Community health workers (CHWs) play a crucial role in addressing healthcare needs across Sierra Leone's diverse districts. A qualitative study employing semi-structured interviews with CHWs and community members to gather insights into their experiences and perceptions. CHWs reported challenges such as inadequate training and support, leading to inconsistent health services in some districts. While CHWs are generally effective, there is a need for enhanced training and sustained funding to ensure consistent healthcare delivery across Sierra Leone’s regions. District authorities should prioritise continuous professional development of CHWs and secure long-term financial support to maintain quality health care.