Freetown - Sierra Leone has taken a major stride toward transforming the nation’s hospital services with the final validation of its first-ever National Hospital Strategy for Services Delivery Transformation. The comprehensive framework—validated today in Freetown—signals a decisive shift toward building a resilient, equitable, and patient-centered hospital system that meets the growing health needs of its people.

For years, Sierra Leone’s health facilities have struggled under the weight of weak infrastructure, staff shortages, fragmented systems, and the absence of a national vision for hospital care. The devastating Ebola outbreak and the COVID-19 pandemic further exposed the fragility of hospital services across the country, threatening progress in health outcomes.

Now, with this new strategy, Sierra Leone is not only responding to past gaps but is proactively charting a path to a stronger, more accountable, and performance-driven hospital system—an effort aligned with the government’s broader commitment to achieving universal health coverage.

“The strategy is very detailed and comprehensive, with ten pillars. I believe if we implement the strategy well, we will not miss anything,” said Chief Medical Officer Dr. Sartie Kenneh. “Additionally, it is a good idea that this document is also linked to primary health care, with the main aim of improving health outcomes. The standard should be implemented to ensure quality of care is provided, with training of health workers to match demand and need. We are assured of WHO’s three-level support to ensure that facilities are fit-for-purpose.”

Developed through months of technical collaboration and nationwide consultations healthcare professionals, clinical leaders, technical experts, the Ministry of Health, WHO, UNICEF and other key partners, the strategy addresses long-standing structural and operational issues in more than 50 secondary and tertiary hospitals across the country. It presents a clear roadmap for improving hospital governance, service delivery, infrastructure, staffing, and patient outcomes.

The strategy is anchored on 11 pillars including: Legal and Regulatory Framework; Leadership, Governance and Coordination; Healthcare Financing; Health Infrastructure; Human Resources for Health; Service Delivery Across Life Stages; Essential Commodities and Supplies; Health Information; Research, Technology, and Innovation; Human Rights, Gender, and Community Engagement; Health Security and Emergencies; and Quality of Care.

“The hospital should be a place that provides quality,” said WHO Country Representative Dr. George Ameh. “Performance-based financing for all cadres of healthcare should be seriously considered. Quality standard benchmarks and control systems should be established—and we must be aware of the antagonists who might stand against the change we want to make.”

This strategy marks a major turning point, placing quality and equity at the center of hospital transformation. It introduces mechanisms for standardizing care, streamlining hospital operations, and aligning hospital services with the Ministry of Health’s life stages approach to care—ensuring that health services are responsive from childhood through adulthood and into older age.

The role of health professionals, particularly nurses and midwives, is central to its successful rollout.

“Nurses and midwives are pivotal at every stage of health systems planning—at all levels in leadership and decision-making, as well as in the total care of patients at facility level,” said Chief Nursing and Midwifery Officer Mary Fullah. “As we have developed the National Hospital Strategy for Service Delivery, I crave the indulgence of the heads of management teams to implement this strategy to the letter in all private and public hospitals.”

Sierra Leone’s health sector is at a critical juncture. With the validation of this strategy and the official launch scheduled for 15 April 2025 during the National Health Summit, the country is now poised to move into the implementation phase. This marks the beginning of a new era where every citizen will have access to quality hospital care, regardless of location or ability to pay.