Service Level Agreement (SLA)


With the support of partners, the Ministry of Health and Sanitation has developed a post-Ebola Health Sector Recovery Plan (HSRP) covering the period 2015 – 2020. The Ministry is aware of the growing interest among donors, implementing partners, private sector, advocacy and other groups in either entering into, or increasing scale of operations in the health sector. While the Ministry recognizes that significant effort is required to rebuild the health system in the country and that to succeed, strategic and mutually beneficial partnerships are necessary, it is also cognizant of the fact that the increased interest among partners demands improved mechanism for better coordination and to ensure that the highest standards of quality in health care provision are met.
The Service Level Agreement (SLA) is an approach that will be used by the Ministry of Health and Sanitation (MoHS) – a Government institution that is mandated with the overall responsibility to ensure provision of health care services in Sierra Leone – to delegate parts of this mandate to non-Government entities. It will ensure that the Ministry captures which partner is implementing which activities in what locations. It will also restore the lead role of the Ministry in setting health priorities in the health sector and ensuring equity through a more equitable distribution of partners and types of interventions across the 13 districts.
The SLA will serve a multitude of purposes:
Enables the MoHS to capture all projects implemented in the health sector into one database that can generate reports to inform decision making;

  • Ensures that all proposed projects are aligned with the MOHS priorities and responds to the gaps identified in the district plans;
  • Ensures that all partner support is rationed across the 13 districts, contributing toward equitable service provision for the Sierra Leonean population;
  • Ensures adherence to quality service standards for goods, services and works;
  • Improves coordination of health care interventions at the district and lower levels and avoid duplication of partner efforts;
  • Strengthens monitoring of partner interventions at the district and local levels and ensures that a significant proportion of donor investments reach the beneficiaries (value for money); and
  • Ensures that interventions (by type) at the lower levels are prioritized and that support to the 13 districts is equitable.

It became necessary to establish a mechanism to ensure coordination, maintain standards and comprehensiveness across focus areas among others. The picture below shows a noble intervention at a Peripheral Health Unit (PHU) that is not comprehensive in the area of focus (rehabilitation/works). The SLA emphasizes comprehensiveness by area of focus.


SLA_MinisterThe Ministry of Health and Sanitation and the Sierra Leonean people appreciate the support of our development partners in both the development of the health sector recovery plan (2015 – 2020) and for the currently ongoing efforts in operational planning and resource mobilization to ensure its full implementation.
We have also received a number of requests from partners who are planning to either increase the scope and/or scale of their engagement in the health sector or wishing to enter into the health sector space in the next few months. This interest among development partners, including the private sector is welcome and will go a long way in ensuring that we fulfill our quest to reach every Sierra Leonean in every corner of the country with high quality health care services.
Our President, His Excellency, Dr. Ernest Bai Koroma is fully committed and looks forward to a time when no Sierra Leonean will have to walk more than 5km to access health care. To make this possible, the Ministry needs the support of our development partners – donors, implementing partners, technical assistance partners, the private sector, our faith based and other partners.
The Service Level Agreement was developed in consultation with a broad range of stakeholders and we are excited about the overwhelming support we received at each of those consultative forums. We asked your opinions, you were straightforward and candid with your feedback and we used it to further refine the thinking to ensure that the implementation of this very important milestone in the history of the Ministry is both responsive and achieves its intended objectives.
We have developed a robust mechanism for managing and reviewing the SLA documents to ensure a quick-turn-around time. We have also established a dedicated SLA Management unit that will be the first point of entry to the Ministry on SLAs and will administer the implementation of this initiative. As we launch the SLA approach to engaging with implementing partners in the health sector, I would like to assure all of you of the commitment of my Ministry in responding to your SLA submissions in a timely manner.
I thank you all for your continued support to the Ministry of Health and Sanitation and look forward to a successful implementation of the health sector recovery plan using the SLA approach.


SLA_CMOIn May 2015, the Ministry of Health and Sanitation assigned a small team to develop a draft SLA document. When I saw it the first time, I knew that we will need to do further work on it to make sure that it achieves the thinking of the leadership and senior management of the Ministry of Health and Sanitation. As with many of the strategic and policy documents that the Ministry develops, consulting internally to ensure Ministry ownership as well as consulting with all our development partners were the logical next steps. Many of you have provided individual and organization inputs to the SLAs and all inputs received were considered. I would like to thank you individually and as groups as the limited space will not allow me to list all of you.



I would like to particularly acknowledge the following:

  • The MoHS team that developed the initial draft of the SLA and for continuing to incorporate comments as we received them.
  • The MoHS top management team, Directors and Program Managers for providing earlier inputs to the draft SLA.
  • The District Medical Officers and Medical Superintendents for providing solid comments during the consultation meetings.
  • The District Mayors, Council Chairs and Chief Administrators for their support to the SLA approach and for providing additional comments.
  • Members of the Health Sector Coordinating Committee and the Health Sector Steering Group for their comments to the SLA document.
  • Angela Spillsbury, Health Advisor at DFID for facilitating the comments from all health development partners and collating them into a single document that MOHS received for consideration.

The SLA template replaces the MOUs and Project Agreements that implementing partners used previously to engage with the Ministry of Health and Sanitation. It is my hope that MOHS at all levels (Central and districts) will resume engaging new partners as well as signing new projects with existing partners using the SLA approach. The road to recovery is still long and I look forward to working with all stakeholders as we together navigate through toward the vision of the Ministry of Health and Sanitation.