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Facility-Based Delivery during the Ebola Virus Disease Epidemic in Rural Liberia: Analysis from a Cross-Sectional,Population-Based Household Survey
Authors:John Ly  Vidiya Sathananthan  Thomas Griffiths  Zahir Kanjee  Avi Kenny  Nicholas Gordon  Gaurab Basu  Dale Battistoli  Lorenzo Dorr  Breeanna Lorenzen  Dana R. Thomson  Ami Waters  Uriah G. Moore  Ruth Roberts  Wilmot L. Smith  Mark J. Siedner  John D. Kraemer
Abstract:BackgroundThe Ebola virus disease (EVD) epidemic has threatened access to basic health services through facility closures, resource diversion, and decreased demand due to community fear and distrust. While modeling studies have attempted to estimate the impact of these disruptions, no studies have yet utilized population-based survey data.ConclusionsWe detected a 30% decreased odds of FBD after the start of EVD in a rural Liberian county with relatively few cases. Because health facilities never closed in Rivercess County, this estimate may under-approximate the effect seen in the most heavily affected areas. These are the first population-based survey data to show collateral disruptions to facility-based delivery caused by the West African EVD epidemic, and they reinforce the need to consider the full spectrum of implications caused by public health emergencies.
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