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

Maternal and child health indicators in Sierra Leone are amongst the worst in the world.  Despite progress, the country is not on track to achieving MDG4 (reduce child mortality) or MDG5 (improve maternal mortality).This study assesses rural women’s levels of knowledge about maternal and child health in Sierra Leone and identifies the practices they use to seek treatment or prevent poor health. This study also examines the effect of husbands’ involvement on maternal and child health.Methods

• The study was carried out in March 2012 in five villages in the rural Bombali district of northern Sierra Leone
• Households with at least one woman with a child under five years old were selected.  In total 244 mothers in 244 different households were included
• Structured questionnaires and interviews were conducted in local languages at participants’ home
• Questionnaire data was analysed using statistical software.  An overall health knowledge score was derived for each participant based on the number of correct responses to health knowledge questions.  Linear regression models were used to assess factors influencing health knowledge scores. 

Key Findings

• The mean overall health knowledge score was 62% and varied widely (18% - 91%)
• Higher levels of education had a significant influence on health knowledge scores.  Each unit increase of education was associated with a 2% increase in health knowledge scores
• Husbands’ role scores did not significantly influence health knowledge scores
• Participants’ knowledge was inadequate for various health parameters, including diarrhoea, malaria, pneumonia, and HIV/AIDS prevention and management
• Inappropriate health seeking behaviour was reported, for example, half of respondents reported taking a seriously unwell child to a relative, 30% would buy  medicines from local person, including 'unregulated pharmacies', compared to only 16% who would immediately take the child to a clinic.
• Household hygiene and sanitation practices and facilities were found to be largely poor.

Conclusions & recommendations

• This study finds that women’s knowledge on maternal and child health care are inadequate in rural Sierra Leone
• Improved health knowledge is essential to achieving the Millennium Development Goals, including those which relate to improved mortality among children (MDG 4) and improved maternal health (MDG 5)
• Health education activities targeting knowledge and practices are recommended to improve maternal and child survival 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.

To read the article for free, click here.  No subscription required.Kanu, J. S., Tang, Y., & Liu, Y. (2014). Assessment on the knowledge and reported practices of women on maternal and child health in rural Sierra Leone: a cross-sectional survey. PloS One, 9(8), e105936.