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Household level contribution to the Free Healthcare in Sierra Leone

Household level contribution to the Free Healthcare in Sierra Leone

As you would recall, the war years in Sierra Leone claimed thousands of human lives of both civilians and gun totters of the different warring factions. Men, who were mostly the combatants, were affected the most.  This led to an exponential increase in the membership of the widowhood community.  (Photo: Father assisting in child care)

This demographic pattern change in the church congregation (three times more women than men) was noticed by a pastor in one of the famous churches in Freetown.

The pastor was able to diagnose immediately why women were outnumbering by 3-folds the number of men, and he decided to offer special prayers for those women who had lost their husbands during the war. He invited the widows out so he can pray for them for God’s support towards securing new affair, meeting their basic needs among others.

It was shocking to the pastor seeing almost all the women coming out as widows. Interestingly, a couple was sitting at the front row and as the widows were queuing out for the prayers, the wife decided to join the queue. She informed her husband that she was going to join the line; and the husband burst with laughter but with an askance look; “Are you a widow? “he queried. But the woman being an illiterate, the husband painstakingly described to the madam “who is a widow, A woman who has lost her husband is called “Orbura” in Temne; “Po’nyahei” in Mende and “Kupepen” in Limba. You are damn blessed as I am by your side, so you are not a widow and please relax!”

The wife however, ignored the explanation and forced her way out whilst complaining to the husband that “I am more than a widow- for the past 20 years of our marriage you have failed to clothe me, you don’t take care of the kids; you hardly feed the home nor do you take care of my parents. What do you think is the difference between me and those widows?” The man in a very sombre and guilty mood apologized and asked the woman not to join the queue.

Most of our women are widows with living husbands. Husbands who do not care about the welfare of their families. They are dead during the day as they renege on their duties but alive at night in making more babies.

This article authored by a woman rightist is examining practical ways through which the household and notably the father (the supposed bread winner) can contribute to and/or complement the free health care initiative (FHCI) in a bid to save the precious lives of both the woman and child.

Despite macro-level challenges (unemployment, high illiteracy rates, weak health systems etc) the household can, to a very large extent, significantly contribute towards ensuring safe motherhood and enhancing the survival of newborns and children when adequate information is provided to the general populace.

This piece attempts to raise the consciousness of parents, the neighbourhood and relatives on their responsibility towards assisting a pregnant woman to successfully sale through pregnancy and ensuring the children survive beyond the critical age of 5 years and become useful citizens of this country.

One of the key steps of this support is improving the nutritional status of the household. Most married men visit cookery stalls and restaurants for breakfast, costing an average of Le5,000-Le10, 000. This guarantees a very delicious and well-balanced food and sometimes accompanied by soft drink. It would interest you to note that some of these are the men that leave with their wives as little as Le10,000 to feed a household of 5-6 members. This is a domestic injustice with dire consequence on the household nutritional status. This injustice should be tackled and household heads (the fathers) ensure nutrition of girls, pregnant women and nursing mothers are improved.

Evidence has shown that there is a strong association between maternal malnutrition and low birth weight. Malnourished mothers face a higher risk of complications and death during pregnancy and child birth. Also, children of these malnourished mothers are born with low weight, are disadvantaged from birth, fail to grow normally, and face a higher risk of disease and premature death.

In most of our traditional homes, when a meal is served in a house, the men eat first then women and children would eat from the remnant. Pregnancy increases the need for calories and essential micro nutrients and it’s high time this be changed and the pregnant woman be given priority in accessing adequate and well-balanced diet. This is similarly important for the growing child and lactating mother.

Another form of support is the facilitative role husbands and fathers can play towards the uptake of maternal and newborn care services.  Men should accompany their pregnant wives and nursing mothers to the clinic to ensure these women and their children benefit from the free curative and preventative services that will guarantee safe delivery and child survival in the home.

Also, the household should put modalities for birth preparedness and these include accessible emergency funds. It is essential that families have immediate access to funds for emergency care (prior to arrival to a health facility) and transport. This reduces delay in seeking care when an obstetric or neonatal complication is recognized. Birth preparedness also include preparing helpers and blood donors, and obtaining supplies needed for the birth, complication readiness and postpartum care to ensure protection of the mother and infant.

Further, household members should ensure they lessen the heavy physical workload for pregnant and new mothers. Maternity leave facilities should be adopted in our homes to encourage women to enjoy relative peace; free from the stress of heavy domestic chores and/or cash go-getting activities. This will guarantee quality care given to the infants and assisting the woman to enjoy a postpartum period.

Supporting mothers on child-rearing is another way of relieving women. Men should change their roles by assisting women in taking care of the babies and/or their siblings when the mother is overwhelmed. This includes changing of diapers, preparing meals, caring for the sick child and the like. This will promote the physical and mental well-being of the mother.

Households should provide psycho-social support to the pregnant and new mothers by discouraging violence against women in the home. Domestic violence, rape and sexual abuse are widespread in most of our homes and this affects women’s productivity, autonomy, quality of life and physical and mental well-being. Further, physical violence against pregnant women increases the risk of preterm labour and delivery, foetal deaths and low birth weight. The household, through the discouraging of this cowardly practice will increase the ego of our women and consequently will prepare them well through the journey to safe motherhood.

The Ernest Koroma Free health care doesn’t provide free food nor child support services. The free healthcare should not entice us to having many children than we can afford to maintain; hence the need to ensure sizeable families through the effective use of family planning services to avoid unwanted pregnancies.

Households should chuck out their ingrained cultural beliefs and myths surrounding family planning use as it is more sinful to put a woman through the risky journey to childbirth; and having children when you are not prepared to support them through to adulthood.

Evidence is abound that the free healthcare has done enormous difference in reducing the unwarranted deaths and suffering in the targeted vulnerable groups. There are however, some challenges ranging from the weak health systems to lack of resources in the implementation of this laudable life-saving scheme. This thus begs for the inputs of all and sundry to complement the efforts of the free healthcare in preventing deaths and promoting the health of our vulnerable groups of women and children in Sierra Leone.

Men should say no to the injustice – where women would have to die in their determination to bring happiness to the home. Fathers should be fully prepared to ensure the innocent child has equal right to good health, food and shelter and must achieve their potentials.

by Mr Alhassan Fouard Kanu

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