Sierra leone Health Profile 2012

HEALTH & DEVELOPMENT
1. Economic and Social development Based on the 2007 Human Development Report, Sierra Leone with a ranking of 177 out of 177 continues to be the least developed country in the world. This is corroborated by the fact that Sierra Leone is ranked 102 out of 108 in the Human Poverty Report with Human Poverty Index (HPI) of 51.7. Progress has however been made especially in creating enabling environment for socio-economic development. The economy witnessed an overall impressive performance in 2006 with real GDP growth estimated at 7.8% as against 7.3% in 2005.
2. Health profile Life expectancy at birth in Sierra Leone is estimated at 47.5years1. Low life expectancy rate in Sierra Leone is associated with heavy disease burden and high child and maternal morbidity and mortality. The underlying factors are pervasive poverty, high level of illiteracy especially among females, limited access to safe drinking water and adequate sanitation, poor feeding and hygienic practices, and overcrowded housing and limited access to quality health services. Disease Burden: Malaria accounts for about 48% of out patient attendances, accounting to about 25% mortality in children and under-fives. The strategic direction for malaria control is vector control and, prevention of malaria, prevention of malaria-in-pregnancy and heath promotion. Significant are Acute Respiratory Illnesses (ARI), 27%, STI and Diarrhoea. HIV/AIDS prevalence is becoming a threat. The national sero-prevalence as at 2005 is estimated as 1.53%. For TB the number of DOTS centre has increased to 80 nationwide and the case detection rate rose from 42% in 2004 to only 52.1% in 2007. Lassa Fever control scaled up. Mass drug administration pursued in control of Onchocerciasis. Hypertension, diabetes and mental illnesses are increasing with drastic changes in lifestyle and drug abuse.
Child and Maternal Morbidity and Mortality: Data shows that Sierra Leone has the highest under-five mortality rate in the world, with almost one out of three dying before the reaching the age of five. Main causes are Malaria, Diarrhoea and Pneumonia. Neonatal mortality account for 20% of all U5 mortality. Malnutrition plays an important part in U5 mortality. Sierra Leone is ranked as having the one of the highest rates of maternal mortality in the world. The main causes are obstructed labour, haemorrhage, anaemia and toxaemia in pregnancy.
3. Health systems Functional health facilities - There is inequitable distribution of service delivery points, rural areas suffering neglect; Challenges faced in supply of drugs and medicines, blood transfusion services, equipment supply and laboratory services (b) Human resources for health – Severe sshortfalls persist in the public services in 2008: Of 300 medical officer required, 78 are available; 600 nurses required, 315 available; 300 midwives required. (c) Administration and management of the health care delivery system – There is ongoing sector reform, in 2005, all primary health care (PHC) activities were devolved to local councils. As a result, government allocations for PHC are directly allocated to district councils through the Ministry of Local Government. The local councils in turn fund health activities proposed by the DHMT. (d) Health care financing - about 69.3% of the total health expenditure in Sierra Leone is out-of-pockets spending, 19.3% from the public sector and 0.4% from the private sector. The challenge here is to adopt a health sector financing policy and strategy that will be both equitable and pro-poor.