Poor quality of maternal and neonatal health services is a significant issue in Sierra Leone, in part due to the protracted civil war followed by the Ebola outbreak. As these events came to an end, the country was faced with the task of revitalizing a seriously impaired health care system. A variety of factors affected the quality of care (QoC), including an absence of clinical guidelines and quality improvement (QI) mechanisms as well as audits and regular reviews of performance in health facilities. In response to these issues, the Sierra Leone Ministry of Health and Sanitation (MoHS) created a vision for 2021 to have a health system of high-quality, accessible, affordable and equitable care for all Sierra Leoneans.1 Thus, a focus on improving the quality of services is a clear priority within this five-year plan.

This situational analysis provides information about the institutionalization of QI in Sierra Leone with a specific focus on maternal and neonatal QoC. This information will assist in identifying the major problems and gaps that constitute the foundation for the planning, implementation and evaluation of maternal and newborn QoC.