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Analytical summary

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The health status of the people of Sierra Leone is still among the worst in the world. Infant and maternal mortality rates remain among the highest in the world. According to the Sierra Leone demographic health survey 2008, life expectancy is 47 years, infant mortality rate is 89 per 1000 live births, under-five mortality rate is 140 per 1000 live births and maternal mortality ratio is 857 per 100 000 births.[1] Fertility rates are high due to low contraceptive prevalence rates.[2]

The most recent United Nations Children’s Fund/WHO estimate for child mortality assumes considerable underreporting in the Sierra Leone demographic health survey 2008 and puts the under-five mortality rate figure at 192 per 1000 live births for 2009.[3] Thus it seems that the indicators for maternal and child mortality for Sierra Leone are in a state of flux and should be reviewed more stringently. However, whichever way they are viewed, the indicators put Sierra Leone among the highest mortality rate countries in the world.

The majority of causes of illness and death, especially of children, in Sierra Leone are preventable with most deaths being attributable to nutritional deficiencies, pneumonia, diarrhoeal diseases, anaemia, malaria, tuberculosis and HIV/AIDS. Malaria remains the most common cause of illness and death in the country, accounting for about 50% of outpatient visits and 38% of hospital admissions. Malaria accounts for about 41% of all hospital deaths among children aged under 5 years (see figure). Hypertension, diabetes and mental illnesses are increasing with drastic changes in lifestyle and drug abuse.[3]
Major causes of hospital deaths for children aged under 5 years in 2010[3]


The greatest burden of disease is on rural populations, and on females within the rural population.

Underlying factors for the high burden of disease are:

  • pervasive poverty
  • high level of illiteracy, especially among females
  • limited access to safe drinking water and adequate sanitation
  • poor feeding and hygienic practices
  • overcrowded housing
  • limited access to quality health services.
Trends in under-five and infant mortality[4]

According to the trends in both infant and under-five mortality rate since 1990, an infant mortality rate of 50 per 1000 live births and an under-five mortality rate of 95 per 1000 live births are projected for 2015, in line with the target for Millennium Development Goal 4 (see figure).[4][5]

Trend in maternal mortality[5][6]

The trend in maternal mortality ratio has been fluctuating, with a sharp increase to 1800 per 100 000 live births in 2000. However, there was an appreciable drop to 1300 per 100 000 live births in 2005 and to 857 per 100 000 live births in 2008, representing a reduction of 28% and 34%, respectively (see figure).[5][6]

Given the prevailing determination of the Government of Sierra Leone and the huge support of development partners in reducing maternal and child mortality, Sierra Leone is likely to meet Millennium Development Goals 4 and 5.[5]


References

  1. Sierra Leone health and demographic survey, 2008: key findings (pdf 3.15Mb). Calverton, Maryland, Statistics Sierra Leone and ICF Macro, 2009
  2. National Health Sector Strategic Plan 2010–2015 (pdf 1.09Mb). Freetown, Government of Sierra Leone, Ministry of Health and Sanitation, 2009
  3. 3.0 3.1 3.2 Performance report. Freetown, Government of Sierra Leone, Ministry of Health and Sanitation, 2010
  4. 4.0 4.1 Leigh B. Child survival and development mid-term review report for the programme 2008–2010. Sierra Leone, United Nations Children’s Fund, 2009
  5. 5.0 5.1 5.2 5.3 Millennium Development Goals progress report 2010 (pdf 2.82Mb). Freetown, Government of Sierra Leone, 2010
  6. 6.0 6.1 National Health Sector Strategic Plan 2010–2015 Joint Programme of Work and Funding (JPWF) 2012–2014 (pdf 2.79Mb). Freetown, Government of Sierra Leone, Ministry of Health and Sanitation, 2012