to see if free health care is a reality, rather than because they are in need of treatment. I think that one of the challenges for staff today is to pick out the needy patients from among them. I just spoke to my boss who is back in Pujehun to oversee the launch. He says that all is under control there and people are being cooperative, so we can hope that is the situation elsewhere as well.There is a guy visiting from DFID this week, who has been involved with launching free healthcare initiatives in 9 countries and he has been very complimentary about the way the Ministry of Health here has prepared itself  and in such a short time. He has also been talking about the strong evidence that even small user fees are a major barrier to very poor people accessing healthcare; and the strong correlation between proportions of people accessing health services and population health outcomes. It does seem blindingly obvious to me that making poor people pay because they are ill is a bad idea, so it has been interesting to hear how much resistance has had to be overcome from the World Bank  to get to this point in Sierra Leone.Today is the start of a journey, rather than the end of it, but it is definitely cause for celebration. I have allowed myself to be persuaded to celebrate by going to an Akon Concert at the National Stadium tonight (no, me neither, but according to Wikipedia he has had 6 Grammy award nominations and is one of the most successful R&B singers of the 21st Century). So tonight you can think of me, as probably the guy with the worst sense of how to move with the rhythm, among an audience of 70,000.