Research for stronger health systems during and after crisis

Ebola in Sierra Leone: effects on health workers and the health system and lessons for future health system reconstruction


The 2014-16 Ebola Virus Disease outbreak evolved in alarming ways in Sierra Leone, and the country struggled to control the escalating crisis against the backdrop of a weak health system. There was a delayed response to the outbreak due to a number of factors ranging from governance and leadership, to a lack of readiness in the health facilities, and challenges relating to human resources for health (HRH). The ReBUILD team involved in the ongoing research into health worker incentives in Sierra Leone recognised a need to:

  • understand, from the health workers' perspective, how the health system responded to the Ebola crisis,

  • to unpick the factors that supported or hindered health workers’ ability to cope with the crisis, and

  • to generate findings that can be utilised in rebuilding the post-Ebola health sector and during any future outbreaks of epidemic disease.

The study examined four districts in Sierra Leone - Bonthe, Kenema, Koinadugu and Western Area - using a qualitative study design and interviews with members of the District Health Management Teams and local councils, health facility managers, international partners, local health workers working in public health facilities and international health workers involved with the treatment of Ebola patients.

The research found that several important coping strategies were used including those that drew upon existing mechanisms, and that supportive supervision, peer support networks and better use of communication technology should be pursued, alongside a programme for rebuilding trusting relations with community structures.

A paper has been published drawing on the outputs of this research - accessible here .

More on Ebola in Sierra Leone

See ReBUILD's Haja Wurie sharing her insights on Ebola, health systems research and health system reconstruction in Sierra Leone, in this video.

Resource list

You can view and download a list of all outputs from ReBUILD's work on human resources for health, including this work on the effects of the Ebola outbreak on health workers. Updated versions will be posted as further resources are added.