Maternal mortality in Sierra Leone: from civil war to Ebola and the Sustainable Development Goals

Figueroa, Carah; Linhart, Christine; Beckley, Walton; Pardosi, Jerico Franciscus

doi:10.1007/s00038-017-1061-7

Cited by 13 publications

(11 citation statements)

References 5 publications

(3 reference statements)

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“…In 2011, Sierra Leone was listed as one of 38 countries where maternal and neonatal mortality is still a public health problem [21]. The country topped 4 years after the list of countries with high maternal mortality ratio with an estimate of 1360 maternal deaths per 100,000 live births [22,23]. Despite this, most deliveries in Sierra Leone are still conducted at home by unskilled birth attendants, making the country one of the most dangerous places for a woman to be pregnant and a child to be born [21].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and predictors of taking tetanus toxoid vaccine in pregnancy: a cross-sectional study of 8,722 women in Sierra Leone

et al. 2020

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Background: Immunization of women during pregnancy to protect them and their infants against tetanus, pertussis and influenza is recommended by the World health Organization (WHO). However, there is limited information about the coverage rate and associated factors in low-income countries. The aim of this study was to measure the prevalence and predictors of taking tetanus toxoid among pregnant women in Sierra Leone. Methods: This study was based on the fifth round of Multiple Indicator Cluster Survey (MICS 5) conducted in Sierra Leone in 2017. In total 8722 women aged between 15 and 49 years were included in this study. Outcome variable was taking of Tetanus Toxoid vaccination during the last pregnancy. Data were analyzed using cross-tabulation and logistic regression methods. Results: The overall prevalence of receiving TT immunization during women's last pregnancy was 96.3% and that of taking at least two doses was 82.12%. In the regression analysis, women from Mende ethnicity had a 0.48 fold lower chance of being immunized (OR = 0.480, 95% CI = 0.385,0.59768) than those from the other ethnicity. In addition, women who attended at least four ANC visits had higher odds of receiving TT vaccine (OR = 1.919, 95% CI = 1.639, 2.245) compared to those who attended less ANC visits. Stratified by areas, this association was observed in both urban (OR = 2.661, 95% CI = 1.924,3.679) and rural areas (OR = 1.716, 95% CI = 1.430,2.059). Attending at least four ANC visits showed a positive association with receiving at least two doses TT (OR = 2.434, 95% CI = 1.711,3.464) in both urban (OR = 2.815, 95% CI = 1.413,5.610) and rural areas (OR = 2.216, 95% CI = 1.463,3.356) as well. Conclusion: Higher number of ANC visits, mass media exposure and higher wealth quintile increased the odds of receiving TT immunization. In addition, minimum two doses which were identified to reduce neonatal mortality. Therefore, immunization campaigns targeting improved utilization of healthcare and immunization services by women of childbearing age in Sierra Leone are strongly recommended.

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Section: Introductionmentioning

confidence: 99%

Prevalence and predictors of taking tetanus toxoid vaccine in pregnancy: a cross-sectional study of 8,722 women in Sierra Leone

et al. 2020

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“…During the pandemic, lack and/or reallocation of resources may reduce access to SRH and increase maternal and childhood mortality rates [16]. The West Africa's large, multi-country Ebola Virus Disease (EVD) outbreak of 2014-2016 showed that there were signi cant impacts on SRH, particularly in the early stages of that outbreak, largely related to health facility closures [27]. Another study from Guinea found a decrease of 51% in Family Planning (FP) visits during the outbreak [28].…”

Section: Discussionmentioning

confidence: 99%

Factors that influenced access and utilisation of sexual and reproductive health services among Ugandan youths during the COVID-19 pandemic lockdown: An online cross-sectional survey

Mambo

Sikakulya

Ssebuufu

et al. 2021

Preprint

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BackgroundThe COVID-19 pandemic has caused a wide range of disruptions in health care access in many low and middle income countries. The aim of this study was to explore factors that influenced access and utilisation of sexual and reproductive health services among Ugandan youths during the COVID-19 pandemic lockdown. MethodsThis was an online cross-sectional study carried out from April 2020 to May 2020 in Uganda. An online questionnaire was used and participants aged 18years to 30 years were recruited using the snowballing approach. The statistical analysis was done using STATA version 14.2.Results Out of 724 participants, 203 (28%) reported not having information and/or education concerning sexual and reproductive health (SRH). About a quarter of the participants (26.9%, n=195) reported not having access to testing and treatment services of sexually transmitted infections during the lockdown. Lack of transport means was the commonest (68.7%) limiting factor to accessing SRH services during the lockdown followed by the long distance from home to SRH facilities (55.2%), high cost of services (42.2%) and curfew conditions (39.1%). Sexually transmitted infections were the commonest (40.4%) problems related to SRH during the lockdown followed by unwanted pregnancy (32.4%) and sexual abuse (32.4%). Limiting factors were more prevalent among the co-habiting youths [CPR: 1.3 (1.13-1.49) and APR:1.2 (1.06-1.41)] followed by unemployed [CPR: 1.3 (1.09 - 1.53) and APR:1.2 (1 - 1.42)] and non-salaried [APR:1.2 (1- 1.42)] than other participants. The bivariate and multivariate regression analyses indicate that problems were more prevalent among the co-habiting youths [CPR: 2.7 (1.88 - 3.74) and APR: 2.3 (1.6 - 3.29)] followed by the unemployed [CPR: 2 (1.27 - 3.2) and APR: 1.6 (1.03 - 2.64)] than in other categories. ConclusionThe findings of this study show that Ugandan youths had limited access to SRH information and services during the COVID-19 lockdown. Cohabiting and unemployed youths were the most affected by problems related to SRH. Lack of transport means and high cost of services were the major limiting factors to access SRH services among the youths. The findings call for concerted efforts from the Government and other stakeholders to incorporate SRH among the priority services when designing responses to any outbreak crisis.

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“…Particularly in Uganda, two major surveys conducted among university students indicated that young people had limited access to sexual and reproductive health services and HIV/AIDS-related programmes despite their engagement in high-risk sexual behaviours [26][27]. The West Africa's large, multi-country Ebola Virus Disease (EVD) outbreak of 2014-2016 tells us that there were signi cant impacts on SRH, particularly in the early stages of that outbreak, largely related to health facility closures [28].…”

Section: Socio-demographic Characteristics Of Participantsmentioning

confidence: 99%

Sexual and Reproductive Health and Rights Challenges among Ugandan Youth during COVID-19 Pandemic lockdown: An online Cross-Sectional Study

Mambo¹,

Sikakulya²,

Ssebuufu³

et al. 2020

Preprint

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Background The COVID-19 pandemic threatens access to sexual and reproductive health and rights. With global health emergencies, there is often a total reversal of priorities and sexual and reproductive health rights services may become challenging. The aim of this study was to establish the challenges to sexual and reproductive health and rights among Ugandan youth during the lockdown due to COVID-19 pandemic. Methods This was an online cross-sectional study carried out from April 2020 to May 2020 in Uganda. An online questionnaire was used and participants aged 18 to 30 years recruited using the snowballing approach. The statistical analysis was done using STATA version 14.Results Out of 724 participants, 203 (28%) reported not having information and/or education concerning sexual and reproductive health (SRH). About a quarter of the participants (26.5%) reported not having testing and treatment services of Sexual transmitted Infections available during the lockdown. Lack of transport means was the commonest (68.7%) limiting factor to access to SRH services during the lockdown followed by the long distance from home to health facility where to get the services (55.2%), cost of services (42.2%) and curfew (39.1%). Sexually transmitted diseases were the commonest (40.4%) challenge relating to SRH during this lockdown followed by unwanted pregnancy (32.4%) and sexual abuses (32.4%). The Multivariate Regression Analysis shows that challenges were more prevalent among the co-habiting youth [APR: 2.3 (1.6 - 3.29), p<0.001] followed by unemployed (Volunteer or unpaid) [APR: 1.6 (1.03 - 2.64), p: 0.037] than others participants. Conclusions The findings of this study show that Ugandan youths have challenges to access to SRHR information and services during lockdown due to COVID-19. Cohabiting and unemployed participants were mostly affected among Ugandan youths. Lack of transport means and cost of services were the limiting factors to access SRHR services among youths. Therefore, effective measures should be put in place to ensure access and availability of SRHR for Ugandan youths during the COVID-19 lockdown.

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Maternal mortality in Sierra Leone: from civil war to Ebola and the Sustainable Development Goals

Cited by 13 publications

References 5 publications

Prevalence and predictors of taking tetanus toxoid vaccine in pregnancy: a cross-sectional study of 8,722 women in Sierra Leone

Prevalence and predictors of taking tetanus toxoid vaccine in pregnancy: a cross-sectional study of 8,722 women in Sierra Leone

Factors that influenced access and utilisation of sexual and reproductive health services among Ugandan youths during the COVID-19 pandemic lockdown: An online cross-sectional survey

Sexual and Reproductive Health and Rights Challenges among Ugandan Youth during COVID-19 Pandemic lockdown: An online Cross-Sectional Study

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