Ebola-Related Complications for Maternal, Newborn, and Child Health Service Delivery and Utilization in Guinea

Abstract

Guinea was one of the three most affected countries in the largest, longest, and deadliest outbreak of Ebola Virus Disease ever recorded. Throughout the outbreak, information on the effects of Ebola on health service delivery and utilization was needed in order to understand the full impact of the outbreak and to inform planning and resource allocation in response to the challenges created by the sudden and severe health crisis. The authors were involved in a rapid assessment conducted to better understand how the delivery and utilization of routine maternal, newborn and child health (MNCH) services were affected by the Ebola outbreak in Guinea. The assessment used data collected January–February 2015 in a convenience sample of public and private facilities in areas of the country that were Ebola infection active, changing and inactive. Monthly data on a number of MNCH services were collected by facility record abstraction, and structured interviews were held with facility directors and MNCH service providers. Results obtained from 45 facilities indicated significant declines in outpatient visits and child health services. However, negative effects on service availability (such as reduced hours, closures, and service suspensions) appeared to be regional and/or facility-specific. Improved infection control behaviors were reported by a majority of providers, but were not universal. A positive finding was that the reporting of routine data between health facilities and districts was not negatively affected by the Ebola epidemic.