The demographic aspects of women’s access to delivery services in Sierra Leone: insights from the Sierra Leone Demographic and Health Survey 2019
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Date
2024
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University of the Western Cape
Abstract
Maternal health is a key public health issue that can have significant implications for a country such as Sierra Leone, which is amongst the cluster of countries with high maternal mortality ratios and morbidity, globally. In the preceding decades, Sierra Leone experienced a devastating civil war and an outbreak of the Ebola virus, which impacted the already fragile public health system, negatively. Hence, pregnancy in Sierra Leone is associated with a 1 in 12 chances of ending in death for mothers, which is alarmingly high in comparison to other countries. Access to delivery services has been named as one of the most useful ways in counteracting maternal mortality. This study aimed to examine the demographic factors influencing women’s access to delivery services in Sierra Leone, using data from the 2019 Sierra Leone’s Demographic and Health Survey. With maternal health being a critical concern in the country, understanding the determinants of access to delivery services is essential for improving maternal and child health outcomes. The independent variables of interest were age, type of place of residence, level of education, wealth index, work status, literacy, media consumption (frequency of listening to the radio, watching television, reading newspapers), marital status and religion. The dependent variables were place of delivery (home, hospital, other), and skilled assistance during delivery (doctor, nurse/midwife, traditional birth attendant). This study utilized a quantitative approach, using data from the Demographic and Health Survey 2019 of Sierra Leone. Univariate, bivariate, and multivariate analyses were done to analyse the different variables in order to understand the effect the diverse demographic aspects have on women’s access to delivery services in Sierra Leone. The findings of this study accepted the hypothesis that different demographic and socio-economic factors influence women’s access to delivery services in Sierra Leone. The key predictors for assistance by a skilled birth attendant and place of delivery were unveiled to be age group, region, type of place of residence, literacy, frequency of watching television, wealth index, and employment status. These findings underscore the complexity of women’s access to delivery services in Sierra Leone, and the need for interventions that address economic, geographic, cultural, and informational barriers.
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maternal morbidity, facility-based deliveries, antenatal care, maternal mortality, maternal and child health