Public confidence in the health care system 1 year after the start of the Ebola virus disease outbreak — Sierra Leone, July 2015

What is already known about this topic? Public mistrust and fear based on misconceptions regarding health care system facilities and providers increased during the Ebola virus disease (Ebola) epidemic in Sierra Leone, and health care system usage rates declined sharply. Sierra Leone’s Ebola recovery and global health security strengthening efforts require willingness of citizens to seek care and place trust in that care. What is added by this report? A majority of participants in a knowledge, attitudes, and practices survey conducted after approximately 15 months of an Ebola epidemic in Sierra Leone expressed at least some confidence in the health care system’s ability to treat patients suspected to have Ebola, and >90% reported confidence that the health care system could also provide non-Ebola services, including immunizations, antenatal care, and maternity care. Respondents from areas with active Ebola transmission had higher confidence in the health care system, as did respondents with higher education levels. Respondents ranked Ebola and malaria as the most important health issues for Sierra Leone. What are the implications for public health practice? Understanding factors contributing to public confidence in the health care system can help develop education and health promotion campaigns. Public confidence in the health care system to deliver basic services provides a foundation on which to build a restored and improved post-Ebola health system in Sierra Leone.