Citizens Accuse Health Facility of Charging Higher Fees for Newborn Boys

By: Akiah P. Glay Dormoh

In Grand Bassa County, the Gorblee Health Center, a government hospital stands accused of charging fees according to the sex of a newborn child. It is well-known that resources allotted to hospitals are stretched thin. Nonetheless, the disparity in fee payment has considerably raised eyebrows.

In Gaye Peter Town, Compound #3, Grand Bassa County, citizens did not only accuse the facility of charging excessively when pregnant women go to the hospital to give birth, they also laid a charge that the amount the facility collects after the delivery of a boy differs from that which is charged for the delivery of a girl. Citizens have told CENTAL that Five Thousand Liberian Dollars (L$ 5,000) is charged as fees for a girl child born at the facility and Seven Thousand Liberian Dollars (L$7,000) is charged for a newborn boy.  Speaking with CENTAL’s Open Expenditure Initiative team members, Madam Victoria (not her real name) who occupies a key position in the community alluded to the impact of the situation. “I have three children, two boys, and a girl. I was told to pay L$4,000 for my daughter and L$7,000 for my sons. I begged and paid 4,500 and 6,500 each. This has made me stop giving birth because I don’t have that kind of money to pay every time,” she said. Several other citizens confirmed the allegation, including prominent and eminent citizens in the community.

Meanwhile, Madam Lydia Kanneh, Officer-In-Charge (OIC) of the health center, denied the allegations. “The minimum amount charged at the hospital is 2,500 and this is cut across, whether male or female. Unless in extreme cases, then more than that will be required. Otherwise, the aforementioned amount is constant,” Madam Kanneh noted. According to her, the purpose of such a fee is to buy hospital materials and compensate midwives who serve as Community Health Providers. In 2016, the government and its partner launched a National Health Assistant Program that ensured traditional midwives were trained to serve and provide assistance to pregnant women living five kilometers or further from a health facility before referrer to a  hospital.  This remedy emerged due to the high maternal mortality rate observed in the country.  The most alarming thing is that pregnant women are charged to access public health facilities that the National Health Policy deemed free.

The 2011-2021 National Health Policy plan[i] mandates free health services for pregnant women. According to the policy, even low fees could deter health-seeking behavior. Therefore, to encourage the uptake of priority services by all people, there should be no fee attached. Imagine if a pregnant woman comes to give birth and doesn’t have money, what will be the outcome? Even as Liberia encourages hospital deliveries to lower newborn maternal death rates, the policy has the opposite impact. Liberia has one of the highest rates of death for newborns in the world.  According to UNICEF, 76 of 1,000 births. The maternal mortality rate from the 2019-2020 Country Health[ii] Survey indicates  93 deaths per 1,000 live births in the 5 years in Liberia preceding the survey, while child mortality was 33 deaths per 1,000 live births and infant mortality is  63 deaths per 1,000 live births. this situation cannot be unique to the Gorblee health center, but other centers in Liberia alike; For instance, FrontPage Africa Reported in 2020 that the acting administrator of Phebe[iii] Hospital warned that patients, who require surgery and emergency services would be made to pay for the cost of fuel. This, according to Rev. Victor Padmore, would help sustain the services at the hospital. Though the policy indicates free, but citizens have always either brought their own supplies or paid some fees. Viola Makor, a  resident midwife at the Link Maternal Waiting Home and the reproductive health supervisor for Suakoko District in Bong County attested when she spoke with Yassah Levelah, the CEO of Comfort Closet that many[iv] women in the community shy away from hospitals because of the demand from the hospitals. For the policy to impact the general public, one of the primary concentrations of the government should be to prioritize health, including ensuring information about healthcare prices is clear and accessible to the public together with increasing healthcare workers’ salaries. 

[i] http://moh.gov.lr/wp-content/uploads/National-Health-Policy-Plan-MOH-2011-2021.pdf

[ii]  Libera Demographic and Health Survey 2019-20  

[iii] https://frontpageafricaonline.com/health/liberia-stranded-phebe-hospital-charging-patients-for-fuel-fee-before-treatment/

[iv] https://www.npr.org/sections/goatsandsoda/2022/10/15/1126110420/giving-birth-in-liberia-you-might-need-to-bring-your-own-bleach-to-get-in-a-hosp

John Doe ‘Liberia Stranded Phebe Hospital’ (2022) Frontpage Africa < https://frontpageafricaonline.com/health/liberia-stranded-phebe-hospital-charging-patients-for-fuel-fee-before-treatmen  t/> accessed 5 June 2023.