Maintains - research to ensure health services are retained during shocks

Maintains is exploring how the health system and its financing can best support the maintenance of existing health services during regular flooding and disease outbreaks, and also respond to the new health needs emerging from these shocks. Explore all our latest research to support Sierra Leone here or download an overview of our work.

Sierra Leone is prone to a range of shocks, and despite lessons learned during the Ebola crisis, the health system still lacks capacity to respond. Floods and landslides are a major problem due to a large number of rivers, a tropical monsoon climate, unplanned urbanisation, and poor waste management. Informal settlements and poor communities are particularly vulnerable.

In addition, high poverty levels, poor education and sanitation, a weak health system, and other structural problems result in the population being exposed to frequent disease outbreaks, such as cholera and measles.

Sierra Leone was one of the last countries to be affected by COVID-19 and we examine the response in the first three months.

A junior doctor at work in a hospital in Sierra Leone that was hit hard by the Ebola crisis
A junior doctor at work in a hospital in Sierra Leone that was hit hard by the Ebola crisis.
Credit: Simon Davis/DFID

Research focus for Sierra Leone

Health system icon

Health system:

How can the health system manage new demands from shocks, whilst maintaining service delivery?

  • Case studies of recent flooding and disease outbreaks, and a review of emergency preparedness levels, will provide empirical evidence of how the health sector currently responds to health shocks. This will be used to identify and research specific approaches or interventions that can build shock responsiveness and define crisis levels of care to be provided during a health shock.
Health finance icon

Health finance:

What are the economic and financial costs of health shocks, how are they being financed, and how can financing arrangements be improved?

  • The current state of health financing will be explored in depth through case studies on the economic and financial costs of health shocks, alongside a health shock financing diagnostic. This will provide recommendations for financing donor health programmes and improving the public financial management of health shock funding.

In conducting these studies, Maintains works directly with the Government of Sierra Leone, FCDO, and other development partners. The research builds on and enhances existing evidence and addresses knowledge gaps.

Oxford Policy Management
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