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Factors associated with the upsurge in the use of delivery care services in Sierra Leone
Authors: Tsawe M, and Sathiya Susuman A
Source: Public Health, 180: 74-81; DOI: 10.1016/j.puhe.2019.11.002
Topic(s): Delivery care
Health care utilization
Institutional births
Maternal health
Country: Africa
  Sierra Leone
Published: DEC 2019
Abstract: OBJECTIVES: Most African countries have poor maternal and reproductive health outcomes. This is due, in part, to many factors such as accessibility issues, which hinder women in developing countries from using life-saving maternal and reproductive health services. Therefore, this study considered two main objectives: (i) to examine prevalence of delivery care services in Sierra Leone; and (ii) to identify sociodemographic factors associated with the use of the aforementioned health services. STUDY DESIGN: A secondary analysis was undertaken using data from the Sierra Leone Demographic and Health Surveys. METHODS: Bivariate and multivariate analyses were used to study the prevalence and factors associated with the use of delivery care services in Sierra Leone. RESULTS: The findings show a general increase in the use of delivery care services between 2008 and 2013, although the use of these services remains quite low. The multivariate analysis shows that maternal age, marital status, socio-economic status, the number of living children, decision-making power, media exposure, skilled antenatal care, and geographic location are crucial factors in the use of delivery care services. CONCLUSIONS: Use of delivery care services remains low in Sierra Leone. It is possible that the introduction of the Free Healthcare Initiative played a vital role in increasing the use of these services. Further policy debates are needed to ensure universal coverage. Copyright © 2019 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved. KEYWORDS: Determinants; Facility delivery; Health services utilisation; Maternal health; Prevalence; Skilled birth attendant