‘I can’t leave everything in the hands of my husband’: Economic constraints and gender roles in care-seeking in post-Ebola Guinea

References

• Asaolu, I. O., Alaofè, H., Gunn, J. K. L., Adu, A. K., Monroy, A. J., Ehiri, J. E., Hayden, M. H., & Ernst, K. C. (2018). Measuring women’s empowerment in Sub-Saharan Africa: Exploratory and confirmatory factor analyses of the demographic and health surveys. Frontiers in Psychology, 9, 1–10. https://doi.org/10.3389/fpsyg.2018.00994
   PubMed Web of Science ®Google Scholar
• ATLAS/ti. (2019). ATLAS/ti. Version 8.4.4 (1135). [Computer sofware for Mac]. Scientific Sofware Development.
   Google Scholar
• Aubel, J. (2012). The role and influence of grandmothers on child nutrition: Culturally designated advisors and caregivers. Maternal & Child Nutrition, 8(1), 19–35. https://doi.org/10.1111/j.1740-8709.2011.00333.x
   PubMed Web of Science ®Google Scholar
• Barden-O’Fallon, J., Barry, M. A., Brodish, P., & Hazerjian, J. (2015). Rapid assessment of Ebola-related implications for reproductive, maternal, newborn and child health service delivery and utilization in Guinea. PLoS Currents, 7, 1–23. https://doi.org/10.1371/currents.outbreaks.0b0ba06009dd091bc39ddb3c6d7b0826
   Google Scholar
• Bedford, K. J. A., & Sharkey, A. B. (2014). Local barriers and solutions to improve care-seeking for childhood pneumonia, diarrhoea and malaria in Kenya, Nigeria and Niger: A qualitative study. PLoS One, 9(6), 1–15. https://doi.org/10.1371/journal.pone.0100038
   Web of Science ®Google Scholar
• Brolin Ribacke, K. J., Saulnier, D. D., Eriksson, A., & von Schreeb, J. (2016). Effects of the West Africa Ebola virus disease on health-care utilization–a systematic review. Frontiers in Public Health, 4(222), 1–12. https://doi.org/10.3389/fpubh.2016.00222
   PubMedGoogle Scholar
• Camara, M., Camara, A., & Camara, N. (2015). The healthcare system in Africa: The case of Guinea. International Journal of Community Medicine and Public Health, 2(4), 685–689. https://doi.org/10.18203/2394-6040.ijcmph20150933
   Google Scholar
• Camara, B. S., Delamou, A., Diro, E., El Ayadi, M. A., Béavogui, A. H., Sidibé, S., Grovogui, F. M., Takarinda, K. C., Kolié, D., & Sandouno, S. D. (2017). Influence of the 2014–2015 Ebola outbreak on the vaccination of children in a rural district of Guinea. Public Health in Action, 7(2), 161–167. https://doi.org/10.5588/pha.16.0120
   PubMed Web of Science ®Google Scholar
• Campbell, C., & MacPhail, C. (2002). Peer education, gender and the development of critical consciousness: Participatory HIV prevention by South African youth. Social Science & Medicine, 55(2), 331–345. https://doi.org/10.1016/S0277-9536(01)00289-1
   PubMed Web of Science ®Google Scholar
• Centers for Disease Control and Prevention. (n.d.). 2014-2016 Ebola Outbreak in West Africa | History | Ebola (Ebola Virus Disease) | CDC. Retrieved June 3, 2020, from https://www.cdc.gov/vhf/ebola/history/2014-2016-outbreak/index.html
   Google Scholar
• Changole, J., Combs Thorsen, V., & Kafulafula, U. (2018). A road to obstetric fistula in Malawi: Capturing women’s perspectives through a framework of three delays. International Journal of Women’s Health, 10, 699–713. https://doi.org/10.2147/IJWH.S171610
   PubMed Web of Science ®Google Scholar
• Chol, C., Negin, J., Agho, K. E., & Cumming, R. G. (2019). Women’s autonomy and utilisation of maternal healthcare services in 31 Sub-Saharan African countries: Results from the demographic and health surveys, 2010–2016. BMJ Open, 9(3), 1–9. https://doi.org/10.1136/bmjopen-2018-023128
   PubMed Web of Science ®Google Scholar
• Cislaghi, B., & Heise, L. (2020). Gender norms and social norms: Differences, similarities and why they matter in prevention science. Sociology of Health & Illness, 42(2), 407–422. https://doi.org/10.1111/1467-9566.13008
   PubMed Web of Science ®Google Scholar
• Colvin, C. J., Smith, H. J., Swartz, A., Ahs, J. W., de Heer, J., Opiyo, N., Kim, J. C., Marraccini, T., & George, A. (2013). Understanding careseeking for child illness in sub-Saharan Africa: A systematic review and conceptual framework based on qualitative research of household recognition and response to child diarrhoea, pneumonia and malaria. Social Science and Medicine, 86, 66–78. https://doi.org/10.1016/j.socscimed.2013.02.031
   PubMed Web of Science ®Google Scholar
• Davies, S. E., & Bennett, B. (2016). A gendered human rights analysis of Ebola and Zika: Locating gender in global health emergencies. International Affairs, 92(5), 1041–1060. https://doi.org/10.1111/1468-2346.12704
   Web of Science ®Google Scholar
• Delamou, A., Delvaux, T., El Ayadi, A. M., Beavogui, A. H., Okumura, J., Van Damme, W., & De Brouwere, V. (2017a). Public health impact of the 2014–2015 Ebola outbreak in West Africa: Seizing opportunities for the future. BMJ Global Health, 2(2), e000202. https://doi.org/10.1136/bmjgh-2016-000202
   PubMed Web of Science ®Google Scholar
• Delamou, A., El Ayadi, A. M., Sidibe, S., Delvaux, T., Camara, B. S., Sandouno, S. D., Beavogui, A. H., Rutherford, G. W., Okumura, J., Zhang, W.-H., & De Brouwere, V. (2017b). Effect of Ebola virus disease on maternal and child health services in Guinea: A retrospective observational cohort study. The Lancet Global Health, 5(4), e448–e457. https://doi.org/10.1016/S2214-109X(17)30078-5
   PubMed Web of Science ®Google Scholar
• Delamou, A., Hammonds, R. M., Caluwaerts, S., Utz, B., & Delvaux, T. (2014). Ebola in Africa: Beyond epidemics, reproductive health in crisis. Lancet, 384(2105), 62363–62364. https://doi.org/10.1016/S0140-6736(14)62364-3
   Google Scholar
• Denzin, N., & Lincoln, Y. (2000). The handbook of qualitative research (2nd ed.). Sage Publications.
   Google Scholar
• Elston, J. W. T., Danis, K., Gray, N., West, K., Lokuge, K., Black, B., Stringer, B., Jimmisa, A. S., Biankoe, A., & Sanko, M. O. (2020). Maternal health after Ebola: Unmet needs and barriers to healthcare in rural Sierra Leone. Health Policy and Planning, 35(1), 78–90. https://doi.org/10.1093/heapol/czz102
   PubMed Web of Science ®Google Scholar
• Ewing, V. L., Tolhurst, R., Kapinda, A., Richards, E., Terlouw, D. J., & Lalloo, D. G. (2016). Increasing understanding of the relationship between geographic access and gendered decision-making power for treatment-seeking for febrile children in the Chikwawa district of Malawi. Malaria Journal, 15(1), 1–10. https://doi.org/10.1186/s12936-016-1559-0
   PubMedGoogle Scholar
• Gabrysch, S., McMahon, S. A., Siling, K., Kenward, M. G., & Campbell, O. M. R. (2016). Autonomy dimensions and care seeking for delivery in Zambia: The prevailing importance of cluster-level measurement. Scientific Reports, 6(1), 1–7. https://doi.org/10.1038/srep22578
   PubMedGoogle Scholar
• Gale, N., Heath, G., Cameron, E., Rashid, S., & Redwood, S. (2013). Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Medical Research Methodology, 13(117), 1–8. https://doi.org/10.1186/1471-2288-13-117
   PubMed Web of Science ®Google Scholar
• Gilson, L. (2003). Trust and the development of health care as a social institution. Social Science & Medicine, 56(7), 1453–1468. https://doi.org/10.1016/S0277-9536(02)00142-9
   PubMed Web of Science ®Google Scholar
• Gilson, L. (2006). Trust in health care: Theoretical perspectives and research needs. Journal of Health Organization and Management, 20(5), 359–375. https://doi.org/10.1108/14777260610701768
   PubMedGoogle Scholar
• Golla, A. M., Malhotra, A., Nanda, P., & Mehra, R. (2011). Understanding and measuring women’s economic empowerment. International Center for Research on Women.
   Google Scholar
• Greene, M. E., & Levack, A. (2010). Synchronizing gender strategies: A cooperative model for improving reproductive health and transforming gender relations. Population Reference Bureau.
   Google Scholar
• Greenspan, J. A., Chebet, J. J., Mpembeni, R., Mosha, I., Mpunga, M., Winch, P. J., Killewo, J., Baqui, A. H., & McMahon, S. A. (2019). Men’s roles in care seeking for maternal and newborn health: A qualitative study applying the three delays model to male involvement in Morogoro Region, Tanzania. BMC Pregnancy and Childbirth, 19(293), 1–12. https://doi.org/10.1186/s12884-019-2439-8
   PubMedGoogle Scholar
• Haneef, C., & Kalyanpur, A. (2020). Global rapid gender analysis for COVID-19. CARE and IRC.
   Google Scholar
• Hatcher, A., de Wet, J., Bonell, C. P., Strange, V., Phetla, G., Proynk, P. M., Kim, J. C., Morison, L., Porter, J. D. H., Busza, J., Watts, C., & Hargreaves, J. R. (2011). Promoting critical consciousness and social mobilization in HIV/AIDS programmes: Lessons and curricular tools from a South African intervention. Health Education Research, 26(3), 542–555. https://doi.org/10.1093/her/cyq057
   PubMed Web of Science ®Google Scholar
• HC3. (2017a). GUINEA: Bridges of hope. Getting communities engaged in health decisions. Johns Hopkins Center for Communication Programs. http://healthcommcapacity.org/wp-content/uploads/2017/04/BridgesofHope-1.pdf
   Google Scholar
• HC3. (2017b). GUINEA: Gold star campaign. Branding quality health services. Johns Hopkins Center for Communication Programs. http://healthcommcapacity.org/wp-content/uploads/2017/04/GoldStar.pdf
   Google Scholar
• HC3. (2017c). GUINEA: Interactive radio programs. Getting the community’s perspective. Johns Hopkins Center for Communication Programs. http://healthcommcapacity.org/wp-content/uploads/2017/04/RadioPrograms.pdf
   Google Scholar
• HC3. (2017d). GUINEA: Interpersonal communication and counseling. Building trust in the health system. Johns Hopkins Center for Communication Programs. http://healthcommcapacity.org/wp-content/uploads/2017/04/IPCTraining.pdf
   Google Scholar
• HC3. (2017e). HC3 Guinea country program end of project report. Johns Hopkins Center for Communication Programs.
   Google Scholar
• HC3. (n.d.). The circle of care model – Health communication capacity collaborative – Social and behavior change communication. Retrieved September 3, 2020, from https://healthcommcapacity.org/hc3resources/circle-care-model/
   Google Scholar
• Hildon, Z. J. L., Escorcio-Ymayo, M., Zulliger, R., Arias De Aramburú, R., Lewicky, N., Harig, H., Chidassicua, J. B., Underwood, C., Pinto, L., & Figueroa, M. E. (2020). “We have this, with my husband, we live in harmony”: Exploring the gendered decision-making matrix for malaria prevention and treatment in Nampula Province, Mozambique. Malaria Journal, 19(1), 1–14. https://doi.org/10.1186/s12936-020-03198-5
   PubMed Web of Science ®Google Scholar
• Institut National de la Statistique. (2018). Annuaire statistique 2018. République de Guinée.
   Google Scholar
• Interagency Gender Working Group. (2017). Gender integration continuum. USAID.
   Google Scholar
• Jemal, A. (2018). Transformative consciousness of health inequities: Oppression is a virus and critical consciousness is the antidote. Journal of Human Rights and Social Work, 3(4), 202–215. https://doi.org/10.1007/s41134-018-0061-8
   PubMed Web of Science ®Google Scholar
• Jennings, L., Na, M., Cherewick, M., Hindin, M., Mullany, B., & Ahmed, S. (2014). Women’s empowerment and male involvement in antenatal care: Analyses of Demographic and Health Surveys (DHS) in selected African countries. BMC Pregnancy and Childbirth, 14(1), 1–11. https://doi.org/10.1186/1471-2393-14-297
   PubMedGoogle Scholar
• Kapilashrami, A., & Hankivsky, O. (2018). Intersectionality and why it matters to global health. The Lancet, 391(10140), 2589–2591. https://doi.org/10.1016/S0140-6736(18)31431-4
   PubMed Web of Science ®Google Scholar
• Kolie, D., Delamou, A., van de Pas, R., Dioubate, N., Bouedouno, P., Beavogui, A. H., Kaba, A., Diallo, A. M., Van De Put, W., & Van Damme, W. (2019). ‘Never let a crisis go to waste’: Post-Ebola agenda-setting for health system strengthening in Guinea. BMJ Global Health, 4(6), e001925. https://doi.org/10.1136/bmjgh-2019-001925
   PubMed Web of Science ®Google Scholar
• Korstjens, I., & Moser, A. (2018). Series: Practical guidance to qualitative research. Part 4: Trustworthiness and publishing. European Journal of General Practice, 24(1), 120–124. https://doi.org/10.1080/13814788.2017.1375092
   PubMed Web of Science ®Google Scholar
• Kyei-Nimakoh, M., Carolan-Olah, M., & McCann, T. V. (2017). Access barriers to obstetric care at health facilities in sub-Saharan Africa-a systematic review. Systematic Reviews, 6(1), 1–16. https://doi.org/10.1186/s13643-017-0503-x
   PubMedGoogle Scholar
• Loignon, C., Nouvet, E., Couturier, F., Benhadj, L., Adhikari, N. K. J., Murthy, S., Fowler, R. A., & Lamontagne, F. (2018). Barriers to supportive care during the Ebola virus disease outbreak in West Africa: Results of a qualitative study. PloS One, 13(9), 1–14. https://doi.org/10.1371/journal.pone.0201091
   Web of Science ®Google Scholar
• Lokot, M., & Avakyan, Y. (2020). Intersectionality as a lens to the COVID-19 pandemic: Implications for sexual and reproductive health in development and humanitarian contexts. Sexual and Reproductive Health Matters, 28(1), 1–5. https://doi.org/10.1080/26410397.2020.1764748
   Google Scholar
• Lufumpa, E., Doos, L., & Lindenmeyer, A. (2018). Barriers and facilitators to preventive interventions for the development of obstetric fistulas among women in sub-Saharan Africa: A systematic review. BMC Pregnancy and Childbirth, 18(1), 1–15. https://doi.org/10.1186/s12884-018-1787-0
   PubMedGoogle Scholar
• McQuilkin, P. A., Udhayashankar, K., Niescierenko, M., & Maranda, L. (2017). Health-care access during the Ebola virus epidemic in Liberia. The American Journal of Tropical Medicine and Hygiene, 97(3), 931–936. https://doi.org/10.4269/ajtmh.16-0702
   PubMed Web of Science ®Google Scholar
• Menéndez, C., Lucas, A., Munguambe, K., & Langer, A. (2015). Ebola crisis: The unequal impact on women and children’s health. The Lancet Global Health, 3(3), e130. https://doi.org/10.1016/S2214-109X(15)70009-4
   PubMed Web of Science ®Google Scholar
• Nkangu, M. N., Olatunde, O. A., & Yaya, S. (2017). The perspective of gender on the Ebola virus using a risk management and population health framework: A scoping review. Infectious Diseases of Poverty, 6(1), 1–9. https://doi.org/10.1186/s40249-017-0346-7
   PubMedGoogle Scholar
• Nuriddin, A., Jalloh, M. F., Meyer, E., Bunnell, R., Bio, F. A., Jalloh, M. B., Sengeh, P., Hageman, K. M., Carroll, D. D., Conteh, L., & Morgan, O. (2018). Trust, fear, stigma and disruptions: Community perceptions and experiences during periods of low but ongoing transmission of Ebola virus disease in Sierra Leone, 2015. BMJ Global Health, 3(2), e000410. https://doi.org/10.1136/bmjgh-2017-000410
   PubMed Web of Science ®Google Scholar
• O’Connell, T. S., Bedford, K. J. A., Thiede, M., & McIntyre, D. (2015). Synthesizing qualitative and quantitative evidence on non-financial access barriers: Implications for assessment at the district level. International Journal for Equity in Health, 14(1), 1–13. https://doi.org/10.1186/s12939-015-0181-z
   PubMedGoogle Scholar
• Parpia, A. S., Ndeffo-Mbah, M. L., Wenzel, N. S., & Galvani, A. P. (2016). Effects of response to 2014–2015 Ebola outbreak on deaths from malaria, HIV/AIDS, and tuberculosis, West Africa. Emerging Infectious Diseases, 22(3), 433–441. https://doi.org/10.3201/eid2203.150977
   PubMed Web of Science ®Google Scholar
• Ponsar, F., Tayler-Smith, K., Philips, M., Gerard, S., Van Herp, M., Reid, T., & Zachariah, R. (2011). No cash, no care: How user fees endanger health-lessons learnt regarding financial barriers to healthcare services in Burundi, Sierra Leone, Democratic Republic of Congo, Chad, Haiti and Mali. International Health, 3(2), 91–100. https://doi.org/10.1016/j.inhe.2011.01.002
   PubMed Web of Science ®Google Scholar
• Pratley, P. (2016). Associations between quantitative measures of women’s empowerment and access to care and health status for mothers and their children: A systematic review of evidence from the developing world. Social Science and Medicine, 169, 119–131. https://doi.org/10.1016/j.socscimed.2016.08.001
   PubMed Web of Science ®Google Scholar
• Save the Children. (2020). COVID-19 and gender equality.
   Google Scholar
• Sharkey, A., Chopra, M., Jackson, D., Winch, P. J., & Minkovitz, C. S. (2011). Influences on healthcare-seeking during final illnesses of infants in under-resourced South African settings. Journal of Health, Population and Nutrition, 29(4), 379–387. https://doi.org/10.3329/jhpn.v29i4.8455
   PubMed Web of Science ®Google Scholar
• Shenton, A. (2004). Strategies for ensuring trustworthiness in qualitative research projects. Education for Information, 22(2), 63–75. https://doi.org/10.3233/EFI-2004-22201
   Google Scholar
• Shoman, H., Karafillakis, E., & Rawaf, S. (2017). The link between the West African Ebola outbreak and health systems in Guinea, Liberia and Sierra Leone: A systematic review. Globalization and Health, 13(1), 1–22. https://doi.org/10.1186/s12992-016-0224-2
   PubMedGoogle Scholar
• Sidibé, S., Camara, B. S., Delamou, A., Touré, A., Bouedouno, P., Samake, A. T., & Beavogui, A. H. (2018). Connaissances, attitudes et pratiques des prestataires de soins de santé de face aux cas suspects d’Ebola en Guinée. Revue d’Épidémiologie et de Santé Publique, 66(6), 369–374. https://doi.org/10.1016/j.respe.2018.09.006
   PubMedGoogle Scholar
• Stanturf, J. A., Goodrick, S. L., Warren Jr., M. L., Charnley, S., & Stegall, C. M. (2015). Social vulnerability and Ebola virus disease in rural Liberia. PLoS One, 10(9), 1–15. https://doi.org/10.1371/journal.pone.0137208
   Web of Science ®Google Scholar
• Story, W. T., Barrington, C., Fordham, C., Sodzi-Tettey, S., Barker, P. M., & Singh, K. (2016). Male involvement and accommodation during obstetric emergencies in rural Ghana: A qualitative analysis. International Perspectives on Sexual and Reproductive Health, 42(4), 211–219. https://doi.org/10.1363/42e2616
   PubMed Web of Science ®Google Scholar
• Thaddeus, S., & Maine, D. (1994). Too far to walk: Maternal mortality in context. Social Science & Medicine, 38(8), 1091–1110. https://doi.org/10.1016/0277-9536(94)90226-7
   PubMed Web of Science ®Google Scholar
• Tibbels, N. J., Hendrickson, Z. M., Mills, H., Sidikaba, S., Vondrasek, C., & Gurman, T. A. (2019). Assessing the salience of trust for the patient-provider relationship: Findings from qualitative research in Post-Ebola Guinea. International Communication Association Meeting.
   Google Scholar
• USAID. (2018). Gender equality continuum tool | USAID ASSIST Project. https://www.usaidassist.org/photo-gallery/gender-equality-continuum-tool
   Google Scholar
• USAID. (2019). USAID/GUINEA country development cooperation strategy.
   Google Scholar
• van de Pas, R., Kolie, D., Delamou, A., & Van Damme, W. (2019). Health workforce development and retention in Guinea: A policy analysis post-Ebola. Human Resources for Health, 17(1), 1–12. https://doi.org/10.1186/s12960-019-0400-6
   PubMed Web of Science ®Google Scholar
• Wanaka, S., Hussen, S., Alagaw, A., Tolosie, K., & Boti, N. (2020). Maternal delays for institutional delivery and associated factors among postnatal mothers at public health facilities of gamo zone, Southern Ethiopia. International Journal of Women’s Health, 12, 127–138. https://doi.org/10.2147/IJWH.S240608
   PubMed Web of Science ®Google Scholar
• Wenham, C., Smith, J., & Morgan, R. (2020). COVID-19: The gendered impacts of the outbreak. The Lancet, 395(10227), 846–848. https://doi.org/10.1016/S0140-6736(20)30526-2
   PubMed Web of Science ®Google Scholar
• World Health Organization. (2014). Global atlas of medical devices - 2014: Guinea. https://www.who.int/medical_devices/countries/gin.pdf?ua=1
   Google Scholar
• World Health Organization. (2015). Guinea: Country cooperation strategy at a glance. https://apps.who.int/iris/bitstream/handle/10665/246211/ccsbrief_gin_en.pdf?sequence=1
   Google Scholar
• World Health Organization. (2020). WHO | About social determinants of health. https://www.who.int/social_determinants/sdh_definition/en/
   Google Scholar
• World Health Organization. (2021). General government expenditure on health as a percentage of total government expenditure. The Global Health Observatory. https://www.who.int/data/gho/data/indicators/indicator-details/GHO/general-government-expenditure-on-health-as-a-percentage-of-total-government-expenditure
   Google Scholar
• Yamanis, T., Nolan, E., & Shepler, S. (2016). Fears and misperceptions of the Ebola response system during the 2014–2015 outbreak in Sierra Leone. PLoS Neglected Tropical Diseases, 10(10), 1–12. https://doi.org/10.1371/journal.pntd.0005077
   Web of Science ®Google Scholar
• Yaya, S., Okonofua, F., Ntoimo, L., Udenige, O., & Bishwajit, G. (2019). Gender inequity as a barrier to women’s access to skilled pregnancy care in rural Nigeria: A qualitative study. International Health, 11(6), 551–560. https://doi.org/10.1093/inthealth/ihz019
   PubMed Web of Science ®Google Scholar