ArticleMaternal and child health journal2026
Characteristics and Determinants for Home Births in Rural Sierra Leone: A Cross-Sectional Study.
Article in Maternal and child health journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionSub-Saharan Africa and Sierra Leone bear one of the world's highest maternal mortality rates. In rural Sierra Leone, 19% of births occur at home, contributing to high maternal mortality ratios. This study aims to identify characteristics and reasons for home births among women in the rural Mathonkara Catchment area in Sierra Leone.
methodsA cross-sectional survey was conducted among 555 women of childbearing age in the Mathonkara Catchment area, Tonkolili district. Data was collected between February 25 and May 12, 2023. A structured questionnaire assessed birthplaces, demographic characteristics, maternal health indicators, care seeking behaviours, and previous experiences of care at health facilities.
resultsThe prevalence of home births was 26.67%. Characteristics associated with home births include the experience of feeling like health care workers did not care about your life (AOR = 19.11; 95% CI:1.57-799.61), a distance of > 1 km to the nearest health facility (AOR = 7.15; 95% CI:3.12-16.51), ≤ 3 antenatal care visits (AOR = 4.84; 95% CI:2.37-10.14), and previous homebirths (AOR = 4.17; 95% CI:2.42-7.30). Common reasons for home births were labour occurring at nighttime, transportation costs and availability, and health care service costs. CONCLUSIONS FOR PRACTICE: The factors influencing home births in rural Sierra Leone are multifaceted. To improve maternal outcomes, it is crucial to address the challenges that impede facility-based births, including quality of care and respectful care at health facilities, distance, economic costs of reaching facilities, and transportation challenges such as quality of roads and availability of transportation.
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