Health-care availability, preference, and distance for women in urban Bo, Sierra Leone

Fleming, Lila C.; Ansumana, Rashid; Bockarie, Alfred S.; Alejandre, Joel D.; Owen, Karen; Bangura, Umaru; Jimmy, David Henry; Curtin, Kevin M.; Stenger, David A.; Jacobsen, Kathryn H.

doi:10.1007/s00038-016-0815-y

Cited by 16 publications

(15 citation statements)

References 30 publications

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“…With regards to delays to reach health facility, the odds of facing near miss were found to be 2 times higher among women who traveled > 10 km compared with those who traveled ≤ 10 km [AOR = 1.99; CI (1.10, 3.61)]. The finding of this study is consistent with studies carried out in Dabat, Ethiopia [31], and Sierra Leone [32]. Poor access to health institution in nearby place, lack of road infrastructure or transport forces women to travel long distance on foot leading to delays in reaching health facilities [19].…”

Section: Discussionsupporting

confidence: 88%

Magnitude of maternal near misses and the role of delays in Ethiopia: a hospital based cross-sectional study

2019

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Objectives This study was aimed to assess the magnitude of maternal near misses and the role of delays including other risk factors. A Hospital based cross sectional study was conducted at three referral hospitals of Amhara region on 572 mothers who came to obtain obstetrics care services from February 01 to July 30, 2018. Results The magnitude of maternal near miss was 26.6% (95% CI 23, 30). With regards to delays, 83 (14.5%), 226 (39.5%), and 154 (26.9%) of women delayed in the decision to seek care, in reaching care, and in receiving care respectively. Women who had no antenatal care [AOR = 3.16; CI (1.96, 5.10)], who stayed in hospital 7 days or more [AOR = 2.20; CI (1.33, 3.63)] and those who had delay in reaching health facility [AOR = 1.99; CI (1.10, 3.61)] were more likely to be near miss. While, women whose husband was able to read and write [AOR = 0.29; CI (0.09, 0.96)] and those with monthly household income between 2001 and 3000 ETB [AOR = 0.35; CI (0.18, 0.70)] were 71% and 65% less likely to be near misses respectively. Promoting antenatal care and increasing maternal health care access could have significant impact in reducing maternal near misses.

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Section: Discussionsupporting

confidence: 88%

Magnitude of maternal near misses and the role of delays in Ethiopia: a hospital based cross-sectional study

2019

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“…Bo Government Hospital (BGH) is the city's only public hospital, and it provides free basic health services along with access to some advanced diagnostics and therapies at a reasonable cost. Bo Government Hospital is the preferred provider for medical care of residents from across the city, including those in the downtown area near BGH and those at the outskirts of the city …”

Section: Methodsmentioning

confidence: 99%

“…Bo Government Hospital is the preferred provider for medical care of residents from across the city, including those in the downtown area near BGH and those at the outskirts of the city. 13,14 All adult BGH outpatients (ages 18 and older) who lived within the Bo district and sought testing for selected conditions at the BGH laboratory during a 3-year period from January 2012 through December 2014 were eligible for inclusion in this study. Recruiting was not limited to adults who had been referred specifically for blood sugar testing, but included any adult referred for biochemistry tests (such as a cholesterol test) or for testing for malaria, typhoid, or tuberculosis.…”

Section: Introductionmentioning

confidence: 99%

The prevalence of type 2 diabetes in urban Bo, Sierra Leone, and in the 16 countries of the West Africa region

Sundufu

Bockarie

Jacobsen

2017

Diabetes Metabolism Res

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“…Poverty further complicates the relationship between health service access and bypassing behaviors in urban environments. Urban poor often live on city outskirts and must travel further for health services [ 21 ]. Inability to pay service fees or the cost of consumables poses a challenge for many women who would prefer to seek another provider if cost was not an issue [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

The Role of Distance and Quality on Facility Selection for Maternal and Child Health Services in Urban Kenya

et al. 2017

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Universal access to health care requires service availability and accessibility for those most in need of maternal and child health services. Women often bypass facilities closest to home due to poor quality. Few studies have directly linked individuals to facilities where they sought maternal and child health services and examined the role of distance and quality on this facility choice. Using endline data from a longitudinal survey from a sample of women in five cities in Kenya, we examine the role of distance and quality on facility selection for women using delivery, facility-based contraceptives, and child health services. A survey of public and private facilities offering reproductive health services was also conducted. Distances were measured between household cluster location and both the nearest facility and facility where women sought care. A quality index score representing facility infrastructure, staff, and supply characteristics was assigned to each facility. We use descriptive statistics to compare distance and quality between the nearest available facility and visited facility among women who bypassed the nearest facility. Facility distance and quality comparisons were also stratified by poverty status. Logistic regression models were used to measure associations between the quality and distance to the nearest facility and bypassing for each outcome. The majority of women bypassed the nearest facility regardless of service sought. Women bypassing for delivery traveled the furthest and had the fewest facility options near their residential cluster. Poor women bypassing for delivery traveled 4.5 km further than non-poor women. Among women who bypassed, two thirds seeking delivery and approximately 46% seeking facility-based contraception or child health services bypassed to a public hospital. Both poor and non-poor women bypassed to higher quality facilities. Our findings suggest that women in five cities in Kenya prefer public hospitals and are willing to travel further to obtain services at public hospitals, possibly related to free service availability. Over time, it will be important to examine service quality and availability in public sector facilities with reduced or eliminated user fees, and whether it lends itself to a continuum of care where women can visit one facility for multiple services reducing travel burden.Electronic supplementary materialThe online version of this article (10.1007/s11524-017-0212-8) contains supplementary material, which is available to authorized users.

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Health-care availability, preference, and distance for women in urban Bo, Sierra Leone

Abstract: The diverse health-care marketplace in Bo allows women to select clinical facilities from across the city. Most women prefer a malaria care provider farther from home than they could comfortably walk when ill.

Cited by 16 publications

References 30 publications

Magnitude of maternal near misses and the role of delays in Ethiopia: a hospital based cross-sectional study

Magnitude of maternal near misses and the role of delays in Ethiopia: a hospital based cross-sectional study

The prevalence of type 2 diabetes in urban Bo, Sierra Leone, and in the 16 countries of the West Africa region

The Role of Distance and Quality on Facility Selection for Maternal and Child Health Services in Urban Kenya

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