Sierra Leone was highly impacted by the 2014–2016 West Africa Ebola outbreak, with 3,955 recorded deaths. Already stressed maternal health services were deeply affected by the outbreak due to fears of viral transmission, reallocation of maternity staff, and broader policies to stop transmission including travel restrictions. This research sought to explore women's perspectives on delaying pregnancy during the Ebola outbreak using family planning methods. Qualitative data collection took place in Kambia District in 2018 and included 35 women participants, with women who were either family planning users or nonusers at the time of the outbreak. Women reported a variety of reasons for choosing to take or not to take family planning during the outbreak, which we categorized as proximal (directly related to the outbreak) or distal (not directly outbreak related). Proximal reasons to take family planning included to avoid interacting with health care spaces where Ebola could be transmitted, to avoid the economic burden of additional children in a time when economic activities were curtailed and to return to school when education resumed postoutbreak. Distal reasoning included gender roles affecting women's decision making to seek family planning, concerns related to the physiological side effects of family planning, and the economic burden of paying for family planning. Women's perspectives for choosing to take or not take family planning during the Sierra Leone Ebola crisis had not been explored prior to this paper. Using the lens of family planning to consider how women choose to access health care in an outbreak gives us a unique perspective into how all health care interactions are impacted by a generalized outbreak of Ebola, and how outbreak responses struggle to ensure such services remain a priority.

中文翻译：

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塞拉利昂埃博拉疫情中的计划生育：女性的近端和远端推理

塞拉利昂受到 2014-2016 年西非埃博拉疫情的严重影响，有 3,955 人死亡。由于担心病毒传播、妇产科工作人员的重新分配以及包括旅行限制在内的更广泛的阻止传播政策，已经强调的孕产妇保健服务受到疫情的严重影响。本研究旨在探讨女性在埃博拉爆发期间使用计划生育方法延迟怀孕的观点。定性数据收集于 2018 年在 Kambia 区进行，包括 35 名女性参与者，其中女性在疫情爆发时要么是计划生育使用者，要么是非计划生育使用者。女性报告了在疫情期间选择采取或不采取计划生育的多种原因，我们将其归类为近端（与爆发直接相关）或远端（与爆发不直接相关）。采取计划生育的近端原因包括避免与可能传播埃博拉病毒的医疗保健场所互动，避免在经济活动受限时增加儿童的经济负担，以及在疫情后恢复教育时重返学校。远距离推理包括影响女性寻求计划生育决策的性别角色、与计划生育的生理副作用相关的担忧，以及支付计划生育费用的经济负担。在本文发布之前，尚未探讨妇女在塞拉利昂埃博拉危机期间选择采取或不采取计划生育的观点。