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Sierra Leone

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Health is of great importance not only to individuals but also to a nation as a whole. In each and every country, economic development is at all times anticipated to advance the health rank of the common country’s population; concurrently, better or rather good health contributes immensely to the economic development by largely broadening the supposed working life of citizens and rising worker productivity. This paper will discuss at length the status of health or rather healthcare and its delivery in the African country of Sierra Leone and how it is managed throughout the nation.

Geography

Sierra Leone is a West African tropical nation that lies between the latitudes 8 30 N and 11 30 W whereby it is washed by the North Atlantic Ocean. On the eastern and northern sides, it borders on Guinea and on the south, on Liberia.  Its geographic area covers about 71,740 sq km. Speaking about the area, it is slightly smaller than South Carolina. The terrain is that of upland plateau, wooded hill country, mountains in the east, and a coastal belt covered by mangrove swamps. The climate is tropical, hot, and humid; summer is characterized by a rainy season from May to December; and the winter spell extends from December to April. In terms of natural resources, the country has chromite, gold, iron ore, bauxite, titanium ore, and diamonds (The WORLD FACTBOOK, n.d.).

Population

The country’s national population estimates of July 2012 are 5,485,998. The population growth rate as of 2012 is estimated at 2.227%. The age structure which is commonly known as a population pyramid denotes how people are distributed in a population through their age groups. Here, the age group of 0-14 years composes 41.8% of the total population whereby females are 1,130,112, and male are 1,113,528. The age group of 15-64 covers about 54.5% of the overall population, and the female count is 1,522,335 whereas the male citizens cover 1,401,907. The group aged 65 and over has 3.7% where the female make up 109,173, and male are 86,614. On the other hand, the birth rate of 2012 is estimated to be 38.12, and the death rate is 11.49. The country has one major city with an estimated population of 875,000 (according to the statistics of the year 2009) (UNdata, n.d.).

Government

The republic of Sierra Leone has a constitutional democracy form of government. It was a British colony and obtained its independence on 27th April 1991. The capital city is Freetown which houses most of the government parastatals and offices.  On administrative divisions, the country has one ares which is called western and three provinces, namely southern, northern, and eastern. The nation adopted its own constitution on 1st October, 1991 where it has been amended a number of times since then. The legal system is commonly a mixed one which consists of customary law and English common law. The president is the head of the government and also the chief of the state. The cabinet of ministers is appointed by the head of the state through the endorsement from the parliamentarians. Elections are held every five years and the president is voted in through the majority of votes. The legislative arm of the government is composed of a unicameral parliament where it is made up of paramount chiefs and elected parliamentarians. The judiciary is made up of the Appeals Court, Supreme Court, and the High Court (The WORLD FACTBOOK, n.d.). 

Economy

Sierra Leone is exceedingly poor as a nation with terrific disparity in revenue allocation. Its real growth rate or rather GDP of 2011 estimates that the rates about 5.1% and GDP per capita was $800 in 2011. The composition of GDP by sector of 2011 estimates was agriculture 51%, industry 21.7%, and services at 27.3%. According to 2007 research analysis, the estimated labor force constituted about 2.2.7 million people. Unemployment rate as of 2005 records show that it was at 2.8% (UNdata (n.d.). The country has enormous mineral deposits, fishery resources, and agriculture; however, due to the civil war it experienced, its social and physical infrastructure has not yet recovered. Almost half of the working-age populace does subsistence farming. Manufacturing comprises largely of light industries and processing of raw resources to be used domestically. Mining of alluvial diamond is the chief source of firm exchange earnings, which accounts for almost half of the country's exports (Sierra Leone Economy, 2012).

The major determinants of health in Sierra Leone include those related to inborn and personal features of persons. This determinant which covers sex and age is predominant in the country as women are more prone to health issues like uterine and cervical cancer, complications in child bearing, and also other complications like breast and thyroid cancer. Age also plays a key role in health issuesas young children are prone to diarrheal and polio diseases (Global Health Observatory Data Repository, n.d.).

Additionally, another significant health determinant in the nation is environment. Many women cook while indoors. Since the housing has poor ventilation, this creates unconducive indoor environment that causes asthma and respiratory illnesses. Again, the widespread lack of sanitation and secure drinking water has contributed heavily to the spread of water-borne diseases. In industries, many workers are exposed to the unhealthy environment as they work with no protection gear inhaling polluted air. These working conditions expose them to occupational accidents and even chemical poisoning.

Education is the key to knowledge, and knowledge is the power. Thus, it brings in the information of high quality health practices and gaining social status through better employments since skills have been gained.  The country is slowly pulling itself after the civil war, but the level of education is still low. Thus, the lack of education exposes many citizens’ health situations as they do not have the information to counter health issues.

Health Status Indicators

These indicators many of which are in data form are used to assess or rather show the position and level of health of the country. Amongst the mostly applied indicators of health level, life expectancy at birth is the most important. This is described as the extra years a newly born child is likely to live with constant mortality trends.  In Sierra Leone, life expectancy at birth according to 2012 estimates was 56.55 years (UNdata, n.d.). 

Another status indicator in health is infant mortality rate which is known as the quantity of fatality of newborns below the age of one year per 1000 live births in a certain year. In the country, infant mortality rate estimated in 2012 is 76.64 deaths/1,000 live births (The WORLD FACTBOOK., n.d.).

Maternity mortality rate is referred to the quantity of females who demise as an effect of pregnancy and childbirth difficulties per 100,000 live births in a certain year. This rate in Sierra Leone as of 2010 statistics was 890 deaths/100,000 live births (UNdata (n.d.)).

The burden of disease has greatly affected the citizens of Sierra Leone predominantly because the country is poorly developed, hence communicable and non-communicable diseases are common. Statistics done by World Health Organization in 2010 shows that the first killer disease of children under the age of 5 was malaria as it was estimated to kill about 23% of the total number of kids who died that year. Thus, the nation has a huge burden of malaria as it is estimated to be the cause number one of death nationwide. It was followed closely by pneumonia which had 17%, diarrhea (12%), and prematurity (10%) (Sierra Leone, n.d.).

DALYs commonly denotes the leading causes of death and disability-adjusted life years; this measure is majorly applied in quantifying the burden of disease. It merges data obtained on the amount of years of life gone from early death with the loss of health from disability. Statistics carried in 2004 shows that the DALYs’ rate on the country was high since for diarrhea was 103 deaths, malaria – 27, and other vector borne illnesses covered 1.8. Malnutrition calculated in percentage stunting in 2005 had 47% nationwide. Also, indoor pollution or environment, according to the 2004 data, showed that it was responsible for 10,800 deaths that year and has DALYs of 67 (Quantifying environmental health impacts, n.d).

Traditional Medicine

Since time immemorial, it is common for the cultures of most African countries that they value traditional medicine to a great extend, thus it is part and parcel of their life. Therefore, since the government could not do away with the use of traditional medicine in the nation,  it enacted the medical parishioners and dental surgeons decree in 1994 allowing customary systems of therapeutics to continue as long as they did not pose any danger to people’s health or life. Throughout the country, customary medicine practitioners have been incorporated into the primary healthcare programs (Legal Status of Traditional Medicine, n.d.).

Healthcare Delivery

Healthcare in the country has been primarily provided by the government. In April 2010, the republic has introduced the Free HealthCare program which assigns free of charge services to kids under 5 years, lactating mothers, and those who are pregnant. Other government-related and health-related agencies include the National AIDS Secretariat, the Ministry of Health and Sanitation, and peripheral health units. Apart from the government, there are numerous non-governmental organizations and associations that assist in providing healthcare to the needy citizens. These international NGOs include UNICEF, UNAIDS, WHO, UNHCR, Save the Children UK, MSF-Belgium, MRC, UNCIEF, and UNFPA (Sierra Leone, n.d.).

Health Priorities

Globally, initiatives and campaigns have been going round on the elimination of the communicable diseases in third world countries. Malaria, for instance, has killed a large number of people in Sierra Leone. However, the ways of controlling it are quite simple. Therefore, a leading priority of this nation is reducing at the length of social, economic, and health burden of both non-communicable and communicable diseases. The key focus will be on preventing and controlling of malaria, combating Tuberculosis and HIV/AIDS, and building up power to handle nationwide immunization campaigns to effectively control the vaccine escapable diseases (Global Health Observatory n.d.).

Another major priority covers the reduction of maternal, child, and infant mortality and morbidity, and the promotion of healthy and responsible reproductive and sexual health behavior. Lots of focus will be giving much support to the recently established Reproductive and Child Health Department together with the ministry of health and sanitation. The World Health Organization will carry on to maintain ability building that intends to develop the health of the ageing citizens, adults, children, and mothers through a life sequence progress approach but with particular consideration to the widespread access to excellence adolescence health, family planning, reproductive and sexual health (Global Health Observatory, n.d.).

Seemingly, it is in the government’s priority to strengthen systems and policies so as to advance superiority and access of health services throughout the nation. This can be achieved through complete health systems expansion at sub-district, district, and national levels, and proper realization of the country’s vision 2015 health agenda which includes taking healthcare facilities to the people at the grass root level, improving the general impact of health delivery and services nationwide, and strengthening the abilities of the ministry of health and sanitation in data collection and analysis of monetary information to enhance decision-making (Global Health Observatory, n.d.).

Lastly, an important priority is fostering coordination and partnerships for countrywide health development. This will be done through the massive technical support to the development partners and ministry of health and sanitation in sustenance of the realization of health sector agendas. Additionally, World Health Organization will keep on its link function with reverence to international funds/alliance, nongovernmental organizations, and foundations (Global Health Observatory, n.d.).

Nursing Implications

Nurses are the people in the ground who interact with the patients on the ground and ensure that their medical needs are attended to. Thus, to have most priorities achieved, nurses should be involved directly. Healthcare delivery is totally low as there are few nurses in the country; to make matter worse, those present are underpaid. This takes away their motivation, therefore, lowering the delivery of healthcare. Also, since they are underpaid, they tend to migrate to other countries where pastures are somehow greener hence leaving behind a huge shortage of health personnel.

In dealing with the nation’s priorities, nurses should educate the public on how to handle most of the communicable diseases, for instance, how to prevent malaria, waterborne diseases like cholera, and also HIV/AIDS. This would assist greatly in reducing the health menace that is being experienced in the country right now.  The information on the  reproductive health together with sexual health behavior can be passed to the public by these nurses (Sierra Leone. (n.d.)).

Conclusion

Healthcare or rather health is a very important matter to all governments as it affects directly the country’s economic development if not dealt with properly. Sierra Leone is actually pulling through after experiencing a prolonged civil war which had derailed development immensely. the total concentration by the government to uplift its health status to a higher standard by 2015 would ensure that the labor force is healthy hence driving the economy forward.

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