Health knowledge and health practices in Makeni, Sierra Leone: a community-based household survey.

BACKGROUND We characterize health knowledge and practices in urban and rural Makeni, Sierra Leone, drawing comparisons between areas served by community health workers (CHWs) with those that are not. We also inquire about causes of infant and maternal mortality and how they are understood in the local context. Our objective was to provide a baseline understanding of health knowledge and practices in Makeni during the implementation of a CHW program. METHODS We conducted 100 household interviews in Makeni City and rural villages in the surrounding area. We compared data between urban and rural areas to identify differences in health knowledge and practices. RESULTS Our sample size covered 855 individuals. Insecticide treated bednet ownership was lower in urban settings compared to rural populations (58% vs 94%; p<.001). With regards to maternal mortality, most respondents indicated 'no clinic' (lack of clinical care or skipped antenatal care visits) as the primary cause (n=35), followed by bleeding (n=17), 'lack of blood' (anemia) (n=11) and 'will of God' (n=11). CONCLUSIONS This initial survey of health knowledge and practices in rural and urban Makeni, Sierra Leone, highlights some simple opportunities for community health promotion, health education programming and behavioral interventions. Findings will inform future iterations of a CHW training module for community health education.

[1]  R. Groen,et al.  Free Health Care for Under 5 Year Olds Increases Access to Surgical Care in Sierra Leone: An Analysis of Case Load and Patient Characteristics , 2013, World Journal of Surgery.

[2]  A. George,et al.  Spoiled breast milk and bad water; local understandings of diarrhea causes and prevention in rural Sierra Leone , 2013, BMC Public Health.

[3]  J. T. Boerma,et al.  Maternal education and child survival: a comparative study of survey data from 17 countries. , 1993, Social science & medicine.

[4]  J. Caldwell,et al.  Education as a factor in mortality decline: an examination of Nigerian data , 1979 .

[5]  D. Pelletier,et al.  An analysis of anemia and pregnancy-related maternal mortality. , 2001, The Journal of nutrition.

[6]  M. Mathai,et al.  Status of Emergency Obstetric Care in Six Developing Countries Five Years before the MDG Targets for Maternal and Newborn Health , 2012, PloS one.

[7]  S. Hodgins,et al.  From research to national expansion: 20 years' experience of community-based management of childhood pneumonia in Nepal. , 2008, Bulletin of the World Health Organization.

[8]  Yuan Tang,et al.  Assessment on the Knowledge and Reported Practices of Women on Maternal and Child Health in Rural Sierra Leone: A Cross-Sectional Survey , 2014, PloS one.

[9]  Daniel R Hogan,et al.  Who Library Cataloguing-in-publication Data , 2022 .

[10]  S. Honda,et al.  Determinants of health facility utilization for childbirth in rural western Kenya: cross-sectional study , 2014, BMC Pregnancy and Childbirth.

[11]  Hannah E Knight,et al.  Why Are Women Dying When They Reach Hospital on Time? A Systematic Review of the ‘Third Delay’ , 2013, PloS one.

[12]  Sowmya R. Rao,et al.  Healthcare seeking for diarrhoea, malaria and pneumonia among children in four poor rural districts in Sierra Leone in the context of free health care: results of a cross-sectional survey , 2013, BMC Public Health.

[13]  M. Hodges,et al.  High level of Schistosoma mansoni infection in pre-school children in Sierra Leone highlights the need in targeting this age group for praziquantel treatment. , 2012, Acta tropica.

[14]  A. Haines,et al.  Achieving child survival goals: potential contribution of community health workers , 2007, The Lancet.

[15]  M. Hodges,et al.  Schistosoma mansoni infection after three years of mass drug administration in Sierra Leone , 2014, Parasites & Vectors.

[16]  A. Lindstrand,et al.  Increased Use of Community Medicine Distributors and Rational Use of Drugs in Children Less than Five Years of Age in Uganda Caused by Integrated Community Case Management of Fever , 2012, The American journal of tropical medicine and hygiene.

[17]  Mirko S. Winkler,et al.  Baseline health conditions in selected communities of northern Sierra Leone as revealed by the health impact assessment of a biofuel project. , 2014, International health.

[18]  R. Scherpbier,et al.  Countdown to 2015 decade report (2000-2010) with country profiles. Taking stock of maternal newborn and child survival. , 2010 .

[19]  D. Hamer,et al.  Community Case Management of Fever Due to Malaria and Pneumonia in Children Under Five in Zambia: A Cluster Randomized Controlled Trial , 2010, PLoS medicine.

[20]  M. Hodges,et al.  Albendazole therapy and reduced decline in haemoglobin concentration during pregnancy (Sierra Leone). , 2001, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[21]  M. Bockarie,et al.  Impact of Three Rounds of Mass Drug Administration on Lymphatic Filariasis in Areas Previously Treated for Onchocerciasis in Sierra Leone , 2013, PLoS neglected tropical diseases.

[22]  Joy Lawn,et al.  Countdown to 2015 decade report (2000–10): taking stock of maternal, newborn, and child survival , 2010, The Lancet.

[23]  Bernadette A. Thomas,et al.  Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010 , 2012, The Lancet.