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Evaluating the implementation of Sierra Leone’s first National Action Plan for Health Security, 2018–2024: lessons learnt and way forward

Article scientifique 2026 Autre

Résumé

Introduction The Parties Self-Assessment Annual Reporting (SPAR) and Joint External Evaluations (JEE) enable countries to assess their capabilities in handling public health threats and addressing gaps through the National Action Plan for Health Security (NAPHS). This study evaluates NAPHS implementation, along with JEE and SPAR capability assessments. Methods We conducted a two-time-point programmatic review of Sierra Leone’s first NAPHS, at mid-term (2021) and end-term (2024) for 19 Technical Areas (TAs). The implementation status of the activities was rated as “Completed”, “In-progress” and “Not-started”. JEE and SPAR reviews were conducted to compare progress. Results The overall implementation rate increased from 56% (2021) to 65% (2024). Only 39 activities (23%) were completed, while 22 (13.3%) were never started. Most activities (105, 63%) remained in progress, and completion rates improved across all TAs (except Food Safety), with six high-performing and five low-performing TAs. SPAR scores rose from 51% to 55%, but declined for Health Emergency Management and Risk Communication. JEE scores remained low (46%), with Prevent and Detect pillars showing limited advancement. Of the $291.13 million NAPHS’s budget, 103/166 (62%) activities were funded ($107.82 million), revealing a minimum funding gap of 55.1%. Conclusion The NAPHS implementation has faced slower-than-expected progress, especially in its latter years, with uncompleted activities and uneven performance across TAs. The NAPHS achievement measures lack consistency compared to JEE and SPAR scores, with funding disparities. External and internal factors were hindrances that require a holistic approach in NAPHS 2.0, focusing on prevention and detection to enhance public health protection against future emergencies.

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Fofanah, B., Sahr, F., Musoke, R., Njuguna, C., Vandi, M., Jalloh, M., Squire, J., Tucker, M., N'dolie, M., Caulker, V., Kanu, J., Jalloh, M., Sesay, S., Kamara, I., Lakoh, S., Bamayange, S., Koroma, O., Ameh, G. (2026). Evaluating the implementation of Sierra Leone’s first National Action Plan for Health Security, 2018–2024: lessons learnt and way forward. https://doi.org/10.3389/fitd.2025.1737087

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Auteur(s)

Bobson Derrick Fofanah Foday Sahr Robert Musoke Charles Njuguna Mohamed Vandi Mustapha Jalloh James Sylvester Squire Medlin Soko Tucker Michael N'dolie Victor Caulker Joseph Sam Kanu Mohamed Boie Jalloh Stephen Sesay Ibrahim Franklyn Kamara Sulaiman Lakoh Saidu Bamayange Osman Baimba Koroma George I. Ameh

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