Trends and equity in mental disorder prevalence in Sierra Leone: a nationwide analysis from 2000 to 2019

Purpose This study aims to analyze age-standardized prevalence of mental disorders in Sierra Leone from 2000 to 2019, examining sex inequalities. Design/methodology/approach This study provides a novel examination of sex-based disparities in mental disorder prevalence in Sierra Leone over a 19-year period, contributing to the limited body of research on mental health equity in low-resource settings. By leveraging WHO’s Health Equity Assessment Toolkit, it offers valuable insights into gender inequalities that can inform targeted policy interventions. Findings Age-standardized prevalence of mental disorders in Sierra Leone was stable from 2000 to 2019, declining from 12,211.2 to 12,154.0 per 100,000. Females had higher rates than males. Female prevalence in 2000 was 12,753.4 (95% CI: 11,612.0–14,000.4) versus 11,605.7 (95% CI: 10,587.1–12,780.0) for males. The sex gap peaked at 1,257.8 cases in 2015 before reaching 1,232.6 in 2019, with females maintaining 10% higher prevalence (R = 1.1). PAF ranged from −5.0% to −5.3% and PAR from −605.5 to −618.4 cases. Research limitations/implications This study adopts a cross-sectional design, which limits the ability to establish causality between sex-based differences and mental disorder prevalence. Additionally, the data may not fully capture contextual factors such as socioeconomic conditions, cultural stigma, or access to mental health services in Sierra Leone, which could influence the observed disparities. Future longitudinal studies are needed to explore causal relationships and the impact of these external factors on mental health outcomes over time. Originality/value Using WHO’s Health Equity Assessment Toolkit, this study analyzed mental disorder prevalence per 100,000 population by sex.