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Maternal and Child Health Services in the Context of the Ebola Virus Disease: Health Care Workers’ Knowledge, Attitudes and Practices in Rural Guinea

Alexandre Delamou(1), Sidikiba Sidibé(2), Alison M. El Ayadi(3), Bienvenu S. Camara(4), Thérèse Delvaux(5), Bettina Utz(6), Abdoulaye II Toure(7), Sah D. Sandouno(8), Alioune Camara(9), Abdoul H. Beavogui(10), Asm Shahabuddin(11), Karen Van der Veken(12), Bouchra Assarag(13), Junko Okumura(14), Vincent De Brouwere(15),


(1) Department of Public Health, Faculty of Medicine, University of Conakry, Guinea; Centre de formation et de recherche en santé rurale de Maferinyah, Forécariah, Guinea
(2) Department of Public Health, Faculty of Medicine, University of Conakry, Guinea; Centre de formation et de recherche en santé rurale de Maferinyah, Forécariah, Guinea
(3) Bixby Centre for Global Reproductive Health, University of California, San Francisco, USA
(4) Centre de formation et de recherche en santé rurale de Maferinyah, Forécariah, Guinea
(5) Women and Child Health Research Centre, Institute of Tropical Medicine, Antwerp, Belgium
(6) Women and Child Health Research Centre, Institute of Tropical Medicine, Antwerp, Belgium
(7) Department of Public Health, Faculty of Medicine, University of Conakry, Guinea
(8) Department of Public Health, Faculty of Medicine, University of Conakry, Guinea
(9) Department of Public Health, Faculty of Medicine, University of Conakry, Guinea
(10) Centre de formation et de recherche en santé rurale de Maferinyah, Forécariah, Guinea
(11) Women and Child Health Research Centre, Institute of Tropical Medicine, Antwerp, Belgium
(12) Women and Child Health Research Centre, Institute of Tropical Medicine, Antwerp, Belgium
(13) Ecole nationale de santé publique, Rabat, Morocco
(14) Institute of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
(15) Women and Child Health Research Centre, Institute of Tropical Medicine, Antwerp, Belgium
Corresponding Author

Abstract


The objective of this study was to document maternal and child health care workers‘ knowledge, attitudes and practices on service delivery before, during and after the 2014 EVD outbreak in rural Guinea. We conducted a descriptive cross-sectional study in ten health districts between October and December 2015, using a standardized self-administered questionnaire. Overall 299 CHWs (94% response rate) participated in the study, including nurses/health technicians (49%), midwives (23%), managers (16%) and physicians (12%). Prior to the EVD outbreak, 87% of CHWs directly engaged in managing febrile cases within the facility, while the majority (89% and 63%) referred such cases to another facility and/or EVD treatment centre during and after the EVD outbreak, respectively. Compared to the period before the EVD outbreak when approximately half of CHWs (49%) reported systematically measuring body temperature prior to providing any care to patients, most CHWs reported doing so during (98%) and after the EVD outbreak (88%). The main challenges encountered were the lack of capacity to screen for EVD cases within the facility (39%) and the lack of relevant equipment (10%). The majority (91%) of HCWs reported a decrease in the use of services during the EVD outbreak while an increase was reported by 72% of respondents in the period following the EVD outbreak. Infection prevention and control measures established during the EVD outbreak have substantially improved self-reported provider practices for maternal and child health services in rural Guinea. However, more efforts are needed to maintain and sustain the gain achieved. (Afr J Reprod Health 2017; 21[1]: 104-113).

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