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Access to essential medicines is a cornerstone of public health, yet in many health systems, poorly coordinated supply chains lead to stockouts and losses. Recent policy reforms and partnerships have created momentum for pharmaceutical supply chain integration in Sierra Leone, yet systemic barriers remain. This study explored the facilitators and barriers to pharmaceutical supply chain integration in Sierra Leone. A qualitative study was conducted using in-depth, semi-structured interviews with sixteen purposively selected key informants. Participants were drawn from six districts in Sierra Leone and included national supply chain leads, program pharmacists, district pharmacists, and development partners, representing diverse perspectives across policy, implementation, and technical support. Data were analysed deductively through thematic content analysis guided by the Socio‑Technical Systems (STS) framework, which structured interpretation across five constructs: technical facilitators, technical barriers, social facilitators, social barriers, and socio‑technical interactions. Data collection and analysis proceeded iteratively until thematic saturation was reached, with NVivo software used to support coding and data management. Digital platforms, alongside supportive policy frameworks and strong partnerships, emerged as key facilitators, improving data visibility, accountability, and coordination. Capacity-building and collaborative networks further enhanced integration. However, systemic barriers persist, including limited storage capacity, fragmented procurement, seasonal distribution challenges, financing gaps, workforce attrition, and heavy donor dependence. Socio-technical interactions revealed that mistrust over data ownership, policy inconsistency, and reliance on partners often undermined progress in integration. While digital innovations and policy initiatives have advanced pharmaceutical supply chain integration in Sierra Leone, sustainability remains constrained by infrastructural, financial, and workforce limitations. Building a resilient and self‑reliant system requires a balanced approach that addresses both technical and social dimensions. Policy action should prioritise strengthening domestic financing, harmonising procurement systems, and investing in human resource capacity alongside technological upgrades. These measures are critical for building a resilient, self‑reliant, and integrated pharmaceutical supply chain that ensures equitable access to medicines.
Child trafficking and the worst forms of child labor are pervasive yet difficult to measure. In three hotspot districts in Sierra Leone’s Eastern Province (Kailahun, Kenema, and Kono), a baseline mixed-methods study estimated that approximately one-third of children aged 5–17 had experienced child trafficking, underscoring the need to understand how exploitation varies across children’s experiences. This study uses latent class analysis to identify profiles of trafficking-related experiences among children who met the study’s operational criteria for child trafficking, supplementing a binary “trafficked/not trafficked” classification with a profile-based characterization of heterogeneity in exploitation experiences. We analyzed caregiver-reported data from a baseline household survey of 2,025 children aged 5–17 in Kailahun, Kenema, and Kono who met an operational definition of child trafficking experience. Models were estimated using all available manifest-indicator data across 19 indicators spanning six trafficking-related labor sectors, five hazardous tasks performed away from home, and eight force, fraud, and coercion experiences. A five-class model was retained based on fit, stability, parsimony, and interpretability. The classes were: Class 1, moderate coercion with minimal hazards (25.8
Reliable estimation of child trafficking prevalence at fine geographic scales is critical for targeted program and policy interventions, yet such estimation is often hindered by sparse or incomplete data. This study investigated the use of small area estimation (SAE) methods—one frequentist and the other hierarchical Bayesian—to improve prevalence estimates using data from a household survey of 3070 households across three hotspot districts in Sierra Leone. SAE models were implemented at the chiefdom level (m = 40), the lowest administrative unit, and compared against traditional district-level estimates. Both SAE approaches yielded chiefdom-specific prevalence estimates and predictive probabilities that exhibit substantial heterogeneity and greater precision than the district-level estimates. By borrowing strength across small areas, SAE methods achieved notable reductions in variance and enhanced inference for rare and sensitive outcomes. These findings underscore the utility of SAE for producing reliable local-level estimates in contexts where direct estimation for small geographic areas is infeasible or insufficient. The study highlights the methodological and practical implications of SAE to inform localized interventions and encourages its broader application in research on hidden or hard-to-reach populations, including those affected by crime victimization and human rights violations.
Withania coagulans (Dunal) Stocks, a medicinal plant of the Solanaceae family, has long been recognized in traditional medicine for its antidiabetic, antimicrobial, and antioxidant activities. In the present study, gas chromatography-mass spectrometry (GC-MS) analysis of the aqueous stem extract of W. coagulans revealed a diverse phytochemical profile, comprising phenolics, terpenoids, and fatty acids. The extract was subsequently assessed for its biological potential using in vitro assays. It exhibited notable antibacterial activity against Salmonella Typhi and Escherichia coli, producing inhibition zones between 15 and 25 mm, comparable to that of standard antibiotics, underscoring its potential as a natural antibacterial agent. The antidiabetic potential of the extract was established by starch hydrolysis and α-amylase inhibition, where the extract achieved 58.33% and 75.8% inhibition, respectively. Antioxidant activity was demonstrated in the DPPH assay, showing a progressive increase in radical scavenging from 27.5% at 100 µg/mL to 57.3% at 500 µg/mL concentration. In silico docking, ADMET analysis, and molecular dynamics simulations identified caryophyllene oxide and 2,2-dimethyl-3-(…)-oxirane as promising lead terpenoids, exhibiting strong predicted binding affinities across antibacterial, antidiabetic, and antioxidant targets. These findings provide scientific support for the ethnopharmacological use of W. coagulans and suggest its potential compounds with predicted multi-target binding affinities.
An infographic diagram linking Withania coagulans synthesis of titanium dioxide nanoparticles to spectral characterization and wound healing.The figure shows an infographic diagram summarizing a workflow from plant based synthesis to testing of titanium dioxide nanoparticles. On the left, a stylized leafy branch is labeled Withania coagulans. A downward arrow leads to a conical flask containing a pale suspension, labeled formation of titanium dioxide nanoparticles. A horizontal arrow from the flask points to the center section labeled Characterization. Four small scientific visuals are stacked vertically with text labels: a smooth decaying curve labeled ultraviolet visible, a spectrum with several peaks labeled Fourier transform infrared, a diffractogram with sharp peaks labeled X ray diffraction, and a speckled micrograph labeled scanning electron microscopy. A vertical connector directs to the right section labeled Biological Activities. At the top right, a circular culture dish with several round zones is labeled Antibacterial. In the middle right, an icon of a reagent flask beside a simple molecular diagram is labeled Antioxidant. At the bottom right, two skin cross section illustrations compare a larger wound area on the left with a smaller wound area on the right, followed by text indicating approximately 99 percent closure at day 15.
