Factors influencing women’s place of delivery in Sierra Leone: Insights from the Sierra Leone Demographic and Health Survey 2019

Abstract

Globally, Sierra Leone is among the countries with a high maternal mortality and morbidity. Pregnancy in Sierra Leone is associated with a 1 in 12 chance of ending in death for mothers, which is relatively high in comparison to other countries. Improving access to delivery services is among the most effective strategies to reducing maternal mortality. This study aimed to examine the demographic factors influencing women’s place of delivery in Sierra Leone, using data from the 2019 Sierra Leone Demographic and Health Survey (2019 SLDHS). This study applied a quantitative approach, analysing secondary data from the Sierra Leone Demographic and Health Survey of 2019. The study sample consisted of 9,899 women who had given birth to live children. Univariate analysis was conducted to describe the distribution of the sample. Bivariate analysis, using the Chi-Square test, was also utilised to examine the association between place of delivery and the various sociodemographic characteristics of women in Sierra Leone. Lastly, multivariate analyses were carried out on the sample using the multinomial logistic regression to explore the influence of the women’s demographic characteristics on the place of delivery. The results showed that more than half of all births occurred in health centres (54%), with home births being the least common (17%). Chi-square analyses revealed significant associations between place of delivery and all socio-demographic variables examined among the Sierra Leonean women. Multivariate analysis further identified age group, religion, place of residence, wealth index, and employment status as key predictors of place of delivery, emphasising the need for targeted interventions to promote equitable access to facility-based deliveries.