Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey

Peter Bai James; George Yendawa; Abdulai  Jawo Bah; Augustus Osborne; Sylvia Satta Kpagoi; Emmanuel Kamanda Margao; Jia Bainga Kangbai; Jon Wardle

doi:10.1186/s12884-023-06126-y

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Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey

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Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey

Peter Bai James, George Yendawa, Abdulai Jawo Bah, Augustus Osborne, Sylvia Satta Kpagoi, Emmanuel Kamanda Margao, Jia Bainga Kangbai and Jon Wardle

BMC pregnancy and childbirth, Vol.23, 810

22/11/2023

DOI: https://doi.org/10.1186/s12884-023-06126-y

Appears in Recent National Centre for Naturopathic Medicine Publications

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Abstract

Low and middle income countries

Homebirth

Women's Empowerment

Healthcare seeking behavior

Sierra Leone

Public health

Midwifery not elsewhere classified

Background A nationwide assessment of the link between women’s empowerment and homebirth has not been fully examined in Sierra Leone. Our study examined the association between women’s empowerment and homebirth among childbearing women in Sierra Leone using the 2019 Sierra Leone Demographic Health Survey (2019 SLDHS) data. Method We used the individual file (IR) of the 2019 SLDHS dataset for our analysis. A total of 7377 women aged 15–49 years who gave birth in the five years preceding the survey were included. Outcome variable was “home birth of their last child among women in the five years preceding the 2019 SLDHS. Women’s empowerment parameters include women’s knowledge level, economic participation, decision-making ability and power to refuse the idea of intimate partner violence. We used the complex sample command on SPSS version 28 to conduct descriptive and multivariate logistic regression analyses. Results Three in every 20 women had home childbirth (n = 1177; 15.3%). Women with low [aOR 2.04; 95% CI 1.43–2.92] and medium [aOR 1.44; 95%CI 1.05–1.97] levels of knowledge had higher odds of giving birth at home compared to those with high levels of knowledge. Women who did not have power to refuse the idea of intimate partner violence against women were more likely to had given birth at home [aOR 1.38; 95% CI1.09-1.74]. In addition, women with no [aOR 2.71; 95% CI1.34-5.46) and less than four antenatal care visits [aOR 2.08; 95% CI:1.51–2.88] and for whom distance to a health facility was a major problem [aOR 1.95; 95% CI1.49-2.56] were more likely to have had a homebirth. However, no statistically significant association was observed between a women’s decision-making power and home birth [aOR 1.11; 95% CI 0.86–1.41]. Conclusion Despite improvements in maternal health indicators, homebirth by unskilled birth attendants is still a public health concern in Sierra Leone. Women with low knowledge levels, who did not have power to refuse the idea of intimate partner violence against women, had less than four ANC visits and considered distance to a health facility as a major problem had higher odds of giving birth at home. Our findings reflect the need to empower women by improving their knowledge level through girl child and adult education, increasing media exposure, changing societal norms and unequal power relations that promote gender-based violence against women, and improving roads and transport infrastructure.

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Title: Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey
Creators: Peter Bai James (Author) - Southern Cross University
George Yendawa (Author) - Case Western Reserve University School of Medicine
Abdulai Jawo Bah (Author) - University of Sierra Leone
Augustus Osborne (Author) - Njala University
Sylvia Satta Kpagoi (Author) - Ministry of Health and Sanitation
Emmanuel Kamanda Margao (Author) - University of Sierra Leone
Jia Bainga Kangbai (Author) - Njala University
Jon Wardle (Author) - Southern Cross University
Publication Details: BMC pregnancy and childbirth, Vol.23, 810
Publisher: BioMed Central Ltd.
Identifiers: 991013150513002368
Academic Unit: National Centre for Naturopathic Medicine
Language: English
Resource Type: Journal article

Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey

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