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Analytical summary - The physical environment

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The most deadly vector-borne disease, malaria, kills over 1.2 million people annually, mostly African children under the age of 5 years.


In Sierra Leone, the Ministry of Health and Sanitation’s National Environmental Health Policy stipulates that the vector control subdivision of the Ministry should be made functional and effective in order to support special disease control programmes, including malaria control, in the country. It also states that the vector control subdivision should create effective functional vector control units in all district and chiefdom headquarter towns. This is to ensure proper countrywide control of all vectors of public health importance.[1]

Sierra Leone’s urban centres (mainly in Freetown) are developing at an unprecedented rate, with increasing levels of urban dwellings, small-scale businesses and resulting pollution from sewage. As a result, improving sanitation is faced with the challenge of rapid urbanization coupled with inadequate infrastructure and services for solid waste disposal.

In urban and periurban areas, the mushrooming of spontaneous, unplanned settlements accommodating a huge proportion of Freetown’s population (approximately 2–3 million) is compounding the problem associated with urban environmental management and planning. There is considerable urban degeneration due to poor housing.[2]

The management of solid wastes is posing serious problems in Sierra Leone. In the municipality of Freetown, waste management is drawing increasing attention, as refuse lies uncollected, causing inconvenience and environmental pollution and being a public health risk.[3]

Every year, indoor smoke is responsible for more than 400 000 deaths in sub-Saharan Africa, mostly among children. However, according to the recent situation analysis and needs assessment survey, air pollution is not yet a serious problem in Sierra Leone.[3]

Water pollution (particularly drinking water) is a serious problem in Sierra Leone. Almost half of the population of Sierra Leone has no access to safe drinking water and only 13% of the population has access to improved non-shared sanitation facilities. Some 74% of urban dwellers have access to safe drinking water while only 46% of rural people use safe water. In the Northern Region, only 30% of residents have access to safe drinking water. According to the Sierra Leone Water Company, on average only 35% of rural residents have access to safe drinking water.[3]

According to the Ministry of Energy and Water Resources, in order to meet Millennium Development Goal targets, annual increments of about 3% and 3.9% of the population having access to improved water sources and sanitation, respectively, are needed.[2] The majority of Sierra Leonean households do not have access to improved sanitation and the situation continues to deteriorate. Between 2005 and 2008, the proportion of the population with improved sanitation decreased from 30% (24% urban, 6% rural) to 13%.[4]

Changes in temperature and rainfall conditions may also influence transmission patterns for many diseases, including water-related diseases such as diarrhoea and vector-borne infections such as malaria. Climate change may also affect patterns of food production, which in turn can have health impacts in terms of rates of malnutrition. While it may be important to take action to adapt to a changing climate, Sierra Leone is not yet in the position to accord further priority to climate change.[3]


  1. National Environmental Health Policy 2000, revised 2007. Government of Sierra Leone, Ministry of Health and Sanitation, 2007
  2. 2.0 2.1 Millennium Development Goals progress report 2010 (pdf 2.82Mb). Government of the Republic of Sierra Leone
  3. 3.0 3.1 3.2 3.3 Report of the situation analysis and needs assessment on health and environment for Sierra Leone. Government of Sierra Leone, Ministry of Health and Sanitation
  4. Sierra Leone health and demographic survey, 2008: key findings (pdf 3.15Mb). Calverton, Maryland, Statistics Sierra Leone and ICF Macro, 2009