Department of Biological Sciences

Permanent URI for this collectionhttps://dspace.njala.edu.sl/handle/20.500.144402/136

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Author: search.filters.author.Osborne, AugustusSubject: search.filters.subject.Maternal Health

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    Sierra Leone’s safe motherhood bill: balancing public health, religious values, and cultural traditions
    (BioMed Central, 2025-07-08) Osborne, Augustus
    Sierra Leone’s safe motherhood and reproductive health care act 2024 represents a pivotal moment in the nation’s efforts to address its maternal health crisis while intersecting religious and cultural heritage. This commentary examines the multifaceted challenges and opportunities presented by this landmark legislation, which aims to transform maternal healthcare delivery in a country with one of the world’s highest maternal mortality rates. It analyzes the bill’s key provisions and their intersection with strong religious beliefs and cultural traditions. We highlight the notable opposition from religious organizations, particularly the Inter-Religious Council of Sierra Leone, which has emerged as a powerful voice against certain aspects of the bill, especially those related to reproductive rights. The paper also reveals the need for improved maternal healthcare, the strong influence of religious institutions, and the strong cultural practices surrounding motherhood and childbirth. It identifies key areas of tension, including the integration of traditional birth attendants into the modern healthcare system, the controversial provisions regarding reproductive rights, and the challenge of implementing universal healthcare access while respecting local customs. In addition, it suggests that successfully implementing the safe motherhood bill requires a carefully balanced approach that acknowledges and incorporates religious and cultural perspectives while advancing essential public health objectives. We propose a framework for stakeholder engagement and policy implementation that emphasizes inclusive dialogue, cultural sensitivity, and gradual integration of modern healthcare practices with traditional systems. This paper contributes to the broader understanding of how developing nations can balance healthcare reform while respecting religious values and cultural traditions. It offers valuable insights for policymakers and healthcare professionals implementing similar reforms in culturally diverse settings where traditional practices and modern medicine must find common ground.
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    Inequalities in the use of three-dose of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine among women in Sierra Leone, 2008–2019
    (BioMed Central, 2025-11-25) Osborne, Augustus
    BACKGROUND: Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is a key intervention for preventing malaria during pregnancy in areas with moderate to high malaria transmission. While IPTp-SP coverage has increased in Sierra Leone, disparities in uptake and completion of the recommended three doses persist. Understanding these trends and inequalities is crucial for improving maternal and child health outcomes. This study examined the trends and inequalities in using three doses of IPTp-SP among pregnant women in Sierra Leone between 2008 and 2019. METHODS: The research utilised data from the Sierra Leone Demographic Health Survey conducted in 2008, 2013 and 2019. The World Health Organisation Health Equity Assessment Toolkit software calculated several inequality measures, including simple difference (D), ratio (R), population-attributable risk (PAR), and population-attributable fraction (PAF). Inequality was assessed for four stratifiers: economic status, education level, place of residence, and sub-national province. RESULTS: In Sierra Leone, IPTp-SP coverage among pregnant women increased from 5.2% in 2008 to 35.7% in 2019. Economic inequalities among pregnant women in Quintile 5 (richest) and Quintile 1 (poorest) increased from a difference of -1.4 percentage points in 2008 to -5.2 percentage points in 2019. Disparities in education-related outcomes among pregnant women with secondary or higher education compared to those with no education decreased from a difference of 4.4 percentage points in 2008 to -3.8 percentage points in 2019. The disparities in place of residence among pregnant women in urban versus rural areas decreased from a difference of 1.4 percentage points in 2008 to -6.3 percentage points in 2019. Provincial inequalities increased from a difference of 4.1 percentage points in 2008 to 18.4 percentage points in 2019. CONCLUSION: Despite the overall improvement in IPTp-SP coverage and the decreasing economic, educational and place of residence-related inequalities, continued provincial-level disparities indicate the necessity of tailoring interventions to address provincial-specific barriers. To achieve universal and equitable coverage of IPTp-SP, the study recommends a multifaceted approach that combines strengthening the health system, targeted behaviour change communication and addressing social determinants of health.