After assuming office in 2007, Ernest Bai Koroma faced a country in distress. Just five years prior Sierra Leone had concluded a fierce 11-year civil war leaving the nation in shambles. The government was no longer capable of delivering basic services to its citizens and there was a vast need for repair in industries such as energy, agriculture, infrastructure and health. The president was faced with the task of deciding what to do about the extremely high maternal and child death rate in the country-which were the highest in the world at the time. There had already been failed attempts at providing free health care in the country so when Koroma announced his initiative to provide free health care to pregnant women, lactating mothers and children who were under the age of five, he faced skeptics who were unsure about his plan. Despite the opposition and criticism of the president’s ambitious plan and quick time frame to implement the policy, Koroma was able to implement the program in Sierra Leone. Many hurdles and obstacles were in the way of the plan and its success as well as important lessons learned throughout the process in regards to reforming the health institution in Sierra Leone.
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