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Number of hospital births decline during Ebola outbreak in Liberia
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A national survey in Liberia conducted via text messages during the 2015 Ebola outbreak confirmed that hospital-based births decreased during the outbreak.
”Estimates show that the majority of people in the world have access to a cell phone. Besides this, the types of and access to new internet and mobile tools are rapidly increasing around the world,” Rumi Chunara, PhD, assistant professor of computer science and engineering and global public health at New York University, told Infectious Diseases in Children. “Internet and mobile tools are useful to complement other data sources since they enable us to get information directly from individuals who may not be using health care systems or other typical institutional sources of health information, especially during emergency situations.”
The researchers conducted the poll in Liberia between March and June 2015. It provided information about individual-level health and health-seeking behaviors during the Ebola outbreak. Once the data were collected, Chunara and colleagues compared results with the 2013 Liberian Demographic Health Survey.
Previous findings from a household survey showed that facility-based deliveries in one rural Liberian county declined by 30% during the outbreak.
The researchers wrote that 6,694 individuals were able to complete the most recent poll. Findings from the poll, published in Nature Digital Medicine, revealed that hospital-based births significantly decreased during the outbreak (P < .05). After the outbreak ended, the researchers observed a 3.3% decrease in births at public hospitals and a 1.1% decrease in births at private hospitals. According to Chunara, people were instead giving birth in their homes, other homes or similar locations not located in hospital facilities.
“During the Ebola outbreak, it was suspected that people were hesitant to go to hospitals because they would be more likely to contract Ebola,” Chunara said in a press release. “If you want to deploy treatment or interventions, you need to know if people are coming to hospitals or staying in their communities.”
When the data from the poll and 2013 survey were compared to better understand births occurring before and after the outbreak, the number of deliveries in public facilities increased by 2.2%. This number, according to the researchers, was not significantly different compared with 2013 data. Births performed in private locations increased when data was compared with babies born before and after the outbreak, and institutional births increased significantly once the outbreak ended.
“Our findings show that this manner of data collection is useful during emergency situations when getting data through other means like surveys and home visits would take a long time,” Chunara said. “Furthermore, our use of statistical matching methods shows that it is possible to make generalizable conclusions based on the sample of mobile phone users.” – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.
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