ReviewGlobalization and health2019
Health sector fragmentation: three examples from Sierra Leone.
Review in Globalization and health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers.
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Who cites it
42 citing papers in PubMed.
- The Kush Drug Epidemic in Sierra Leone: Public Health Implications, Socioeconomic Drivers and Health System Responses.Public health challenges · 2026Review
- Best practices for designing interventions to improve health worker performance in low- and middle-income countries.Journal of global health · 2026Article
- Home health care, e-health, and telemedicine policies in selected middle and high-income countries: a rapid policy review.npj health systems · 2026Article
- Designing equitable and effective partnerships for transformative health outcomes in Port Loko District, Sierra Leone: a grassroots public health perspective.International health · 2026Article
- Outbreak preparedness for women and girls in low- and middle-income countries: a qualitative study.BMC global and public health · 2026Article
- Normativity of Culturally-Specific Discipline Practices and Linkages to Caregiver-Child Relationship Quality in Sierra Leone.Journal of family violence · 2026Article
- Article
- Disability-related care trajectories in a pluralistic health system: a qualitative study in urban Sierra Leone.BMC public health · 2026Article
- Article
- Reimagining primary health care: a historical and contemporary scoping review of community-based primary health care models and innovations.Preventive medicine reports · 2026Review
- Prolonged multisectoral aid-driven reliance on health systems and governance post-conflict era in Somalia.Tropical medicine and health · 2026Review
- Evaluating Honduras' health financing system: a comprehensive application of the WHO Health Financing Progress Matrix.Revista panamericana de salud publica = Pan American journal of public health · 2026Article
- Family Strengthening to Prevent Family Separation and Entrance into Residential Care Institutions in Sierra Leone: A Quasi-experimental Study.Child & youth care forum · 2025Article
- Editorial: Cervical screening awareness week 2023: integrating cervical cancer screening and precancer treatments.Frontiers in oncology · 2025Article
- Barriers and facilitators to implementing a single-visit, screen-and-treat approach with thermal ablation for cervical cancer prevention in Kenya.PLOS global public health · 2025Article
- Responding to fluctuations in public and community trust and health seeking behaviour during the COVID-19 pandemic: a qualitative study of national decision-makers' perspectives in Guinea and Sierra Leone.BMC public health · 2024Article
- How Can Community Data Be Leveraged to Advance Primary Health Care? A Scoping Review of Community-Based Health Information Systems.Global health, science and practice · 2024Article
- Unsalaried health workers in Sierra Leone: a scoping review of the literature to establish their impact on healthcare delivery.International journal for equity in health · 2023Article
- Article
- Implementing community-based health program in conflict settings: documenting experiences from the Central African Republic and South Sudan.BMC health services research · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFragmentation across governance structures, funding, and external actor engagement in Sierra Leone continues to challenge the efficiency and coherence of health sector activities and impedes sustained health system strengthening. Three examples are discussed to highlight the extent, causes, and impacts of health sector fragmentation in Sierra Leone: the community health worker programme, national medical supply chain, and service level agreements.
resultsIn these examples we discuss factors contributing to fragmentation, the impact on efficiency of systems and sustainability of interventions, and persistent barriers to achieving sustainable improvements in health system performance. Prolonged external dependence and a proliferation of partner and donor involvement tending towards vertical programming and funding have contributed to this fragmentation.
conclusionAlignment of policy and planning initiatives, investment in proactive (to reduce need for reactive) policy and plan development, strengthened partnerships, and strengthened governance and accountability mechanisms offer opportunities for greater health sector integration.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.