You are here

Article Text

Article menu

Download PDFPDF

XML
Infectious diseases
Research
Access to facility delivery and caesarean section in north-central Liberia: a cross-sectional community-based study
  1. Matthew G Gartland1,
  2. Victor D Taryor2,
  3. Andy M Norman3,
  4. Sten H Vermund1,4
  1. 1Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
  2. 2Ganta United Methodist Hospital, Ganta, Nimba, Liberia
  3. 3Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
  4. 4Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
  1. Correspondence toMatthew G Gartland; matthew.gartland{at}vanderbilt.edu

Abstract

Objective Rural north-central Liberia has one of the world's highest maternal mortality ratios. We studied health facility birthing service utilisation and the motives of women seeking or not seeking facility-based care in north-central Liberia.

Design Cross-sectional community-based structured interviews and health facility medical record review.

Setting A regional hospital and the surrounding communities in rural north-central Liberia.

Participants A convenience sample of 307 women between 15 and 49 years participated in structured interviews. 1031 deliveries performed in the regional hospital were included in the record review.

Primary outcomes Delivery within a health facility and caesarean delivery rates were used as indicators of direct utilisation of care and as markers of availability of maternal health services.

Results Of 280 interview respondents with a prior childbirth, only 47 (16.8%) delivered their last child in a health facility. Women who did not use formal services cited cost, sudden labour and family tradition or religion as their principal reasons for home delivery. At the regional hospital, the caesarean delivery rate was 35.5%.

Conclusions There is an enormous unmet need for maternal health services in north-central Liberia. Greater outreach and referral services as well as community-based education among women, family members and traditional midwives are vital to improve the timely utilisation of care.

  • Liberia
  • Maternal health
  • Health care utilization
  • Emergency obstetric care

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

https://doi.org/10.1136/bmjopen-2012-001602

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text