Women In Liberia Research Articles

Gendered Impacts of the COVID-19 Pandemic on Marginalized Women in Liberia: Resilience and Enduring Challenges

Gendered Impacts of the COVID-19 Pandemic on Marginalized Women in Liberia: Resilience and Enduring Challenges

Associations between child marriage and reproductive and maternal health outcomes among young married women in Liberia and Sierra Leone: A cross-sectional study.

Child marriage has been associated with a range of negative maternal and reproductive health outcomes. This study explored these associations in Liberia and Sierra Leone and examined how child marriage intersected with other measures of social disadvantage. Data were derived from 631 and 1,325 married or cohabitating women aged 20-24 interviewed in the 2019-2020 Liberia and 2019 Sierra Leone Demographic and Health Surveys, respectively. Analyses were stratified by country. Regression models examined associations between age at first marriage (<15, 15-17, and 18+ years) and reproductive and maternal health outcomes, as well as interactions between child marriage and measures of social disadvantage. Multivariable regression results were presented as adjusted odds ratios and 95% confidence intervals. Over half of currently married/cohabitating women aged 20-24 in Liberia (52%) and Sierra Leone (54%) married before age 18, and over one in 10 married before age 15. In both countries, after adjusting for other factors, being married before the age of 18 was significantly associated with early fertility, high fertility, and low fertility control. Associations were particularly strong among women who first married before age 15. In Liberia, women who married at age 15-17 had significantly lower odds of skilled attendance at delivery and institutional delivery if they lived in the North Central region. Sierra Leonean women who married before age 15 had lower odds of institutional delivery and lower odds of four or more ANC visits if they lived in the North Western region. This study found clear associations between child marriage and negative reproductive health outcomes in Liberia and Sierra Leone, with stronger associations among women married in early adolescence. Child marriage and region of residence intersected to shape young women's access to skilled attendance at birth and institutional delivery. These findings call for further investigation and targeted intervention.

Comprehensive knowledge about HIV/AIDS and associated factors among reproductive age women in Liberia

IntroductionAcquired Immune Deficiency Syndrome (AIDS) continues to be a deadly pandemic and a serious threat to public health. Globally, reproductive age women are more likely to be infected with Human Immunodeficiency Virus (HIV). Comprehensive knowledge about HIV/AIDS is pivotal in the fight against AIDS. However, comprehensive HIV/AIDS knowledge is low in Sub-Saharan African (SSA) nations including Liberia, which contributes to the high incidence of HIV in these nations. This study assessed the level of comprehensive knowledge about HIV/AIDS and its associated factors among reproductive age women in Liberia.MethodsThe prevalence and associated factors of comprehensive knowledge about HIV/AIDS among reproductive age women in Liberia were determined using secondary data analysis of 2019–2020 Liberia Demographic and Health Surveys (LDHS). Comprehensive knowledge about HIV/AIDS was a composite variable computed from six variables available in the Demographic and Health Survey (DHS). The study included 7,621 reproductive age women in weighted samples. A generalized linear mixed model with robust error variance was used. For the variables included in the final model, adjusted prevalence ratios (aPR) with 95% confidence intervals (CI) were calculated.ResultsThe prevalence of comprehensive HIV/AIDS knowledge among Liberian women aged 15–49 was 33.5%. Women’s age and education, and distance to health facility were positively associated with comprehensive knowledge about HIV/AIDS among Liberian reproductive age women. In contrast, community poverty level was negatively associated with comprehensive knowledge about HIV/AIDS.Conclusion and recommendationsThis study demonstrates that the prevalence of good comprehensive HIV/AIDS knowledge was relatively low among reproductive age women in Liberia. Hence, health practitioners and policymakers should strengthen HIV/AIDS sensitization programmes to increase women’s knowledge about HIV/AIDS.

Anaemia and Dietary Diversity among Pregnant Women in Margibi and Grand Cape Mount Counties, Liberia.

Background: Globally, anaemia remains a severe public health concern among women of reproductive ages, including pregnant women in developing countries such as Liberia. Poor dietary diversity is a major contributor to micronutrient deficiencies. However, there is limited documentation of anaemia prevalence and dietary diversity among pregnant women in Liberia. Objective: The present study assessed the prevalence of anaemia and dietary diversity among pregnant women in the Margibi and Grand Cape Mount Counties in Liberia. Methods: The study design was cross-sectional. Systematic sampling was used to recruit 139 pregnant women between 15-49 years from antenatal clinics in Margibi and Grand Cape Mount counties. Dietary intake obtained from a 24-hour recall was used to assess dietary diversity following the FAO dietary diversity determination protocol for women in their reproductive ages. Anaemia was determined from blood obtained from finger pricks using a Hemocue. Results: Nearly all the pregnant women (98.1%) consumed grains. Conversely, only a few women (23.7%) consumed vitamin A-rich fruits and vegetables. Anaemia was discovered in 54% of the pregnant women. The mean haemoglobin level was 10.44 ± 1.46 g/dl. The mean Minimum Dietary Diversity among women of reproductive age (MDD-W) was 3.57±1.01. There was no significant association between anaemia and dietary diversity among 12 pregnant women. Poor dietary diversity was observed in 83.5% of the pregnant women,85.1% in Margibi and 80.8% in Grand Cape Mount, respectively. Conclusion: This study confirms evidence of anaemia and poor dietary diversity among pregnant women. It highlights evidence for the need to encourage and improve diversity in dietary intake. This can be achieved through awareness, education and knowledge of dietary diversity during pregnancy

A comparative study of machine learning algorithms for predicting domestic violence vulnerability in Liberian women

Domestic violence against women is a prevalent in Liberia, with nearly half of women reporting physical violence. However, research on the biosocial factors contributing to this issue remains limited. This study aims to predict women’s vulnerability to domestic violence using a machine learning approach, leveraging data from the Liberian Demographic and Health Survey (LDHS) conducted in 2019–2020.We employed seven machine learning algorithms to achieve this goal, including ANN, KNN, RF, DT, XGBoost, LightGBM, and CatBoost. Our analysis revealed that the LightGBM and RF models achieved the highest accuracy in predicting women’s vulnerability to domestic violence in Liberia, with 81% and 82% accuracy rates, respectively. One of the key features identified across multiple algorithms was the number of people who had experienced emotional violence.These findings offer important insights into the underlying characteristics and risk factors associated with domestic violence against women in Liberia. By utilizing machine learning techniques, we can better predict and understand this complex issue, ultimately contributing to the development of more effective prevention and intervention strategies.

Does Mobile Phone Tele-Reminder Increased Iron Status and Diet Quality of Pregnant Women Availing Antenatal Care Services at Phebe and Charles B. Dunbar Hospitals Bong County, Liberia A Cluster Randomized Control Trial

Anemia in pregnancy is a serious public health problem in Liberia. This study aimed to assess the effect of mobile phone tele-reminder on the iron status and diet quality of pregnant women in Liberia. A two-arm, double-blinded cluster randomized control trial was conducted in this study, with ANC screening rooms as a unit of randomization. At the Phebe and Charles B. Dunbar hospitals in Bong County, Liberia, 150 pregnant women who had never previously attended an ANC were recruited for the study (75 intervention women and 75 control women). Iron status measured as hemoglobin (g/dl) and diet quality were primary outcomes of this study. Secondary outcome measures were adherence to daily iron and folic acid supplementation and prevalence of anemia among pregnant women with malaria infection. The analysis was an intent-to-treat. The effect of the intervention on the primary study outcome (iron status) was examined using an independent sample t-test (for group-level analysis). Effects of treatment on diet quality was measured using the Fisher’s Exact Test. A binary logistic regression with a 95% Confidence Interval (CI) was used to analyze the effect of treatment on secondary outcomes. Pregnant women assigned to the intervention group had a significantly greater mean hemoglobin level after the two interventions, t (2.4) = 447, p&lt;0.05; d = 0.23). In the intervention group, there were significant odds in the consumption of 2-3 fish/meat/poultry products compared to the control group (93% versus 83%, adjusted odds ratio, 2.93; 95% CI, 0.99-8.70). A trend towards adherence to the IFA supplementation and an increase in consumption of iron-rich foods was observed. In Liberia, mobile phone tele-reminders appeared to be effective in improving iron status, diet quality, and IFA supplementation adherence when integrated into an existing antenatal care protocol.

Understanding the uptake of HIV testing among women in Liberia: the role of female genital mutilation/cutting

Past studies show that the processes of female genital mutilation/cutting (FGM/C) on women can increase their susceptibility to HIV infection. This is because genital tears or ruptures, scars and wounds from FGM/C may expose survivors to heightened risks of contracting sexually transmitted infections, including HIV, if they engage in unsafe sexual practices. Hence, there is the need to promote HIV screening and testing among this population. Yet, in Liberia, there is a dearth of studies exploring the uptake of HIV testing among women who have experienced FGM/C. To understand this relationship, we used the 2019–2020 Liberia Demographic and Health Survey (LDHS) and employed logistic regression analysis to answer the following questions: (1) Are FGM/C survivors less likely to have been tested for HIV compared to non-FGM/C women; and (2) How does this disparity in the uptake of HIV testing differ by women’s marital status? We found that survivors of FGM/C were less likely to have been tested for HIV than non-FGM/C women, even after accounting for theoretically relevant variables (OR = 0.83, p < 0.01). In response to our second question, we found that survivors of FGM/C who were formerly married were less likely to have been tested for HIV compared to their non-FGM/C counterparts (OR = 0.48, p < 0.01). These findings highlight the importance of trauma-informed HIV prevention strategies in Liberia, and the need for policymakers to take a holistic approach to addressing the challenges that FGM/C survivors, especially formerly married women, may face in accessing HIV prevention and testing services, and to work towards creating a more inclusive and supportive environment for all at-risk groups.

“Uncle Sugar’s Belles”

Abstract This article examines the confinement of Liberian women by US Army Forces in Liberia (USAFIL) for the purpose of regulated prostitution during World War II. The racial makeup of USAFIL as an overwhelmingly African American unit and its deployment to the only sovereign Black republic in Africa created what US Army officials called “an exceptional situation.” This essay explores what army leaders meant by “exceptional” and the resultant creation of “exceptional measures” to control sexual liaisons between American soldiers and women in Liberia. Sexual relations between Black GIs and Liberian women defied the racist segregationist logic used by American military leaders to police Black GIs’ sexuality elsewhere during the war. USAFIL officials consequently racialized venereal disease and prostitution to justify confining and regulating Black Liberian women’s bodies in the name of soldiers’ health, as well as to uphold their racial and military authority. Shifting perspectives, this case study then considers how women in Liberia resisted army regulation of their sexuality and what they gained and lost through sex work, despite their confinement. Finally, this essay analyzes USAFIL’s regulation of prostitution in a transnational comparative context to illuminate the exceptional authority US Army officials assumed and asserted over women and prostitution in Liberia.

The feasibility and acceptability of Project POWER: a mindfulness-infused, cognitive-behavioral group intervention to address mental and sexual health needs of young pregnant women in Liberia

BackgroundFollowing 14 years of civil war in Liberia, war exposure, gender-based violence, and extreme poverty have been identified as key challenges affecting the mental and sexual health of young pregnant women and the health of their unborn children. Despite ongoing efforts to rebuild the country’s healthcare infrastructure, empirical and culturally tailored interventions to address the consequences of war are severely limited. To address these concerns, we developed Project POWER (Progressing Our Well-being, Emotions, and Relationships), a mindfulness-infused, cognitive-behavioral intervention for young adult pregnant women. This study sought to 1) assess the feasibility and acceptability of POWER and 2) determine the preliminary efficacy of POWER for improving mental and sexual health outcomes among Liberian war-exposed young adult pregnant women.MethodsEighty-seven women aged 18–25 were recruited from three catchment areas in Monrovia, Liberia to participate in a two-condition, pre-post design quasi-experimental pilot trial. Participants were allocated to the intervention (POWER) or the control condition (a health education program) based on where they resided relative to the catchment areas. Each condition completed a ten-session program delivered over 5-weeks. Feasibility and acceptability of POWER were examined using program logs (e.g., the number of participants screened and enrolled, facilitator satisfaction, etc.) and data from an end-of-program exit interview. The preliminary efficacy of POWER on mental and sexual health outcomes was assessed using repeated measures ANOVA with time and condition as factors.ResultsAnalyses provided preliminary support for the feasibility and acceptability of POWER. Participants attended an average of 8.99 sessions out of 10 and practiced material outside the sessions at least 2.77 times per week. Women in both conditions showed significant reductions in the level of prenatal distress (baseline, M = 16.84, 3-month assessment, M = 12.24), severity of post-traumatic stress disorder (PTSD) symptoms (baseline, M = 11.97, 3-month assessment, M = 9.79),), and the number of transactional sexual behaviors (baseline, M = 1.37, 3-month assessment, M = .94) over time. Participants who received POWER showed significant reductions in the frequency of depressive symptoms (baseline, M = 5.09, 3-month assessment, M = 2.63) over women in the control condition.ConclusionsFindings suggest that POWER may be a feasible and acceptable intervention to promote mental and sexual health for young adult pregnant women in Liberia. However, fully powered clinical trials are still needed to determine the efficacy and effectiveness of POWER before recommending its use on a larger scale in Liberia.

Intimate partner violence and associated factors among reproductive age women in Liberia: a cross-sectional study using a recent Liberian demographic and health survey

BackgroundIntimate partner violence (IPV) is a major public health problem and a violation of women's human rights. Almost one third of women aged 15–49 years who have been in a relationship have experienced to some form of physical and/or sexual violence by their intimate partner worldwide.ObjectiveThe study aimed to assess the prevalence of intimate partner violence within the last 12 months and associated factors among reproductive aged women in Liberia.MethodThis study was based on a large community-based cross-sectional survey, Liberia Demographic Health Survey (LDHS), conducted From October 16, 2019, to February 12, 2020, in Liberia. The 2019–20 LDHS used a stratified two-stage cluster design. Multivariable logistic regression was used to identify independent intimate partner violence among reproductive age women in Liberia and to control confounders. Adjusted odds ratio and confidence interval (CI) were used to declare statistical significance in the final model. Those variables with p value < 0.05 were considered as statistically significant.ResultThe overall prevalence of IPV within the last 12 months was 44.74% (42.73–46.77). age of the women 41% (AOR = 0.59, 95%CI 0.37–0.93), 42% (AOR = 0.58, 95%CI 0.35–0.94), and 59% (AOR = 0.41, 95%CI 0.25–0.68) among women with in the age group of 35–39, 40–44 and 45–49 respectively, south central region (AOR = 0.71, 95%CI 0.52–0.96), women’s primary education (AOR = 1.28, 95%CI 1.01–1.63), female household head (AOR = 0.77, 95%CI 0.61–0.97), husbands higher education (AOR = 0.62, 95%CI 0.39–0.99), positive wife beating attitude (AOR = 1.57, 95%CI 1.29–1.90), husband drinks (AOR = 2.59, 95%CI 2.14–3.15) and Women’s decision making autonomy (AOR = 0.75, 95%CI 0.61–0.93) were significantly associated with IPV.ConclusionThe prevalence of IPV in Liberia was high. Socio-demographic characteristics of women, husbands education, sex of household head, having a positive attitude towards wife-beating, partner’s alcohol drinking habit and women empowerment was significantly associated with IPV in Liberia. Policymakers and program designers have to take into account those factors when they design interventions to reduce IPV in Liberia.

Program Planning to Develop Infrastructure for Cancer Care in Liberia.

Liberia's health infrastructure was completely devastated after 14 years of back-to-back civil war. Postconflict rebuilding of the country's health workforce and infrastructure has become a priority. Initially, the focus was on the diagnosis and treatment of communicable diseases that caused multigenerational family losses. With the increasing burden of noncommunicable diseases, however, the country has turned its attention to addressing diabetes, cancer, and cardiovascular and respiratory diseases, with the development of the noncommunicable disease unit under the Ministry of Health. Recovering from another setback caused by the Ebola virus outbreak in 2014, the country assembled a diverse group of stakeholders to form Liberia's first National Cancer Committee. To structure a program that would address the increasing burden of cervical and breast cancers, the major cause of mortality among reproductive-aged women in Liberia, input from the International Atomic Energy Agency was critical. This article describes the preplanning activities for developing infrastructure to support cancer care in Liberia that occurred between 2013 and 2020 and is still ongoing. This case study is intended to serve as a planning guide for countries with limited resources as they work toward the goal of eliminating cervical cancer and developing infrastructure to address their country's burden of all cancers.

Prevalence and Correlates of Intimate Partner Violence against Women in Liberia: Findings from 2019-2020 Demographic and Health Survey.

Background: Intimate partner violence is a global public health crisis and a human rights issue. The objectives of the study were to conduct secondary analysis of the most recent Liberia Demographic and Health Survey (2019–2020) to determine the descriptive and analytical epidemiology of intimate partner violence (IPV) and its correlates in 15–49 year old ever-married women. Methods: Association of physical, emotional, sexual, and having experienced any type of IPV with 10 explanatory socio-demographic, attitudinal, and experiences were analyzed using simple and multiple logistic regression models. Results: 55.29% of women reported having ever experienced some form of IPV perpetrated by their current or most recent husband/partner, with the most common type being physical violence. Having been slapped, insulted, made to feel bad, and physically forced into unwanted sex were the most common types of physical, emotional, and sexual IPV. The multivariable analysis showed statistically significant association with IPV for number of living children, women’s acceptance of IPV, husband/partner’s use of alcohol, and having witnessed parental physical IPV. Conclusions: The prevalence of having experienced physical and/or sexual intimate partner violence in Liberia was much higher than the prevalence for the WHO Africa region of 33%, highlighting the need for better women empowerment and gender equality in Liberia.

Modern Contraceptive Utilization and Associated Factors Among Married Women in Liberia: Evidence from the 2019 Liberia Demographic and Health Survey.

BackgroundContraceptive methods help individuals control the number, interval, and timing of pregnancies and prevent unwanted pregnancies.ObjectiveThis study aimed to assess the prevalence of modern contraceptive utilization and associated factors among married reproductive-age women in Liberia.MethodsThis study was based on a large community-based cross-sectional survey, conducted from October 16, 2019, to February 12, 2020, in Liberia. The survey employed a multistage cluster sampling technique to recruit study participants. Binary logistic regression was used to identify associated factors of contraceptive utilization. A p-value of <0.05 and a 95% confidence interval were used to declare statistical significance.ResultsThe overall modern contraceptive utilization among reproductive-age women in Liberia was 23.87% (95% CI: 27.3, 29.9). Women with the age group of 20 and 24 years [AOR = 2.08 (95% CI:1.37, 3.14)], 25–29 years [AOR = 1.73 (95% CI: 1.13, 2.65)], 45–49 years [AOR = 0.46, 95% CI: 0.27, 0.76], being Muslim [AOR = 0.52, 95% CI: 0.399, 0.67], residing in South Eastern Regions (B) [AOR = 1.40, 95% CI: 1.11, 1.79], south central [AOR=0.48 95% CI:0.37, 0.61] and North Central region [AOR = 0.48, 95% CI: 0.37, 0.61], being employed [AOR = 1.26, 95% CI:1.06, 1.51], having 1–2 child/children [AOR = 2.81, 95% CI:1.80, 4.39] 3–4 children [AOR = 3.87, 95% CI:3.87, 6.24] and 5 and above [AOR = 7.06, 95% CI: 4.27, 11.69], completed primary [AOR = 1.52, 95% CI: 1.22, 1.88] and higher education [AOR = 1.72, 95% CI: 1.01, 2.94], having educated husband [AOR = 1.35, 95% CI: 1.12, 1.63], being from richer households [AOR = 1.41, 95% CI:1.09, 1.82], and had declared infecund [AOR = 0.13, 95% CI: 0.046, 0.36] were independently associated with modern contraceptive utilization among married women in Liberia.ConclusionThe prevalence of modern contraceptive utilization among reproductive-age women in Liberia was low. Contraceptive utilization was affected by partners’ education and participants’ socio-demographic and obstetric attributes. Thus, public health interventions are urgently required to enhance use of contraceptives among this group of population.

Introducing the Local Agricultural Potential Index: An approach to understand local agricultural extension impact for farmer adaptive capacity and gender equity

Despite significant work to enhance women’s empowerment in agriculture, women remain marginalized across the globe. This includes gender gaps in agricultural extension and advisory service implementation that can lead to inequitable resource and knowledge access by farmers, specifically women. However, gender does not exist in isolation, it is place and time specific. This study investigated the impact of gender and geography on smallholder farmer access to and agency over resources/knowledge. The overarching question we explored was the role that extension providers might play in building farmer adaptive capacity and gender equity. To do so, a mixed-methods approach was used to develop a new multidimensional index from participant responses to 352 surveys and 44 focus groups. The index has four domains that represent farmer’s access to resources, leadership opportunities, household power, and time allocation; it is called the Local Agricultural Potential Index or L-API. The index was applied to a case study setting in rural Liberia due to its designation as a USAID-Feed the future country, and national investment in gender equality and poverty alleviation through agricultural development. Statistical and spatial analysis results indicate that women in Liberia, on average, have lower access to information and communication technology, leadership opportunities, and credit; as well, when compared to their male counter parts, less agency to make decisions at home and in the community. Further, a surprising spatial finding was that rurality did not have a diminishing impact on access. We concluded that the L-API is one example of a process and the resulting tool, informed by locally relevant indicators, to help improve farmer access to and agency over extension services. The L-API is meant to provide a baseline tool to be tailored in different locations based on local needs and can be used as a measure for adaptive capacity.

Maternal choices of delivery sites among recently delivered women in Liberia, 2017

Introduction: To reduce maternal mortality, many countries encourage women to deliver in health facilities, where complications can be handled more effectively. In Liberia, attempted home deliveries accounted for about 10% of maternal deaths in 2016/2017. It is therefore necessary to identify the factors influencing maternal choice of delivery site in Liberia. This study seeks to determine the preferred choice of delivery site and factors associated with the choice in Liberia.

Maternal choices of delivery sites among recently delivered women in Liberia, 2017

Background: To reduce maternal mortality, many countries encourage women to deliver in health facilities, where complications can be handled more effectively. In Liberia, attempted home deliveries accounted for about 10% of maternal deaths in 2016/2017. It is therefore necessary to identify the factors influencing maternal choice of delivery site in Liberia. This study seeks to determine the preferred choice of delivery site and factors associated with the choice in Liberia. Methods: A cross-sectional design was used to study 630 women of reproductive age who had given birth less than one year before the survey. A two-stage cluster sampling

Health Care Policy and Reform—Case Study on Liberia Tuberculosis among Childbearing Age Women

Objective: Liberia health care needs to focus on addressing this disease called Tuberculosis among childbearing age women in Liberia and the world; focusing on women’s health governance of Liberia should involve these three sets of actors to control a disease outbreak. The first set of state actors, including politicians, policymakers, and other government officials, need to provide health care education in every part. The public sector health bureaucracy comprising the health ministry, health, social insurance agencies, public pharmaceutical procurement and distribution entities, etc., is central. Still, non-health public sector actors also play a role. Methods: The researcher used the questionnaire method as the main instrument for the study. Results: This survey indicates that 48% of those responding to health education can reduce TB among childbearing age women showed that education could minimize the spread of TB. 25% can improve economic status. 27% said it could reduce the illiteracy rate. The instruments used were positively related to the topic to obtain the needed findings. This set comprises public, private, should not be-for-profit individuals and groups that deliver health services and organizations that support service provision: medical training institutions, health insurance agencies, the pharmaceutical industry. Health service delivery can be presenting from the health system perspective, with inputs, processes, outputs, and outcomes. WHO’re Systems Thinking for Health Systems Strengthening explaining that service delivery includes “effective, safe and quality personal and non-personal health interventions that are providing to those in need, when and where needed (including infrastructure), with minimal waste of resources”. Conclusion: Inputs for a sound health system, the need for health care delivery include financial resources, competent health care staff, adequate physical facilities and equipment, essential medicines and supplies, current clinical guidelines, and operational policies.

Overcoming data collection challenges for breast and cervical cancer in a resource poor setting: Postwar cancer registration in Liberia

Objective: Breast and cervical cancers are the most common cancers affecting women in Liberia. The lack of pathology limits efforts to determine the exact burden of disease and public health awareness and prevention strategies.

Cervical cancer risk factors and screening preferences among Muslim women in Monrovia, Liberia.

Cervical cancer is the most common cancer in reproductive aged women in Liberia. Lack of awareness and screening capacity are both major contributors to the prevalence of this disease. The minority Muslim population in this country is largely unscreened. The objective of the study was to assess cervical cancer risk factors and screening preferences among Muslim women living in Monrovia, Liberia and to offer self-screening with HPV testing. A multiple step implementation strategy was devised in order to outreach to the Muslim population with the engagement of community and religious leaders, about an upcoming screening program and informational session at a local clinic. Over 150 Muslim women attended the session, 120 completed the HPV screening, and 55 women completed the questionnaires. Questionnaire data revealed overall low risk factors for cervical cancer, but also low use of family planning as well as low knowledge about cervical cancer and HPV. Participants showed an interest in screening and a majority preferred self-collected tests. These preferences should be incorporated in future programming. To engage minority populations in screening programs, there may be success with targeted messages, involvement of community religious leaders, and eliciting feedback to incorporate preferred strategies and improve participation and programming.

Acceptability and feasibility of insect consumption among pregnant women in Liberia.

Maternity waiting homes (MWHs) in Liberia promote facility‐based delivery to reduce maternal mortality. However, women often must bring their own food and supplies to MWHs, which makes food insecurity a barrier to the utilisation of MWHs. Consumption of edible indigenous insects is a common practice and has notable nutritional benefits but has not been studied in Liberia as a potential solution to food insecurity at MWHs. The purpose of this study is to (a) examine the acceptability of insect consumption in the context of Liberian beliefs, (b) identify species commonly consumed by pregnant women in Liberia, and (c) examine the feasibility of harvesting insects as food and income generation for women staying at MWHs. Focus groups were conducted at 18 healthcare facilities in Liberia. Participants included chiefs, community leaders, women of reproductive age, traditional birth attendants, women staying at MWHs, and male partners. Focus group participants identified many different species of insects consumed by pregnant women in the community as well as the perceived health impacts of insect consumption. They also described their own experiences with insect hunting and consumption and the perceived marketability of insects, particularly palm weevil larvae. The results of these discussions demonstrate that insect consumption is an acceptable practice for pregnant women in rural Liberia. These findings suggest that it is feasible to further explore the use of palm weevil larvae as dietary supplementation and income generation for women staying at MWHs in Liberia.