Sierra Leone

Photo of nurses helping a newborn child in the maternity ward at the Princess Christian Maternity Hospital, in Freetown Sierra Leone on June 18, 2015. Photo: Dominic Chavez/World Bank
Nurses help a newborn child in Freetown, Sierra Leone. Photo: Dominic Chavez/World Bank

Throughout the five-year project period RRHO supports and complements HRSA’s Resilient and Responsive Health Systems (RRHS) initiative implemented by ICAP at Columbia University in Sierra Leone. In so doing, both projects jointly strengthen the ability of the impact partners to become self-learning organizations that are also interdependent and can promote and capacitate South-South engagement with the goal of contributing to PEPFAR’s human resources for health (HRH) strategy:

Policies & Guidelines

Visit the Resource Library to access and download national policies & guidelines for Sierra Leone.

Country Indicators

Population (Global Health Observatory, 2016): 7,396,000
Life expectancy at birth M/F (years) (Global Health Observatory, 2016): 52/54
Under-5 mortality (Demographic and Health Surveys [DHS]): 181/1,000 live births (rural), 158/1,000 live births (urban)
Maternal Mortality Ratio: 1,165 / 100,000
Children <5 underweight (CIA World Factbook): 18.1%
Disease burden (HRH Strategy 2017-2021):

  • Malaria incidence rate: 406 per 1,000 population at risk
  • Tuberculosis incidence rate: 310 per 100,000 population
  • HIV prevalence rate: 1.3% in adults ages 15-49

HIV in Sierra Leone

Since 2010, new HIV infections have increased by 7% and AIDS-related deaths have increased by 6%. Sierra Leone’s fragile health system was weakened by the Ebola virus disease outbreak in 2014–2015. The national response is guided by the National Strategic Plan of 2016–2020. Sierra Leone is the first country in western Africa to have an approved public health approach towards programming for key populations. The country has a funded catch-up plan that is being delivered through the Fast-Track cities initiative (UNAIDS).

Number of people living with HIV (UNAIDS 2017): 61,000 [51,000 - 73,000]
Adults aged 15 to 49 prevalence rate (UNAIDS 2017): 1.4% [1.1% - 1.7%]
Adults aged 15 and over living with HIV (UNAIDS 2017): 55,000 [46,000 - 66,000]
Women aged 15 and over living with HIV (UNAIDS 2017): 32,000 [27,000 - 39,000]
Children aged 0 to 14 living with HIV (UNAIDS 2017): 5,500 [3,800 - 6,700]
Deaths due to AIDS (UNAIDS 2017): 2,600 [2,100 - 3,200]
Orphans due to AIDS aged 0 to 17 (UNAIDS 2015): 23,000 [18,000 - 28,000]

WHO Building Blocks in Sierra Leone

This WHO framework describes health systems in terms of six core components or “building blocks” including service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership & governance (WHO, 2010). Click on each tab to explore these health system indicators.

Service Delivery

  • Primary health units (PHUs) (UNICEF 2014): 1,185
  • Health facility availability of running water (UNICEF 2014, pg.48): 21%
  • Available water / soap for handwashing at PHUs (UNICEF 2014, pg.50): 98% / 93%
  • Available detergent / chlorine at PHUs (UNICEF 2014, pg.50): 41% / 9%
  • Functioning incinerator or appropriate burning pit for waste management at PHUs (UNICEF 2014, pg.52): 72% [53% - 80%]
  • PHUs with ambulance available on call (UNICEF 2014, pg.52): 59% [45% - 67%]
  • Facilities with basic equipment required for service delivery (Basic Package of Essential Health Services 2015-2020): 35%
  • Number of health facilities by district (Basic Package of Essential Health Services 2015-2020): Table 1 below

Table 1: Number of Health Facilities by District, July 2015

Organization unit MCHP CHP CHC Government Hospital Private Clinic Private Hospital Total
Bo 69 24 28 1 2 3 127
Bombali 55 32 15 1 5 3 111
Bonthe 15 26 14 1 4 2 62
Kailahun 18 42 14 1 1 1 77
Kambia 40 15 13 1 2 1 72
Kenema 60 33 26 1 2 2 124
Koinadugu 43 18 10 1 2 0 74
Kono 44 25 16 1 1 0 87
Moyamba 55 26 18 1 2 1 103
Port Loko 70 21 15 2 1 2 111
Pujehun 49 14 13 1 0 0 77
Tonkolili 75 15 12 1 1 2 106
Western Area 39 28 39 11 22 10 149
Total 632 319 233 24 45 27 1280