Last-mile Health Supply Chains in Sierra Leone

Across Quarters 2 and 3 of 2025, the approach was implemented in several districts. In Moyamba and Bombali, 189 Peripheral Health Units (PHUs) were reached within 5 days during the peak rainy season. Teams used off-road vehicles, motorbikes, canoes and ferries to reach remote and riverine communities, while daily coordination and real-time reporting supported rapid problem-solving.

In Kenema, 134 health facilities received Free Healthcare Initiative commodities through a coordinated exercise involving the DHMT, the National Medical Supplies Agency and community stakeholders. In Kono, all 111 PHUs were reached following extensive picking and packing activities, underlining the value of district ownership, advance planning and community participation.

However, implementation was not the same in every district. In Kambia and Western Area Urban, fuel delays, vehicle maintenance issues, storm damage to storage space and internet connectivity problems affecting the supply system created challenges. Teams adapted by adjusting schedules, carrying out preparatory activities at the same time as other tasks, repurposing temporary spaces for packing and maintaining close coordination across actors. These adaptations helped keep deliveries moving despite significant constraints.