Assessment of reproductive health care services during Ebola in Sierra Leone

The Ebola outbreak in Sierra Leone had a significant impact on women’s access to reproductive health care, through both reduced availability of services and changes in communities’ decisions to seek care. We carried out a rapid assessment of provision of services and reproductive health care-seeking behaviour for UNFPA.

The study evaluated the impact of Ebola on reproductive health services and explored attitudes, practices, perceptions and challenges in health-seeking behaviour amongst women and adolescents in the context of the Ebola outbreak. We analysed key data, including Health Management Information System (HMIS) and Emergency Obstetric and Newborn Care (EmONC) facility assessment data, and interviewed health providers and community members to explore the impact of Ebola on demand- and supply-side factors affecting use of reproductive health services and the consequent impact on health outcomes.

The study found that between May 2014 and April 2015, maternal deaths increased by 22% and newborn deaths increased by 25%, solely as a result of reduced access to routine health services. Population coverage of essential reproductive health service interventions declined, although owing to highly irregular patterns in the number of monthly family planning visits before the Ebola outbreak, there is no statistical evidence that family planning visits declined more than usual after May 2014.

Project achievements:

Our findings were shared with partners nationally, and in affected districts. They were used to develop strategies and interventions to strengthen reproductive health services, so as to help minimise the impact of the world’s worst Ebola outbreak on women, newborn and children’s health across Sierra Leone.