(UNTESTED)

sub tree_paths
{
  my $tree = shift; # assumes hashref
  map
  {
    my $k = $_;
    my $v = $tree->{$k};
    ref $v
      ? map( [ $k, @$_ ], tree_paths( $v ) )
      : [ $k, $v ] 
  }
  keys %$tree
}


# now use it with the OP's $hash hashref

print "Count Section Item\n";
for (
  sort {
    $b->[2] <=> $a->[2] # count
  or
    $a->[0] cmp $b->[0] # section
  or
    $a->[1] cmp $b->[1] # item
  } tree_paths($hash) )
{
  my( $section, $item, $count ) = @$_;
  printf "%5d %7s %7s\n", $count, $section, $item;
}