Facility-based deliveries were reduced by approximately 8% during the Ebola epidemic in rural Liberia, according to a study by John Kraemer from the Georgetown University, Washington, DC, USA, and colleagues, published in PLOS Medicine.
The researchers conducted a survey to develop a representative sample of births in Rivercess County, Liberia, a part of the country with relatively limited Ebola transmission. Controlling for potential confounders, the researchers compared the odds of facility-based delivery among 686 births in the period before the Ebola epidemic with 212 births during the epidemic. They observed that the odds of facility-based delivery were 41% lower among women who reported a belief that Ebola was or may be transmitted in health facilities, but not significantly lower among women who reported believing that Ebola was not transmitted in health facilities. Because health facilities never closed in Rivercess County, this estimate may under-approximate the effect seen in the most heavily affected areas.
The authors say: "Though health systems were most drastically affected in locations where Ebola transmission directly affected healthcare workers and facilities, our results suggest that significant collateral health effects also occurred in relatively lightly affected regions"
Source: PLOS