Date of Conferral



Doctor of Public Health (DrPH)


Public Health


James Rohrer


Improving maternal health has been a challenge for developing nations with very high rates of maternal mortality. Sub-Saharan Africa, particularly Sierra Leone, has some of the highest maternal mortality rates in the world. In an attempt to improve on this, the Sierra Leonean government enacted free maternal healthcare services in 2010. The Sierra Leone Free Healthcare Initiative (SLFHCI) provides free healthcare for pregnant women, lactating mothers, and children under 5 years old. This research explored the impact of the free healthcare on hospital deliveries. The determinant of health model was used to evaluate the effectiveness of the SLFHCI program, and a quantitative study design was used to analyze 1,200 samples of secondary data. Five research questions aimed to determine how the pre and postimplementation periods of the SLFHCI program impacted the rate of antenatal services usage, hospital deliveries, low birth weight deliveries, very low birth weight deliveries, and preterm deliveries. Descriptive statistics, chi-square tests, and logistic regression were used to analyze data. The results indicated improvements in antenatal visits, hospital deliveries, low birth weight deliveries, and preterm deliveries after adjusting for covariates. The results suggest that the SLFCHI program is an effective strategy for preventing low birth weight and preterm deliveries and for improving antenatal visits and hospital deliveries. The knowledge gained from this research could provide a roadmap for improving overall maternal care in Sierra Leone and other affected countries. Strategies to improve the quality of the SLFHCI intervention are worthy of further investigation