
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
Sierra Leone Country Profile (IHME - Global Burden of Disease, 2018)
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 |