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Solthis has been present in Sierra Leone since 2011. Solthis provides support to hospitals and health centers in the capital, Freetown, in order to improve access to care for all sick people. Solthis operations in Sierra Leone focus mainly on care for chronic diseases, such as HIV/AIDS, and their transmission from mother to child.

Carte Sierra-Leone

Population (millions)6
Life expectancy at birth
HDI rank
Fertility rate4,6
Infant mortality per 1,000 births
Number of physicians per 10,000 population
Total health expenditures (% of GDP)
18,8 %

Source: UNDP, 2014 Human Development Report

Health priorities

The health situation in Sierra Leone is particularly worrisome. Malaria, tuberculosis, and HIV/AIDS are the leading causes of death, particularly among the most fragile groups: women and children under five. The maternal mortality rate (1,100 deaths per 100,000 births) and the mortality rate in children under five (161 deaths per 1,000 births) are among the world's highest.

Like Guinea, Sierra Leone has also had to deal with the Ebola epidemic, which triggered a major health crisis and revealed weaknesses in the country's health system. The disorganization of all health services had a serious impact on access to care for everyone. In particular, continuity of care for people with chronic diseases, such as HIV/AIDS, was severely disrupted.

Operational context

  • Start of the program in Sierra Leone: 2011
  • Partners: National Aids Secretariat (NAS), National Aids Control Program (NACP-Ministry of Health), NETHIPS (Network of HIV Positives in Sierra Leone)
  • Areas of operation: Freetown
  • Team: 11 permanent health professionals, including 7 nationals
  • 10 sites supported
  • Focus of operations: HIV/AIDS, Ebola, TB, Hepatitis, Mother-Child Health, Neurological Opportunistic Infections

Under the partnership agreement signed with the Ministry of Health and the National HIV/AIDS Control Program (NACP), Solthis provides support to Freetown hospitals and health centers in the following ways:

  • Improved access to care for all sick people
  • Care for HIV-positive children
  • Coordination of the national HIV prevention program with regard to international funding and procurement

2014: Third year of operations. Solthis continued its fieldwork centered in the capital city of Freetown, with three main objectives:

  • To improve access to treatment with a focus on pediatrics and the Prevention of Mother-To-Child Transmission (PTMTC)
  • To improve the quality of HIV care in the city's healthcare structures by increasing the coordination between pediatric services, the Prevention of Mother-To-Child Transmission, and HIV
  • To improve data collection tools to avoid an increase the number of lost to follow-up

2015: Continuity of care when dealing with Ebola.

Improved pediatric care

  • Support for the model pediatric hospital Ola During: training of healthcare staff and assistance in reorganizing the departments
  • Support for the development of national guidelines: infant diagnosis, therapeutic protocol

Adult care

  • Support for the Ministry of Health in developing new national recommendations to better meet needs identified in the field
  • Training for physicians and nurses on applying these new recommendations

Supply and inventory management

  • Introduction of supply management tools: forecasts, orders, inventory tracking and management
  • Support for negotiating grants from international donors for the purchase of antiretrovirals
  • Support for pharmacies in the selection and proper use of medications

Biological and virological monitoring

  • Advocacy for operationalizing the viral load in Sierra Leone with funding from the Global Fund

Operational research

  • Diagnosis and care of neurological opportunistic infections in HIV-positive patients
  • Hepatitis B research focused on specific populations: HIV-positive patients, pregnant women, and blood donors
  • Research to improving dispensing and monitoring

Introduction of a health information system

  • Introduction of patient monitoring software
  • Data correction work to have exhaustive databases and better follow-up of patient care activities
  • Support for the integration of HIV data into the DHIS2 software in order to have a single data management platform

Continuity of care when dealing with Ebola

  • Ensuring the safety of caregivers and patients within healthcare structures
  • Search of patients lost to follow-up and adaptation of care delivery for treated patients
  • Preparing for the post-Ebola phase by participating in deliberations on strengthening Sierra Leone's health system

Key numbers: Solthis in Sierra Leone

In 2014, Solthis it is:

  • 10 sites supported
  • 124 health professionals trained
  • 5 000 patients on ARV treatment in supported centers
  • 100 % of infants under 18 months diagnosed HIV-positive under treatment in the reference pediatric hospital Ola During


Solthis’ address in Sierra Leone

Sierra Leone – Freetown
N°1 The Maze – Off King
Street Willberforce

Country action




Health priority


Associated contents

A Participatory Approach to Improving Retention in HIV Treatment and Care for Newly Diagnosed Patients in a Secondary Health Facility in Sierra Leone

2017 |  Scientific Papers


  • Authors : Wole Ameyan, Hannah Kamara, Jaicy Sesay, Mariama Sheriff, Khadija Dumbuya, Mabinty Timbo, Sulaiman Conteh and Etienne Guillard
(Solthis, Sierra Leone)
  • Published by Journal of AIDS & Clinical Research

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Solthis' Report: “Managing Risk in Fragile States: Putting Health First! Optimising the Efficiency of the Global Fund’s Grants”

2014 |  Scientific Papers |  , ,


capture beandeau rapport fm eng pr enews

“Managing Risk in Fragile States: Putting Health First!

Optimising the Efficiency of the Global Fund's Grants”

This evidence-based report is the result of a work over several months, including 4 missions (Guinea, Mali, Niger and Sierra Leone) and interviews with 140 stakeholders. Through this work, we identified bottlenecks in the implementation of the Global Fund's grants in the field, showing that the Global Fund's Risk Management Policy is not well-adapted to fragile states. The additional safeguard measures which have been put in place by the Secretariat after the investigations of the Office of the Inspector General were meant to mitigate the financial risks and to reassure donors. However, experiences in challenging operating environments clearly show that these measures are mainly focused on financial risks and have caused significant malfunctions that jeopardise both the impact and the sustainability of the programmes. In order to make progress and to cope with the challenges specific to fragile states, we think it is now time for the Board members and the donors of the Global Fund to opt for an ambitious and innovative policy, which would put financial risk at its proper place: behind risks to public health. The main recommendations we are addressing in the report aim to place the public health risk at the centre of the mechanism, by:
  • Improving the balance between the analysis and the management of the different risks.
  • Simplifying and clarifying the control procedures: limit the number of contractors and the levels of validation.
  • Defining indicators or objectives for terminating additional safeguard measures to encourage appropriation and capacity building.
  • Investigating the possibility of an increased presence of the Global Fund in the field, by missions of several weeks or several months.
  • Adapting the indicators and procedures of performance-based funding and accountability measures to fragile states.
Full version of the report in English here You can also read our 4-pages booklet here The article of Altermondes dedicated to this topic and the interview of the author Hélène Roger

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CROI 2016 : Access to HIV care in the health districts affected by the Ebola outbreak in Sierra Leone

2016 |  Posters


Presentation of the poster “access to HIV care in the health districts affected by the Ebola outbreak in Sierra Leone” for the CROI 2016. Download the poster Jacques CROI 2016 Official Website : CROI 2016

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