The Ebola crisis revealed not only weaknesses in Sierra Leone’s health system, but also the limits of international capacity support over the last 13 years. The central argument of this report is that capacity building in the country’s health sector has been thought about and operationalised in a narrow, technical way. This dominant approach has ignored both the relational and systemic dimensions of capacity. A smarter model of capacity building is needed – one that does justice to the challenge of health systems strengthening, and to citizens seeking quality healthcare. To that end, the report proposes five recommendations which are also relevant to capacity development in other countries.