Date of Award

Spring 5-10-2012

Degree Type

Honors College Thesis


Political Science, International Development, and International Affairs

First Advisor

Robert Press

Advisor Department

Political Science, International Development, and International Affairs


The West African nation of Sierra Leone has received a large amount of attention for its especially high numbers of maternal mortality. Women in that country face a 1 in 8 chance of dying in childbirth or of related complications (WHO, 2011). In response, in 2010 Sierra Leone instituted a policy of free medical care to pregnant women and children under age 5. The Free Health Care Initiative, as it is called, emphasizes physician and clinical care, an approach that seems top-heavy considering the severe lack of physicians in the country. This study will compare the Free Health Care Initiative of Sierra Leone to health care policy in the Netherlands, where midwife care and home birth are more common than any other industrialized nation. A comparison of maternal health care in Sierra Leone and the Netherlands is interesting, because both countries have a large number of births taking place at home, with a large number of midwives, and important, because these factors have not been compared in any previous study. While the consensus among development-minded organizations such as the World Bank, favors a modernization theory-based approach, this study argues that that more attention should be paid to the Dutch model of health care, and that more resources should be devoted to community-based health care.