This briefing paper maps the actors that constitute the plural health system in Sierra Leone and the relationships between them. Second, it examines the factors that influence health-seeking behaviour before setting out some recommendations on ways forward when developing appropriate interventions to address malnutrition.
- Sierra Leone is characterised by a plural health system, combining state and non-state health providers that people move between.
- Citizens navigate this plurality with reference to a number of factors, including proximity, cost, tradition, perceived effectiveness, experience of treatment and household power relations.
- The dominant paths of healthcare access vary across communities, so those seeking to improve healthcare must understand how the above factors play out in different contexts and tailor programmes accordingly.