Background The quality of contraceptive counseling information received by prospective clients of family planning services can greatly influence both the uptake and continued use of contraceptives. Therefore, an understanding of the level and determinants of quality contraception information among young women in Sierra Leon could inform family programs, with the aim of reducing the high unmet need in the country. Methods We analyzed secondary data from the 2019 Sierra Leone Demographic Health Survey (SLDHS). Participants were young women aged 15–24 years, who were using a family planning method (n = 1,506). Good quality family planning counselling was defined a composite variable that included; a woman being told about side effects, how to deal with side effects, and the availability of other family planning methods/options. Logistic regression was performed using SPSS software version 25. Results Out of 1,506 young women, 955 (63.4%, 95% CI: 60.5–65.3) received good quality family planning counselling services. Of the 36.6% that received inadequate counselling, 17.1% received no counselling at all. Good quality family planning counselling services was positively associated with receiving family planning services from government health facilities (aOR: 2.50, 95% CI: 1.83–3.41), having no major challenges with distance to access healthcare (aOR: 1.45, 95% CI: 1.10–1.90), having visited a health facility (AOR: 1.93, 95% CI: 1.45–2.58), and having been visited by a health field worker within the last 12 months (aOR: 1.67, 95% CI: 1.24–2.26) while residing in the southern region ( aOR: 0.39, 95% CI: 0.22–0.69) and belonging to the richest wealth quintile (aOR: 0.49, 95% CI: 0.24–0.98) were associated with less odds of receiving good quality family planning counselling services. Conclusion About 37% of the young women in Sierra Leone do not receive good quality family planning counselling services of which 17.1% received none. Based on the study’s findings, it is important to emphasize the need to ensure that all young women have access to proper counselling services especially for those receiving these services from private health units, from the southern region and richest wealth quintile. Ensuring easier access through increasing affordable and friendly access points and strengthening field health workers’ capacity in providing family planning services could also help improve access to good quality family planning services.

Background Globally, about 289,000 maternal deaths are registered annually. Timely access to quality maternal health services is an effective intervention to reduce maternal deaths. Postnatal care (PNC) is one of the recommended packages in the continuum of maternity care aimed at reducing maternal and neonatal mortality. This study aimed to determine the prevalence and factors associated with PNC utilisation in Sierra Leone. Methods We used Sierra Leone Demographic and Health Survey (UDHS) 2019 data of 7,326 women aged 15 to 49 years. We conducted multivariable logistic regression to determine the factors associated with PNC utilisation, using SPSS version 25. Results Out of 7,326 women, 3,329 (45.5%, 95% CI: 44.6–46.8) had their babies have at least a PNC contact, 6,646 (90.7%, 95% CI: 90.2–91.5) had a postnatal check after childbirth and 3,133 (42.8%, 95% CI: 41.9–44.1) had PNC for both their babies and themselves. Delivery by caesarean section (aOR 1.79, 95% CI: 1.20–2.67), having a visit by a health field worker (aOR 1.77, 95% CI: 1.47–2.13), having had eight or more ANC contacts (aOR 1.79, 95% CI: 1.45–2.22), initiating ANC after first trimester (aOR 1.18, 95% CI: 1.04–1.35), being a Muslim (aOR 1.34, 95% CI: 1.11–1.61), belonging to richer wealth quintile (aOR 1.69, 95% CI: 1.22–2.35), being of low parity (2–4) (aOR 1.20, 95% CI: 1.04–1.39), having no big problems seeking permission to access healthcare (aOR 1.52, 95% CI: 1.27–1.83) and having had delivery at home (aOR 1.75, 95% CI: 1.32–2.32) were associated with more PNC utilisation odds. On the other hand, being resident in the Eastern region (aOR 0.31, 95% CI: 0.21–0.46) and urban areas (aOR 0.71, 95% CI: 0.52–0.98) were associated with lower odds of utilising PNC. Conclusion Although maternal PNC utilisation is high, utilisation of PNC by neonates alone and by both the mother and neonatal is low. More focus is needed to mothers and their neonates from the Eastern region, urban areas, Christians, less empowered in terms of healthcare seeking decision making and those who are more parous, utilise less ANC contacts and utilise health facilities for delivery.

IntroductionGlobally, Sierra Leone has some of the worst maternal and child health indicators. The situation is worsened by a dearth of evidence about the level of continuum of care, an evidence-based intervention aimed at reducing maternal and perinatal morbidity and mortality. Hence this study aimed to fill this gap in evidence in the level of and factors associated with continuum of maternal and newborn care.MethodThe study employed data from the 2019 Sierra Leone Demographic Health Survey (SLDHS). Analysis was restricted to women who had a live birth in the five years preceding the survey (n = 7,326). Bi-variable and multivariable logistic regression were performed using SPSS software version 25.ResultsOnly 17.9% (95% CI: 17.4-19.1) of the women utilized complete continuum of care (CoC) for maternal and newborn health services in Sierra Leone. About 22% (95% CI: 21.3-23.1) utilized 8 or more antenatal care (ANC) contacts, 88% (95% CI: 87.9-89.4) had skilled birth attendance (SBA) while 90.7% (95% CI: 90.2-91.5) and 90.4% (95% CI: 89.9-91.2) of mothers and neonates utilized postnatal care (PNC) respectively. Having started ANC within first trimester (aOR 1.71, 95% CI: 1.46-2.00), belonging to the Southern region (aOR 1.85, 95% CI: 1.23-2.80), belonging to richer wealth quintile (aOR 1.76, 95% CI: 1.27-2.44), using internet (aOR 1.49, 95% CI: 1.12-1.98) and having no big problems seeking permission to access healthcare (aOR 1.34, 95% CI: 1.06-1.69) were significantly associated with utilization of CoC.ConclusionThe overall completion of continuum of maternal care is low, with ANC being the lowest utilized component of continuum of care. The study findings further call for urgent attention for maternal health stakeholders to develop and implement tailored interventions prioritizing women empowerment, access to affordable internet services, timely initiation of ANC contacts, women in developed regions such as the Western and those from poor households.

Hypertension is an important worldwide public-health challenge due to its high prevalence and being a risk factor for cerebrovascular, cardiovascular, and chronic renal diseases. Despite these risk factors, blood pressure control among hypertensive patients is still poor.  The main objective was to assess dietary and lifestyle factors associated with uncontrolled blood pressure control among Ugandan hypertensive patients at Kiruddu hospital. Materials and methods: A cross-sectional study involving 271 adult hypertensive patients attending the outpatient hypertensive clinic was enrolled. Data were obtained on dietary, lifestyle factors (alcohol intake, smoking status, and level of physical activity), social demographics, Body Mass Index (BMI), comorbidities, and adherence to hypertensive medication. An average of the current and previous two Blood pressure readings was recorded. Factors associated with uncontrolled blood pressure were assessed using a multivariate logistic regression model. Results: The mean age of study participants was 57 ± 0.76 years, with female dominance (77.9%). Among the study participants, 121 (44.7%) had uncontrolled BP. Dietary factors that were associated with uncontrolled blood pressure with adjusted OR (95%CI) included consumption of raw salt: 4.18 (1.32-13.24) and inadequate fruit consumption: 2.18 (1.26-3.75) while clinical factors included being overweight: 2.51 (1.27-4.95) and poor adherence to antihypertensive medications prescribed: 1.82 (1.03-3.21). Conclusion: The proportion of hypertensive patients with uncontrolled Blood Pressure was high (44.7%). Consumption of raw salt, inadequate fruit consumption, being overweight and poor adherence to antihypertensive medication were significantly associated with uncontrolled BP. From these findings, factors that were associated with the control of blood pressure are modifiable.

Background Hypertension is an important worldwide public-health challenge because of its high prevalence and for being a risk factor for cerebrovascular, cardiovascular and chronic renal disease. Despite these risk factors, blood pressure control among hypertensive patients is still poor. Objectives To assess dietary and lifestyle factors associated with uncontrolled blood pressure control among a series of Ugandan hypertensive patients under care at a Kiruddu hospital.Methods A cross sectional study involving 271 adult hypertensive patients attending general outpatient hypertensive clinic were enrolled. We collected data on dietary and lifestyle factors, social demographics, BMI, comorbidities, and adherence to hypertensive medication. Dietary factors were based on recommended DASH diet including nine food items salt; grains; fruits; vegetables; nut/seeds, and legumes; dairy; meat; fat; and sweets. Questionnaires on alcohol intake, smoking status and level of physical activity were also administered. An average of the previous two Blood pressure readings were recorded while weight and height were measured for each subject at enrolment. Factors associated with uncontrolled blood pressure (>140/90mmHg) were assessed using a multivariate logistic regression model.Results The mean age of study participants was 57 years (SD ± 0.76 years), with female dominance (77.9%). Among the study participants, 121 (44.7%) had uncontrolled BP. Dietary factors that remained significantly associated with uncontrolled blood pressure with adjusted OR (95%CI) included consumption of raw salt: 4.18 (1.32-13.24) and inadequate fruit consumption (less than 7days/week): 2.18 (1.26-3.75) while clinical factors included being overweight: 2.51 (1.27-4.95) and poor adherence to antihypertensive medications prescribed: 1.82 (1.03-3.21).Conclusion The proportion of hypertensive patients with uncontrolled BP was high (44.7%). Consumption of raw salt, inadequate fruit consumption being overweight and poor adherence to antihypertensive medication were significantly associated with uncontrolled BP. From these findings, many of the factors that impact on the control of blood pressure are fortunately modifiable.