Observational studyBMJ open2019
Impact of Ebola outbreak on reproductive health services in a rural district of Sierra Leone: a prospective observational study.
Observational study in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 5 of them syntheses that pooled it.
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Who cites it
35 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- A systematic review of the indirect impacts of COVID-19 on sexual and reproductive health services and outcomes in humanitarian settings.BMJ global health · 2023Pooled it
- Epidemics, Lockdown Measures and Vulnerable Populations: A Mixed-Methods Systematic Review of the Evidence of Impacts on Mother and Child Health in Low-and Lower-Middle-Income Countries.International journal of health policy and management · 2022Pooled it
- The effect of Ebola virus disease on maternal health service utilisation and perinatal outcomes in West Africa: a systematic review.Reproductive health · 2022Pooled it
- Pooled it
- Community health workers for pandemic response: a rapid evidence synthesis.BMJ global health · 2020Pooled it
- Trends and factors associated with skilled birth attendance in a post-Ebola context: DHS Guinea 2018.Journal of public health in Africa · 2025Article
- Impact of Ebola and COVID-19 on maternal, neonatal, and child health care among populations affected by conflicts: a scoping review exploring demand and supply-side barriers and solutions.Conflict and health · 2024Article
- Women empowerment indices and utilization of health facilities during childbirth: evidence from the 2019 Sierra Leone demographic health survey.BMC health services research · 2023Article
- "Africans, we know how to adapt indeed": Adaptations to family planning and reproductive health services in humanitarian settings in Nigeria during the COVID-19 pandemic.PLOS global public health · 2023Article
- Challenges and solutions adopted by frontline health managers in the management of routine health services during the COVID-19 pandemic at the grassroots level in India: A qualitative quest.Journal of family medicine and primary care · 2022Article
- 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
- Continuum of maternal and newborn health in Sierra Leone: a 2019 national survey.Archives of public health = Archives belges de sante publique · 2022Article
- Sexual and reproductive health services during outbreaks, epidemics, and pandemics in sub-Saharan Africa: a literature scoping review.Systematic reviews · 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
- Did COVID-19 Impact Contraceptive Uptake? Evidence from Senegal.Studies in family planning · 2022Article
- Impact of Covid-19 on Maternal Health Seeking in Ghana.Journal of international development · 2022Article
- New endemic and pandemic pathologies with interhuman airborne transmission through ear, nose and throat anatomical sites.Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2022Article
- The impact of the COVID-19 pandemic on health service use in sub-Saharan Africa.Public health action · 2022Article
- Article
- Integrated Tuberculosis and COVID-19 Activities in Karachi and Tuberculosis Case Notifications.Tropical medicine and infectious disease · 2022Article
Corrections and comments
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the trends concerning utilisation of maternal and child health (MCH) services before, during and after the Ebola outbreak, quantifying the contribution of a reorganised referral system (RS).
designA prospective observational study of MCH services.
settingPujehun district in Sierra Leone, 77 community health facilities and 1 hospital from 2012 to 2017.
main outcome measuresMCH utililization was evaluated by assessing: (1) institutional deliveries, Cesarean-sections, paediatric and maternity admissions and deaths, and major direct obstetric complications (MDOCs), at hospital level; (2) antenatal care (ANC) 1 and 4, institutional delivery and family planning, at community level. Contribution of a strengthened RS was also measured.
resultsAt hospital level, there is a significant difference between trends Ebola versus pre-Ebola for maternal admissions (7, 95% CI 4 to 11, p<0.001), MDOCs (4, 95% CI 1 to 7, p=0.006) and institutional deliveries (4, 95% CI 2 to 6, p=0.001). There is also a negative trend in the transition from Ebola to post-Ebola for maternal admissions (-7, 95% CI -10 to -4, p<0.001), MDOCs (-4, 95% CI -7 to -1, p=0.009) and institutional deliveries (-3, 95% CI -5 to -1, p=0.001). The differences between trends pre-Ebola versus post-Ebola are only significant for paediatric admissions (3, 95% CI 0 to 5, p=0.035). At community level, the difference between trends Ebola versus pre-Ebola and Ebola versus post-Ebola are not significant for any indicators. The differences between trends pre-Ebola versus post-Ebola show a negative difference for institutional deliveries (-7, 95% CI -10 to -4, p<0.001), ANC 1 (-6, 95% CI -10 to -3, p<0.001), ANC 4 (-8, 95% CI -11 to -5, p<0.001) and family planning (-85, 95% CI -119 to -51, p<0.001).
conclusionsA stronger health system compared with other districts in Sierra Leone and a strengthened RS enabled health facilities in Pujehun to maintain service provision and uptake during and after the Ebola epidemic.
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