In 1985, Sierra Leone had 52 hospitals and 263 dispensaries and health treatment centers. In 1990, there was one hospital bed per 1,000 inhabitants. Only 38% of the population had access to health care services in 1992. As of 1999, there were an estimated 0.1 physicians per 1,000 people. As of 1999 total health care expenditure was estimated at 5.3% of GDP.
Lassa fever has continued to spread in the Kenema district since 1996. A World Health Organization (WHO) mission investigated the outbreak and is helping to remedy short supplies in this war-torn country. With WHO and UNICEF technical assistance, an endemic diseases control unit reduced the incidence of sleeping sickness and yaws and began a leprosy control campaign. Malaria, tuberculosis, and schistosomiasis remain serious health hazards, as does malnutrition. In 1999, there were 274 reported cases of tuberculosis per 100,000 people.
As of 2002, the crude birth rate and overall mortality rate were estimated at, respectively, 44.6 and 18.8 per 1,000 people. The infant mortality rate was 154 per 1,000 live births in 2000 and maternal mortality was 2,100 per 100,000 live births in 1995. Since 1994, UNICEF estimated that Sierra Leone has one of the highest mortality rates in the world.
About 4% of married women (ages 15 to 49) were using contraception in 2000. The fertility rate was 5.8 children per woman surviving through the childbearing years in 2000. The prevalence of child malnutrition was 23% of children under five in 1989–1995. Immunization rates for children up to one year old in 1997 included: diphtheria, pertussis, and tetanus, 26%, and measles, 28%. Rates for 1992 included tuberculosis, 60%, and polio, 43%. Life expectancy in 2000 was 39 years, among the lowest in the world.
At the end of 2001, the number of people living with HIV/AIDS was estimated at 170,000 (including 7% of the adult population) and deaths from AIDS that year were estimated at 11,000. HIV prevalence in 1999 was 3 per 100 adults.