Distance, accessibility and costs. Decision-making During Childbirth in Rural Sierra Leone: a Qualitative Study
dc.contributor.author | Treacy, Laura | |
dc.contributor.author | Bolkan, Håkon Angell | |
dc.contributor.author | Sagbakken, Mette | |
dc.date.accessioned | 2018-08-10T07:48:48Z | |
dc.date.accessioned | 2018-08-28T07:51:08Z | |
dc.date.available | 2018-08-10T07:48:48Z | |
dc.date.available | 2018-08-28T07:51:08Z | |
dc.date.issued | 2018-02-20 | |
dc.identifier.citation | Treacy L, Bolkan Ha, Sagbakken M. Distance, accessibility and costs. Decision-making During Childbirth in Rural Sierra Leone: a Qualitative Study. PLoS ONE. 2018;13(2) | en |
dc.identifier.issn | 1932-6203 | |
dc.identifier.issn | 1932-6203 | |
dc.identifier.uri | https://hdl.handle.net/10642/6095 | |
dc.description.abstract | Background: Sierra Leone has one of the highest maternal mortality ratios in the world. Efforts to reduce maternal mortality have included initiatives to encourage more women to deliver at health facilities. Despite the introduction of the free health care initiative for pregnant women, many women still continue to deliver at home, with few having access to a skilled birth attendant. In addition, inequalities between rural and urban areas in accessing and utilising health facilities persist. Further insight into how and why women make decisions around childbirth will help guide future plans and initiatives in improving maternal health in Sierra Leone. The objective of this study was to explore the perceptions and decision-making processes of women and their communities during childbirth in rural Sierra Leone. Methods and findings: Data were collected through seven focus group discussions and 22 in-depth interviews with recently pregnant women and their community members in two rural villages. Data were analysed using systematic text condensation. Findings revealed that decision-making processes during childbirth are dynamic, intricate and need to be understood within the broader social context that they take place. Factors such as distance and lack of transport, perceived negative behaviour of hospital staff, direct and indirect financial obstacles, as well as the position of women in society all interact and influence how and what decisions are made. Conclusions: Pregnant women face multiple interacting vulnerabilities that influence their healthcare-seeking decisions during pregnancy and childbirth. Future initiatives to improve access and utilisation of safe healthcare services for pregnant women need to be based on adequate knowledge of structural constraints and health inequities that affect women in rural Sierra Leone. | en |
dc.description.sponsorship | This research was partly funded by the Ivar Hells Foundation (10 000 NOK). The funder had no role in study design, data collection and analysis decision to publish, or preparation of the manuscript. There was no additional external funding received for this study. | en |
dc.language.iso | en | en |
dc.publisher | Public Library of Science | en |
dc.relation.ispartofseries | PLoS ONE;13 (2) | |
dc.rights | ©2018 Treacy et al. This is an open access article distributed under the terms of the Creative CommonsAttribution License, which permits unrestricted use, distribution, and reproduction in any medium,provided the original author and source are credited. | en |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.subject | Childbirths | en |
dc.subject | Birth decisions | en |
dc.subject | Sierra Leone | en |
dc.title | Distance, accessibility and costs. Decision-making During Childbirth in Rural Sierra Leone: a Qualitative Study | en |
dc.type | Journal article | en |
dc.type | Peer reviewed | en |
dc.date.updated | 2018-08-10T07:48:48Z | |
dc.description.version | publishedVersion | en |
dc.identifier.doi | http://dx.doi.org/10.1371/journal.pone.0188280 | |
dc.identifier.cristin | 1515042 | |
dc.source.journal | PLoS ONE |
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HV - Institutt for sykepleie og helsefremmende arbeid [1388]
HV - Department of Nursing and Health Promotion
Med mindre annet er angitt, så er denne innførselen lisensiert som ©2018 Treacy et al. This is an open access article distributed under the terms of the Creative CommonsAttribution License, which permits unrestricted use, distribution, and reproduction in any medium,provided the original author and source are credited.