Table 1.
Summary of articles with utilization outcomes
| Source | Country | Location | Study Design | Outcomes | Pre-Ebola Period (Number of Months) | Ebola Period (Number of Months) | Control for Seasonality | Number of Health Centers, Hospitals (Total) | Sampling | Limitations | Sources of Funding | Notable Author Affiliations | Study Quality | Risk of Bias |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
Ortuno-Gutierrez et al. (2016) |
Guinea |
Conakry |
Pre-Post |
HIV, TB |
Apr-Dec 2013 (9 mo) |
Apr-Dec 2014 (9 mo) |
Yes |
1, 0 (1) |
None |
Single facility, had an intervention to maintain quality of care during Ebola |
Damien Foundation |
Medecins Sans Frontieres (MSF) / Doctors Without Borders;National Ministry of Health |
Good |
High |
|
Moisan et al. (2016) |
Guinea |
Guèckèdou |
Pre-Post |
Malaria, OPD, Other Child Diseases |
Malaria: April-July 2012 & 2013 (4 mo); OPD: Apr-Sep 2013 (6 mo); ARI: Sept-Dec 2013 (4 mo) |
Malaria: April-July 2014 (4 mo); OPD: Apr-Sep 2014 (6 mo); ARI: Sept-Dec 2014 (4 mo) |
Yes |
38, 0, (38) |
None |
Missing data likely, but not reported |
National Ministry of Health |
Good |
Medium |
|
|
Leuenberger et al. (2015) |
Guinea |
Macenta |
Pre-Post |
HIV, OPD, TB |
Aug - Dec 2013 (5 mo) |
Aug - Dec 2014 (5 mo) |
Yes |
0, 1 (1) |
None |
Single facility |
[US] National Institutes of Health |
Fair |
High |
|
|
Barden-O'Fallon, Barry, Brodish, Hazerjian (2015) |
Guinea |
Nationwide (Sampled: Guèckèdou, Conakry, Boffa, Coyah, Dabola, Dalaba, Faranah, Fria, Kissidougou, N’Zèrèkorè, Siguiri, Mamou and Mandiana) |
Pre-Post |
ANC, FBD, FP, HIV, Imm, OPD, Other Child Diseases |
Oct-Dec 2013 (3 mo) |
Oct-Dec 2014 (3 mo) |
Yes |
29, 16 (45) |
Convenience |
Used a purposive sampling method; Large amount of missing data for HIV outcomes |
USAID |
Fair |
Medium |
|
|
Plucinski, 2015 |
Guinea |
Nationwide (Sampled: Conakry, Fria, Gaoual, Labe, Guèckèdou, Macenta, Kerouane, Mandiana) |
Difference-in-Difference |
ANC, Malaria, OPD |
Jan - Nov 2013 (11 mo), April-July 2013(4 mo), Aug-Nov 2013 (4 mo) |
Jan - Nov 2014 (11 mo), April-July 2014 (4 mo), Aug-Nov 2014 (4 mo) |
Yes |
112, 8 (120) |
Probability |
Did not adjust for survey design; did not calculate confidence intervals |
Global Fund to Fight AIDS, Tuberculosis and Malaria, and President’s Malaria Initiative |
US Centers for Disease Control (CDC), Catholic Relief Services, National Ministry of Health |
Fair |
Low |
|
Ndawinz et al. (2015) |
Guinea |
Conakry |
Pre-Post |
HIV |
Jun-14 (1 mo) |
November 2014 (1 mo) |
No |
0, 1 (1) |
None |
Single hospital |
Solidarité Thérapeutique et Initiatives pour la Santé |
National Ministry of Health |
Fair |
High |
|
Delamou et al. (2014) |
Guinea |
Conakry |
Pre-Post |
Inpatient |
July-September 2013 (3 mo) |
July-September 2014 (3 mo) |
Yes |
0, 1 (1) |
None |
Single facility, short period, limited information |
National Ministry of Health, MSF |
Fair |
High |
|
|
Ly et al. (2016) |
Liberia |
Rivercess |
Cross-sectional Survey with Recall |
FBD |
March 2011 - June 14, 2014 (39.5 mo) |
June 15, 2014 - April 13, 2015 (10 mo) |
No |
N/A |
Probability |
Social desirability and recall bias |
Direct Relief and UBS foundation |
Last Mile Health; National Ministry of Health |
Excellent |
Low |
|
Loubet et al. (2015) |
Liberia |
Monrovia |
Time-series |
HIV |
Jan-May 2014 (5 mo) |
June-Oct 2014 (5 mo) |
Yes |
0, 2 (2) |
Convenience |
Few facilities |
Ensemble pour une Solidarite Therapeutique en Reseau (ESTHER) France provided funding for the electronic patient database system |
National Ministry of Health |
Good |
High |
|
Lori et al. (2015) |
Liberia |
Bong |
Pre-Post |
FBD |
Jan-July 2014 (7 mo) |
Aug-Oct 2014 (3 mo) |
No |
10, 2 (12) |
Convenience |
Small, purposive sample |
USAID; Fogarty International; National Institutes of Health (NIH) |
Fair |
Medium |
|
|
Iyengar, Kerber, Howe, & Dahn (2015) |
Liberia |
Margibi, Bong |
Pre-Post |
ANC, FBD, Malaria |
March 2014 (1 mo) |
August or September 2014 (1 mo) |
No |
Not Reported |
None |
Limited data on facilities; May be affected by reporting |
Save the Children (Saving Newborn Lives program) |
Save the Children, National Ministry of Health |
Fair |
High |
|
Tattevin et al. (2015) |
Liberia |
Monrovia |
Pre-Post |
HIV |
Jan-May 2014 (5 mo) |
June-Oct 2014 (5 mo) |
No |
0, 1 (1) |
None |
Single facility; Short Ebola Period |
National Ministry of Health |
Fair |
High |
|
|
Liberia MoHSW (2014) |
Liberia |
Nationwide (with ANC by county) |
Pre-Post |
ANC, FBD, FP, HIV, Imm, OPD, Malaria, Other Child Diseases, TB |
Jan - Dec 2013 (12 mo) |
Jan - Dec 2014 (12 mo) |
Yes |
651, 36 (687) |
None |
Missing data (reporting rate declined 83% in 2013 to 72% in 2014). Excludes private facilities. |
National Ministry of Health |
Fair |
High |
|
|
Grépin and Chunara (2015) |
Liberia |
Nationwide |
Cross-sectional Survey with Recall |
FBD |
March 2014 (1 mo) |
September 2014 (1 mo) |
No |
N/A |
Convenience (SMS-based sample) |
Recall and social desirability bias. Did not present evidence that the SMS sample was nationally representative. |
UK Aid |
Fair |
Medium |
|
|
Brolin Ribacke et al. (2016) |
Sierra Leone |
Nationwide |
Pre-Post |
Inpatient, FBD |
Jan - May 2014 (5 mo) |
FBD: May-Dec 2014 (8 mo), C-sections/FBD: June-Dec 2014 (7 mo), Jan-May 2015 (5 mo) |
Yes (Jan-May 2015), No (May/June-Dec 2014) |
0, 32 (32) |
None |
Missing data imputed to zero |
Swedish National Board of Health and Welfare; The Wallenburg Foundation; CapaCare; Norwegian University of Science and Technology |
National Ministry of Health |
Good |
Low |
|
Bundu et al. (2016) |
Sierra Leone |
Freetown |
Pre-Post |
Surgery, Inpatient |
Surg: Aug 2013 (1 mo); INP: Dec 2013 (1 mo) |
Surg: Aug 2014 (1 mo), INP: December 2014 (1 mo) |
Yes |
0, 1 (1) |
None |
Single Hospital |
King's Sierra Leone Partnership, King's Centre for Global Health |
National Ministry of Health |
Fair |
High |
|
Elston et al. (2015) |
Sierra Leone |
Moyamba; Koinadugu |
Pre-Post |
FBD, Imm, Inpatient, OPD |
Aug-Dec 2013 (5 mo), Oct-Jan 2013 (4 mo), Jan-June 2014 (6 mo) |
Aug-Dec 2014 (5 mo), Oct-Jan 2014 (4 mo), July-Dec 2014 (6 mo) |
Yes, No (Imm) |
4, 1 (5) |
Convenience |
Few facilities, selective reporting of outcomes |
National Ministry of Health; Doctors of the World |
Fair |
High |
|
|
Bolkan et al. (2014) |
Sierra Leone |
Nationwide |
Pre-Post |
Inpatient, Surgery |
Jan - May 2013 (5 mo) |
June-Oct 2014 (5 mo) |
No |
0, 40 (40) |
None |
Missing data |
CapaCare, Norwegian University of Science and Technology, national board of health and welfare in Sweden |
National Ministry of Health |
Fair |
Low |
|
Jones et al. (2016) |
Sierra Leone |
Nationwide |
Pre-Post |
ANC, FBD |
April 2013 - Mar/Apr 2014 (12 to 13 mo) |
April/May 2014 - Jan 2015 (9 to 10 mo) |
Yes |
65, 13 (78) |
None |
Missing data on ANC/PNC, Limited to EMoC facilities |
WaterAid - grant from Voluntary Service Overseas |
Good |
Low |
|
|
UNICEF Sierra Leone Health Facility Survey (2015) |
Sierra Leone |
Nationwide |
Pre-Post |
ANC, FBD, HIV, Imm, Malaria, Malnutrition |
May 2014 (1 mo) |
September 2014 (1 mo) |
No |
1137, 0 (1137) |
None |
Extent of missing not reported |
UNICEF, National Ministry of Health |
Good |
Medium |
|
|
UNFPA Rapid Assessment (2015) |
Sierra Leone |
Nationwide |
Pre-Post |
ANC, FBD, FP, Imm |
Jan 2013 - Apr 2014 (16 mo) |
May-Sept 2014 (5 mo) |
Yes |
Not Reported |
None |
Limited data on reporting facilities |
Fair |
Medium |
||
| Quaglio et al. (2016) | Sierra Leone | Pujehun | Pre-Post | FBD, Inpatient, Surgery | FBD/INP: July-Dec 2013 (6 mo), Jan-Dec 2013 (12 mo) | FBD/INP: July-Dec 2014 (6 mo), Jan-Dec 2014 (12 mo) | Yes | 0, 1 (1) | None | Single hospital | Doctors with Africa (DwA) CUAMM | National Ministry of Health | Fair | High |
ANC – antenatal or postnatal care, FBD – facility-based deliveries, FP – family planning, HIV – HIV service delivery, Im – immunizations, Inpatient – impatient admissions including maternity, Malaria – diagnosis or treatment of malaria, Malnutrition – diagnosis or treatment of child or maternal malnutrition, OPD – outpatient department visits, Surgery – inc. C-section, TB – tuberculosis services, mo – months