Sierra Leone has a network of 1284 public and private health facilities, including 54 hospitals, and is organized into three levels of care. Health facility density is an indicator of service access to outpatient consultations. It shows, on average, there were 1.8 facilities per 10 000 population. Eight districts (Bo, Bombali, Bonthe, Kambia, Kenema, Moyamba, Pujehun and Tonkolili) had a facility density at or above the recommended threshold of two facilities per 10 000 population. The Western urban and Western rural districts were lowest with regard to health facility density at the time of the assessment. The wide gap between urban and rural facility densities is notable, at 0.7 and 2.6, respectively.