Evaluating Public Policy Costs in Rural Development Planning: The Example of Health Care in Sierra Leone

Rural Development Planning in Less Developed Countries, especially in Africa, has followed a pattern since colonial times that concentrates public service facilities in urban administrative centers. In many of these countries most of the population lives in rural areas. Public facility location at urban administrative centers may therefore have associated social welfare costs. There is a need to explore the possibility of locating public services at centers that are more accessible to a wider population. The analysis in this study compares a distribution of rural health care facilities proposed by the government of Sierra Leone against a distribution that is achieved through location-allocation planning. The results show that rural development planning would be more successful if a shift is made from the administrative network to a careful analysis of the actual distribution of the target population for a particular service.