Country guide — Africa and the Indian Ocean
Expat insurance and health insurance in Sierra Leone
In short
Sierra Leone requires a visa for any stay: with no diplomatic representation of the country in France, applications are made via the Sierra Leonean government's online platform before departure, though a visa on arrival at Freetown airport remains possible while this system is being rolled out; yellow fever vaccination, endemic in the country, is a condition of entry. France Diplomatie reports that healthcare infrastructure is underdeveloped and that there is no hospital emergency service in the country, making insurance covering medical costs and medical repatriation essential, since the embassy cannot cover these costs under any circumstances. No social security agreement between France and Sierra Leone has been identified in CLEISS's list of countries with such agreements. The French embassy in Freetown closed in 1996; Sierra Leone has since been covered by the French embassy in Conakry (Guinea), which maintains a diplomatic office in Freetown. The country was one of the epicentres of the major West African Ebola epidemic (2014-2016), with the WHO declaring the end of transmission on 17 March 2016; Connaught Hospital, in Freetown, is the country's main public referral hospital.
Key figures
- French embassy in Freetown closed since 1996: Sierra Leone is covered by the French embassy in Conakry (Guinea), which has a diplomatic office in Freetown.
- Life expectancy at birth: 61.96 years in 2024 (World Bank).
- Current health expenditure: 4.72% of GDP in 2023 (World Bank).
- 2014-2016 Ebola epidemic: Sierra Leone was one of the hardest-hit countries in West Africa; the WHO declared the country free of virus transmission as of 17 March 2016 (France Diplomatie).
Local healthcare system
France Diplomatie states that healthcare infrastructure is underdeveloped in Sierra Leone and that there is no emergency service in the country. Care provision relies on a strained public sector and a limited number of private or faith-based facilities, mostly concentrated in Freetown. Connaught Hospital, located on Percival Street in central Freetown, is the country’s main public hospital: opened in 1912, affiliated with the University of Sierra Leone as a teaching hospital, it concentrates most of the country’s specialists and specialised services and serves as the referral hospital for complex medical and surgical cases. On the private side, France Diplomatie mentions in particular Choithram Memorial Hospital (Hill Station, Freetown), Aspen Medical Center and Davidson Nicol Medical Center, though these facilities do not necessarily have all the technical capabilities expected in France. The country was one of the three epicentres of the major West African Ebola epidemic of 2014-2016; the World Health Organization declared Sierra Leone free of virus transmission as of 17 March 2016. None of these facilities is a substitute for recognised coverage in France or a medical repatriation contract.
Legal and visa obligations
- Mandatory visa for any stay: with no diplomatic representation of Sierra Leone in France, applications are made online via the official platform of the Sierra Leonean government before departure; according to France Diplomatie, since this online system is still being made more reliable, a visa on arrival at Freetown airport remains possible.
- Yellow fever: mandatory vaccination, as the disease is endemic in Sierra Leone according to France Diplomatie — a condition of entry into the country.
- Malaria: present throughout the country; a travel medicine consultation before departure is recommended to determine appropriate chemoprophylaxis.
- Vaccinations recommended depending on exposure and length of stay: hepatitis A and B, typhoid fever, tuberculosis (children under 15), rabies (young children), as well as chikungunya, dengue and mpox depending on the epidemiological context.
- France Diplomatie describes taking out a repatriation assistance contract before departure as essential, since medical costs cannot be covered by the embassy under any circumstances.
- Currency: mandatory declaration above 10,000 USD imported. Diamond exports are reserved for professionals licensed by the Ministry of Mineral Resources.
Other health risks reported by France Diplomatie: dengue, chikungunya and Zika (possible vector transmission, mosquito protection recommended), cholera (food- and waterborne transmission, hygiene precautions recommended), Lassa fever (present in the east of the country, contact with rodents or contaminated food), tuberculosis, rabies (in case of animal contact) and poliomyelitis.
Cost of some medical procedures
Orders of magnitude from specialised sources, not official fee schedules.
| Procedure | Public sector | Private sector |
|---|---|---|
| GP consultation (private sector, Freetown) | — | rate varies by facility, not publicly disclosed (no national fee schedule identified) |
| Specialist consultation | — | rate varies by specialty and facility, not publicly disclosed |
| Hospitalisation, Connaught Hospital (public sector) | rate varies by department, not publicly disclosed | — |
| Hospitalisation, Choithram Memorial Hospital (private sector) | — | rate varies by facility and room type, not publicly disclosed |
| Medical evacuation (air ambulance) | — | high cost, generally several tens of thousands of euros depending on distance and severity, exact amount not publicly disclosed — the main reason insurance is described as 'essential' by France Diplomatie, especially since no hospital emergency service is reported in the country |
Social security agreements with France
No bilateral social security agreement between France and Sierra Leone has been identified. CLEISS does not list Sierra Leone among the countries that have concluded such an agreement with France, unlike neighbouring or nearby countries such as Senegal, Mali, Côte d’Ivoire, Togo, Benin or Cape Verde.
- No French rights-retention form applies in Sierra Leone.
- No coordination between the two schemes for sickness, maternity, old age, disability or family benefits.
- Joining the CFE or taking out private international insurance remain the only forms of coverage recognised by a French system, whatever the profile.
- Since the French embassy in Freetown closed in 1996, consular formalities for French nationals living in Sierra Leone go through the French embassy in Conakry (Guinea), which maintains a diplomatic office in Freetown; this arrangement does not create any additional social coordination.
Which insurance for my profile
General matrix — does not recommend any specific product or insurer.
| Profile | Regulatory constraint | Points of attention |
|---|---|---|
| Working holiday visa | No France-Sierra Leone programme identified | Not applicable — private health insurance needed for any stay, in addition to the mandatory visa |
| Student | No specific legal health insurance obligation identified beyond the visa and yellow fever vaccination | Check the host institution's requirements; private cover and repatriation strongly recommended, given the lack of a reported hospital emergency service in the country |
| Seconded employee / expat | No explicit health insurance requirement identified for the visa or stay in the sources consulted | No bilateral agreement and no hospital emergency service: international private cover or CFE with medical evacuation is essential |
| Retiree | No health cover via a bilateral agreement, since none exists | CFE or international private insurance essential, including medical repatriation |
| Family with children | Mandatory yellow fever vaccination for all members, including children | Check coverage for each member, particularly for malaria, Lassa fever and emergency medical evacuation |
Hospitals and care network
- Freetown (Percival Street, city centre) — Connaught Hospital: national public referral hospital, opened in 1912, affiliated with the University of Sierra Leone as a teaching hospital, capacity of around 350 beds, the country's main referral centre for complex medical and surgical cases.
- Freetown (Hill Station) — Choithram Memorial Hospital: private facility, mentioned by France Diplomatie among the capital's care facilities.
- Freetown — Aspen Medical Center and Davidson Nicol Medical Center: private facilities also mentioned by France Diplomatie, with no public detail on their respective capacities.
Practical steps
- Before departure: submit the visa application online via the official platform of the Sierra Leonean government (failing that, a visa may be possible on arrival at Freetown airport according to France Diplomatie), and take out an assistance contract covering medical costs and medical evacuation, given the lack of any Franco-Sierra Leonean coordination and of a reported hospital emergency service in the country.
- Before departure: medical consultation/vaccination centre visit for yellow fever (mandatory, endemic disease), and depending on exposure, hepatitis A and B, typhoid fever and rabies, as well as to determine appropriate antimalarial chemoprophylaxis.
- Voluntary membership of the CFE recommended given the lack of any health coordination between the two countries.
- On arrival: register with the roll of French nationals living abroad, at the French embassy in Conakry (Guinea), which the Freetown diplomatic office has reported to since the French embassy in Sierra Leone closed in 1996.
Frequently asked questions
Is health insurance mandatory for a stay in Sierra Leone?
No legal insurance obligation has been identified for entry, but France Diplomatie describes taking out a contract covering medical costs and medical evacuation as essential, especially since the country has no reported hospital emergency service and the embassy cannot cover these costs under any circumstances.
Is there a hospital emergency service in Sierra Leone?
No: France Diplomatie explicitly states that there is no emergency service in the country and that healthcare infrastructure there is underdeveloped, which reinforces the need for insurance with medical evacuation.
Does French social security coordinate healthcare with Sierra Leone?
No: no bilateral social security agreement between France and Sierra Leone has been identified, as CLEISS does not list this country. No health coordination therefore exists between the two schemes.
Where can you get treated in Freetown in case of serious need?
Connaught Hospital is the main public referral hospital, with a capacity of around 350 beds. Choithram Memorial Hospital, a private facility, as well as Aspen Medical Center and Davidson Nicol Medical Center, are also mentioned by France Diplomatie among the capital's care facilities.
Should you get vaccinated before travelling to Sierra Leone?
Yes: yellow fever vaccination is mandatory, as the disease is endemic in the country. France Diplomatie also recommends, depending on exposure, hepatitis A and B, typhoid fever, tuberculosis for children under 15 and rabies, as well as appropriate antimalarial chemoprophylaxis, since malaria is present throughout the country.
Moving to Sierra Leone? Get a quote
Written by Expavy
Sources
- France Diplomatie — Sierra Leone, Travel advice, Health
- France Diplomatie — Sierra Leone, Travel advice, Entry and stay
- CLEISS — Country files (list of countries with agreements, Sierra Leone absent)
- French Embassy in Conakry — France in Guinea and Sierra Leone (Freetown embassy closure in 1996, diplomatic office in Freetown)
- World Bank — Life expectancy at birth, Sierra Leone
- World Bank — Current health expenditure (% of GDP), Sierra Leone
- Wikipedia — Connaught Hospital