Assignment Reports
SAGE is a DFID supported, integrated programme to improve the lives of adolescent girls, responding to the multiple and interrelated disadvantages they face. It comprises two components: Delivery of integrated services for vulnerable adolescent girls through a safe spaces approach, including enhancing their access to sexual and reproductive health (SRH) education and services. Support for… Read more
This article presents the findings of a theory‐based evaluation of the Sierra Leone Free Health Care Initiative (FHCI), using mixed methods. Analytical approaches included time‐series analysis of national survey data to examine mortality and morbidity trends, as well as modelling of impact using the Lives Saved Tool and expenditure trend analysis. We find that the… Read more
This brief highlights how Sierra Leone can improve the sustainability of the free health care initiative (FHCI) financing, lower household out-of-pocket (OOP) payments on health care, and decrease its dependence on donors. A secondary analysis provides insights into how Sierra Leone could work towards achieving its longer-term health goal of Universal Health Coverage (UHC). If… Read more
As part of the review of Sierra Leone’s Free Health Care Initiative (FHCI), researchers assessed its monitoring and evaluation (M&E) system, strengths and weaknesses, and the changes that took place as a result of the FHCI. This brief notes that a strong M&E system is crucial to help improve performance and achieve results. Several key… Read more
In 2010, the Free Health Care Initiative (FHCI) abolished health user fees for pregnant women, lactating mothers and children under five. This was a response to very high mortality and morbidity levels among mothers and children and reports that financial costs were a major barrier to health service uptake and use by these groups. This… Read more
In 2010, the Government of Sierra Leone (GoSL) took steps towards establishing the Free Health Care Initiative (FHCI). At its core, this was the removal of user fees (on drugs and consultations) for pregnant women, lactating mothers and children under five. This brief is based on an independent review of FHCI completed in 2016, which looked… Read more
Refugee schools in West Africa tend to be dominated by men, with even early years classes taught mostly by male teachers. There are very few female teachers and even fewer female head teachers or education administrators. Although enrollment in the lower classes is more or less gender balanced, by the upper primary level, many of… Read more
This report details the results of a rapid review of the evidence with respect to three aspects of education service delivery in Sierra Leone. Firstly it considers the theory of change for a decentralised approach to improving education outcomes. Secondly, it considers the theory of change for Direct Instruction (DI) Lesson Approach. Thirdly, it considers theory… Read more
Dr Haja Wurie is based at the College of Medicine and Allied Health Sciences in Freetown, Sierra Leone. In this HEART talks video she describes the rebuilding of health systems in the post-conflict period in Sierra Leone as ‘fire-fighting’. This meant that the response did not adequately capture gender. Ensuring service provision for women and… Read more
Sierra Leone is almost at the bottom in the Human Development Index, ranking 180th out of 187 countries. There is significant gender inequality where a mere 23% of women are literate, half the rate among men, while domestic violence is widespread. In addition, infectious diseases such as malaria, TB and HIV/ AIDS are the leading… Read more
The current Ebola outbreak is concentrated in Sierra Leone, Liberia, and Guinea: countries with limited state capacity which are recovering from political instability and conflict. The indirect consequences of the Ebola epidemic and its disruption of public and private services threaten the lives and livelihoods of more than 22 million people in Ebola-affected areas. As… Read more