Sierra Leone is located in Western Africa. According to the World Bank, the life expectancy in Sierra Leone has increased from 39 to 54 years from 1990 to 2017, being the fourth lowest worldwide. The general government expenditure on health as a percentage of total of government was 10.84% in 2014. The per capita GDP of Sierra Leone in 2020 was 509.4$. The ratio of medical doctors per 10,000 people was 0.74. According to the Demographic Health Survey (DHS), the number of nurses and midwives personnel per 10,000 was 72.54 in 2018. The percentage of births by 15- to 19-year-olds attended by skilled health personnel in 2017 was 81.72% (78.28-84.72). According to the latest information, the antenatal care coverage (at least four visits) is 78.8%. Sierra Leone has the highest MMR in the world, at 717 maternal deaths per 100,000 live births in 2019. Sierra Leone continues to experience outbreaks that have overwhelmed and added to the already fragile health system. In addition, the per capita total expenditure on health services is 95$, and 76% of health spending is from individual out-of-pocket expenditure, 16% is government-funded, and 13% is from donors' fund.
Cervical cancer is common and fatal among women in Rwanda. Eastern Africa is one of the most affected cervical cancer burden region, with an incidence of 30 cases per 100,000 women per year. Before 10 years, the global cancer statistics showed that 1,000 women are diagnosed annually in Rwanda, and almost 700 women died of cervical cancer in the year of 2010. The disease is the most commonly diagnosed condition among women aged 15-44 years. The estimated incidence of cervical cancer in Rwanda was 49 cases per 100,000 women per year, which is higher than the estimated cases for Eastern Africa and globally, with 34.5 and 16 new cases around 2010, respectively. Studies showed that the prevalence of pre-cancer and invasive cervical cancer (5.9%) and (1.7%) was high in Rwanda. The associated factors with the high prevalence were a result of the factors such as multiple sexual partners, high parity (over three kids born), tobacco use, and long-term contraceptive pill use. Table 2 shows the data of the associated factors of cervical cancer by country.