R4D Sierra Leone

Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for Human Resources for Health (HRH)

Thu, 05 Apr 2012 07:48 GMT

Document Type: Case Study
Creator: McPake, B.; Witter, S.; Ensor, T.; Fustukian, S.; Newlands, D.; Martineau, T.

Production Year: 2011

Citation: McPake, B.; Witter, S.; Ensor, T.; Fustukian, S.; Newlands, D.; Martineau, T. Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for Human Resources for Health (HRH). Queen Margaret University, East Lothian, UK (2011) 196 pp.

Summary:

In the last decade a growing consensus has emerged that user fees are regressive and undermine equitable access to essential health services, and in particular, may negatively affect pregnant women and children under five. A policy shift removing or reducing fees has occurred with consequences for the health system, including the need for replacement revenue and to ensure quality in response to increased utilization. Both of these raise specific concerns for human resources for health (HRH) and suggest that careful planning of the supply side response to the demand stimulated by removal of fees has to take place.

This research responds to this concern. Its objective is to determine the associations and interrelationships between workforce characteristics (stock, distribution, competencies and motivational state) and equitable access to Reproductive, Maternal and Neonatal Health (RMNH) services resulting from the removal of, or exemption from user fees.

The study was conducted in five countries: Ghana, Nepal, Sierra Leone, Zambia and Zimbabwe, and consisted of literature review of international and local published and grey literature, desk based analysis of secondary data from the five countries and field work in two countries, including primary data collection in Zimbabwe.

This document comprises a 6-page policy brief, the main report, the literature review, the 5 case studies and references.

Case Study: Women and politics in Sierra Leone

Fri, 02 Mar 2012 08:32 GMT

Document Type: Case Study

Production Year: 2011

Citation: Anon. Case Study: Women and politics in Sierra Leone. Pathways for Women's Empowerment RPC, Brighton, UK (2011) 2 pp.

Summary: Despite the engagement of Sierra Leonean women in the peace process, and efforts to increase women's participation in public life, they face difficulties today in entering parliamentary politics. Since the end of the country’s brutal civil war in 2002, Sierra Leone has had two national and two local elections, with preparations for a third round of national and local elections underway in 2012. Despite some positive changes, especially at the local level, women continue to be underrepresented in Sierra Leone’s political institutions. Sierra Leonean women have a distinguished history of involvement in pre-independence politics. Unfortunately, the country’s chequered political history of coups and counter-coups and one-party authoritarianism in the post-independence era, put an end to women’s political activism. Despite their lack of involvement in politics prior to the civil war, women and women’s organisations have played a vital role in promoting peace and leading high profile campaigns to increase women’s representation in public life. Yet still Sierra Leonean women are poorly represented in parliament and local governance.

A research programme to support health system development in Sierra Leone

Fri, 02 Mar 2012 07:27 GMT

Document Type: Briefing
Creator: ReBUILD

Production Year: 2011

Citation: ReBUILD. A research programme to support health system development in Sierra Leone. ReBUILD Consortium, (2011) 2 pp.

Summary: A brief overview of the health system in Sierra Leone, and the approach ReBUILD is taking to support development of the health system following thc conflict in the country, is presented.

Bio-United case study

Thu, 01 Mar 2012 10:19 GMT

Document Type: Case Study
Creator: AECF

Production Year: 2011

Citation: AECF. Bio-United case study. (2011) 7 pp.

Summary: In late 2008 Bio United (a subsidiary of Biolands International) started operations with no grid power, like most 85% of rural Sierra Leone, and in the absence of a good phone signal or internet connection, and established their base on the outskirts of Pendembu. Their model emphasizes local governance and management of cocoa production supported by expert advice on improving the quality of farm management and the value of the crop. AECF provided a grant matched by company investment to develop the business from which farmers get a greater proportion of the value of the cocoa they produce.

Women's voices, work and bodily integrity in pre-conflict, conflict and post-conflict reconstruction processes in Sierra Leone

Wed, 01 Feb 2012 09:40 GMT

Document Type: Conference Paper
Creator: Abdullah, H.; Ibrahim, A. F.; King, J.

Production Year: 2006

Citation: Abdullah, H.; Ibrahim, A. F.; King, J. Women's voices, work and bodily integrity in pre-conflict, conflict and post-conflict reconstruction processes in Sierra Leone. Presented at West Africa Scoping Workshop of the Pathways of Women's Empowerment Research Programme Consortium Meeting, Accra, Ghana, 4-7 July 2006. (2006) 22 pp.

Summary: This Country Paper on Sierra Leone was prepared for the West Africa Scoping Workshop, Accra, Ghana, 4-7 July 2006.

Pathways West Africa Synthesis Report 2006-2011

Thu, 26 Jan 2012 09:45 GMT

Document Type: Report
Creator: Pathways West Africa

Production Year: 2011

Citation: Pathways West Africa. Pathways West Africa Synthesis Report 2006-2011. Pathways West Africa, Accra, Ghana (2011) 36 pp.

Summary: This report provides highlights of some of the activities and research undertaken over the past five years. The three countries, on which this research is focused, Ghana, Nigeria and Sierra Leone, share a common colonial history and pre-independence nationalist collaborations, and present commonalities as well as important differences for studying the pathways which women collectively and individually have taken toward their empowerment. Women in all three countries have high fertility and high maternal mortality rates, and high labour force participation rates with marked levels of personal autonomy, but they have low visibility in current politics and decision-making structures at local and national levels. The Pathways of Women’s Empowerment RPC provided an opportunity for hub researchers to plan and conduct research on some common themes (policy processes and discourses on empowerment; work and changes and continuities in women’s everyday lives; popular culture; women in local governance structures), and to be in continuous dialogue and exchange with researchers in other hubs. The process, methodologies, findings and communication strategies continue to yield a rich harvest with implications for policy, theory, activism and further research.

Women engaging politically: beyond magic bullets and motorways

Fri, 20 Jan 2012 05:37 GMT

Document Type: Research Paper
Creator: Tadros, M.

Production Year: 2011

Citation: Tadros, M. Women engaging politically: beyond magic bullets and motorways. Pathways Policy Paper, October 2011, 14 pp.

Summary: This policy paper adopts an upside-down approach to women’s political empowerment. While the number of women we need to get into legislatures has often assumed centrestage, this paper takes women’s pathways as its starting point. In so doing, it challenges the narrow conception of women’s political engagement as occupying formal positions and seeks to present a more nuanced perspective on the spaces, relationships and ways of working that influence power hierarchies and dynamics. The paper’s aims are two-fold. First, through a multi-country case study, it explores the possibilities and limitations of mainstream approaches such as quotas to strengthening women’s access to political power. Second, it seeks to broaden the debate by practically engaging with the question of how we can support women’s political leadership in ways that speak to women’s realities in very concrete ways.

Africa Health Infoway Final Report.

Wed, 23 Nov 2011 06:26 GMT

Document Type: Technical Report

Production Year: 2011

Citation: Anon. Africa Health Infoway Final Report. WHO, Geneva, Switzerland (2011) 5 pp.

Summary:

The (AHI) was intended to be a district-based public health information network for African health. It aimed to provide a technology platform to collect sub-national health data and statistics for analysis and dissemination. This data would in turn be used to facilitate decision making in health, and to strengthen the capacity of African countries to use information in decision making.

AHI completed a scoping study, which was carried out in selected countries to assess the existing environment in the use of ICT in public health at district level.

Decentralization in Sierra Leone: Impact, Constraints and Prospects.

Thu, 17 Nov 2011 03:46 GMT

Document Type: Technical Report
Creator: Fanthorpe, R.; Lavali, A.; Sesay, M. G.

Production Year: 2011

Citation: Fanthorpe, R.; Lavali, A.; Sesay, M. G. Decentralization in Sierra Leone: Impact, Constraints and Prospects. Fanthorpe Consultancy, Purley, UK (2011) 105 pp.

Summary:

DFID Sierra Leone and other donors have been supporting a long term project to re-establish decentralised governance in the towns and districts of Sierra Leone. Local councils have now been in operation for seven years and are set to receive greater fiscal transfers from central government. With options now opening up to channel additional resources through decentralised local councils, this study was commissioned to assess: (a) the impact of local councils on the delivery of pro-poor development, particularly the delivery of basic services and on opportunities for poor people to articulate their voice; (b) the institutional strategies and power relationships that affect local councils' capacity to fulfil this design purpose. The fundamental question here is whether elected local councils have provided a more effective means – or perceived to be more effective – of delivering development outcomes and responding to the needs of the poor.

Specific questions addressed in the study:

Have local councils had a material impact on development outcomes in terms of the delivery of basic services?
Have local councils improved pro-poor decision making and enhanced poor people's voice in local level political structures?
To what degree have local councils used their power to deliver development outcomes that would not otherwise have taken place?
To what degree have established local power networks particularly chiefs ? been affected by the establishment of local councils?
What are the major constraints upon making local councils more powerful actors in delivering pro-poor development and enhancing poor people's voice in local decision making?
How do local people and civil society groups perceive local council operations, particularly in comparison and contrast to existing chieftaincy structures?

Successive sections of the report analyse findings from the four research components (literature review, key informant interviews, focus group discussions and a quantitative survey of 600 questionnaires covering four districts: Bo, Bombali, Kono and Western Area Rural District (WARD)). The report concludes with responses to the main research questions. A full version of the literature review is annexed along with the tabulated survey results.

Decentralization in Sierra Leone: impact, constraints and prospects

Fri, 11 Nov 2011 11:37 GMT

Project Status: Completed
Project Background:

Specific questions addressed in the study:

Have local councils had a material impact on development outcomes in terms of the delivery of basic services?
Have local councils improved pro-poor decision making and enhanced poor people’s voice in local level political structures?
To what degree have local councils used their power to deliver development outcomes that would not otherwise have taken place?
To what degree have established local power networks – particularly chiefs – been affected by the establishment of local councils?
What are the major constraints upon making local councils more powerful actors in delivering pro-poor development and enhancing poor people’s voice in local decision making?
How do local people and civil society groups perceive local council operations, particularly in comparison and contrast to existing chieftaincy structures?

Approach and Methodology
The research had four components:

Literature review
Key informant interviews
Focus group discussions
Quantitative survey of 600 questionnaires covering four districts: Bo, Bombali, Kono and Western Area Rural District (WARD)

Project Objectives: This study was commissioned by DFID to assess:

The impact of decentralized structures (local councils) on the delivery of pro-poor development, particularly the delivery of basic services and on opportunities for poor people to articulate their voice.
The institutional strategies and power relationships that affect local councils’ capacity to fulfil this design purpose.

Project Conclusions: The conclusions and response to the research questions are in the executive summary of the main report, pages 2-6