-Due to lack of hospital bill
BY: Shallon S.Gonlor
Dozens of women who have recently given birth at government health facilities in Nimba County are currently reportedly being held captive as they are unable to cover their hospital expenses. WomenVoices has been hinted that these women have been made to remain detained at local health facilities and referral hospitals across the county due to financial constraints.
As we can recalled, this practice goes against the established framework set by Liberia’s Ministry of Health and its partners, aimed at promoting childbirth in healthcare facilities..
This revelation appears more vivid, considering cases of recent mothers who are still being held in medical custody at various government-run health centers, despite giving birth a month ago. Reports indicate that these women are required to pay a hospital fee of at least $15,000.00 LD before they can be discharged and return to their homes.
Sources familiar with the matter, including individuals within the healthcare sector in the county, have highlighted the persistent violation of women’s rights in such facilities. An example cited is that of a young woman in her early 20s who is currently admitted at G.W. Harley Hospital in Sanniquellie City, facing pregnancy complications necessitating urgent medical intervention, possibly surgical, to safely deliver her baby.
Despite receiving treatment initially without any upfront charges, she remains detained at the health center as of February 2024 due to her inability to settle the hospital bill.
Like her, several other women who are still undergoing treated at the facilities in the county are likely to have similar experience,
and it is said that if they cannot afford to pay the targeted bill on departure, they may be detained. This leaves them with no option but to remain at the hospitals with their babies for weeks or months while their families raise the necessary funds.
Our informers at various local health centers also stressed that women are not denied treatment, but point to the need for co-payments for services delivered before being discharged from the facility.
This practice, accordingly is not just limited to maternal health, it also happens with other patients who have had surgical or other costly procedures.
Women who need emergency obstetric care are therefore faced with dilemma; risk giving birth at home without access to medical care, or face an uncertain period of detention in hospital until someone pays their bill.
Women detention is detrimental to maternal and child health with short and long-term implications for the infant. Pregnancy and childbirth are precarious times for both mother and baby and institutional deliveries are considered best practice in global health.
The threat of being detained discourages women from going to hospital, reducing antenatal care and increasing the risk of maternal and infant death around childbirth.
Detention is an abuse of women’s and children’s rights and contravenes national and international laws.
Meanwhile, there appear to be two main reasons that this illegal practice persists in the health system; a persistent shortage of government funding to public hospitals; and poor governance within the health facilities.
Given the complex nature of hospital detentions, reflecting failings in health systems, governance and financing, eliminating this practice is not always straightforward. It requires concerted action across to include political leaders, health, justice and finance ministries, local government, and local community groups.
The exact policy and systems reforms required will depend on the context of each Liberian, relevant stakeholder, and civil society group as a strategy to address this problem.
At the same time, diverse voices of Nimba citizens are calling on the Government of Liberia through the Executive and Legislative Branches to introduce specific legislation “Hospital Detention Law” that will assist implementation, evaluation, and protect pregnant women against the encroachment of informal hospital fees.
The citizens of Nimba said free health care for pregnant women and children if implemented will promote access to health services and accelerate progress towards the child and maternal health millennium development goals.
For the mother and child, the benefits are obvious both in financial and health terms, resulting in reduced mortality and morbidity by encouraging delivery in a facility.
Referencing an evidence in Ghana, the universal free care for pregnant women increased health facility utilization and reduced inequalities, with a greater increase in the proportion of facility-based deliveries amongst the poorest groups.
The citizens also contended that increasing health coverage leads to improved population and better maternal healthcare which can lead to healthier offspring decades later.
While benefits are clear, the costs of financing free health services from already stretched state budgets, with many competing priorities, is a major hurdle.
Public hospitals in Liberia are typically severely under-resourced, and healthcare workers are poorly paid.
Outlining significant need for free health care delivery for pregnant women, the citizens noted that it is essential that public financing be allocated efficiently and equitably to meet the healthcare needs of vulnerable groups including pregnant women and young children in health facilities.
They added further that stopping the detention of patients does not prevent other substandard or inhumane practices from occurring. It is, however, an obvious extreme that should not be tolerated.
For their part, several victimized women who also spoke lamented that banning the detention of pregnant women who have given birth and baby in hospitals, and providing free health services for them should be a top priority for the government and development partners of Liberia President, Joseph Boakai and Vice President Jeremiah Koung presidency.
The scores of women stated that ending the practice of medical detention has an important role in advancing women’s rights and respecting their dignity, improving both their health and the health of their children.
