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Introduction to Country Context

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The Republic of Sierra Leone is one of the 54 countries of Africa. It is situated on the west coast and shares borders with Guinea and Liberia. The country’s total surface area is about 72 000 km2. Its 400 km coastline overlooks the north Atlantic Ocean.

Sierra Leone has an estimated population of 5.9 million, 37% of which reside in urban areas.[1] The average annual growth rate is about 2%. However, the population is experiencing significant rural to urban migration, leading to an estimated urbanization rate of 2.9%.[1]

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The female population accounts for 52% of the total population and the average total fertility rate is 5.1 children per woman.[1] Women of the reproductive age group 15–49 years constitute approximately 25% of the population. Adolescents and young people represent about 55% of the population. Infants and children aged under 5 years constitute 4% and 16%, respectively.

The adult literacy rate is estimated at 27% for women and 45% for men. There are about 20 distinct language groups in Sierra Leone, reflecting the diversity of cultural traditions.

Administratively, the country is divided into four regions: the Northern, Southern and Eastern Regions, and the Western Area. The regions are divided into 12 districts, which are further divided into chiefdoms. The chiefdoms are further subdivided into sections. In all, there are 149 chiefdoms. The Western Area is divided into Western Rural and Western Urban, with the capital city, Freetown, the seat of government.

The district councils consist of the district chairpeople, administrators and councillors who administer the districts; the chiefdoms are governed by locally elected paramount chiefs. With the recent decentralization process, the country has been divided into 19 local councils that have been further subdivided into 392 wards. Each ward is headed by an elected councillor.[2]

Sierra Leone has an average annual gross domestic product growth rate of more than 5.5% and this is expected to increase to 7.2% by 2011. The macroeconomic stability and economic growth will help reduce poverty, increase equity and enable the Government of Sierra Leone to allocate additional resources to the health sector.

Socioeconomic, cultural, environmental and lifestyle factors in Sierra Leone have a significant role in the causation of ill health. Socioeconomic variables that affect health and contribute to the high morbidity and mortality rates include:[1][2][3]
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  • marital status
  • educational status
  • level of awareness, attitude and practice in personal and environmental health
  • level of poverty
  • infrastructure.



References

  1. 1.0 1.1 1.2 1.3 Sierra Leone health and demographic survey, 2008: key findings. Calverton, Maryland, Statistics Sierra Leone and ICF Macro, 2009
  2. 2.0 2.1 National Health Sector Strategic Plan 2010–2015 (pdf 1.09Mb). Freetown, Government of Sierra Leone, Ministry of Health and Sanitation, 2009
  3. African Health Workforce Observatory HRH fact sheet Sierra Leone (pdf 28.72kb) Brazzaville, WHO Regional Office for Africa, 2006