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Analytical summary - Leadership and governance

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The Ministry of Health and Sanitation is the statutory body responsible for coordinating health interventions and actions in Sierra Leone. The Ministry has made several provisions to influence the overall policy framework in the country.[1][2]

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In collaboration with development partners, the Ministry developed the Joint Programme of Work and Funding to operate the National Health Sector Strategic Plan in a more coordinated and effective manner by outlining the priority health interventions to be implemented over the period 2012–2014, their resource implications and financing situation.[3]

Recently, the Ministry and its partners signed a compact agreement for better coordination of the health sector.[4]

The Minister of Health and Sanitation is the overall head of the Ministry. There are three broad areas of responsibility in the Ministry: political, administrative and professional. The political head is the Minister, supported by Deputy Ministers. The professional head is the Chief Medical Officer, assisted by the Deputy Chief Medical Officer. These are followed in hierarchy by other directors and the programme managers of the various technical programmes. There is a Chief Nursing Officer as well as a Chief Pharmacist within the professional wing. The administrative head is the Permanent Secretary.[1]

At district level, the district health management team, headed by a District Medical Officer, oversees all primary health care activities delivered through the peripheral health units. A Medical Officer is responsible for clinical activities at the district hospital. At the provincial or national hospitals, a Medical Superintendent or Hospital Manager is responsible for administration and supervision.[1]

With the devolution of services through the Local Government Act 2004, the core functions of the Ministry remain as:

  • policy formulation, setting standards and quality assurance
  • resource mobilization
  • capacity development and technical support
  • provision of nationally coordinated services, for example epidemic control
  • coordination of health services
  • monitoring and evaluation of the overall sector performance and training.[1]

The Ministry has multiple leadership responsibilities, including policy formulation, setting standards and regulations, collaboration and coalition building, monitoring and oversight, and resource mobilization. In this regard, the Ministry provides leadership and coordinates the efforts of all health care providers and financers at all levels of care.

The Government has established health sector legislation and regulatory statutory bodies to assist the Ministry. These are:

The Ministry also contributes to the development of the International Health Regulation (2005).

The 2010 health sector performance assessment highlighted the following issues:[5]

  • The districts had a clear plan for developing the health of their people.
  • There was weak coordination of events within and between central and district health management team levels.
  • Supervision of district health management teams and facilities was uncoordinated and weak.
  • There were inadequate logistics for supervision.
  • There was limited involvement of district health management teams and hospital staff in procurement processes.
  • Referral systems were weak in all districts.
  • Maintenance culture was weak in all districts.
  • Capacity in the regulatory bodies was weak.
  • There was low community participation in facility management.
  • Most nongovernmental organizations did not work in collaboration with the district health management team, leading to inefficient use of resources.



References

  1. 1.0 1.1 1.2 1.3 National Health Sector Strategic Plan 2010–2015 (pdf 1.09Mb) Government of Sierra Leone, Ministry of Health and Sanitation, 2009
  2. National Health Policy final 2002 (revised 2009). Government of Sierra Leone, Ministry of Health and Sanitation
  3. National Health Sector Strategic Plan 2010–2015 Joint Programme of Work and Funding (JPWF) 2012–2014 (pdf 2.79Mb). Government of Sierra Leone, Ministry of Health and Sanitation, 2012
  4. Health Compact (pdf 510.02kb). Government of Sierra Leone, 2011
  5. Performance report. Government of Sierra Leone, Ministry of Health and Sanitation, 2010