Impact of the Ebola Viral Disease Epidemic on Reproductive and Maternal and Child Health Services in Sierra Leone
Methods: We conducted an analysis to assess the impact of the epidemic on reproductive and maternal and child health services in Kenema, the second Sierra Leone district to report Ebola cases. We compared numbers of patients who used key reproductive, maternal and child health services during the six-month pre-epidemic period (January-June, 2014) to numbers of patients during the maximum Ebola reporting period (July-September, 2014) and to numbers of patients in the months when Ebola reporting began declining (October-December, 2014).
Results:Decreased utilization occurred during months of maximum Ebola reporting (July-September) from pre-epidemic levels in numbers of women who: received contraceptive pills (-20.6%), injections (-30.2%) and implants (-47.3%); attended one and four or more antenatal visits (-14.8%, -21.9%, respectively) and postnatal (-16.6%) visits; had antenatal HIV screening (-25.3%), institutional vaginal (-14.5%) or cesarean (-81.0%) deliveries; and attended community (-33.5%) and school-based (-72.4%) reproductive health information sessions (all p<.01). But in subsequent months, when Ebola reporting declined, numbers of patients utilizing these services rose by 3.2% to 290.0% from nadirs remaining from 9.5% to over 95% below pre-epidemic levels.
Conclusions: The Ebola viral disease epidemic is impacting services essential to reducing maternal and child mortality. These data suggest resiliency and potential for post-epidemic recovery in most services.
Learning Areas:Clinical medicine applied in public health
Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public
Describe the impact of the Sierra Leonean Ebola viral disease (EVD) epidemic on reproductive and maternal and child health services in Kenema, Sierra Leone. Compare the impact of the EVD epidemic by type of service, particularly in-hospital vaginal and cesarean deliveries versus community-based services Assess the recovery in the months after the epidemic peak, to identify the most impacted, least resilient services
Keyword(s): Maternal and Child Health, Women's Health
Qualified on the content I am responsible for because: I am a doctoral student (PhD) in the Dept. of Health Promotion and Disease Prevention of the Stempel College of Public Health and Social Work, Florida International University. My MS is in biology. I have collaborated in Global Public Health projects, conducting data analyses in studies of depression in patients with HIV infection using combined antiretroviral therapy (cART) and disclosure of their status to perinatally HIV-infected youth in Haiti and the Dominican Republic.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.