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The National Nursing and Midwifery Strategic Plan 2019–2023 has been developed through a systematic approach to determining the strengths and challenges of the nursing and midwifery systems in Sierra Leone. The strategy aims to assess the context-specific needs in nursing and midwifery within the wider remit of the relevant policies of the Ministry of Health and Sanitation (MoHS), and to translate these into strategies for the improved provision of services. The size of the competent health workforce including nurses and midwives, required to provide universal health coverage for the basic package of care is inadequate in Sierra Leone. For instance, fewer than 500 midwives are presently practising when approximately 3,000 midwives are needed to meet the needs of the population.

In order to develop a context-specific plan, this National Nursing and Midwifery Strategic Plan has been set out in four main chapters. The first chapter describes the background of the health sector in Sierra Leone, and the national and global context, and discusses the policies and guidelines that have been developed to inform actions. The second chapter focuses on the nursing and midwifery systems in Sierra Leone with a focus on the structure, strengths, weaknesses, opportunities and threats to professional improvements, as well as the cross-cutting factors that currently affect the practice of nursing and midwifery. The SDGs and the concept of universal health coverage are also discussed. The third and fourth chapters go into the details of the Strategic Plan, outlining its vision, goals and conceptual framework, and the strategic directions and actions to improve nursing and midwifery systems towards achieving universal health coverage, along with costing.