UN, SL Sign $3.5M Health Project

By Lemuella Tarawallie

United Nations agencies, in collaboration with the Ministry of Health, have signed the $3.5 million Programme Document (ProDoc) for the UN Joint Flagship Initiative under Pillar Two of the United Nations Sustainable Development Cooperation Framework (UNSDCF) 2025–2030, marking a major step toward accelerating Universal Health Coverage (UHC) in Sierra Leone.

The signing ceremony took place on Friday, 12 December 2025, at the Ministry of Health Conference Room in Freetown and was facilitated by UNICEF. The initiative will pilot the Sierra Leone Person-Centered Life-Stage Approach to health service delivery in Moyamba District.

The UN Resident Coordinator, Seraphine Wakana, said in her opening remarks that eight UN agencies are co-investing approximately US$3.5 million into the district health system, aligning resources behind a single vision and integrated results framework. She described the approach as a move beyond fragmented projects toward coherent co-funding and joint accountability, in line with UN 2.0 reforms.

Ms. Wakana added that the signing represents more than a formal agreement; it signals a new way of working together for health and human development. She explained that the flagship initiative is the first selected programme under Pillar Two of the 2025–2030 Cooperation Framework, which focuses on human capital and essential services.

She noted that Moyamba District was chosen because it mirrors many rural health challenges in Sierra Leone, including gaps in service delivery and outcomes below national averages. She cited indicators such as a high total fertility rate of 5.4 children per woman (compared to the national average of 4.2), under-five mortality of 135 per 1,000 live births (compared to 122 nationally), and high levels of child stunting and adolescent pregnancy. She added that if a successful and inclusive model is built in Moyamba, it can be adapted and scaled across the country.

Ms. Wakana also emphasized that the initiative supports Sierra Leone’s national framework for a person-centered life-stage approach, launched in 2023, which shifts away from disease-specific programs toward holistic care across all stages of life. Implementation will begin in selected demonstration sites, including Moyamba District Hospital, Moyamba Junction Community Health Centre, Rotawa Community Health Post, and Mokele Mother and Child Health Post, linking community-level care to hospital services.

The Permanent Secretary of the Ministry of Health, in his welcome address, described the partnership as a new model of alignment between the UN family and the ministry. He noted that Moyamba District was selected as a demonstration site due to its strategic location and diversity, reflecting characteristics of all regions of the country, making it an ideal testing ground for a model that can later be scaled nationwide. He also highlighted the symbolic importance of the signing, coinciding with Universal Health Coverage Day.

Speaking on behalf of the government, the Deputy Minister of Planning and Economic Development described the signing as a promise to the people of Moyamba that health services will respond to their needs throughout their entire life journey. He reaffirmed the ministry’s commitment to guide and support the flagship initiative and thanked development partners for their continued collaboration in building a healthier and more inclusive Sierra Leone.

Minister of Health, Dr. Austin Demby, explained the meaning of Universal Health Coverage and the rationale behind the person-centered life-stage approach. He said UHC means that the health and wellbeing of all 8.5 million Sierra Leoneans must be addressed holistically. Under the new approach, health workers will no longer treat patients based only on a single disease, but will assess and respond to all aspects of a person’s health needs.

Dr. Demby outlined how the life-stage approach follows individuals from pregnancy through childhood, adolescence, adulthood, and old age, ensuring integrated and continuous care. He emphasized the importance of real-time data and analytics to guide decision-making, noting that the ministry is working with partners to establish a health data hub to monitor outcomes and respond quickly to emerging challenges.

He clarified that Moyamba is not merely a pilot district but a demonstration site, as the approach is already being rolled out across all 16 districts. Lessons learned from Moyamba will inform nationwide implementation. He also highlighted recent investments in digital connectivity, including Starlink, to strengthen communication between district health offices and the central ministry.

In closing the ceremony, the Chief Medical Officer described the initiative as the realization of years of planning and coordination. He stressed the importance of pooled financing, strong partnerships with the Ministry of Finance, UN agencies, and the private sector, and the use of data to achieve national goals such as zero maternal deaths, zero child deaths, and zero unvaccinated children. He called on Moyamba District to lead as a pace-setter, assuring continued national support.

The event also featured a presentation by UNICEF Representative Rudolf Schwenk, who highlighted UNICEF’s contributions to strengthening Sierra Leone’s health sector. The ceremony concluded with the formal signing of the Programme Document by the UN agencies and the Ministry of Health, signaling the start of a new chapter in collaborative, people-centered health service delivery in Sierra Leone.