It is widely believed that for managers of organizations to perform effectively, they require personal and task-specific skills widely referred to as managerial competencies. Globally, Health Care Management is moving towards management of Integrated Health Care Systems which require health workers to have appropriate managerial competencies. Studies in health care management have revealed a lack of competent management particularly in developing countries. A WHO report highlights that a lack of managerial competencies by health workers was a major reason why many least developed countries will not meet the United Nations health related Millennium Development Goals. Sierra Leone is implementing a Free Health Care Initiative through its public health care system and the focus of this study is to determine if health workers have the right managerial competencies to implement this initiative by identifying the managerial competencies and competency gaps based on 39 managerial competencies derived from a similar study in South Africa. This book will be useful to Health Care Managers, Policy Planners, Human Resource Managers, medical and nursing schools.