In areas affected by the epidemic, many pregnant women do not go to a maternity hospital to give birth for fear of contracting the virus.
They are the collateral victims of the Ebola epidemic which hit West Africa from December 2013. In Sierra Leone, Guinea or Liberia, many have preferred to stay at home to give birth instead of giving birth. go to a maternity ward. Maternal and child health have been hit hard by the deadliest Ebola outbreak. Visible consequences even in regions spared by the virus, reports a study conducted in Liberia, and published this Tuesday in the journal PLOS Medicine.
In just 2 years, more than 28,600 men, women and children have contracted Ebola haemorrhagic fever, of which 11,310 have died. The last survivors have been released from treatment centers in recent weeks, and the transmission of this deadly virus has been announced in Sierra Leone, Liberia and Guinea.
But the health systems of these countries will keep the traces of the Ebola epidemic for a long time to come. No less than 500 health professionals have lost their lives trying to save those of the sick. Some health centers have had to close their doors for lack of doctors, nurses or midwives who have gone to treatment centers to support their colleagues. Infrastructure still closed today.
Fear, paranoia and false beliefs
A chaotic situation that threatened the lives of thousands of pregnant women and their newborns. It is this indirect consequence of the Ebola epidemic that researchers at Georgetown University, in collaboration with the organization Last Mile Health which is dedicated to health in rural areas of Liberia, wanted to assess in order to better understand how to rebuild the health system in these countries.
By comparing births, including places of birth, before and during the epidemic, the researchers noted that 30% of pregnant women did not go to a maternity hospital during the outbreak. “The district we studied was affected by Ebola, and its infrastructure remained open, unlike other parts of the country where the epidemic was more intense,” said John Kraemer, lead author of this work. Thus, our results undoubtedly underestimate the impact of the epidemic on maternity hospitals in severely affected areas. “
The fear of contracting the Ebola virus seems to be the main reason for expecting mothers to flee maternity hospitals. In fact, among mothers convinced that the virus is transmitted in health centers, the birth rate in the maternity unit is 41% lower than among women who do not have this mistaken idea.
In Sierra Leona, paranoia and rumors of conspiracy by medical personnel against the population has also led to the avoidance of maternity hospitals. The mortality rate in childbirth and that of newborns had then climbed and reached respectively 30 and 24%. However, the country had succeeded in improving maternal and child health in recent years.
Rebuilding a stronger health system
Liberia is also experiencing the same backtracking. “Before the epidemic, the country had made immense progress. The rate of babies born in maternity hospitals had increased significantly, resulting in healthier mothers and children, says John Kraemer. Maternal health services, like almost all other health services in Liberia, have been severely damaged. It is crucial to focus on rebuilding this health system, which will require long-term investments ”.
In July 2015, a World Bank report published in the journal The Lancet Global Health warned about the consequences of the Ebola epidemic on maternal health. She estimated that the deaths of health workers attributable to Ebola could lead to an upsurge in maternal mortality in Guinea, Liberia and Sierra Leone, with a return to rates observed in the 1990s. This could lead to complications during pregnancy or childbirth. The World Bank then called on these countries to considerably increase the number of health workers.
For John Ly, co-responsible for this work and medical director of the Last Mile Health organization, “building and preserving a stronger health system is essential to prevent future threats”.
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