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BMC Infectious Diseases. 2024.", "country_ids": [ "SLE" ], "coverage_domains": [ "actors", "authoritative_review", "hospital_organization", "primary_care" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "referral hospitals are under-resourced and overcrowded", "institution": null, "locator": { "locator_type": "xml_text_anchor", "section": "Background", "source_word_anchor": "referral hospitals are under-resourced and overcrowded", "source_word_count": 6 }, "material_id": "material:37c06675641cf2679eb5e2d5", "notes": [ "Do not present this review as current national measurement." ], "origin": "candidate-analytical-mappings", "period": "November 2019-April 2021 review window", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "review_literature" ], "source_system": null, "source_version": { "detected_media_type": "application/xml", "response_sha256": "da130a8783a61fa61c25f9228df6a4d82a7c178c23f76460196d1e5cd443ab6a" }, "statement": "The review reports referral-hospital constraints in its specified evidence base, not current national performance.", "tags": [], "territory": "Sierra Leone", "title": "Review evidence supplies period-bound context", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.ebi.ac.uk/europepmc/webservices/rest/PMC11662533/fullTextXML" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Ministry of Health and Sanitation, Sierra Leone. Healthcare Financing Strategy 2021-2025. Freetown: MoHS; 2021. https://mohs.gov.sl/download/50/policy-documents/17819/healthcare-financing-strategy-2021-2025-final-version-for-printing-19-11-21-3.pdf", "country_ids": [ "SLE" ], "coverage_domains": [ "actors", "autonomy", "decision_rights", "governance", "government_responsibilities", "market_structure", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "Sierra Leone Social Health Insurance", "institution": "Ministry of Health and Sanitation, Sierra Leone", "locator": { "locator_type": "pdf_page_anchor", "page": 6, "physical_pdf_page": 6, "section": "Abbreviations", "source_word_anchor": "Sierra Leone Social Health Insurance", "source_word_count": 5 }, "material_id": "material:842e3c53baa6d6d08a542154", "notes": [ "Treat financing language as formal strategy. Do not infer current insurance operation, purchasing practice, provider revenue control, or nationwide autonomy." ], "origin": "country-evidence-improvement-sources", "period": "Strategy period 2021-2025; proposed and planned financing arrangements are not evidence of later operation", "publication_date": null, "publication_year": 2021, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "c2e5b4b3b16dd72c82b64bb02f2b2787ec50e05357d91b2a711af7db7402733d", "page_count": 60, "response_sha256": "c2e5b4b3b16dd72c82b64bb02f2b2787ec50e05357d91b2a711af7db7402733d" }, "statement": "The strategy provides a formal financing-policy framework, including health-insurance terminology and planned financing directions. It does not allocate a complete facility-level decision-rights matrix or verify implementation of the proposed arrangements.", "tags": [], "territory": "Sierra Leone national health-financing strategy", "title": "Healthcare Financing Strategy 2021-2025", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://mohs.gov.sl/download/50/policy-documents/17819/healthcare-financing-strategy-2021-2025-final-version-for-printing-19-11-21-3.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Ministry of Health and Sanitation, Sierra Leone. National Community Health Worker Policy. Freetown: MoHS; 2021. https://mohs.gov.sl/download/50/policy-documents/17820/national-chw-policy-2021-2.pdf", "country_ids": [ "SLE" ], "coverage_domains": [ "actors", "governance", "government_responsibilities", "networks", "patient_flows", "primary_care", "referral_design", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "National Community Health Worker Policy", "institution": "Ministry of Health and Sanitation, Sierra Leone", "locator": { "locator_type": "pdf_page_anchor", "page": 1, "physical_pdf_page": 1, "section": "Title page", "source_word_anchor": "National Community Health Worker Policy", "source_word_count": 5 }, "material_id": "material:f8aaa929e31b6a9b4f3d092e", "notes": [ "Keep community-worker and referral descriptions as policy design. Do not infer current coverage, actual referral behavior, patient completion, or outcomes." ], "origin": "country-evidence-improvement-sources", "period": "Policy issued 2021; community deployment and referral completion are not established", "publication_date": null, "publication_year": 2021, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "42f789d421755921e3dc879e48665149a660059dac9075ae874f35a5ddbc22d5", "page_count": 54, "response_sha256": "42f789d421755921e3dc879e48665149a660059dac9075ae874f35a5ddbc22d5" }, "statement": "The policy formally positions community health workers within a primary-care and referral design. It does not provide patient-level evidence that referrals were made, accepted, completed, or timely.", "tags": [], "territory": "Sierra Leone community-health-worker policy scope", "title": "National Community Health Worker Policy", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://mohs.gov.sl/download/50/policy-documents/17820/national-chw-policy-2021-2.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Ministry of Health and Sanitation, Sierra Leone. National Digital Health Strategy 2018-2023. Freetown: MoHS; 2018. https://mohs.gov.sl/download/50/policy-documents/17822/sl-national-digital-health-strategy-nov-2018.pdf", "country_ids": [ "SLE" ], "coverage_domains": [ "actors", "facility_data", "governance", "government_responsibilities", "networks", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "ICT-enabled system supports delivery of quality", "institution": "Ministry of Health and Sanitation, Sierra Leone", "locator": { "locator_type": "pdf_page_anchor", "page": 2, "physical_pdf_page": 2, "section": "Vision", "source_word_anchor": "ICT-enabled system supports delivery of quality", "source_word_count": 6 }, "material_id": "material:3e1978e000d6b9b3f0ba201d", "notes": [ "Keep the 2018-2023 period explicit. Do not use this strategy to establish current information-system function, data quality, or national performance." ], "origin": "country-evidence-improvement-sources", "period": "Strategy period 2018-2023; the strategy does not establish post-2023 system status", "publication_date": null, "publication_year": 2018, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "b4376daea0711e84c7ea3088e6ff13a8a004234370f9550c67f3c0cbb84d8135", "page_count": 8, "response_sha256": "b4376daea0711e84c7ea3088e6ff13a8a004234370f9550c67f3c0cbb84d8135" }, "statement": "The strategy records a time-bounded formal digital-health reform direction for an ICT-enabled health-information system. It does not establish uptake, interoperability, facility reporting completeness, or current digital-health practice.", "tags": [], "territory": "Sierra Leone national digital-health strategy", "title": "National Digital Health Strategy 2018-2023", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://mohs.gov.sl/download/50/policy-documents/17822/sl-national-digital-health-strategy-nov-2018.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Ministry of Health and Sanitation, Sierra Leone. National Health Policy. Freetown: MoHS; 2021. https://mohs.gov.sl/download/50/policy-documents/17814/gosl-nhsp-final-expert-edited-version-19-11-21-2.pdf", "country_ids": [ "SLE" ], "coverage_domains": [ "actors", "governance", "government_responsibilities", "hospital_organization", "market_structure", "ownership", "primary_care", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "provide and regulate comprehensive healthcare services", "institution": "Ministry of Health and Sanitation, Sierra Leone", "locator": { "locator_type": "pdf_page_anchor", "page": 10, "physical_pdf_page": 10, "section": "Mission", "source_word_anchor": "provide and regulate comprehensive healthcare services", "source_word_count": 6 }, "material_id": "material:8604611a8c6856d90eaa3ebd", "notes": [ "Treat the policy as formal direction. Do not infer current regulation, ownership distribution, private-sector scale, contracting, or service performance." ], "origin": "country-evidence-improvement-sources", "period": "Policy issued 2021; no inference is made about subsequent implementation or market share", "publication_date": null, "publication_year": 2021, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "e1fa41dbf6173168b6be043182a093250f44504c64aac611945ffff6913468de", "page_count": 51, "response_sha256": "e1fa41dbf6173168b6be043182a093250f44504c64aac611945ffff6913468de" }, "statement": "The policy sets out formal government direction for comprehensive health services and regulation. It does not measure the ownership mix, private-provider activity, service use, or performance of public-private arrangements.", "tags": [], "territory": "Sierra Leone national health policy", "title": "National Health Policy", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://mohs.gov.sl/download/50/policy-documents/17814/gosl-nhsp-final-expert-edited-version-19-11-21-2.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Ministry of Health and Sanitation, Sierra Leone. National Health Sector Monitoring and Evaluation Strategy 2021-2025. Freetown: MoHS; 2021. https://mohs.gov.sl/download/50/policy-documents/17815/final-me-strategy-compiled_dec.pdf", "country_ids": [ "SLE" ], "coverage_domains": [ "actors", "decision_rights", "facility_data", "governance", "government_responsibilities", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "Results and Accountability Framework", "institution": "Ministry of Health and Sanitation, Sierra Leone", "locator": { "locator_type": "pdf_page_anchor", "page": 11, "physical_pdf_page": 11, "section": "Monitoring and evaluation framework", "source_word_anchor": "Results and Accountability Framework", "source_word_count": 4 }, "material_id": "material:d51f56a069ad2c398be758ad", "notes": [ "Distinguish a formal monitoring design from observed data quality, accountability enforcement, facility results, or current sector performance." ], "origin": "country-evidence-improvement-sources", "period": "Strategy period 2021-2025; monitoring design is not evidence of data completeness or accountability in practice", "publication_date": null, "publication_year": 2021, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "87991202704c867524688e17fa04e064fb05566c7608e7906f9dc425856c846b", "page_count": 70, "response_sha256": "87991202704c867524688e17fa04e064fb05566c7608e7906f9dc425856c846b" }, "statement": "The strategy formally specifies a monitoring and evaluation framework and associated accountability language for the 2021-2025 plan period. It does not verify reporting completeness, enforcement, facility performance, or a current accountability outcome.", "tags": [], "territory": "Sierra Leone national health-sector monitoring and evaluation", "title": "National Health Sector Monitoring and Evaluation Strategy 2021-2025", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://mohs.gov.sl/download/50/policy-documents/17815/final-me-strategy-compiled_dec.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Ministry of Health and Sanitation, Sierra Leone. National Health Sector Strategic Plan 2021-2025. Freetown: MoHS; 2021. https://mohs.gov.sl/download/50/policy-documents/17821/gosl-nhssp-2021-2025-version-final-expert-edited-19-11-21-2.pdf", "country_ids": [ "SLE" ], "coverage_domains": [ "actors", "decision_rights", "governance", "government_responsibilities", "hospital_organization", "market_structure", "networks", "primary_care", "referral_design", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "coherent framework to drive health sector coordination", "institution": "Ministry of Health and Sanitation, Sierra Leone", "locator": { "locator_type": "pdf_page_anchor", "page": 15, "physical_pdf_page": 15, "section": "Introduction", "source_word_anchor": "coherent framework to drive health sector coordination", "source_word_count": 7 }, "material_id": "material:b06ed50143632bd14014cab6", "notes": [ "Keep the 2021-2025 period visible. Do not infer current institutional practice, national performance, provider autonomy, or completed referrals from strategy language." ], "origin": "country-evidence-improvement-sources", "period": "Strategic-plan period 2021-2025; the plan does not establish arrangements after that period", "publication_date": null, "publication_year": 2021, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "cf8a66402d5b36d5fccd5f5ac46466607f789926758f592f72f5d690519e2c89", "page_count": 128, "response_sha256": "cf8a66402d5b36d5fccd5f5ac46466607f789926758f592f72f5d690519e2c89" }, "statement": "The plan presents a formal national coordination framework and strategic pillars for state and non-state health-sector actors. It is a time-bounded planning instrument, not evidence that its objectives were implemented or that it describes current authority.", "tags": [], "territory": "Sierra Leone national health sector", "title": "National Health Sector Strategic Plan 2021-2025", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://mohs.gov.sl/download/50/policy-documents/17821/gosl-nhssp-2021-2025-version-final-expert-edited-19-11-21-2.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Ministry of Health and Sanitation, Sierra Leone. National Primary Health Care Operations Handbook. Freetown: MoHS; 2021. https://portal.mohs.gov.sl/download/33/publications/1662/nphco-handbook-17th-sept-21.pdf", "country_ids": [ "SLE" ], "coverage_domains": [ "actors", "autonomy", "decision_rights", "governance", "hospital_organization", "networks", "primary_care", "referral_design" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "hospital acts as the hub of the health system", "institution": "Ministry of Health and Sanitation, Sierra Leone", "locator": { "locator_type": "pdf_page_anchor", "page": 147, "physical_pdf_page": 153, "section": "Chapter 11: The Role of Hospitals in Primary Health Care", "source_word_anchor": "hospital acts as the hub of the health system", "source_word_count": 9 }, "material_id": "material:f0b19283e2cf5b4010ec2fbb", "notes": [ "Use as formal design only. Do not infer that every hospital is a functioning referral hub, that any delegation is exercised, or that accountability arrangements are uniform." ], "origin": "country-evidence-improvement-sources", "period": "Handbook issued 2021; current operational use and local variation are not established", "publication_date": null, "publication_year": 2021, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "249a69000d16bcb4df3f663f184eae264658d14a08462267d8131731a7fee386", "page_count": 185, "response_sha256": "249a69000d16bcb4df3f663f184eae264658d14a08462267d8131731a7fee386" }, "statement": "The handbook formally describes a first-referral hospital as part of a wider district health system and discusses autonomy in the context of district administrations. It does not document a complete current hospital-autonomy or accountability score.", "tags": [], "territory": "Sierra Leone primary-health-care and first-referral design", "title": "National Primary Health Care Operations Handbook", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://portal.mohs.gov.sl/download/33/publications/1662/nphco-handbook-17th-sept-21.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Kangbai JB, et al. Public health system in post-pandemic Sierra Leone: a scoping review. BMC Infectious Diseases. 2024. doi:10.1186/s12879-024-10360-w. https://pmc.ncbi.nlm.nih.gov/articles/PMC11662533/", "country_ids": [ "SLE" ], "coverage_domains": [ "actors", "authoritative_review", "facility_data", "hospital_organization", "networks", "patient_flows", "primary_care", "referral_design", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "referral hospitals are under-resourced and overcrowded", "institution": "BMC Public Health", "locator": { "html_text_block": "paragraph 2", "locator_type": "xml_text_anchor", "section": "Background", "source_word_anchor": "referral hospitals are under-resourced and overcrowded", "source_word_count": 6 }, "material_id": "material:7a87af9e6980fb89d76f822a", "notes": [ "Preserve the review period, evidence-synthesis design and interview context. Do not represent reported constraints as current nationally measured performance." ], "origin": "country-evidence-improvement-sources", "period": "Evidence and interviews concerning the COVID-19 period, with literature search bounded to November 2019-April 2021", "publication_date": null, "publication_year": 2024, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "review_literature" ], "source_system": null, "source_version": { "detected_media_type": "application/xml", "file_sha256": "da130a8783a61fa61c25f9228df6a4d82a7c178c23f76460196d1e5cd443ab6a", "response_sha256": "da130a8783a61fa61c25f9228df6a4d82a7c178c23f76460196d1e5cd443ab6a" }, "statement": "The scoping review reports infrastructure, workforce, referral-hospital and rural-access challenges in its bounded evidence base. 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