By Foday Moriba Conteh
Sierra Leone’s Minister of Health, Dr. Austin Demby, has showcased the country’s early progress in implementing its National Health Compact during a high-level National Health Compacts Roundtable held in Geneva, Switzerland, reaffirming the Government’s commitment to strengthening healthcare systems through improved coordination, accountability and domestic resource mobilization.
The roundtable, hosted by Seed Global Health in collaboration with Sierra Leone and Uganda, brought together global health stakeholders, policymakers and development partners to discuss innovative strategies for advancing national health systems and strengthening partnerships in healthcare delivery.
Addressing delegates on Wednesday, 20th May 2026, Dr. Austin Demby underscored Sierra Leone’s determination to move beyond theoretical discussions, stating that the country is actively demonstrating what a functioning National Health Compact looks like in practice.
According to the Health Minister, Sierra Leone officially launched its National Health Compact in Tokyo in December 2025 under the framework of “One Plan, One Budget and One Reporting Framework.” He explained that the initiative was jointly signed by major development partners and co-governed by the Ministries of Health and Finance, reflecting the Government’s determination to create a coordinated and transparent health delivery system.
Speaking on the operational structure of the Compact, Dr. Austin Demby highlighted four key pillars guiding its implementation: Alignment, Acceleration, Accompaniment and Accountability.
On Alignment, he stressed the importance of ensuring that national systems remain at the centre of healthcare implementation, emphasizing the need for stronger coordination between the Ministry of Health and the Ministry of Finance. He maintained that the approach seeks to prioritize national structures over fragmented donor-led systems, which often create inefficiencies in healthcare delivery.
Discussing Acceleration, the Health Minister pointed to the Government’s “300 Days of Activism for Triple Zeros” campaign, which he described as a presidential accountability initiative designed to drastically reduce maternal deaths, child mortality and the number of unvaccinated children across the country.
He disclosed that by Day 75 of implementation, Sierra Leone had recorded a remarkable 60 percent reduction in maternal deaths when compared to the 2025 baseline, a development he said demonstrates the effectiveness of targeted interventions supported by real-time monitoring systems.
While acknowledging progress, Dr. Austin Demby admitted that Accompaniment remains an area requiring further strengthening, noting that some development partners continue to operate parallel reporting systems despite signing onto the National Health Compact. He emphasized that genuine partnership should extend beyond formal commitments made during signing ceremonies and translate into practical cooperation aligned with national priorities.
On Accountability, the Health Minister highlighted several innovations already operational within Sierra Leone’s health sector, including live performance dashboards, district health heatmaps, weekly review systems and real-time monitoring mechanisms for the Triple Zeros initiative. He described those measures as clear evidence that Sierra Leone’s accountability framework in the health sector is functioning effectively.
Addressing the issue of financing, Dr. Austin Demby emphasized that Sierra Leone’s strategy is firmly rooted in domestic resource mobilization. He disclosed ongoing efforts by Government to attain the Abuja Declaration target of allocating 15 percent of the national budget to healthcare while exploring additional funding streams through taxes on tobacco, alcohol, sugar-sweetened beverages and unhealthy packaged foods.
He further revealed plans for the implementation of the Sierra Leone Social Health Insurance Scheme (SLeSHI), alongside ongoing discussions on debt swaps aimed at supporting long-term investments in the country’s healthcare system.
Concluding his presentation, Dr. Austin Demby positioned Sierra Leone as a potential reference country for nations seeking to establish similar health compacts, encouraging countries to draw lessons not only from Sierra Leone’s successes but also from the challenges encountered during implementation.
