Table 2 Factors identified by Sierra Leone lab participants contributing to delayed diagnosis and timely pre-eclampsia management
Delay | Examples |
|---|---|
Misconceptions | Common misconceptions reported by lab participants held by some communities included beliefs such as: • ‘Fits are a sign that a woman is possessed by demons or devils’ • ‘Pre-eclampsia is associated with taking a bath at night’ • ‘Swollen feet show that the woman is expecting a male infant’ |
Transport costs and logistics | Distance to healthcare facility and cost of transport |
Lack of trust in the quality of care received at the health facility or hospital | • Residual fear from Ebola of contracting disease at health facilities • Lack of trained staff • Many staff are volunteers with no regular salary • Poor adherence to guidance and management pathways • No accountability resulting in a lack of urgency to refer patients or deliver key interventions |
Stockouts of basic equipment and medications | i.e. blood pressure machines, urine dipsticks, blood pressure medication, scanners |
Cost of care | ‘Free’ healthcare is not free; women are often asked to pay for consumables |