-Report
By Alhaji Haruna Sani
An alarming report from SEND Sierra Leone has revealed the critical condition of 44 public health facilities across six districts: Kailahun, Kenema, Falaba, Kono, Port Loko, and Pujehun.
The assessment, which highlights severe gaps in infrastructure, water and sanitation, medical equipment, staffing, and waste management, paints a grim picture of the state of rural healthcare.
The findings emphasize the urgent need for intervention from the Government of Sierra Leone (GoSL), the Ministry of Health, and international donor partners. The report calls for a collaborative approach to rebuild the healthcare system and ensure equitable access to quality healthcare for all citizens, particularly those in rural areas.
Over 90% of the facilities assessed were rated as having poor infrastructure by their managers, with issues including leaking roofs, crumbling walls, and overcrowding. The lack of accessibility features, such as ramps or handrails, was also prevalent in 65% of the facilities, making them inaccessible to people with disabilities.
Those deficiencies compromise hygiene standards, limit patient privacy, and exacerbate health risks for vulnerable populations, including the elderly and disabled.
Only 28% of facilities have a reliable piped water supply, with many relying on unclean wells. Alarmingly, 92% lack adequate menstrual hygiene management (MHM) facilities, disproportionately affecting female patients and staff.
The absence of clean water and sanitation heightens infection risks and discourages healthcare utilization, especially among women and girls.
Over 80% of healthcare workers reported shortages of essential medical equipment, including diagnostic tools and medications. Those deficiencies force patients to seek care in distant, better-equipped facilities, resulting in delays and added costs.
Without adequate tools, healthcare workers struggle to provide timely diagnoses and treatments, leading to poorer health outcomes.
Facilities often operate with just two healthcare workers, leading to overwhelming workloads and burnout. Additionally, staffs lack access to professional development opportunities, leaving them underprepared for modern healthcare challenges.
Overworked and undertrained staffs are more prone to errors, reducing the quality of patient care.
Most facilities lack proper waste segregation systems, with some resorting to open burning of medical waste, releasing harmful pollutants. Only 14% of facilities practice safe waste management.
Poor waste practices endanger public health and the environment, particularly in rural areas with no formal waste disposal systems.
The report provides actionable recommendations to address these challenges, including infrastructure upgrades, renovate and construct accessible healthcare facilities with reliable water and sanitation systems.
It recommends human resource strengthening by recruiting and retaining more healthcare workers and providing continuous professional development opportunities.
It also recommends for the establishment of efficient supply chains to ensure consistent availability of essential medicines and equipment, foster stronger relationships between healthcare providers and communities through culturally sensitive training and patient-centered care.
SEND Sierra Leone urges the Ministry of Health, donor partners, and international agencies to prioritize investments in rural healthcare. The report calls for immediate action to rebuild the country’s healthcare infrastructure and ensure that even the most underserved communities have access to safe and dignified medical services.
“The challenges are significant but surmountable,” the report concludes. “With coordinated efforts and targeted investments, Sierra Leone can create a resilient and equitable healthcare system capable of addressing current and future health crises.”
For rural communities in Sierra Leone, such intervention is not just necessary, it is long overdue.
