Sierra Leone

Concern’s health and nutrition programming in Sierra Leone is designed to meet the basic needs of communities in rural and urban areas and address some of the most pressing healthcare challenges in the country—particularly those surrounding maternal, newborn, and child health (MNCH).

Our flagship program, the FCDO-funded Saving Lives in Sierra Leone, works in close partnership with the Ministry of Health and District Health Management Teams to improve MNCH outcomes across six districts, with a key emphasis on strengthening local health systems. In 2025, the project ensured last-mile distribution for essential supplies to over 560 peripheral health units (including many hard-to-reach riverine facilities). It also introduced two innovative early-warning systems to help detect and respond to potentially fatal conditions, including some of the most common causes of maternal mortality in the country.

We also work with health outreach teams on blood drives, family planning outreach, and routine immunisations. Additionally, Concern is partnered with Wageningen University, the University of Oxford, and Yale University on research projects that position Sierra Leone at the forefront of innovation for vaccination systems. This commitment also advances vaccination research and evidence-based programming to improve equitable access and reduce preventable deaths.

Sierra Leone’s agriculture sector employs more than 40% of the country’s workforce, leaving many farmers vulnerable in the face of climate risks. Our livelihoods work in Sierra Leone therefore places a large emphasis on nutrition (including preventative nutrition).

We work with smallholder farmers in Sierra Leone to improve their resilience against extreme weather (especially flooding) with Climate Smart Agriculture and find opportunities to increase market access. We also prioritize financial inclusion through initiatives like Village Savings and Loans Associations (VSLAs)—small, member-run microfinancing groups that help people living in extreme poverty to build up a collective financial safety net, pooling savings and taking out loans at low-interest rates. 

One of our key livelihoods programs at the moment is the Irish Embassy-funded LIFE (Livelihoods, Inclusion, Food, and Energy), which aims to improve food security and livelihoods across 30 communities in Tonkolili District. LIFE takes a four-pronged approach to this goal, strengthening farming productivity, nutrition, gender equality, and climate resilience. Working with rural community farmers, we also link participants to urban markets for both resources and points of sale. As part of this, last year we established 30 VSLAs, comprising 30 members each for a total of 900 members.

As mentioned above, the challenges faced in Sierra Leone don’t exist in silos—improving nutrition often means improving livelihoods and agriculture practices. That’s why our work in Sierra Leone takes an integrated approach to sustainably and successfully break the cycle of poverty. 

A key program in this vein is Yoti Yoti (aka, Food and Nutrition Security through Equitable and Climate Smart Food Systems). This five-year project, funded by Irish Aid, works to reduce food and nutrition insecurity in the northwestern districts of Tonkolili and Port Loko across several key areas, including agriculture, livelihoods, nutrition, partnerships, and advocacy.  

Through Yoti Yoti, we’ve trained lead farmers who have then shared their new skills (including a tested method to improve rice cultivation – a key staple in Sierra Leone) across a series of Farmer Field Schools. The adoption rate for improved farming practices increased from 5% at baseline to 50% in 2025, doubling the average number of crops grown per family. We also worked with programme participants to improve local irrigation systems.

In tandem with this, Yoti Yoti works with families via cooking demonstrations and other trainings on health and nutrition (including proper hygiene practices, safe water use, and effective waste management) to ensure dietary diversity, food safety, and overall cleaner, healthier homes and families. It also provides business trainings to support new income-generating activities and has supported over 5,200 VSLA members. These participants have used their newfound social funds to further strengthen community resilience by rehabilitating schools, responding to local emergencies, and installing solar lights. 

Yoti Yoti is also designed as a roadmap for partnerships and research. The project is being implemented with four local partners and in collaboration with several government ministries, making use of collective expertise and resources while also laying the groundwork for sustainability so that the success of this project can continue to grow without ongoing support from Concern. The learnings from this project will also be used to inform policy at both the local and national level.