Freetown, Sierra Leone – March 2025 – The Government of Sierra Leone, through the Ministry of Health’s Directorate of Policy, Planning, and Information, successfully conducted two critical assessments to evaluate and strengthen the country’s Health Information System (HIS). Held from 26 to 28 March 2025 at the Lumley Atlantic Hotel Conference Room in Freetown, the assessments were supported technically by the World Health Organization (WHO) Country Office and financially by the WHO Regional Office for Africa (WHO-AFRO).

The three-day engagement brought together a consistent cohort of national stakeholders for both the HIS Functionality Assessment (26–27 March) and the SCORE (Survey, Count, Optimize, Review, Enable) Assessment Workshop (28 March). Participants included representatives from Statistics Sierra Leone, the National Civil Registration Authority (NCRA), the National Public Health Agency (NPHA), District Health Management Teams (DHMTs), hospitals, and Primary Health Units (PHUs), whose technical input and active participation underscored national ownership and multisectoral collaboration. 

The HIS Functionality Assessment utilized WHO-AFRO’s standardized self-assessment tool to provide a structured analysis of the performance, efficiency, and security of Sierra Leone’s health information systems. This diagnostic process enabled the country to identify strengths, uncover systemic gaps, and define strategic actions for improvement.

On 28 March, the same group of stakeholders reconvened for the SCORE Assessment Workshop, applying WHO’s SCORE tool (Survey, Count, Optimize, Review, Enable) to evaluate the availability, quality, and use of health data across the national health system.

The assessments revealed notable strengths. Sierra Leone demonstrated robust capacity in conducting population-based surveys, maintaining updated national health facility master lists, and generating health data at multiple levels of the health system. Progress in disease surveillance and health facility assessments—largely bolstered by the national response to COVID-19 since 2018—was particularly commendable. The country also continues to benefit from an established legal framework for civil registration, following the enactment of the NCRA Act in 2016, which has notably improved birth reporting systems.

However, the assessments also highlighted persistent challenges. Gaps remain in the financing of HIS and in the systematic monitoring and evaluation of health information performance. Limited capacity for conducting routine performance reviews has made it difficult to track progress toward national and global health targets. Additionally, despite improvements in birth registration, substantial gaps persist in the reporting of deaths and causes of death—an area identified as a key national priority for reform.

Building on the findings, stakeholders collaboratively developed a set of strategic recommendations to guide the strengthening of Sierra Leone’s HIS. These include improving the integration of data collection systems, enhancing data quality, addressing financing constraints, and promoting a culture of evidence-based decision-making at all levels of the health system.

The successful completion of the HIS Functionality and SCORE assessments represent a significant step in Sierra Leone’s ongoing efforts to build a resilient, data-driven health sector. With strong political will, cross-sectoral engagement, and continued support from WHO and other partners, the Ministry of Health is poised to develop and implement a strategic roadmap that ensures reliable, accessible, and actionable health data.

Sierra Leone’s commitment to adopting global best practices for HIS assessment and reform underscores its leadership in advancing universal health coverage and achieving the health-related Sustainable Development Goals (SDGs).