Assessing the Barriers and Services at Peripheral Health Facility Units to Improving Maternal Health Outcome in Pujehun District, Sierra Leone

Abstract

Background: Maternal mortality remains a significant health problem in low-resource settings due to weak health systems and poor health service delivery. The World Health Organization (WHO) reported that 94% of global maternal deaths occur in low-income countries, with two-thirds in Sub-Saharan Africa, mainly due to inadequate healthcare access.

Aim: The study aims to access the barriers and services needed at the Peripheral Health Facility (FHF) level to improve maternal health outcomes in the Pujehun District.

Research Methodology: This study utilised a convergent parallel mixed-methodology research design to collect quantitative and qualitative data among healthcare workers, pregnant women and key stakeholders in Pujehun District. A multi-stage sampling technique and simple random sampling were employed to select participants. The combination of quantitative data was collected through Google Forms, and qualitative data was collected through focus group discussions and key informant interviews to understand maternal health services in Pujehun District comprehensively.

Results: The survey revealed inconsistent customer satisfaction with maternal health services, with half satisfied, 37.5% partially happy, and 12.5% unhappy. Geographical accessibility was a significant issue, with 30% of localities less than 5 km from medical facilities and 40% more than 10 km away. Basic amenities were lacking in 27.5% of facilities, despite 72.5% having accessible facilities. These findings highlight the need for better infrastructure and accessibility in maternal healthcare services.

Conclusion: Participants emphasised the importance of timely responses to critical cases, strict attendance policies, feedback mechanisms, staff attitudes, punctuality, and responsiveness in maternal healthcare.