Browsing by Author "James, Peter Bai"

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Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey
(BioMed Central, 2023-11-22) James, Peter Bai
BACKGROUND: A nationwide assessment of the link between women's empowerment and homebirth has not been fully examined in Sierra Leone. Our study examined the association between women's empowerment and homebirth among childbearing women in Sierra Leone using the 2019 Sierra Leone Demographic Health Survey (2019 SLDHS) data. METHOD: We used the individual file (IR) of the 2019 SLDHS dataset for our analysis. A total of 7377 women aged 15-49 years who gave birth in the five years preceding the survey were included. Outcome variable was "home birth of their last child among women in the five years preceding the 2019 SLDHS. Women's empowerment parameters include women's knowledge level, economic participation, decision-making ability and power to refuse the idea of intimate partner violence. We used the complex sample command on SPSS version 28 to conduct descriptive and multivariate logistic regression analyses. RESULTS: Three in every 20 women had home childbirth (n = 1177; 15.3%). Women with low \[aOR 2.04; 95% CI 1.43-2.92\] and medium \[aOR 1.44; 95%CI 1.05-1.97\] levels of knowledge had higher odds of giving birth at home compared to those with high levels of knowledge. Women who did not have power to refuse the idea of intimate partner violence against women were more likely to had given birth at home \[aOR 1.38; 95% CI1.09-1.74\]. In addition, women with no \[aOR 2.71; 95% CI1.34-5.46) and less than four antenatal care visits \[aOR 2.08; 95% CI:1.51-2.88\] and for whom distance to a health facility was a major problem \[aOR 1.95; 95% CI1.49-2.56\] were more likely to have had a homebirth. However, no statistically significant association was observed between a women's decision-making power and home birth \[aOR 1.11; 95% CI 0.86-1.41\]. CONCLUSION: Despite improvements in maternal health indicators, homebirth by unskilled birth attendants is still a public health concern in Sierra Leone. Women with low knowledge levels, who did not have power to refuse the idea of intimate partner violence against women, had less than four ANC visits and considered distance to a health facility as a major problem had higher odds of giving birth at home. Our findings reflect the need to empower women by improving their knowledge level through girl child and adult education, increasing media exposure, changing societal norms and unequal power relations that promote gender-based violence against women, and improving roads and transport infrastructure.
Prevalence and Correlates of Herbal Medicine Use among Women Seeking Care for Infertility in Freetown, Sierra Leone
(Hindawi Publishing Corporation, 2018) James, Peter Bai
In resource‐poor countries where access to infertility care is limited, women may turn to traditional medicine to achieve motherhood. It is unknown whether Sierra Leonean women with such condition use herbal medicine. This study investigates the prevalence and factors associated with herbal medicine use among women seeking care for infertility. This was a questionnaire‐based cross‐sectional study conducted among women seeking care for infertility at various clinics within Freetown, Sierra Leone. Data analysis included Chi‐square tests and logistic regression. Out of the 167 women that participated, 36.5% used herbal medicine for infertility treatment. Women with no formal (AOR 4.03, CL: 1.38–11.76, p = 0.011), primary education (AOR: 6.23, CL: 2.02–19.23, p = 0.001) and those that visited a traditional medicine practitioner (AOR: 20.05, CL: 2.10–192.28, p = 0.009) as well as women suffering from other reproductive health problems (AOR: 2.57, CL: 1.13–5.83, p = 0.024) were more likely to use herbal medicines. Friends and family (n = 57, 96.7%) were the main influencers of herbal medicine use. Only (n = 12) 19.7% of users disclosed their status to their healthcare provider. Over half (n = 32, 52.5%) could not remember the name of the herb they used. Luffa acutangula (n = 29, 100%) was the herbal medicinal plant users could recall. Herbal medicine use among women seeking care for infertility in Freetown is common. Healthcare providers should be aware of the potential dyadic use of herbal and allopathic medicines by their patients and be knowledgeable about commonly used herbal remedies as well as being proactive in communicating the potential risks and benefits associated with their use.
Psychological distress and coping mechanisms due to the COVID-19 pandemic among the adult population in Bo Sierra Leone. A cross-sectional study
(Public Library of Science, 2025-02-07) James, Peter Bai
Psychological distress is widely recognized as a significant health concern that poses a potential risk to the overall mental wellbeing of individuals. This study investigated the psychological distress associated with the COVID-19 pandemic and the coping methods employed by adults in Bo district, Sierra Leone. This research used a snapshot approach (cross-sectional design) to describe the prevalence of psychological distress during the COVID-19 pandemic among 502 adults residing in Bo district, Sierra Leone. We collected study data using a structured questionnaire that comprised of participant's demographics, Kessler Psychological Distress Scale (K10), Fear of COVID-19Scale (FCV-19S), Brief Resilient Coping Scale (BRCS), and Duke-UNC Functional Social Support instrument. We used backward stepwise binary logistic regression to identify the key factors linked to psychological distress. The average psychological stress score was 22.96±11.35, with approximately one-third of participants (n = 160, 31.9%) exhibiting very high levels of psychological distress. The mean score for fear of COVID-19 was 29.71±6.84, with the majority (n = 420,83.7%) being fearful of COVID-19. The mean score for the Brief Resilient Coping Mechanism was 12.49±4.51, with half of the participants considered low resilient copers (n = 257,51.2%). The mean score for functional social support was 25.35±8.85, with (n = 240, 47.8%) having increased social support. Individuals with a known health condition \[aOR = 4.415, 95% CI = 1.859-10.484\], who provided care to a family member/patient with known/suspected COVID-19 \[aOR = 4.485, 95% CI = 1.575-12.775\], who knew someone who died from COVID-19 \[aOR = 3.117, 95% CI = 1.579-6.154\], with an increased fear of COVID-19 \[aOR = 4.344, 95% CI = 2.199-8.580\] had higher odds of moderate to severe psychological distress. Moderate resilient copers \[aOR = 0.523, 95% CI = 0.296-0.925\] had lower odds of psychological distress compared to the low resilient copers. Participants with increased social support had lower odds of psychological distress than those with low support \[aOR = 0.253, 95% CI = 0.147-0.434\]. A significant proportion of the study cohort residing in Bo, Sierra Leone, experienced high levels of mental stress because of the COVID-19 pandemic. This study shows the importance of designing and implementing programs that minimize COVID-19 stressors and enhance the coping skills and social support network.
Sexual risk behaviour among school-going adolescents in Sierra Leone and Liberia. A secondary analysis of the 2017 Global school health survey
(Research Square Platform LLC, 2022-05-16) James, Peter Bai
**Background:** There is very little information on sexual risk behaviour among Sierra Leone and Liberia school-going adolescents. The present study assessed the prevalence and determinants of sexual risk behaviours among school-aged adolescents in Sierra Leone and Liberia. **Method:** We used publicly available nationally representative cross-sectional datasets of the 2017 Sierra Leone and Liberia Global school health survey. The sample consisted of 2798 and 2744 school-going adolescents from Sierra Leone and Liberia, respectively. **Results:** The majority of adolescents in the two countries were involved in multiple sexual risk behaviour (80.2%), with higher prevalence observed in Sierra Leone (85.2%) than in Liberia (75.3%), Liberian adolescents showed lesser odds of indulging in multiple sexual risk behaviours than their Sierra Leonean counterparts (AOR=0.572; 95%CI: 0.345-0.946). Male compared to females were more likely to engage in multiple sexual risk behaviour (AOR=2.310;95%CI:1.543-3.458), with a similar pattern observed in both countries. Alcohol use was associated with multiple sexual risk behaviour (AOR=3.064; 95%CI: 2.137-4.392). Also, in Sierra Leone and Liberia, adolescents with one and two or more forms of psychological distress were more likely to have ever had sex than those who do show any form of psychological distress. Missing class/school was associated with multiple sexual risk behaviour (AOR=1.655; 95%CI:1.133-2.418). Peer support was only found to be a protective factor against no condom use among Liberian adolescents (AOR=0.608; 95%CI: 0.435-0.850). Less parental support was only associated with ever had sex more likely to have ever had sex as seen among adolescents in Sierra Leone (AOR=2.027; 95%CI: 1.322-3.107) but not Liberia (1.034(0.650-1.644). **Conclusion:** Our study found a high sexual risk behaviour among school-going adolescents in Sierra Leone and Liberia. Our finding highlights the need to strengthen sexual and reproductive health education in schools and communities that incorporate mental health promotion activities tailored to this group.
Sexual risk behaviour among school-going adolescents in Sierra Leone and Liberia: a secondary analysis of the 2017 Global school-based student health surveys
(BioMed Central, 2022-12-24) James, Peter Bai
BACKGROUND: Sierra Leone and Liberia have experienced civil wars and, recently, Ebola outbreaks that led to profound economic hardship, psychopathologies and family disruptions. These factors are associated with sexual risk behaviours among youths. However, there is very little information on sexual risk behaviour among Sierra Leonean and Liberian school-going adolescents. The present study assessed the prevalence and determinants of sexual risk behaviours among school-going adolescents (10-19 years) in Sierra Leone and Liberia. METHOD: We used publicly available nationally representative cross-sectional datasets of the 2017 Sierra Leone and Liberia Global school health survey. The sample consisted of 2798 and 2744 school-going adolescents from Sierra Leone and Liberia, respectively. Complex sample descriptive and regression analysis was used to analyse our data. RESULTS: The majority of adolescents in the two countries were involved in multiple sexual risk behaviour (80.2%), with a higher prevalence observed in Sierra Leone (85.2%) than in Liberia (75.3%). Liberian adolescents showed lesser odds of indulging in multiple sexual risk behaviours than their Sierra Leonean counterparts (AOR = 0.572; 95%CI: 0.345-0.946). Male, compared to females, were more likely to engage in multiple sexual risk behaviour (AOR = 2.310;95%CI:1.543-3.458), with a similar pattern observed in both countries. Alcohol use was associated with multiple sexual risk behaviour (AOR = 3.064; 95%CI: 2.137-4.392). Also, in Sierra Leone and Liberia, adolescents with one and two or more forms of psychological distress were more likely to have ever had sex than those who did not show any form of psychological distress. Missing class/school was associated with multiple sexual risk behaviour (AOR = 1.655; 95%CI:1.133-2.418). Peer support was only found to be a protective factor against no condom use among Liberian adolescents (AOR = 0.608; 95%CI: 0.435-0.850). Less parental support was only associated with ever had sex among adolescents in Sierra Leone (AOR = 2.027; 95%CI: 1.322-3.107) but not in Liberia (AOR = 1.034; 95%CI: 0.650-1.644). CONCLUSION: Our study found a high sexual risk behaviour among school-going adolescents in Sierra Leone and Liberia. Our finding highlights the need to strengthen sexual and reproductive health education in schools and communities that incorporate mental health promotion activities tailored to this group.
The use of condoms and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African countries
(BioMed Central, 2022-12-16) James, Peter Bai
BACKGROUND: Adolescents in sub-Saharan Africa still face sexual and reproductive health challenges. Contraceptives have been used to address these challenges. Despite efforts at national and global levels, contraceptive uptake among young people in Africa remains a challenge due to personal, societal, and health systems-based barriers. We estimated the prevalence and correlates of condom use and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African (SSA) countries. METHODS: We conducted a secondary analysis of the Global School-based Student Health Surveys (GSHS) datasets pooled from nine SSA countries. We included a sample of 27,504 school-going adolescents 11 years and younger and 18 years and older. We employed meta-analysis using a random-effects model to estimate the total prevalence of the use of condoms, other birth control methods other than a condom and any birth control method at last sexual intercourse. We conducted complex sample descriptive and logistic regression analyses to determine the characteristics and determinants of not using condoms and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African countries, respectively. RESULTS: More than half \[n = 4430, 53.8% (43.9-63.8)\], two-fifth \[n = 3242, 39.5% (33.2-45.9) and two-thirds of adolescents \[n = 4838, 65.6% (57.5-73.7)\] of sexually active in school adolescents across the nine sub-Saharan African countries used condom, other birth control methods and any form birth control method during their last sexual intercourse, respectively. The non-use of condoms at last sex was associated with being younger (less than 16 years) \[AOR = 1.48;95%CI: 1.12-1.94\], early sexual debut \[AOR = 1.81(1.47-2.22)\], having two or more sexual partners \[AOR = 1.30(1.06-1.58)\] and no/minimal parental support \[AOR = 1.54(1.17-2.03)\]. The non-use of other birth control methods at last sex was associated with being male \[AOR = 1.37 (1.09-1.73)\], early sexual debut \[AOR = 1.83(1.48-2.27) and having no parental support \[AOR = 1.64(1.34-2.00)\]. CONCLUSION: Contraceptive need among sexually active school adolescents in the nine sub-Saharan African countries is high. Such a need calls for the development of country-specific and or the review of existing school-based sexual health education and youth-friendly sexual and reproductive health interventions that target risky adolescents and promote adolescent-parent effective communication, connectedness and support.
Women's Empowerment and Homebirth in Sierra Leone. A Secondary Analysis of the 2019 Sierra Leone Demographic Health Survey
(Research Square Platform LLC, 2022-09-13) James, Peter Bai
Background A nationwide assessment of the link between women's empowerment and homebirth has not been examined in Sierra Leone. Our study examined the association between women's empowerment and homebirth using the 2019 Sierra Leone Demographic Health Survey (2019 SLDHS) data. Method We used the individual file (IR) of the 2019 SLDHS dataset for our analysis. A total of 7377 women aged 15–49 years who gave birth in the five years preceding the survey were included in our study. Our outcome variable was "home birth of their last child among women in the five years preceding the 2019 SLDHS. Women's empowerment parameters include women's knowledge level, economic participation, decision-making ability, and attitude towards wife beating. We used the complex sample command on SPSS version 28 to conduct descriptive and multivariate logistic regression analyses. Results Three in every 20 women had home childbirth (n = 1177,15.3%). Women with low \[AOR = 2.04.;95%CI: 1.43–2.92\] and medium \[AOR = 1.44;95%CI: 1.05–1.97\] levels of knowledge compared to those with high levels of knowledge had higher odds of giving birth at home. Women who were in favour of wife beating were more likely to have had homebirth compared to those who were against wife beating \[AOR = 1.38;95%CI:1.09–1.74\]. In addition, women with no \[AOR = 2.71;95%CI:1.34–5.46) and less than four \[AOR = 2.08;95%CI:1.51–2.88\] antenatal care visits and who considered the distance to a health facility as a major problem \[AOR = 1.95;95%CI:1.49–2.56\] were more likely to have had a home birth. However, no significant association between a women's decision-making power and home birth was observed \[AOR = 1.11;95%CI:0.86–1.41\]. Conclusion Despite improvements in maternal health indicators, homebirth by unskilled birth attendants is still a public health concern in Sierra Leone. Women with low knowledge levels, who favour wife beating, had less than four ANC visits and considered distance to a health facility as a major problem had higher odds of giving birth at home. Our findings reflect the need to empower women by improving their knowledge level through girl child and adult education, increasing media exposure, changing societal norms and unequal power relations that favour gender-based violence, and improving roads and transport infrastructure.