F Q Shannon1, E Horace-Kwemi1, R Najjemba2, P Owiti3,4, J Edwards5,6, K Shringarpure7, P Bhat8, F N Kateh1. 1. Ministry of Health, Monrovia, Liberia. 2. Makerere University College of Health Sciences, Kampala, Uganda. 3. Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya. 4. International Union Against Tuberculosis and Lung Disease, Paris, France. 5. Operational Research Unit (LUXOR), Médecins Sans Frontières, Brussels Operational Centre, Brussels, Belgium. 6. Johns Hopkins University, School of Public Health, Baltimore, Maryland, USA. 7. Baroda Medical College, Vadodara, India. 8. Ministry of Health, Government of Karnataka, India.
Abstract
Setting: All health facilities, public and private, in Liberia, West Africa. Objectives: To determine access to antenatal care (ANC), deliveries and their outcomes before, during and after the 2014-2015 Ebola outbreak. Design: This was a descriptive cross-sectional study. Result: During the Ebola outbreak in Liberia, overall monthly reporting from health facilities plunged by 43%. Access to ANC declined by 50% and reported deliveries fell by one third during the outbreak. Reported deliveries by skilled attendants and Caesarian section declined by respectively 32% and 60%. Facility-based deliveries dropped by 35% and reported community deliveries fell by 47%. There was an overall decline in reported stillbirths, maternal and neonatal deaths, by 50%, during the outbreak. ANC, reported deliveries and related outcomes returned to pre-outbreak levels within one year following the outbreak. Conclusion: The Liberian health system was considerably weakened during the Ebola outbreak and had difficulties providing basic maternal health services. In the light of the major reporting gaps during the Ebola period, and the reduced use of health facilities for maternal care, these findings highlight the need for measures to avoid such disruptions during future outbreaks.
Setting: All health facilities, public and private, in Liberia, West Africa. Objectives: To determine access to antenatal care (ANC), deliveries and their outcomes before, during and after the 2014-2015 Ebola outbreak. Design: This was a descriptive cross-sectional study. Result: During the Ebola outbreak in Liberia, overall monthly reporting from health facilities plunged by 43%. Access to ANC declined by 50% and reported deliveries fell by one third during the outbreak. Reported deliveries by skilled attendants and Caesarian section declined by respectively 32% and 60%. Facility-based deliveries dropped by 35% and reported community deliveries fell by 47%. There was an overall decline in reported stillbirths, maternal and neonatal deaths, by 50%, during the outbreak. ANC, reported deliveries and related outcomes returned to pre-outbreak levels within one year following the outbreak. Conclusion: The Liberian health system was considerably weakened during the Ebola outbreak and had difficulties providing basic maternal health services. In the light of the major reporting gaps during the Ebola period, and the reduced use of health facilities for maternal care, these findings highlight the need for measures to avoid such disruptions during future outbreaks.
Entities:
Keywords:
ANC; SORT IT; caesarian section; delivery outcomes; operational research
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