Advisor, Health Financing (Sierra Leone)

This role was posted on August 1, 2026. Please note that we will review applications on a rolling basis.

The Role

At Last Mile Health (LMH), we work to deploy a health worker within reach of everyone, everywhere. Do you have experience in health financing and a passion for driving systemic change in resource-constrained settings? If so, you may be our Advisor, Health Financing with the Sierra Leone program.

The Advisor, Health Financing will report directly to the Country Director for day-to-day implementation and government engagement, with a dotted-line reporting relationship to the Director, Health Financing, who will provide technical leadership and mentorship. As part of Last Mile Health's multidisciplinary Health Systems Strengthening (HSS) Team, the Advisor will work closely with our Sierra Leone Program and government counterparts to strengthen financing for primary healthcare and community health.

The Advisor will be embedded within the Directorate of Policy, Planning and Information (DPPI) in the Ministry of Health and collaborate closely with the Directorate of Primary Health Care and the National Community Health Worker Programme. In this role, you will provide technical leadership to support evidence-informed health financing policy, strengthen domestic resource mobilization, and advance the Government of Sierra Leone's plan to transition approximately 8,500 Community Health Workers (CHWs) from donor-funded stipends to the government payroll.

This role will serve as a trusted technical advisor, bringing together the Ministry of Health, Ministry of Finance, Parliament, development partners, and other key stakeholders to strengthen budget planning, financing policies, and accountability mechanisms for community health. This role also contributes to Sierra Leone's broader efforts to strengthen primary healthcare financing and supports regional initiatives such as Africa Frontline First, which aims to expand and professionalize the community health workforce across Africa.

This position is a 24-month Fixed-term role with the potential of renewal. This position is only open to candidates who are currently located and authorized to work in Sierra Leone. This role is onsite and located in Freetown, Sierra Leone.

What You'll Do

Fiscal Space & Costing Analysis for CHW Payroll Integration and CHW Payroll Absorption Roadmap

• Undertake a fiscal space assessment evaluating the feasibility of absorbing CHWs into the government payroll including analysis of wage bill ceilings.
• Develop costed CHW payroll absorption scenarios (phased, full, hybrid) for use in MoH-MoF budget negotiations.
• Identify domestic resource mobilization options to finance payroll integration, including budget reallocation, earmarking, and efficiency gains.
• Take active participation in the MOH Health Financing TWG and the Government Financing Committee. 
• Support financing advocacy efforts with the Ministry of Finance and Health development partners.
• Map the full administrative and policy pathway for transitioning CHWs to government payroll,  including criteria for placing CHWs on the government payroll, approvals required across the MoH, MoF and other necessary line Ministries. 
• Develop a phased payroll integration roadmap with timelines, financial implications, bottleneck mitigation strategies, and risk analysis.
• Work with MOH to facilitate cross-ministerial coordination sessions between MoF, MoH, Local government, Districts councils and other key stakeholders such as State House, VP office, MOPED. 

Community Health Financing embedment in the overall Health Financing Agenda

• Work in collaboration with DPPI and the Health Financing Unit in the development of the Strategic purchasing agency for Universal Health Care and support the establishment of schemes and provider payment mechanisms that also include Community Health financing as part of an  integrated, broader national Health financing framework.

Domestic Resource Mobilization for Community Health (CH)

• Assess opportunities to increase domestic health financing for Community Health, including revenue efficiency gains, SIN taxes, earmarking options, and reallocation from lower-priority lines.
• Develop a domestic resource mobilisation strategy for community health financing, with a policy brief and recommendations for MoH and MoF.

What You'll Bring

• Bachelor's degree in Economics, Public Health, International Development, Political Science, or a related field.
• Graduate-level training in Health Financing, Health Economics, Public Policy, Public Administration, International Development, Public Health, or a related discipline.
• Demonstrated professional experience iin health financing, health economics, public policy, public health, or health systems strengthening.
• Strong understanding of Sierra Leone's health financing landscape, including Ministry of Health and Ministry of Finance planning and budgeting processes.
• Experience working with government counterparts and engaging senior policymakers.
• Demonstrated experience in health financing, health policy, governance, or health systems strengthening.
• Technical expertise in one or more health financing areas, including costing, cost-effectiveness analysis, strategic purchasing, resource mobilization, national health accounts, or resource mapping.
• Experience providing technical assistance or policy advisory support to governments.
• Strong analytical and quantitative skills, including experience conducting costing analyses and using standard costing methodologies.
• Experience supporting health policy development in low- and middle-income countries.
• Experience producing policy briefs, advocacy materials, and technical reports for government audiences.
• Experience working with multilateral organizations, bilateral donors, or international NGOs.

You'll Impress Us If: 

• You are deeply committed to health equity and social justice.
• You have exceptional stakeholder management and relationship-building skills.
• You communicate complex technical concepts clearly to both technical and non-technical audiences.
• You are highly organized and able to manage multiple priorities in a fast-paced environment.
• You are proficient in Microsoft Office and data analysis tools.
• You are fluent in written and spoken English. 

Compensation Information

At Last Mile Health, we strive to reward our employees equitably and transparently. This means that we pay our employees based on a clear and consistent methodology and without regard to their identity or personal relationships. We have made this model fully transparent so that everyone has access to all information related to compensation. We hope this helps you better understand Last Mile Health’s values and commitments to our employees. We look forward to answering any questions you may have during the hiring process.

Before applying to this role, please take a moment to learn more about our approach to compensation and how compensation works in each of the countries where we operate. Please find the link to our compensation model and benefits overview below:

OVERVIEW OF LAST MILE HEALTH’S COMPENSATION MODEL

Compensation for this position:

The Band for this position: SLE-3

For the Sierra Leone range is $13,078- $22,589 USD per annum, depending upon experience doing an equivalent role. Please note that this compensation is subject to statutory taxes.

About Last Mile Health

Last Mile Health partners with governments to design, scale, strengthen, and sustain high-quality community health systems, which empower teams of community and frontline health workers to bring life-saving primary healthcare to the world’s most remote communities. LMH is a registered 501(c)3 non-profit organization. For more information, visit www.lastmilehealth.org. We are an equal opportunity employer and value diversity at LMH. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.