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Sierra Leone - P4H Network
Current Health Expenditure (CHE) as % Gross Domestic Product (GDP)8.6%CHE/GDP
Out-of-pocket (OOPS) spending as % of Current Health Expenditure (CHE)51.4%OOP/CHE
Domestic General Government Health Expenditure (GGHE-D) as % General Government Expenditure (GGE)6.9%GGHE-D/GGE
Gross Domestic Product (GDP), in constant (2020) US$ per capita4BGDP (USD)
Population in thousands (K), millions (M) or billions (B)8.4MPopulation
Incidence of Catastrophic Health Spending at 10% Threshold (SDG 3.8.2) Total16.4%Catastrophic Health Spending

Meeting the African Union's health spending standards to advance universal health coverage

Sierra Leone’s health sector still heavily depends on out-of-pocket (OOP) spending

Total health expenditure increased by 22% from SLE 3,421 billion (about $346.5 million) in 2019 to SLE 4,184.5 billion in 2020 (approximately US$ 287.5 million). In 2020, the percentage of household OOP marginally decreased from 52.9% to 52.3%.

The country’s nominal GDP in 2020 was USD 3.9 billion and GDP per capita was US$ 533. The health budget allocation for 2019-2020 was 11%, which is 4 percentage points less than the 15% threshold for government health spending set by the African Union’s Abuja Declaration in 2001.

Ministry of Health and Sanitation implemented reforms

The Life Stages Approach of the Ministry of Health and Sanitation (MOHS) aims to provide high-quality health care throughout life without financial hardship to households. Reforms implemented include launch of the Free Health CareInitiative (FHCI) in 2010. FHCI eliminated fees for basic maternal, child and primary care services for pregnant women, children under five and seniors. Removal of these financial barriers aims, therefore, to improve access to targeted services, especially maternal and child health services. In turn, improved access should result in higher utilization rates and improved health outcomes.

Key documents support journey towards universal health coverage

In December 2021, the MOHS launched a universal health coverage (UHC) road map during Universal Health Coverage Day celebrations. The road map provides steps and milestones. It also provides a framework for critical reforms in health financing, including a social health insurance scheme that the country has been exploring since 2007. Other key health financing documents that have been launched and support the country’s journey towards UHC include the National Health and Sanitation Policy, National Health Sector Strategic Plan and the Health Financing Strategy.

In addition to Sierra Leone’s UHC road map and the processes and reforms that the country has taken to date and continues to take as it moves towards attaining UHC, in September 2022, Sierra Leone benefited from collaboration with its first P4H country focal person