Why is Sierra Leones economy struggling? 0000227620 00000 n Terms & Conditions! endobj The density threshold targets set in the investment plans are far below both the current regional average and international thresholds associated with improved health outcomes and service delivery indicators (Fig. Human Resources for Health If Sierra Leone were to aim to meet the same targets as Guinea and Liberia, it would have to increase its current stock by sevenfold (to meet Guineas density threshold) and more than tenfold (to meet Liberias): its annual growth rates would have to be 21.5% or 26%, depending on the density target chosen. Annual salary estimates were also obtained from payroll data from government health departments in Liberia, Sierra Leone, and Guinea. It claimed more than 11,300 lives across West Africa. Salaries range from 1,440,000 SLL (lowest average) to 25,500,000 SLL (highest average, actual Health worker-to-population density targets per 1000 population for doctors, nurses, and midwives are only specified in Liberia (1.12) and Guineas (0.78) investment plans and fall far short of the regional average for Africa (1.33) or international benchmarks of 2.5 per 1000 population and 4.45 for universal health coverage. Health labor market analyses in low- and middle-income countries: an evidence-based approach. Mohamed Vandi, also not his real name, is a Community Health Worker who serves as a surveillance officer. Is the country of Sierra Leone a good country? WebWho is the highest paid worker in sierra leone? Witter S, Wurie H, Bertone MP. 0000010096 00000 n Foreign men think that we like the life, but I hate it.. The ban has been difficult to police, however. Benjamin, however, said even when women have been given funds to start a small business, some have been arrested for defaulting on microcredit loans. Global Health security after Ebola: four global commissions. <> 8 How long has Sierra Leone been a republic? Widespread consensus in the immediate aftermath suggested a watershed moment had arrived whereby the importance of the worlds weakest health systems for global health security was understood and from where a sea change in support for the recovery of those health systems would emerge. Although data wereverified by government stakeholders, no formal quality assessment was undertaken. 0000002020 00000 n Bull World Health Organ. Where training cost was not known, the training cost for a staff group with similar earnings was used. August 4, 2020. 0000079996 00000 n It has to pay for the girls to leave sex work, said Benjamin. Here are 9 facts about healthcare in Sierra Leone. jobs where the remuneration is directly dependent upon the profits derived from the goods and services produced), and, in this capacity, have engaged, on a continuous basis, one or more persons to work for them as employee(s). Hum Resour Health. The low base for some of the projections for example, currently Sierra Leone has only 22 rural doctors (but 91.9% rural population)drives the high growth rates calculated. *Names have been changed to protect the identities of sex workers and their clients who requested anonymity. In comparison, the average global life expectancy is 72.6 years. Neighboring West African countries have successfully boosted their appeal to tourists, and it is hoped that Sierra Leone will do so as well. <>stream He speaks eighteen languages fluently, including Temne, Krio, Mende, Fula, Kono, The economy of Sierra Leone is that of a least developed country [1] with a GDP of WebBackground Little is known about strategies for optimising the scale and deployment of community health workers (CHWs) to maximise geographic accessibility of primary healthcare services. 0000202189 00000 n Salaries range from 836,000 SLL (lowest) to 2,660,000 SLL Health worker Ebola infections in Guinea, Liberia and Sierra Leone, 2015, Geneva. That is not to say the venture is not laudable. Organizations which have ceased operations are included and noted as defunct. We assessed the implications of the density targets identified in the investment plans in relation to population threshold densities associated with increased service delivery coverage, graduate production, and cost. A major challenge is the shortage of primary healthcare workers (HCWs) in rural areas due to especially high rates of attrition. In fact, four out of every ten hospital visits in Sierra Leone are due to malaria. It is also important to recognize that health workforce, while indispensable to any strategy to strengthen health systems, is not a sufficient investment on its own. Contact. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. CH coordinated the study across countries and provided conception, design, content, and review input in the writing of this manuscript. <>/MediaBox[0 0 612 792]/Parent 7 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> On the 21st of April this year, the government of Sierra Leone issued a press statement highlighting a weekly breakdown of risk allowances to health workers which was to cover the period from April 1. However, these are mostly community health workers (CHW) and therefore have little bearing on the analysis of doctors, nurses, and midwives. Sierra Leone, country of western Africa. 422 0 obj 0000003482 00000 n The economy of Sierra Leone is that of a least developed country[1] with a GDP of approximately US$1.9 billion in 2009. 0000011412 00000 n Goals of the organization include providing medical supplies and contraceptives, giving training to healthcare workers and working with the community to eliminate attitudes that prevent women from discovering their rights to sexual and reproductive health. Employment can also be hard to achieve due to discrimination. But then they want to dominate us in our own country.. The first is the more efficient geographical distribution of health staff than any of the three countries is currently achieving. Obviously, the 2018 scandal was a real wake-up call, and our members have fundamentally changed their approach to safeguarding policies and practice, Stephanie Draper, CEO of Bond, told The New Humanitarian. endstream They said they intended to push on until their backlog is paid. [278 0 0 0 0 0 0 0 0 0 0 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 667 722 0 0 0 0 0 0 0 0 556 0 0 0 0 0 0 0 0 0 0 944 0 0 0 0 0 0 0 0 0 556 0 0 556 556 0 0 556 222 0 0 222 833 556 556 0 0 333 500 278 556 500 722] State Minimum Wages | Barbara McPake. Trends in wages decreased by -100.0 percent in Q4 2022. Anyone being sent to Sierra Leone for business purposes will need a business visa. %%EOF According to a 2015 survey, 84 percent of Sierra Leoneans have paid a bribe just to use government services. White label accounts can distribute our data. The capital, Freetown, commands one of Often, even the families send them to the streets.. Scheffler R, Herbst CH, Lemiere C, Campbell J. Dr. Abdul Karim Bangura is one of the most educated people in the world. (DOCX 15 kb), Budget forecast, workforce cost and projections, 2014, 2020, 2030. But as of now, its been two months without getting any pay, he said. Liberia, with the largest density of all three countries, is only close to half the African average (with 0.77), with Guinea and Sierra Leone falling even further behind (with 0.20 and 0.15, respectively). When I started doing prostitution as a teenager, it was so, so bad for me, she said, noting that her clients have come from the UN and other aid groups. immigration Foreign citizens working in Sierra Leone must hold a valid work permit and residence permit. 420 0 obj CARE is currently present in approximately 30 percent of the countrys communities, particularly in areas that have high rates of HIV infection and teenage pregnancy. Liberia has the largest stock of mid-level cadres, and Sierra Leone has the largest stock of low-level cadres. endobj The cookie is used to store the user consent for the cookies in the category "Performance". This section looks at the extent to which the fiscal space for HRH (current and projected) in Guinea and Liberia is sufficient to accommodate the proposed scaling up and potential scaling up to internationally recommended density targets. Five national and international groups in Makeni, a city in northern Sierra Leone, founded the coalition. 0000202008 00000 n WebA person working as Social Worker in Sierra Leone typically earns around 1,700,000 SLL per month. Julius Cuffie, a member of Parliament who suffers from polio, brings awareness to the disableds struggles. Road accidents kill thousands each year in the country. The Free Healthcare Initiative (FHCI) aims to decrease the nations high maternal, infant and child mortality rate. 5f%6&ZMsC%GSxn]~] 2). services: 32.9% (2017 est.). Hum Resour Health. As well as the normal visa requirements (certificate of vaccination, passport, completed visa application form, passport photograph) the authorities will ask for a profile of the company you represent, with a letter of invitation from a registered company or organization in Sierra Leone. endobj When Oxfam staff in Haiti were caught paying earthquake survivors for sex, many aid organisations moved to overhaul their safeguarding policies and tried to clamp down on the practice of transactional sex, noting the power disparities between staff and the people they serve. Interventions that focus on improving efficiency in both training institutions and the use of health staff once trained could further support a trajectory towards an adequate workforce capacity in both volume and motivation terms at a sustainable cost in all three countries. Training cost data for Sierra Leone were unavailable and regional costs used in their place. The Oxfam scandal, first reported by The Times of London in 2018, involved former country director Roland van Hauwermeiren and other staff of using young sex workers while based in Haiti after the 2010 earthquake, which killed between 100,000 and 300,000 people, and left some 1.6 million people displaced. Disaggregated cadre density in rural and urban areas, 2014 and projected. WebSierra Leone, officially the Republic of Sierra Leone, is a country in West Africa. 2015;93:6319. Significant labor market inefficiencies: loss of trained staff to attrition; demotivated staff; high levels of absenteeism are known problems shared at least to some extent by all three countries [4, 6, 16]. 26,776 listeners. Sierra Leone remains among the worlds poorest countries, ranking 180th out of 187 countries in the Human Development Index in 2011. Connect with fellow expats in Sierra Leone, Get Information in our Sierra Leone Guides, Exchange tips about expat life in Sierra Leone. The cookie is used to store the user consent for the cookies in the category "Analytics". I always look for white men when I go out. Guineas estimates used, for example, were US$1200 for a doctors salary per year and US$2800 to train a doctor, respectively. All three countries plan substantial scale-up of these and there is evidence that such workers can be effectively used to support service delivery and health outcomes [19], but it is not clear the extent to which they can substitute for professional staff, if at all. The cost of living in 0000001835 00000 n Yes, weve been given the lectures about power imbalances and everything and I understand that but if we dont pay women for this type of thing, then realistically that means they or their children may not eat for the day. The paper further costs and compares the plans to likely fiscal space (the ability of the government to increase spending on health) to assess their feasibility. Language links are at the top of the page across from the title. O Density targets for doctors, nurses, and midwives, compared with international thresholds. In addition to the authors, other contributors included Tana Wuliji (WHO) Laurence Codija (WHO), Matt Edwards (CfWI), John Fellows (CfWI), Ramesh Govindaraj (World Bank), Cristina Sanchez (CfWI), and Barbara Tomai (CfWI). The Ebola outbreak of 2014 hit Sierra Leone particularly hard. 419 0 obj Verified answer. 2023 BioMed Central Ltd unless otherwise stated. The datasets used and analysed in this paper are available from the corresponding author on reasonable request. The previous section has shown the investment plan density targets are far from global targets based on estimates of requirements to achieve minimum service delivery coverage and health outcome standards. [278 0 0 0 0 889 0 191 333 333 0 0 278 333 278 278 556 556 556 556 556 556 556 556 556 556 278 0 0 0 0 556 0 667 667 722 722 667 611 0 722 278 0 0 556 833 722 778 667 0 722 667 611 0 667 944 0 667 0 0 0 0 0 0 0 556 556 500 556 556 278 556 556 222 222 500 222 833 556 556 556 556 333 500 278 556 500 722 500 500 500] 414 0 obj These numbers show that a 2020 target for achieving international targets of health workforce ratios is clearlynot feasible. Liberias stated target is 1.4 doctors, nurses, midwives, and physician assistants per 1000 population. 0000001516 00000 n ERA Applicant Site: New Method for All Job Vacancy Application Note: Registered and solely operated in Sierra Leone. Coins First Leone All bore the portrait of the first prime minister of Sierra Leone, Sir Milton Margai. Progress has levelled off since then and there is a feeling that the time may be right for the country to diversify from its reliance on mining; however, mining is sure to remain an important part of the economy. But five years after the 2018 Haiti scandal gave way to the supposed reforms of the #AidToo movement, little has changed on the ground particularly in countries like Sierra Leone, where sex workers say aid workers are still part of their clientele. While the country boasts an abundance of natural resources, it is also a poor nation, with a healthcare system in dire need of improvement. Capacity, both in terms of numbers and skills of health workers, is one of the main barriers to improving the health system. Figure4 shows the estimated number of graduates required to meet the international threshold under the baseline attrition, training dropout, and public sector employment scenario. Corruption exists in Sierra Leones healthcare system. Several male aid workers told The New Humanitarian that sex in Sierra Leone and elsewhere is often transactional, and prohibiting aid workers from such arrangements is both naive and unrealistic. InterNations Freetown End of Year Dinner & Dance, InterNations Freetown June Official Event, InterNations Freetown October Official Event. Both countries, however, point to the importance of carrying out labor market assessments in order to identify strategies that target solutions to address rural/urban imbalances. There are a number of large companies in Freetown including Fourah Bay College, the Awareness Times newspaper, The Sierra Leone Broadcasting Corporation, and Capital Radio. [226] Standard users can export data in a easy to use web interface or using an excel add-in. Advanced users can use our Python/R/Matlab packages. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. 2016;14(1):3. For some 26,000 women, sex work has been one way to earn cash in uncertain times in Sierra Leone, which still has a large humanitarian presence since the Ebola outbreak, which brought in a surge of some $900 million in aid. Mining has attracted a large amount of foreign investment and in 2013 played a large part in pushing growth to 20%. Scheffler et al. Our projections keep the ratios of doctors, nurses and midwives constant and in line with the current ratios. Human resources for health: overcoming the crisis. endobj WebA person working in Sierra Leone typically earns around 5,700,000 SLL per month. 6). Corruption in healthcare in Sierra Leone is a taboo. Tourism is an industry on the up, and is expected to continue to rise, as Sierra Leone can boast beautiful beaches and a tropical climate. A copy of the result of the comparison of Wage bill as a proportion of health expenditures under different cost projections. The aggrieved workers include endobj <> WebSierra Leone - Get a free salary comparison based on job title, skills, experience and education. Although Guinea has the smallest stock of combined health workers (when all health worker categories are included), it has a large stock of community health volunteers and the largest stock of doctors of the three countries. The workforce will not be effective if other elements of the health system are not also strengthened. 0000003250 00000 n 0000009465 00000 n Acad Med. The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". President Ernest Bai Koroma launched an Agenda for Prosperity in 2013, aiming to bring the country closer to a middle-income country status within the next few decades. )nfc?li1ZEJj{8:9n'1JC).P(A@)[v1(0)8$m>;?S>}v.D?aw;cHjj;OU|#W%9WdJM& @:HKN&kQ4KxSht:B)8;%9,6-\kdj{-Xx2OsLP'Nfvi1+4(K.0O7c\82Ei$h_XXP0^ We managed the lack of reliable information on attrition by using sensitivity analysis to model hypothetical alternative estimates of attrition, drop-outs, and employment rates for illustrative purposes. Google Scholar. Strengthening global health security by embedding the International Health Regulation requirements in health systems. Washington DC: World Bank; 2017. This cookie is set by GDPR Cookie Consent plugin. 5 Jun. California Privacy Statement, Despite its relatively small population, there were more cases of Ebola in Sierra Leone than any other country. Sign up to receive our original, on-the-ground coverage that informs policymakers, practitioners, donors, and others who want to make the world more humane. hb```b````c`6bb@ !V(GS:0` nE*Yx.|*^a Wt4#K(f`g`adap, 5Y 0a"$Zy,L3%0L`iwb8mY|t2V.bA[,i"Eu1Ar 3@A\{@ 4 All three Ebola-affected countries had large shortfalls and maldistribution in their health workforce before the crisis, which were made worse by the epidemic. Please take our survey to help us better understand how we can serve our community with new and exciting formats and projects. Sierra Leones health outcomes rank among the worst in the world. 0000003765 00000 n However, rates of the illness are falling across the country due to preventative practices such as sleeping under insecticide treated nets. Guineas stated target is 0.26 doctors per 1000 population, 0.26 nurses per 1000 population, and 0.26 midwives per 1000 populationthis produces a target density of 0.78 per 1000 population for doctors, nurses, and midwives by 2024. West African countries focus on post-Ebola recovery plans. The average salary in Freetown is SLL 35k. Lack of defined and cross-country comparability of rural and urban areas in Sierra Leone and Liberia were managed by defining the region including the capital city as urban and all other areas as rural. Mineral and resource-rich, Sierra Leone is a top producer of iron ore, but little of this wealth or international aid money has trickled down to the countrys most marginalised, according to Marie Benjamin, director of the Society for Women and AIDS in Africa (SWAA), a federation of several groups. The aggrieved workers include surveillance officers, contact tracers, case investigators, quarantine and psychosocial counselors, among other categories of workers. Sierra Leones health workforce had fallen to a level per 1000 population of 0.2 by 2008, and this workforce was heavily concentrated in urban areas [5]. Blesz. According to the National Health Strategic Plan 20102015, published in 2009 ( 3 ), Sierra Leone had a total health workforce of 2,402 persons. Tips from other Freetown expats and locals opened my eyes to Sierra Leone's many facets, from town masquerades to national parks. In 2010, Sierra Leone began offering free health care. The distribution of health workers is uneven in all three countries, although Liberias workforce is more evenly distributed than the others, with 57% of doctors in rural areas, and 43% in urban areas (the population distribution is 68% rural and 32% urban). He said they intended to continue on the sit down strike until they receive their pay for work done from April 1 to May 31. Sierra Leone has a government-mandated minimum wage, and no worker in Sierra Leone can be paid less then this mandatory minimum rate Public sector payroll data from 2015 were used for the health workforce analysis. Seydu. 0000029845 00000 n The government also hopes the initiative improves general health across the country. (2016a) estimate a need in low-income countries for a ratio of approximately 2.5:1 nurses and midwives to doctors [17]. https://www.nbcnews.com/storyline/ebola-virus-outbreak/runaway-doctors-missing-supplies-cripple-care-ebola-hit-liberia-n220686, http://www.imf.org/external/pubs/ft/weo/2016/01/weodata/index.aspx. 413 0 obj Some of Sierra Leones COVID-19 front line workers have embarked on an indefinite strike action due to delay in payment of their incentives. Download historical data for 20 million indicators using your browser. They say they havent received a dime from the government since the country began responding to the pandemic on March 31 this year. There are 120 countries with a higher Minimum Wage then Sierra Leone, and Sierra Leone is in the bottom percent of all countries based on the yearly minimum wage rate. WebThe Employers in the Mining Companies that are operating in Sierra Leone recognise the United Mine Workers' Union holding the Collective Bargaining Certificates (Bargaining Certificate No.l) issued by the Ministry of Employment, Labour and Social Security under the Regulation of the Wages and Industrial Relations Act 1971; as the sole negotiating The survey should only take about 8-10 minutes to complete. This was part of a memorandum agreed between government and the various category of health workers. As the 2014 West African Ebola outbreak was finally declared over, a period of unprecedented attention to global health security began, with four global commissions in a space of less than 1year [1]. In Sierra Leone, achieving a target similar to Guineas in 2024 would cost US$18.25 per capita annually; achieving a target similar to Liberias in 2024 would cost US$24.10 per capita annually. We were expecting that they could come to us to address the issue, but since they have held back, we will continue like this, he told Politico. Each role at LMH is graded on a number of criteria, including scope of authority, autonomy, people and budget Among other things, these plans seek to expand the availability of well-performing health workers at all levels of the health system and contain workforce scaling-up targets for each country to aim to achieve. Table7 shows the workforce growth rates required for plan targets in each country, broken down by rural and urban requirements. The differences across countries reflect large differences in cost estimates for wages and for training which are more important in the overall cost projection than the scenario differences. The Minister of Energy, Ambassador Henry O. Macauley has been exposed as the highest paid Cabinet Minister in Sierra Leone with a monthly salary of US$5,900.00 (Five Thousand Nine Hundred United States Dollars), documents at the Accountant Generals office show. Skuad handles the hiring, payroll, and tax compliance on their behalf, leaving the organizations free to concentrate on their primary business activities. If they cannot earn as much, then they will always go back.. We would also like to thank our anonymous reviewers for greatly helping us improve the manuscript, and the leadership team at the World Bank, Trina Haque, Olusoji Adeji and Ibrahim Magazi for their overall support and guidance in getting the manuscript published. Sierra Leone has a literacy rate of about 40 percent. Foreign men think that we like the life, but I hate it, said *Isata, a 17-year-old sex worker in Sierra Leones capital of Freetown, who said aid workers were among her clients. 0000004572 00000 n Investment focused on nurses and midwives rather than on doctors will reduce costs in all countries. The authors declare that they have no competing interests. The Liberian investment plan includes a housing allowance for 10% of the workforce (in underserved areas) and plans to develop fair and equitable remuneration by introducing and financing a hardship allowance. Goodwin MC, Gleason WM, Kontos HA. Disabled residents face tough conditions. 0000065062 00000 n After 42 days without new Ebola infections, Sierra Leone was declared free of the deadly Ebola infection on Saturday Nov. 7. 0000004326 00000 n Nearly all international aid organisations ban staff from paying for sex while on assignment, and many have so-called zero-tolerance policies for engaging in transactional sex or the broader category of fraternisation. There's a complex mix around exploitation, but also consent, and the agency of women making shrewd choices in less than ideal material conditions, Westendorf told The New Humanitarian in February. Sierra Leone's minimum wage was last changed in 1-Jan-2015 . 0000029619 00000 n In Guinea, achieving the proposed target of 0.78 nurses, midwives, and physicians per 1000 population in 2024 would cost US$1.51 per capita annually. Donors making a difference: immunization. The program has not been without its challenges, however, due to the aforementioned weaknesses of previous systems of health care in Sierra Leone. }CB@MqXLoHXz/~>Utq*. This cookie is set by GDPR Cookie Consent plugin. The industry and sector follow the Industry Classification Benchmark taxonomy. Ugandas Yoweri Museveni is the highest earning East African head of state with a monthly salary of Sh1.5 million, followed closely by Mr Kenyatta with a monthly pay of Sh1.4 million. (DOCX 18 kb). I think there's a lot more to be done in the sector to address the material conditions and to address the inequality that's created.".
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