Diagnostic availability survey, Sierra Leone, 2019

Between February 2019 and September 2019, a cross-sectional mixed-methods survey was conducted in all 40 Community Health Centres (CHCs) in Western Area, one of five principal divisions in Sierra Leone. All CHCs in Western Area Rural District (n = 15) and Urban District (n = 25) were included in the survey, totalling 40 CHCs. The survey was based on the Basic Package of Essential Health Services as the national benchmark for essential tests that match the disease profile and meet the needs and priorities of the country. The Basic Package included 27 tests for the CHC level, 17 of which were RDTs in the form of lateral flow dipsticks, cassettes or handheld devices. In addition to the tests listed in the Basic Package, the survey included two tests (the manual Widal test and the Cholera RDT), which were of interest to the MOHS because of their perceived high popularity and availability in Sierra Leone, despite having limited sensitivity. We did observational checks of the equipment, consumables and reagents needed to carry out the five manual assays with the highest reported availability. In addition, the survey included questions about supply sources for tests and reagents, staffing, and availability of essential infrastructure and systems (electrification, water supply, maintenance, biosafety, and waste management).