ArticleReproductive health2018
"In the hospital, there will be nobody to pamper me": a qualitative assessment on barriers to facility-based delivery in post-Ebola Sierra Leone.
Article in Reproductive health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- The effect of Ebola virus disease on maternal health service utilisation and perinatal outcomes in West Africa: a systematic review.Reproductive health · 2022Pooled it
- Characteristics and Determinants for Home Births in Rural Sierra Leone: A Cross-Sectional Study.Maternal and child health journal · 2026Article
- "It shows that I belong": a qualitative study assessing birth companionship of choice in a maternity clinic in Freetown, Sierra Leone.BMC pregnancy and childbirth · 2025Article
- Barriers and facilitators to healthcare facility utilization by non-Ebola patients during the 2018-2020 Ebola outbreak in the Democratic Republic of Congo.Global health research and policy · 2024Article
- Improvement in Infection Prevention and Control Compliance at the Three Tertiary Hospitals of Sierra Leone following an Operational Research Study.Tropical medicine and infectious disease · 2023Article
- Indirect Effects of Ebola Virus Disease Epidemics on Health Systems in the Democratic Republic of the Congo, Guinea, Sierra Leone and Liberia: A Scoping Review Supplemented with Expert Interviews.International journal of environmental research and public health · 2022Article
- Has Ebola delayed progress on access to routine care and financial protection in Sierra Leone? Evidence from a difference-in-differences analysis with propensity score weighting.Social science & medicine (1982) · 2022Article
- Infection Prevention and Control in Three Tertiary Healthcare Facilities in Freetown, Sierra Leone during the COVID-19 Pandemic: More Needs to Be Done!International journal of environmental research and public health · 2022Article
- Article
- Childbirth violence-based negative health consequences: a qualitative study in Iranian women.BMC pregnancy and childbirth · 2021Article
- Health seeking behavior after the 2013-16 Ebola epidemic: Lassa fever as a metric of persistent changes in Kenema District, Sierra Leone.PLoS neglected tropical diseases · 2021Article
- Challenges in Maternal and Child Health Services Delivery and Access during Pandemics or Public Health Disasters in Low-and Middle-Income Countries: A Systematic Review.Healthcare (Basel, Switzerland) · 2021Review
- Improving the experience of facility-based delivery for vulnerable women through obstetric care navigation: a qualitative evaluation.BMC pregnancy and childbirth · 2021Article
- Risk factors for preeclampsia and eclampsia at a main referral maternity hospital in Freetown, Sierra Leone: a case-control study.BMC pregnancy and childbirth · 2021Article
- The perfect storm: Disruptions to institutional delivery care arising from the COVID-19 pandemic in Nepal.Journal of global health · 2021Article
- Scoping Review on the Impact of Outbreaks on Sexual and Reproductive Health Services: Proposed Frameworks for Pre-, Intra-, and Postoutbreak Situations.BioMed research international · 2021Article
- Perspectives of health workers on the referral of women with obstetric complications: a qualitative study in rural Sierra Leone.BMJ open · 2020Article
- Perceptions of isolation during facility births in Haiti - a qualitative study.Reproductive health · 2019Article
- Impact of Ebola outbreak on reproductive health services in a rural district of Sierra Leone: a prospective observational study.BMJ open · 2019Observational
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSierra Leone has one of the highest maternal mortality rates in the world. Encouraging the use of skilled birth attendance in health facilities is an important step in the endeavor to increase the number of safe deliveries. However, public trust in health facilities has been greatly damaged during the Ebola epidemic outbreak in Sierra Leone in 2014/2015, and little is known about external and intrinsic barriers to facility-based delivery (FBD) in the country since the end of the Ebola epidemic.
methodsWe conducted a qualitative study on FBD in Princess Christian Maternity Hospital, Freetown, which is the national referral maternity hospital in Sierra Leone. We performed six focus group discussions with providers, pregnant women and recent mothers surrounding experiences, attitudes and behaviors regarding FBD and potential barriers. Discussions were tape recorded, transcribed and evaluated through content analysis.
resultsWomen in our study were overall technically aware of the higher safety linked with FBD, but this often diverged from their individual desire to deliver in a supportive and trusted social and traditional environment. Close relatives and community members seemed to be highly influencial regarding birth practices. Many women associated FBD with negative staff attitudes and an undefined fear. Logistic issues regarding transportation problems or late referral from smaller health centers were identified as frequent barriers to FBD.
conclusionsMore supportive staff attitudes and acceptance of an accompanying person throughout delivery could be promising approaches to increase women's confidence in FBDs. However, these approaches also imply revising health systems structures, like staff working conditions that are conducive for a friendly atmosphere, sufficient space in delivery wards allowing the women to bring a birth companion, or like the establishment of a reliable peripheral ambulance system to ensure transportation and fast referral.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.