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The global reference list of 100 core health indicators is a standard set of indicators published by the World Health Organization in 2015. We reviewed core health indicators in the public domain and in-country for Sierra Leone, the African continent and globally. Review objectives included assessing available sources, accessibility and feasibility of obtaining data and informing efforts to monitor program progress. Our search strategy was guided by feasibility considerations targeting mainly national household surveys in Sierra Leone and topic-specific and health statistics reports published annually by WHO. We also included national, regional and worldwide health indicator estimates published with open access in the literature and compared them with cumulative annual indicators from the weekly national epidemiological bulletin distributed by the Sierra Leone Ministry of Health and Sanitation. We obtained 70 indicators for Sierra Leone from Internet sources and 2 (maternal mortality and malaria incidence) from the national bulletin. Of the 70 indicators, 14 (20%) were modified versions of WHO indicators and provided uncertainty intervals. Maternal mortality showed considerable differences between 2 international sources for 2015 and the most recent national bulletin. We were able to obtain the majority of core indicators for Sierra Leone. Some indicators were similar but not identical, uncertainty intervals were limited and estimates differed for the same year between sources. Current efforts to improve health and mortality surveillance in Sierra Leone will improve availability and quality of reporting in the future. A centralized core indicator reporting website should be considered.
To reduce dependency on the Internet we prioritized compilation reports of health-related data and scientific literature that could be downloaded from the Internet with a locally purchased third-generation (3G) USB modem and reviewed off-line. If indicators were not available in Internet-accessible print versions, we used online databases. For example, we prioritized WHO’s World Health Statistics Reports over WHO’s online database Global Health Observatory [8]. All reports and scientific articles used for the review were open access. We searched for recent national household surveys in Sierra Leone and topic-specific and health statistics reports published annually by WHO. We also searched for national, regional and worldwide health indicator estimates published with open access in the literature. If provided by the source, we included uncertainty intervals independent of the method used to calculate them and the terminology used (e.g. credible interval, confidence interval). If sources provided values for both sexes and/or breakdowns for male and female, these were presented. If a compilation report provided multiple year ranges instead of a singular year for the indicator we did not attempt to identify a specific year for Sierra Leone from the original data source. Two indicators from the national weekly epidemiological bulletin for epi week 52, 2016 (26 December 2016 to 1 January 2017) were selected to be reported in addition to the most recent Internet source: maternal mortality (annual ratio based on 229,000 live births in 2015 [9]) and malaria (cumulative annual incidence week 1 to 52, 2016 presented in the bulletin). We provided SDG targets [2] and indicated if core and source indicators were not identical but similar and could be considered for adaptation to the core indicator in the future.
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