Characteristics and Determinants for Home Births in Rural Sierra Leone: A Cross-Sectional Study.

IF 1.9 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Maternal and Child Health Journal Pub Date : 2026-06-01 Epub Date: 2026-06-02 DOI:10.1007/s10995-026-04277-w

Jenny Wussow, Tatyana D Fedorova, Moses Ibrahim Conteh, Sebastian Starling, Rosa Roemers, Amadu Wurie Bah, Ishmael Abu Kalokoh, Haja Sarrah Sheriff, Abubakarr Dumbuya, Zainab Matilda Sankoh, Håkon Angell Bolkan, Josien Westendorp, Rugiatu Jalloh, Lena Skovgaard Andersen, Monica Lauridsen Kujabi

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引用次数: 0

Abstract

Introduction: Sub-Saharan Africa and Sierra Leone bear one of the world's highest maternal mortality rates. In rural Sierra Leone, 19% of births occur at home, contributing to high maternal mortality ratios. This study aims to identify characteristics and reasons for home births among women in the rural Mathonkara Catchment area in Sierra Leone.

Methods: A cross-sectional survey was conducted among 555 women of childbearing age in the Mathonkara Catchment area, Tonkolili district. Data was collected between February 25 and May 12, 2023. A structured questionnaire assessed birthplaces, demographic characteristics, maternal health indicators, care seeking behaviours, and previous experiences of care at health facilities.

Results: The prevalence of home births was 26.67%. Characteristics associated with home births include the experience of feeling like health care workers did not care about your life (AOR = 19.11; 95% CI:1.57-799.61), a distance of > 1 km to the nearest health facility (AOR = 7.15; 95% CI:3.12-16.51), ≤ 3 antenatal care visits (AOR = 4.84; 95% CI:2.37-10.14), and previous homebirths (AOR = 4.17; 95% CI:2.42-7.30). Common reasons for home births were labour occurring at nighttime, transportation costs and availability, and health care service costs.

Conclusions for practice: The factors influencing home births in rural Sierra Leone are multifaceted. To improve maternal outcomes, it is crucial to address the challenges that impede facility-based births, including quality of care and respectful care at health facilities, distance, economic costs of reaching facilities, and transportation challenges such as quality of roads and availability of transportation.

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塞拉利昂农村家庭分娩的特征和决定因素：一项横断面研究。

导言：撒哈拉以南非洲和塞拉利昂是世界上产妇死亡率最高的地区之一。在塞拉利昂农村，19%的分娩发生在家中，导致产妇死亡率高。本研究旨在确定塞拉利昂农村Mathonkara集水区妇女在家分娩的特点和原因。方法：对通科利里县马通卡拉流域555名育龄妇女进行横断面调查。数据收集于2023年2月25日至5月12日之间。一份结构化问卷评估了出生地、人口特征、孕产妇健康指标、求医行为和以前在卫生机构的护理经历。结果：家庭分娩率为26.67%。与在家分娩相关的特征包括：感觉卫生保健工作者不关心自己的生活（AOR = 19.11; 95% CI:1.57-799.61）、距离最近的卫生设施（AOR = 7.15; 95% CI:3.12-16.51）、≤3次产前保健（AOR = 4.84; 95% CI:2.37-10.14）和以前在家分娩（AOR = 4.17; 95% CI:2.42-7.30）。在家分娩的常见原因是夜间分娩、交通费用和可获得性以及保健服务费用。实践结论：影响塞拉利昂农村家庭分娩的因素是多方面的。为了改善产妇结果，至关重要的是应对阻碍在设施分娩的挑战，包括保健设施的护理质量和尊重护理、距离、到达设施的经济成本以及道路质量和交通可用性等交通挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Maternal and Child Health Journal PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

3.20

自引率

4.30%

发文量

271

期刊介绍： Maternal and Child Health Journal is the first exclusive forum to advance the scientific and professional knowledge base of the maternal and child health (MCH) field. This bimonthly provides peer-reviewed papers addressing the following areas of MCH practice, policy, and research: MCH epidemiology, demography, and health status assessment Innovative MCH service initiatives Implementation of MCH programs MCH policy analysis and advocacy MCH professional development. Exploring the full spectrum of the MCH field, Maternal and Child Health Journal is an important tool for practitioners as well as academics in public health, obstetrics, gynecology, prenatal medicine, pediatrics, and neonatology. Sponsors include the Association of Maternal and Child Health Programs (AMCHP), the Association of Teachers of Maternal and Child Health (ATMCH), and CityMatCH.