CTAP II – Country Specific Health Sector Accountability Report for Sierra Leone

Sierra Leone has some of the world's worst health indices, with a life expectancy of 47 years, an infant mortality rate of 89 per 1,000 live births, an under-five death rate of 140 per 1,000 live births, and an infant mortality ratio of 857 per 100,000 births (SLDHS, 2008). Most illnesses and deaths in Sierra Leone are preventable, with dietary deficiencies, pneumonia, anaemia, malaria, TB, and now HIV/AIDS being the leading causes of death. Diarrhoea and acute respiratory infections are also major causes of hospitalization and illness in the country. The rural population and ladies within the rural population bear the largest burden of disease. Women are also more likely than men to be forced to curtail their economic activity due to illness. Sierra Leone's healthcare expenses remain relatively high, resulting in low usage (on average 0.5 visits per person per year). Out-of-pocket expenses of over 70% remain among the highest in Africa (NHA Report, 2007).