Sierra Leone's response to COVID-19: A Rapid Assessment
Sierra Leone was one of the last countries in the world to be affected by the pandemic but has faced a series of institutional and operational challenges that have slowed down response efforts to COVID-19. The government’s preparedness from January was led by the Ministry of Health and Sanitation, and then the EVD Emergency Operations Committee (EOC) was reactivated in March, led by the Ministry of Defense. There remain issues around coordination and evidence-led decision-making to resolve. Quickly following this was the implementation of resource intensive approaches for quarantine and disease surveillance. However, given the rapid increase in cases this has been unsustainable to maintain, resulting in a lack of testing and insufficient support for COVID-19 patients and their families.
Unlike most other countries, Sierra Leone has not imposed an extended lockdown due to a deep concern about the negative economic consequences of comprehensive restrictions on economic activity. Instead, two 3-day lockdowns, policies of social distancing and a ban on inter-district travel have been implemented, although voluntary compliance rates seem low and there is a lack of capacity to enforce these policies. As prolonged restrictions on economic activity are unlikely, considerations should focus on how economic activities can be modified during COVID-19 and how voluntary compliance can be supported.
The Response Communication Team has attempted to disseminate information on prevention and treatment of COVID-19 that is tailored to different audiences. There has also been an information campaign to encourage citizens to continue to seek medical care for non-COVID-19 related diseases. However, non-COVID-19 health services have been affected by the pandemic’s onset, as the government has reallocated already insufficient personnel to fight the virus. There is reason to believe that this reallocation of resources will disproportionately affect women and children. Given this concern, there is insufficient consideration towards Gender and Social Inclusion (GESI) in the response. Select initiatives are however taking place to raise awareness on sexual and gender-based violence, ante- natal healthcare, and gendered communication messaging (especially targeted at the youth).
Non-health sectors have also been impacted by COVID-19. As schools have been closed the government has attempted to continue education through distance learning. Social distancing policies and nightly curfews greatly curtail business opportunities for many bars and restaurants; the inter-district travel ban restricts the movement of supplies and foods across the country. While there are some social protection mechanisms in place to combat these economic challenges, overall social protection is limited. Both the government and international organisations are looking to strengthen this over the next few months, as the financial impact of the pandemic is felt by the poorest and most vulnerable households.
This report comes at a time when Sierra Leone is on the edge of a new stage of the COVID- 19 response—first cases have been confirmed in most districts. The authors have tried to translate a description of events into insights for external actors looking to support the country’s efforts to combat COVID-19, largely focusing on the operational aspects of the COVID-19 response. Specifically, this report identifies entry points for the Maintains programme in Sierra Leone, although these might also be useful to other actors in country.