The effect of Ebola virus disease on maternal health service utilisation and perinatal outcomes in West Africa: a systematic review

Abstract

Background Ebola outbreaks pose a major threat to global public health, especially in Sub-Saharan Africa. These outbreaks disrupt the already fragile maternal health services in West Africa. The aims of this study is to assess the effect of Ebola virus disease (EVD) on maternal health service utilisation and perinatal outcomes. Methods This systematic review was conducted in West Africa, and the databases used were Medline, PubMed, CINAHL, Scopus, EMBASE and African journals online. Studies that reported the effect of the Ebola outbreak on maternal health services in West Africa were eligible for this systematic review. The search was limited to articles written in the English language only and published between 2013 and 2020. Three authors independently appraised the articles, and the data were extracted using a standardised data extraction format. The findings were synthesised using a narrative summary, tables, and figures. Results Twelve studies met the inclusion criteria and were used for this systematic review synthesis. The results showed that antenatal care significantly decreased during Ebola virus disease and strove to recover post-Ebola virus disease. Women were less likely to have institutional childbirth during Ebola virus disease and struggled to recover post-Ebola virus disease. In addition, this review revealed a substantially higher rate of maternal mortality post EVD than those observed before or during the outbreak. Conclusion Based on our findings, antenatal care, institutional childbirth, and postnatal care are attempting to recover post-Ebola virus disease. We recommended that responsible bodies and stakeholders need to prepare locally tailored interventions to increase the number of women attending ANC, institutional childbirth, and PNC services post-EVD and future outbreaks including COVID-19. In order to build trust, creating community networks between health care providers and trusted community leaders may increase the number of women attending antenatal care (ANC), institutional childbirth and postnatal care (PNC) post-EVD and during future outbreaks. Further studies are needed to examine health centre and hospital availability and accessibility, and capacity to deliver maternal health services post-Ebola virus disease and future outbreaks.

Childhood Hepatitis B Immunization Coverage and Barriers in Sierra Leone, Liberia, and Guinea: Analysis of National Surveys (2018-2020)

“…Guinea is the most populous of the three countries (15.5 million), while Sierra Leone and Liberia had population estimates of 8.14 million and 5.18 million in 2021, respectively [12]. Furthermore, the three countries share a recent history of civil warfare (1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001) and new public health challenges, including the largest Ebola outbreak in history (2014-2016)-all of which have aligned to further weaken already fragile local healthcare systems [13,14]. Additionally, all three countries are grappling with major HBV epidemics.…”

Determinants of incomplete childhood hepatitis B vaccination in Sierra Leone, Liberia, and Guinea: Analysis of national surveys (2018–2020)

“…Guinea is the most populous of the three countries (15.5 million), while Sierra Leone and Liberia had population estimates of 8.14 million and 5.18 million in 2021, respectively [12]. Furthermore, the three countries share a recent history of civil warfare (1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001) and new public health challenges, including the largest Ebola outbreak in history (2014-2016)all of which have aligned to further weaken the already fragile local healthcare systems [13,14]. Additionally, all three countries are grappling with major HBV epidemics.…”

Health care in pregnancy during the COVID‐19 pandemic and pregnancy outcomes in six low‐ and‐middle‐income countries: Evidence from a prospective, observational registry of the Global Network for Women’s and Children’s Health

“…Fear of contracting infection and lack of trust in the healthcare system may also adversely affect the demand for services. For example, during the Ebola virus outbreak in West Africa, many hospitals were closed because of transmission concerns, while available healthcare staff and resources were reallocated from routine health services to care for those with the virus 18,19 . Disruptions in access to healthcare services during pandemics often disproportionately impact the most vulnerable populations, including pregnant women, neonates and children, especially in resource‐constrained settings 8…”

“…COVID-19, Global Network, health care, low and middle-income countries, pregnancy concerns, while available healthcare staff and resources were reallocated from routine health services to care for those with the virus. 18,19 Disruptions in access to healthcare services during pandemics often disproportionately impact the most vulnerable populations, including pregnant women, neonates and children, especially in resource-constrained settings. 8 To minimise the impact of the ongoing COVID-19 pandemic on essential health services, and in particular, upon women's and newborns' health care, it is essential to understand the impact of the COVID-19 pandemic on healthcare service delivery and on pregnancy outcomes.…”