Evidence map›Paper›PMID 42229967›Full record

ArticleBMJ open2026

Barriers to healthcare access during pregnancy and after birth for adolescent girls living with disability in Sierra Leone: a qualitative study.

Philemon Kamara, Mangenda Kamara, Lucy November, Jane Sandall, Prince T Williams, Haja Wurie, Cristina Fernandez Turienzo

Abstract read
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Philemon KamaraLifeline Nehemiah Projects, Freetown, Sierra Leone.
Mangenda KamaraUniversity of Sierra Leone, Freetown, Western Area, Sierra Leone.
Lucy NovemberDepartment of Women & Children's Health,School of Life Course & Population Health Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.
Jane SandallDepartment of Women & Children's Health,School of Life Course & Population Health Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.
Prince T WilliamsLifeline Nehemiah Projects, Freetown, Sierra Leone.
Haja WurieUniversity of Sierra Leone, Freetown, Western Area, Sierra Leone.
Cristina Fernandez TurienzoDepartment of Women & Children's Health,School of Life Course & Population Health Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK cristina.fernandez_turienzo@kcl.ac.uk.ORCID http://orcid.org/0000-0002-7393-6593

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveIn 2017, Lifeline Nehemiah Projects in Sierra Leone launched 2YoungLives, a mentoring initiative for vulnerable pregnant adolescents, including those living with disabilities. Drawing from the social model of disability, we aimed to investigate the exacerbated disabling barriers which prevent these girls and their babies from accessing available healthcare and develop comprehensive solutions to improve their access.

designQualitative methods were used in this study.

settingParticipants were invited to participate in face-to-face interviews in one district in Sierra Leone.

participantsSix pregnant or postnatal adolescents living with disability, alongside four caregivers and five stakeholders from various organisations participated in semi-structured interviews employing thematic analysis.

resultsWe identified four key themes: (1) discrimination and financial barriers within the healthcare system, despite laws ensuring free healthcare for persons living with disabilities, (2) societal stigma manifested through abandonment by families and inadequate support, (3) lack of understanding of disability issues, particularly of those with intellectual impairments, leading to stigmatisation and exclusion, and (4) infrastructural limitations which hinder accessibility to essential services, with many facilities remaining non-compliant with disability regulations.

conclusionAdolescent girls living with disability during pregnancy and after birth in Sierra Leone face barriers to accessing healthcare, including caregiver ignorance, lack of autonomy, disabling services, social stigma and ineffective policy implementation, despite existing supportive laws. These findings keep those women who are arguably the most vulnerable, adolescent and living with a disability, from accessing perinatal healthcare, exacerbating their risk and that of their babies. Solutions include the need to enforce disability-inclusive policies and infrastructure adaptations, awareness and training for healthcare providers and community advocacy to break down social stigma.

Indexed as

Disability DiscriminationHealth Services AccessibilityPregnancy in AdolescenceAdolescentFemaleHumansPersons with DisabilitiesPregnancyQualitative ResearchSierra LeoneSocial StigmaAdolescentsDisabled PersonsPregnancyPUBLIC HEALTH

Identifiers

PMID42229967
PMCPMC13239463

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.