PMI Impact Malaria

Sierra Leone



PMI Impact Malaria in Sierra Leone

PMI Impact Malaria (IM) is the flagship global service delivery project of the U.S. President’s Malaria Initiative (PMI). To fight malaria and save lives, IM is supporting Sierra Leone’s national malaria control program (NMCP) in its efforts to strengthen malaria service delivery.

In 2018, IM began working with Sierra Leone’s NMCP to improve malaria case management at the community and public facility levels, with an emphasis on protecting those who are most at risk—particularly young children and pregnant women.

To advance malaria service delivery in Sierra Leone, IM focuses mainly on strengthening health provider competence, bolstering national diagnostic capacity, and enhancing the country’s ability to collect and use data for decision-making.


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Malaria Country Context

Sierra Leone’s entire population of about 7.6 million people is vulnerable to malaria. Malaria transmission in Sierra Leone has two peaks, one that begins during the rainy season in May and the second towards the end of the season in October/November. The malaria parasite species Plasmodium falciparum causes the majority of infections.

Malaria continues to be a leading cause of illness and death in Sierra Leone, particularly among children under the age of five. In 2018, the national health information system reported about 2.2 million confirmed cases of malaria, compared to a World Health Organization (WHO) estimate of 2.9 million cases. During this same time, Sierra Leone reported about 1,300 deaths due to malaria while the WHO estimate was 17,600 malaria deaths.

The country’s health service delivery system is pluralistic with the Government, faith-based missions, NGOs, and the private sector providing services. District health services form the core component of public primary health care, composed of a network of peripheral health units (PHUs) and district hospitals.


This is PMI Impact Malaria’s geographic coverage in Sierra Leone:



PMI Impact Malaria has supported Sierra Leone’s NMCP in achieving these key accomplishments:

  • Implemented a new approach of supportive supervision at the facility level with standard automated checklists, called OTSS+, that focuses on continuous improvement of the competencies of health providers in case management, malaria in pregnancy (MIP), and diagnostics. So far, 471 health workers at 210 health facilities have benefited from OTSS+, with action plans developed to address identified malaria service delivery challenges.
  • Revitalized the country’s MIP Technical Working Group (MIP TWG), after inactivity for three years. The MIP TWG identified key stakeholders and developed an annual action plan to address the most pressing MIP challenges in Sierra Leone.
  • Disseminated over 400 high quality, user-centered malaria case management job aides to all PHUs in IM’s focus districts.
  • Assessed laboratory capacity at the national referral hospital, numerous regional and district hospitals, and a set of health facilities in IM’s focus districts. This assessment highlighted diagnostic capacity gaps with an emphasis on malaria microscopy. Based on the findings, the NMCP will conduct a training of trainers (TOT) for 20 malaria microscopists to form a core cadre for national malaria microscopy capacity-strengthening activities.


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Photo Credit: Keith Esch/PMI Impact Malaria, Sierra Leone

Sources: PMI’s Sierra Leone Country Brief, PMI’s Sierra Leone Malaria Operational Plan FY 2020, 2019 World Malaria Report Sierra Leone Country Profile, PMI Impact Malaria Sierra Leone, and Sierra Leone’s NMCP