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Health sector fragmentation: three examples from Sierra Leone
Arwen Barr1, Lauryn Garrett2, Robert Marten3
1Simon Fraser University, 8888 University Drive, Burnaby, Canada.
Globalization and Health
|January 24, 2019
Summary
Health sector fragmentation in Sierra Leone hinders progress. Addressing governance, funding, and external actor engagement is crucial for efficient and sustainable health system strengthening.
Area of Science:
- Global Health
- Health Systems Research
- Public Health Policy
Background:
- Health sector fragmentation in Sierra Leone challenges efficiency and coherence.
- Examples include community health worker programs, medical supply chains, and service level agreements.
Purpose of the Study:
- To analyze the extent, causes, and impacts of health sector fragmentation.
- To identify barriers to sustainable health system improvements.
Main Methods:
- Qualitative analysis of health sector fragmentation.
- Case studies on community health workers, supply chains, and service level agreements.
Main Results:
- Fragmentation stems from governance issues, funding structures, and external actor engagement.
- Prolonged external dependence and vertical programming exacerbate fragmentation.
- Impacts include reduced system efficiency and intervention sustainability.
Conclusions:
- Alignment of policy and planning is essential for integration.
- Investment in proactive policy development is needed.
- Strengthened partnerships, governance, and accountability are key opportunities.
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