Book excerpt: World Bank Discussion Paper No. 347. Describes the elements of health reform in Sierra Leone as the West African nation attempts to overhaul its health system and focus it on the neediest populations. To highlight the role of key stakeholders, the study reviews the actions proposed and taken for reforming a package of health services, organizing the provision of those services, and financing the health sector. The paper also identifies factors critical for success and concludes with an assessment of future prospects for reform of this crucial sector.