Mapping Sierra Leone’s plural health system and how people navigate it

Lisa Denney and Richard Mallett

Type: Briefing Paper, Sierra Leone

Organisation: ODI

Country: Sierra Leone

Date: 19/09/2014

Full summary

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.


Key messages


  • 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.