The district hospital bed capacity should not be less than 45 beds and must have two (2) resident doctors. It is the first-referral centre, which handles all services in a holistic manner including the Basic Package of Health Services. Cases referred to the district hospital level include major surgery under general anaesthesia; X-rays; comprehensive emergency obstetric care, including Caesarean sections; and family planning methods relevant for Sierra Leone.
The hospital also provides a wider range of essential drugs and laboratory services than the health centres. The hospital is staffed with doctors, including male or female OB/GYNs, surgeon, anaesthetist, and paediatrician; midwives; lab and X-ray technicians; pharmacist; and dentist and dental technician. Each district hospital covers a population of about 500,000.