Assessment on the Knowledge and Reported Practices of Women on Maternal and Child Health in Rural Sierra Leone: A Cross-Sectional Survey

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Abstract

Background

Globally, Sierra Leone is ranked among the countries with the worst maternal and child health indicators. The mortality of women and children is significantly higher compared with other developing countries. The death of women and children can be prevented by simple cost-effective community-based interventions. The aim of this present study was to learn the knowledge levels of women on maternal and child health, and treatment-seeking and preventive behaviours in rural Sierra Leone and provide appropriate suggestions for policy makers. Moreover, the study also aimed to evaluate the effect of a husband’s involvement on health knowledge and practices of women in rural Sierra Leone.

Methods

Women with at least a child of five years or below were interviewed in their households through a structured questionnaire. Characteristics of the households and of the respondents were collected and the number of correct answers given to the health knowledge and practice questions and their percentage distributions were tabulated and an overall health knowledge score was calculated.

Results

The mean score of the derived overall health-related knowledge was 61.6% (maximum of 91% and a minimum of 18%) with a standard deviation of 14.7% and a median of 63.3%. Multivariable regression analyses showed education and number of pregnancies are associated with knowledge score, with significantly improved health knowledge scores amongst those who accessed higher education. There were some inappropriate practices in hygiene and sanitation. However, vaccination coverage was high with almost 100% coverage for BCG.

Conclusions

Based on the findings of this study, women’s knowledge on maternal and child health care are inadequate in rural Sierra Leone. Health promotion activities focusing on prevention of diarrhoea, malaria and pneumonia, improvement in health-related knowledge on pregnancy, delivery, neonatal care and environmental sanitation would be invaluable.

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Most cited references 14

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Maternal mortality associated with hypertensive disorders of pregnancy in Africa, Asia, Latin America and the Caribbean.

L Duley (1992)

To present estimates of maternal mortality associated with hypertensive disorders of pregnancy in Africa, Asia, Latin America and the Caribbean, and to discuss strategies to prevent these deaths. Retrospective review of all available data. Database of the World Health Organization's Maternal Health and Safe Motherhood Programme. Estimates of the total maternal mortality and the proportions of deaths associated with hypertensive disorders of pregnancy. Estimates of mortality associated with hypertensive disorders of pregnancy were similar in Africa, Latin America and the Caribbean, despite considerably higher total mortality in Africa. Variations in both overall mortality and that associated with hypertensive disorders of pregnancy were greatest in Asia. Despite their limitations, these data suggest that between 10-15% of maternal deaths are associated with hypertensive disorders of pregnancy, and that 10% are associated with eclampsia. Where maternal mortality is relatively high, the excess is likely to be due to a high mortality associated with haemorrhage and infection and reductions are most likely to come from reductions in these deaths. Evidence from both developed and developing countries suggests that deaths associated with hypertensive disorders of pregnancy are the most difficult to prevent. More rigorous assessment of interventions designed to prevent these deaths is urgently required.

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The influence of economic development level, household wealth and maternal education on child health in the developing world.

P Melacini, Christopher Hong, Katholiki Georgiades … (2006)

This study estimates the relative importance to child health (indicated by weight and height for age) of economic development level [gross domestic product (GDP) converted to international dollars using purchasing power parity (PPP) rates: GDP-PPP], household wealth and maternal education and examines the modifying influence of national contexts on these estimates. It uses information collected from mothers aged 15-49-years participating in Demographic Health Surveys (DHS) conducted in 42 developing countries. In multilevel regression models, the three study variables exhibited strong independent associations with child health: GDP-PPP accounted for the largest amount of unique variation, followed by maternal education and household wealth. There was also substantial overlap (shared variance) between maternal education and the other two study variables. The regressions of child health on household wealth and maternal education exhibited substantial cross-national variation in both strength and form of association. Although higher education levels were associated with disproportionately greater returns to child health, the pattern for household wealth was erratic: in many countries there were diminishing returns to child health at higher levels of household wealth. We conclude that there are inextricable links among different strategies for improving child health and that policy planners, associating benefits with these strategies, must take into account the strong moderating impact of national context.

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Maternal education and child survival in developing countries: the search for pathways of influence.

Edward Cleland, Jack van Loon (1987)

During the past two decades a considerable amount of information has become available from developing countries showing that maternal education has a strong impact on infant and child mortality. On average each one-year increment in mother's education corresponds with a 7-9% decline in under-5s' mortality. Education exercises a stronger influence in early and later childhood than in infancy. The central theme of this paper is to assess the various mechanisms or intervening factors which could explain how mother's education influences the health and survivorship of her children. Two of the possible intervening variables, namely reproductive health patterns and more equitable treatment of sons and daughters, play a relatively minor role in the explanation of the relationship. Economic advantages associated with education (i.e. income, water and latrine facilities, housing quality, etc.) account for about one-half of the overall education-mortality relationship. The influence of use of preventive and curative health services as a group of intervening variables is complex and variable. There are countries whose primary health services are so weak that they have no effect on the health of mothers and children; there are also other countries whose health services may tend to accentuate educational disparities because of differential access. Little is known about the intervening role of health beliefs and domestic practices, but it is hypothesized that they are important in the explanation of the education-mortality relationship. Finally, suggestions for specific studies on mechanisms or intervening factors are made and the relevance of such studies for formulation of health and educational policies is stressed.

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Author and article information

Contributors

Andrew Vallely: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, USA )

ISSN (Electronic): 1932-6203

Publication date Collection: 2014

Publication date (Electronic): 28 August 2014

Volume: 9

Issue: 8

Electronic Location Identifier: e105936

Affiliations

[1]Department of Epidemiology & Biostatistics, School of Public Health, Jilin University, Changchun City, Jilin Province, P. R. China

University of New South Wales, Australia

Author notes

* E-mail: ywliu@ 123456jlu.edu.cn

Competing Interests: The authors have declared that no competing interests exist.

Conceived and designed the experiments: JSK YL. Performed the experiments: JSK. Analyzed the data: JSK YT YL. Contributed reagents/materials/analysis tools: YL. Wrote the paper: JSK YL.

Article

Publisher ID: PONE-D-13-11347

DOI: 10.1371/journal.pone.0105936

PMC ID: 4148396

PubMed ID: 25166504

SO-VID: 916ee30a-72d0-4bf0-b42b-75f4818d1720

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 17 March 2013

Date accepted : 30 July 2014

Page count

Pages: 13

Funding

This study was supported by grants from the National Natural Science Foundation of China (30870952) and Science and Technology Department of Jilin Province (200905185, 20080735). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Assessment on the Knowledge and Reported Practices of Women on Maternal and Child Health in Rural Sierra Leone: A Cross-Sectional Survey

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PLOS Global Public Health

Most cited references 14

Maternal mortality associated with hypertensive disorders of pregnancy in Africa, Asia, Latin America and the Caribbean.

The influence of economic development level, household wealth and maternal education on child health in the developing world.

Maternal education and child survival in developing countries: the search for pathways of influence.

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