TY - JOUR

T1 - Exploring health-seeking behavior among adolescent mothers during the Ebola epidemic in Western rural district of Freetown, Sierra Leone

AU - Massaquoi, Hamida

AU - Atuhaire, Catherine

AU - Chinkonono, Gorgeous Sarah

AU - Christensen, Betty Nyawira

AU - Bradby, Hannah

AU - Cumber, Samuel Nambile

PY - 2021/1/7

Y1 - 2021/1/7

N2 - 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.

AB - 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.

KW - Adolescent

KW - Attitude of Health Personnel

KW - Attitude to Death

KW - Attitude to Health

KW - Epidemics

KW - Fear

KW - Female

KW - Focus Groups

KW - Health Facilities

KW - Health Services Accessibility

KW - Hemorrhagic Fever, Ebola/epidemiology

KW - Humans

KW - Patient Acceptance of Health Care/psychology

KW - Pregnancy

KW - Pregnancy in Adolescence/psychology

KW - Qualitative Research

KW - Quarantine/psychology

KW - Sierra Leone/epidemiology

KW - Socioeconomic Factors

KW - Trust/psychology

KW - Young Adult

U2 - 10.1186/s12884-020-03521-7

DO - 10.1186/s12884-020-03521-7

M3 - Journal article

C2 - 33413227

VL - 21

SP - 37

JO - B M C Pregnancy and Childbirth

JF - B M C Pregnancy and Childbirth

SN - 1471-2393

IS - 1

ER -