Sierra Leone: Ebola Needs Analysis Project (ENAP): Sierra Leone Multi-Sector Assessment Reports (April 2015)

Executive summary

The number of new Ebola infections in Sierra Leone is declining, despite the outbreak continuing to claim lives. New cases have dropped to around 9-12 per week, according to recent WHO figures. There were over 500 cases per week at the height of the crisis around late November 2014.
The impact on the lives of the thousands of people directly affected by the disease has been devastating. It has caused substantial suffering to many others, leaving the population very vulnerable.

No recent assessment has evaluated and compared the status of populations in areas with high, medium and low exposure to Ebola. In this report, we refer to low, medium or high exposure areas based on the proportion of Ebola cases up to January 2015, compared to the 2014 population projections for those areas. Low Ebola exposure areas are districts in which the proportion of EVD cases compared to the population is between 0.01% and 0.10%. Medium Ebola exposure districts are defined as districts in which the proportion ranges from 0.11% to 0.20%. High exposure districts are districts in which the proportion of EVD cases is between 0.21% and 0.52%.

The Ebola Needs Analysis Project (ENAP) assessment was designed as a probability sample survey, conducted with 188 KIs from 59 chiefdoms and wards. The aim was to analyse the impact of the Ebola crisis from a multi-sectoral perspective.

The rationale for sampling area selection was as follows:

• Six out of 14 districts were selected to represent high, medium and low Ebola exposure areas.

• Two districts were chosen for each category.

• In each case, one was a more agriculture-dependent district and the other had a population with more varied livelihoods and a higher dependency on markets for food.

National estimate of people at risk due to serious unmet needs were calculated based on KI responses and 2014 population projections, and calculated with a 95% confidence interval.

Key findings

Results show that the impact of the Ebola crisis is noticeable across the whole country, going beyond directly affected populations and geographical areas.
The health, food security, livelihoods and educational conditions are worse than at the same time last year, prior to the Ebola outbreak.

KIs ranked the priority needs in the following order:

1. Food security and livelihoods
   
   1. Health
      
   2. Education
      

Health and food security needs were more acute in high exposure areas, than in medium or low ones.
However, there is no significant correlation between exposure levels and livelihoods and education needs.

Populations appear to have been negatively affected regardless of the number of Ebola cases in their area.