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Introduction <p>Sub-Saharan Africa and Sierra Leone bear one of the world’s highest maternal mortality rates. In rural Sierra Leone, 19% of births occur at home, contributing to high maternal mortality ratios. This study aims to identify characteristics and reasons for home births among women in the rural Mathonkara Catchment area in Sierra Leone.</p> Methods <p>A cross-sectional survey was conducted among 555 women of childbearing age in the Mathonkara Catchment area, Tonkolili district. Data was collected between February 25 and May 12, 2023. A structured questionnaire assessed birthplaces, demographic characteristics, maternal health indicators, care seeking behaviours, and previous experiences of care at health facilities.</p> Results <p>The prevalence of home births was 26.67%. Characteristics associated with home births include the experience of feeling like health care workers did not care about your life (AOR = 19.11; 95% CI:1.57-799.61), a distance of &gt; 1&#xa0;km to the nearest health facility (AOR = 7.15; 95% CI:3.12–16.51), ≤ 3 antenatal care visits (AOR = 4.84; 95% CI:2.37–10.14), and previous homebirths (AOR = 4.17; 95% CI:2.42–7.30). Common reasons for home births were labour occurring at nighttime, transportation costs and availability, and health care service costs.</p> Conclusions for Practice <p>The factors influencing home births in rural Sierra Leone are multifaceted. To improve maternal outcomes, it is crucial to address the challenges that impede facility-based births, including quality of care and respectful care at health facilities, distance, economic costs of reaching facilities, and transportation challenges such as quality of roads and availability of transportation.</p>

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Characteristics and Determinants for Home Births in Rural Sierra Leone: A Cross-Sectional Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月2日

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  • Jenny Wussow,
  • Tatyana D. Fedorova,
  • Moses Ibrahim Conteh,
  • Sebastian Starling,
  • Rosa Roemers,
  • Amadu Wurie Bah,
  • Ishmael Abu Kalokoh,
  • Haja Sarrah Sheriff,
  • Abubakarr Dumbuya,
  • Zainab Matilda Sankoh,
  • Håkon Angell Bolkan,
  • Josien Westendorp,
  • Rugiatu Jalloh,
  • Lena Skovgaard Andersen,
  • Monica Lauridsen Kujabi

摘要

Introduction

Sub-Saharan Africa and Sierra Leone bear one of the world’s highest maternal mortality rates. In rural Sierra Leone, 19% of births occur at home, contributing to high maternal mortality ratios. This study aims to identify characteristics and reasons for home births among women in the rural Mathonkara Catchment area in Sierra Leone.

Methods

A cross-sectional survey was conducted among 555 women of childbearing age in the Mathonkara Catchment area, Tonkolili district. Data was collected between February 25 and May 12, 2023. A structured questionnaire assessed birthplaces, demographic characteristics, maternal health indicators, care seeking behaviours, and previous experiences of care at health facilities.

Results

The prevalence of home births was 26.67%. Characteristics associated with home births include the experience of feeling like health care workers did not care about your life (AOR = 19.11; 95% CI:1.57-799.61), a distance of > 1 km to the nearest health facility (AOR = 7.15; 95% CI:3.12–16.51), ≤ 3 antenatal care visits (AOR = 4.84; 95% CI:2.37–10.14), and previous homebirths (AOR = 4.17; 95% CI:2.42–7.30). Common reasons for home births were labour occurring at nighttime, transportation costs and availability, and health care service costs.

Conclusions for Practice

The factors influencing home births in rural Sierra Leone are multifaceted. To improve maternal outcomes, it is crucial to address the challenges that impede facility-based births, including quality of care and respectful care at health facilities, distance, economic costs of reaching facilities, and transportation challenges such as quality of roads and availability of transportation.