Hamida Massaquoi1, Catherine Atuhaire2, Gorgeous Sarah Chinkonono3, Betty Nyawira Christensen3, Hannah Bradby4, Samuel Nambile Cumber5,6,7. 1. Department of Women's and Children Health, International Maternal and Child Heath, Uppsala University, Uppsala, Sweden. 2. Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda. catuhaire@must.ac.ug. 3. Section for Epidemiology and Social Medicine, Department of Public Health, Institute of Medicine (EPSO), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. 4. Department of Sociology, Uppsala University, Uppsala, Sweden. 5. Office of the Dean, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa. 6. School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa. 7. Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Abstract
BACKGROUND: From 2014 to 2016, the largest Ebola outbreak in history threatened Sierra Leone and its neighbouring countries, Guinea and Liberia. The Ebola outbreak impacted pregnant adolescent girl's access to prenatal care during the pandemic. The aim of this study is to understand health-seeking behaviour among adolescent mothers who were pregnant during the Ebola epidemic in Waterloo, Sierra Leone. METHODS: The present qualitative study uses the "Three Delay" model, as a theoretical framework to understand and explore adolescent mother's health-seeking behaviour through four focus group discussions with five participants in each discussion group. The data were analysed using thematic analysis. RESULTS: A multitude of challenges were identified following the Ebola epidemic. The fear of contracting Ebola was a common reason for not seeking care or utilising services. This notion was perpetuated by perceptions in the community and participants personal experiences. Quarantines, national lockdowns, roadblocks, loss of income and extreme poverty were also identified as barriers to accessing health facilities during Ebola. The different encounters with health workers and the challenges that arose at the health facilities were subsequently additional discouraging factors influencing participant's decision not to seek health care. CONCLUSION: Many of the pre-existing maternal health, societal and social-economic challenges were exacerbated during the Ebola. The epidemic also contributed new challenges such as public fear, mistrust towards health professionals and the health system. Greater emphasis needs to be placed on improving maternal care in general, but also improving preparedness for maternal care in case of future outbreaks, especially for the most vulnerable groups such as adolescent mothers.
BACKGROUND: From 2014 to 2016, the largest Ebola outbreak in history threatened Sierra Leone and its neighbouring countries, Guinea and Liberia. The Ebola outbreak impacted pregnant adolescent girl's access to prenatal care during the pandemic. The aim of this study is to understand health-seeking behaviour among adolescent mothers who were pregnant during the Ebola epidemic in Waterloo, Sierra Leone. METHODS: The present qualitative study uses the "Three Delay" model, as a theoretical framework to understand and explore adolescent mother's health-seeking behaviour through four focus group discussions with five participants in each discussion group. The data were analysed using thematic analysis. RESULTS: A multitude of challenges were identified following the Ebola epidemic. The fear of contracting Ebola was a common reason for not seeking care or utilising services. This notion was perpetuated by perceptions in the community and participants personal experiences. Quarantines, national lockdowns, roadblocks, loss of income and extreme poverty were also identified as barriers to accessing health facilities during Ebola. The different encounters with health workers and the challenges that arose at the health facilities were subsequently additional discouraging factors influencing participant's decision not to seek health care. CONCLUSION: Many of the pre-existing maternal health, societal and social-economic challenges were exacerbated during the Ebola. The epidemic also contributed new challenges such as public fear, mistrust towards health professionals and the health system. Greater emphasis needs to be placed on improving maternal care in general, but also improving preparedness for maternal care in case of future outbreaks, especially for the most vulnerable groups such as adolescent mothers.
Entities:
Keywords:
Adolescent pregnancy; Ebola; Health-seeking behaviour; Maternal health; Sierra Leone
Authors: Susan Jones; Betty Sam; Florence Bull; Steven Bagie Pieh; Jaki Lambert; Florence Mgawadere; Somasundari Gopalakrishnan; Charles A Ameh; Nynke van den Broek Journal: Midwifery Date: 2017-05-22 Impact factor: 2.372
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