By: Laymah Kollie
Mamba Point – The United Nations Population Fund (UNFPA) has called on Liberia to eliminate service fees charged to survivors of gender-based violence (GBV) at public health facilities, warning that the practice is undermining the country’s own commitments to protect women and girls.
Speaking Wednesday at a High-Level Policy Dialogue on Removing Service Fees for GBV Survivors, UNFPA Deputy Officer-in-Charge Leonard Kamugisha said survivors who summon the courage to seek help are too often met first by a registration desk demanding payment, rather than a provider ready to deliver care. “The first thing they encounter should not be a registration desk demanding a service fee,” Kamugisha said, adding that survivors should instead meet “a service provider with open arms and ready to provide life-saving care.”
Kamugisha acknowledged that Liberia has made real progress on GBV, pointing to the government’s inclusion of a target to cut GBV incidence by half under its national development agenda, alongside improved prevention, reporting, and clinical response systems. He said Liberia has shown “an unwavering commitment to fighting Gender-Based Violence.” But he said that progress is being undercut at the facility level, where financing gaps often push clinics to charge survivors out of pocket, even though national policy calls for free care.
He was careful to note the fees are not imposed out of malice. Many facilities, he said, levy the charges “not out of malice, but out of necessity to cover running costs” to stay open amid insufficient government funding, but the effect on survivors is the same regardless of the motive behind it.
The UNFPA official stressed that delays caused by an inability to pay can have life-altering consequences. He pointed specifically to “the crucial 72-hour window” for post-exposure prophylaxis (PEP) against HIV and emergency contraception, warning that this window “closes while a survivor scrambles to find money.”
Beyond the immediate health risks, he said, financial hurdles “feed into the shadows of stigma and fear,” discouraging reporting and letting perpetrators walk free, with user fees that “disproportionately punish the least privileged, most vulnerable women and girls” in rural and peri-urban areas.
Alarming Numbers on Child Survivors
Kamugisha cited figures from Liberia’s health management information system covering the past five years that point to a health and protection crisis largely affecting children.
According to the data he presented, adolescent girls between the ages of 10 and 19 accounted for 91 percent of reported rape survivors, with girls aged 10 to 14 alone making up 61 percent of cases. Less than half of survivors, 47 percent, reported to a health facility within the critical 72-hour period, and even among those who did, only 31 percent received HIV prophylaxis and just 26 percent received emergency contraception in time. Kamugisha said the numbers are “a clear demonstration that the survivors of sexual violence are also some of the most vulnerable in our communities.”
However, Kamugisha said UNFPA’s work in Liberia is guided by a global strategy aimed at ending unmet need for family planning, preventable maternal deaths, and gender-based violence altogether. He said the agency stands ready to support the policy dialogue and the resulting document, describing the removal of user fees for GBV survivors as “a milestone not just for the health and wellbeing of survivors but for justice as well.”
“UNFPA remains committed to working with all partners to support the government of Liberia to achieve its development agenda and to ensure a Liberia where every girl and woman can live with dignity,” Kamugisha said.
The dialogue, held in Monrovia, drew legislators, government ministers, UN agency representatives, and civil society organizations.
