International rights group Amnesty International said on Tuesday that one in eight women in Sierra Leone risks death during childbirth or pregnancy and the government must act to improve maternal health care.
"Women and girls are dying in their thousands because they are routinely denied their right to life and health, in spite of promises from the government to provide free health care to all pregnant women," it said.
The organisation called the one-in-eight number "one of the highest maternal death rates in the world."
"Thousands of women bleed to death after giving birth," Amnesty said in a statement. "Most die in their homes. Some die on the way to hospital, in taxis, on motorbikes or on foot."
It added that "less than half of deliveries are attended by a skilled birth attendant and less than one in five are carried out in health facilities."
British Prime Minister Gordon Brown is expected to announce new financing for health care in developing countries, including Sierra Leone, at the United Nations General Assembly on Wednesday, Amnesty said.
"Additional money is desperately needed in Sierra Leone but will not reach women and children in remote areas who are at greatest risk," said the organisation's secretary general, Irene Khan.
"The lives of women and girls will only be saved when the health system is properly managed and the government is held to account."
Campaigners will tour the war-torn West African country in the coming weeks to spur debate on the issue, Amnesty said.