Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey
Abstract 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...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-023-06126-y |
| _version_ | 1797451134796824576 |
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| author | Peter Bai James George A Yendewa Abdulai Jawo Bah Augustus Osborne Satta Sylvia Kpagoi Emmanuel Kamanda Margao Jia Kangbai Jon Wardle |
| author_facet | Peter Bai James George A Yendewa Abdulai Jawo Bah Augustus Osborne Satta Sylvia Kpagoi Emmanuel Kamanda Margao Jia Kangbai Jon Wardle |
| author_sort | Peter Bai James |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-03-09T14:50:28Z |
| format | Article |
| id | doaj.art-7d638d23cb244206b841fa85a8951fa7 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-09T14:50:28Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-7d638d23cb244206b841fa85a8951fa72023-11-26T14:31:29ZengBMCBMC Pregnancy and Childbirth1471-23932023-11-0123111210.1186/s12884-023-06126-yDo disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health surveyPeter Bai James0George A Yendewa1Abdulai Jawo Bah2Augustus Osborne3Satta Sylvia Kpagoi4Emmanuel Kamanda Margao5Jia Kangbai6Jon Wardle7National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross UniversityDepartment of Medicine, Case Western Reserve University School of MedicineFaculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra LeoneDepartment of Biological Sciences, School of Environmental Sciences, Njala UniversityBo Government Hospital, Ministry of Health and SanitationFaculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra LeoneSchool of Community Health Sciences, Njala UniversityNational Centre for Naturopathic Medicine, Faculty of Health, Southern Cross UniversityAbstract 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.https://doi.org/10.1186/s12884-023-06126-yHomebirthWomen’s empowermentSierra Leone |
| spellingShingle | Peter Bai James George A Yendewa Abdulai Jawo Bah Augustus Osborne Satta Sylvia Kpagoi Emmanuel Kamanda Margao Jia Kangbai Jon Wardle Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey BMC Pregnancy and Childbirth Homebirth Women’s empowerment Sierra Leone |
| title | Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey |
| title_full | Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey |
| title_fullStr | Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey |
| title_full_unstemmed | Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey |
| title_short | Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey |
| title_sort | do disempowered childbearing women give birth at home in sierra leone a secondary analysis of the 2019 sierra leone demographic health survey |
| topic | Homebirth Women’s empowerment Sierra Leone |
| url | https://doi.org/10.1186/s12884-023-06126-y |
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