Sierra Leone

Sierra Leone has integrated MMS into national ANC guidelines and established a dedicated working group to oversee implementation. MMS has been added to the Essential Medicines List and incorporated into national health information systems, including DHIS2 for monitoring. Capacity building is underway, with more than 1,400 health workers trained on the transition from IFA to MMS. Procurement and distribution are currently supported by partner funding, while sustained government financing remains a challenge as the overall health sector budget continues to decline. The government and partners operate a coordination mechanism that guides planning and implementation of MMS activities, and MMS is provided free of charge to pregnant women through the public health system. Several awareness‑raising efforts were undertaken in 2024 to support scale‑up, including demand creation through advocacy, communication, and social mobilization (ACSM).
Key lessons include the successful integration of MMS into national systems, strong acceptance among pregnant women due to its broader nutrient profile, and the persistent need for stable domestic funding. Priority next steps include advocating for long‑term financing, training central and district staff on distribution and reporting, cascading MMS training to frontline health workers, strengthening stakeholder engagement at district and community levels, revising health facility forms to track MMS uptake, improving monitoring and supervision of last‑mile distribution, and reporting MMS data separately from IFA.