Format

Send to

Choose Destination
BMC Pregnancy Childbirth. 2015 Apr 8;15:87. doi: 10.1186/s12884-015-0500-9.

Exploration of perceptions and decision-making processes related to childbirth in rural Sierra Leone.

Author information

1
International Community Health, University of Oslo, P.O box 1130, Blindern, Oslo, 0317, Norway. ltreacy@hotmail.com.
2
Oslo and Akerhus University College, Faculty of Health Sciences, Oslo, Norway. Mette.Sagbakken@hioa.no.
3
National Center for Minority Health Research (NAKMI), Gullhaugveien 1-3, 0484, Oslo, Norway. Mette.Sagbakken@hioa.no.

Abstract

BACKGROUND:

Maternal mortality ratio (MMR) remains high in Sierra Leone. Efforts have been made to reduce MMR by increasing the number of women delivering at a health facility through introduction of the Free Health Care Initiative in 2010. Despite this, utilisation remains lower than aimed for, with marked inequalities between rural and urban settings. This study explores the perceptions and decision-making processes of women and their communities during childbirth in rural Sierra Leone.

METHODS:

A qualitative, cross-sectional study employing focus group discussions, in- depth interviews and informal interviews with pregnant women and community members in rural northern Sierra Leone. Data were analysed using systematic text condensation.

RESULTS:

Data revealed that the decision-making processes are complex and multi-faceted. Decisions regarding the place of delivery and with whom assisting the birth are often made collectively. A normal delivery is seen as one that occurs within the village. Previous experiences, perceptions and expressions of bodily symptoms as well as the interpretation of different risks affect these decisions. The health seeking behaviours were found to be flexible and dynamic, and the final decisions about where to give birth could be governed by unexpected circumstances.

CONCLUSIONS:

Decision-making processes during childbirth in rural Sierra Leone are dynamic and intricate and need to be understood within the broader social context. Future initiatives to improve access and utilisation of safe health services for pregnant women within rural Sierra Leone need to be based on adequate knowledge of women's preferences, cultural-specific traits, capabilities, perceptions of risk and the constraints in which they may live.

PMID:
25886036
PMCID:
PMC4403930
DOI:
10.1186/s12884-015-0500-9
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center