The case of smallholders in Sierra Leone - agrilife - Europa

Healthcare is essentially provided by the government, accompanied by international health
programs. However, medical care is generally not free of charge in Sierra Leone, and
poorer families are often unable to pay user or prescription fees. The utilisation rate of
health care facilities by the general population is estimated at 0.5 contacts per capita per
annum, implying that on average only one-half of the population attends a health care
facility during the year (UNDP, 2007). Only the Western Area (i.e. Freetown) meets the
WHO recommended staffing ratio of one doctor per 12 000 persons; while in the Kailahun
District (Eastern region) the ratio is of 1/191 340 (UNDP, 2007).
Diseases such as malaria and tuberculosis are prevalent and widespread, and recently the
HIV/AIDS epidemic has been posing a particularly serious challenge (UNDP, 2007). The
2008 prevalence of HIV/AIDS in the population is higher than the world average of less
than 1% but lower than the average of 6% for Sub-Saharan Africa (UNAIDS, 2008). The
country also suffers from epidemic outbreaks of diseases including yellow fever, cholera,
Lassa fever and meningitis (Ministry of Health and Sanitation, 2007).
The sanitation situation is also precarious. 83% of households in Sierra Leone use pit
latrines, buckets, bush and rivers/streams as their sanitation systems for waste disposal,
posing serious health and environmental problems for communities. In the urban areas,
sanitation problems arise mainly from poor systems of solid waste disposal. According to
Jalloh (2006) it is a common practice for many household to dispose of refuse by dumping
on roadside, in drainages or in backyards.
2.4 Education
Education in Sierra Leone is compulsory for six years at the primary level and for three
years at the junior secondary level. A shortage of schools and teachers has made full
implementation impossible (Wang, 2007). Two thirds of the adult population of the
country is illiterate: the adult literacy rate is 47.9% for males, and 27% for females
(CWIQ, 2007). Since the end of the war, the situation has improved considerably, with an
estimated primary school enrolment of 74.8% for children 6-11 years old (CWIQ, 2007).
Nonetheless, access to education remains highly unequal. During the 2000/2001
academic year, there were a total of 2,704 primary schools in the country and it was only
in the Western region that private schools existed. In all the regions, the male population
engaged in education was greater than that of females, particularly in the Northern region,
while the gap was closest in the Western region. In terms of pupil to teacher ratio, the
national average was 1:37, ranging from 1:23 in the Western region to 1:46 in the Eastern
region. A similar situation prevails concerning secondary schools (Jalloh, 2006).
2.5 Macroeconomics
Since 2000, Sierra Leone’s economy has recovered strongly, with an annual GDP growth of
5.5% in 2008 (World Bank, 2009). Figure 3 reflects the trend of the recovery since the years
of civil unrest which was initially high given the dramatic decline of the economy during the
prolonged period of conflict.
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