The Ministry of Health (MoH) and the National Civil Registration Authority (NCRA), in collaboration with the World Health Organization (WHO), concluded Sierra Leone’s inaugural two-day workshop of the death reporting sub-committee on 25 September 2025. This meeting brought together health professionals, civil registration experts, academia, and partners to initiate efforts aimed at institutionalizing the Medical Certification of Cause of Death (MCCD) and implementing the WHO International Classification of Diseases, 11th Revision (ICD-11) in the country. The initiative is part of a broader effort to strengthen mortality reporting and improve the accuracy of health data for policy and planning purposes.
Sierra Leone faces significant challenges in generating reliable mortality data, with only 13.4% of deaths currently registered with the NCRA. A major barrier is the limited use of standardized medical certification practices in health facilities and the underreporting of community deaths. Strengthening certification practices and adopting ICD-11 will allow for standardized classification of causes of death, enhance international comparability, and reinforce both the health management information system (HMIS) and civil registration and vital statistics (CRVS) systems.
The workshop focused on defining the sub-committee’s terms of reference, finalizing a roadmap, exploring governance frameworks, and building consensus on next steps, which include community awareness campaigns, deployment of tools, and monitoring and evaluation. WHO Country Representative Dr. George Ameh emphasized the moral and practical importance of reliable mortality data, noting that every death must be accurately recorded and analyzed to inform decisions that save lives.
The Director General of NCRA, Mohamed Mubashir Massaquoi, highlighted the importance of inter-institutional collaboration and thanked WHO for its technical guidance in building functional death reporting processes. Emmanuella Anderson, Gender Representative from the Ministry of Health, underscored the need for inclusivity, emphasizing that women and communities are disproportionately affected when deaths go unreported, and that institutionalizing medical certification ensures all lives are counted and valued.
The workshop validated the terms of reference, explored enabling legal and policy frameworks, and laid the groundwork for phased implementation of the adapted WHO MCCD tool and ICD-11. Next steps include a multi-sectoral rollout, integration of ICD-11, and institutionalization of training at academic levels. These measures aim to establish a sustainable national system for cause-of-death reporting, improving death registration coverage and ensuring that health policies and programs are guided by accurate and timely mortality data. WHO reaffirmed its commitment to supporting Sierra Leone in strengthening MCCD, aligning with global best practices, and advancing capacity, digital innovations, and integration into health information systems.
