Sierra Leone Public Expenditure Review 2021 - Improving Quality of Public Expenditure in Health

Jul 19, 2026

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Sierra Leone Public Expenditure Review 2021 examines how public spending in health is structured, executed, and performs across the health sector. It reviews government health policies and the service delivery system, analyzes health status indicators, and assesses system performance including infrastructure, workforce, pharmaceuticals, and health information systems. The report evaluates financing sources, public expenditure levels and compositions, development partner support, and budget execution, then identifies efficiency and equity issues and presents findings and recommendations to improve the quality of health expenditure.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages56

Reading Time2 h 21 min

AccessFree to download

Key Messages

Executive Summary

Introduction

Objectives of the PER

Methodology and Data Limitations

Organization of the Report

Health Policies and Healthcare Delivery System

Overview of Government Policies and Priorities

Sierra Leone Health Care Delivery System

Health Status

Demographics

Health Outcomes and International Benchmarking

Burden of Disease

Health Systems Performance

Infrastructure and Equipment

Health Workforce

Pharmaceutical Supply Chain

Health Management Information System

Utilization of Health Services

Sources of Financing Healthcare

Review of Public Health Expenditure

Levels of Health Expenditure

Economic Composition of Government Health Expenditure

Functional Composition of Government Health Expenditures

Development Partners Support

Budget Execution Performance

Efficiency and Equity Issues

Efficiency Issues

Equity Issues

Findings and Recommendations

Annex 1: Study Methodology

Annex 2: Definitions of Health Input and Output Indices

SIERRA LEONE PUBLIC EXPENDITURE REVIEW 2021 Improving Quality of Public Expenditure in Health Pub lic Disclosure Authorized Pub lic Disclosure Authorized Pub lic Disclosure Authorized Pub lic Disclosure Authorized June 2021 © 2021 The World Bank 1818 H Street NW, Washington DC 20433 Telephone: 202 473 1000; [Internet: www.worldbank.org](Internet: www.worldbank.org)[ ](Internet: www.worldbank.org)Some rights reserved This work is a product of the staff of The World Bank. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of the Executive Directors ofThe World Bank or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. Rights and Permissions The material in this work is subject to copyright. Because The World Bank encourages dissemination of its knowledge, this work may be reproduced, in whole or in part, for noncommercial purposes as long as full attribution to this work is given. Attribution—Please cite the work as follows: “Sierra Leone Programmatic Public Expenditure Reviews 2021: Improving Quality of Public Expenditure in Health. 2021. © Macroeconomics Trade and Investment Global Practice, World Bank Group.” All queries on rights and licenses, including subsidiary rights, should be addressed to World Bank Publications, The World Bank Group, 1818 H Street NW, Washington, DC 20433, USA; fax: 202 522 2625; [e mail: pubrights@worldbank.org](e mail: pubrights@worldbank.org). Acknowledgements The Sierra Leone Health Sector Public Expenditure Review was conducted by a World Bank team led by Kofi Amponsah (Senior Health Economist and Task Team Leader), Daniel Amponsah (Policy Analyst and External Affairs Associate), Ayodeji Oluwole Odutolu (GFF Country Focal Person), Bahie Mary Rassekh (Health Specialist, Consultant), Kodjo Evlo (Economist, Consultant), Angus Fayia Tengbeh (Global Health Specialist, Consultant), Youssouf Kiendrebeogo (Senior Economist, EAWM2) and Kemoh Mansaray (Senior Economist, EAWM2) . The team worked closely with the government team led by Dr. Francis Smart, Director, Directorate of Policy, Planning and Information (DPPI), MoHS, supported by Dr. Michael Amara, Principal Health Economist, DPPI, and Mr. Nathaniel Soloku, Health Economist, DPPI in carrying out the fieldwork and stakeholder consultations. Overall guidance and direction were provided by Pierre Laporte (Country Director, AWCW1), Gayle Martin (Country Manager, AWCW1), and Gaston Sorgho (Practice Manager, HAWH3). The team is grateful to Mr. MorieMomoh (Permanent Secretary, Ministry of Health and Sanitation (MoHS), Mr. Laima Dumbuya (Budget Officer, MoHS), Mr. Kamara (Deputy Accountant General, Ministry of Finance, MoF), Mrs. Sheila Max Macarthy (Assistant Accountant General), Mr. Tasima Jah (Director of Budget, MoF), Mr. Gbessay Ernest Swaray (Deputy Director of Budget, MoF), M. Adams S. Kargbo (Director of Local Government Financing, MoF), Mr. Idrissa Kanu (Director of Revenue and Tax Policy Division, MoF), Mr. Dausy Wurie (Assistant Director of Budget, MoF), Mr. Selassi D’Almeida (Health Systems Adviser, WHO) . Finally, we are grateful to all those who in diverse ways contributed to the conduct of this important study. CONTENTS ACKNOWLEDGEMENTS ii KEY MESSAGES viii ABBREVIATIONSAND ACRONYMS x EXECUTIVE SUMMARY 1 1 INTRODUCTION 6 1 1 Objectives ofthe PER 7 1 2 Methodology and Data Limitations 7 1 3 Organization of the Report 7 2 HEALTH POLICIES AND HEALTHCARE DELIVERY SYSTEM 8 2 1 Overview of Government Policies and Priorities 8 2 2 Sierra Leone Health Care Delivery System 8 3 HEALTH STATUS 11 3 1 Demographics 11 3 2 Health Outcom

FAQs

What does the Sierra Leone Public Expenditure Review 2021 focus on?

It focuses on improving the quality of public expenditure in health by reviewing policies, service delivery, health system performance, financing, expenditure composition, and budget execution. The review also examines efficiency and equity issues and provides findings and recommendations.

Which areas of health systems performance are assessed?

The report assesses infrastructure and equipment, health workforce, pharmaceutical supply chains, health management information systems, and utilization of health services.

How does the report evaluate financing and spending performance in the health sector?

It reviews sources of healthcare financing, levels and compositions of public health expenditure, support from development partners, and budget execution performance. These analyses feed into the efficiency and equity assessment.

Jul 19, 2026

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