To compare attendance for child health services during Ebola in peripheral health units (PHUs) that had fully integrated a six month point of contact (6mcp) compared to those that had not.
The 6mcp was piloted in 2012 to incorporate vitamin A supplementation (VAS) into the expanded program of immunization, improve infant and young child nutrition (IYCN) and provide confidential family planning (FP) counselling and provision of short/long term commodities for the infant mother. Nation-wide scale-up started in 2014 but was suspended by July due to the Ebola. Attendance for routine child health services from February-June and August- December 2014 were compared in seven PHUs that were versus seven that were not providing the full range of interventions. These were matched for workload, staff cadre, community characteristics and ability to remain open.
Over 40% of PHUs in central and East End of Freetown had to close for deconterminantion during Ebola. Attendance for children 6-23 months in PHUs that were versus were not offering the full range of interventions at the 6mcp dropped by 39% (from 3720 to 2256) and by 58% (from 3767 to 1640) respectively (p<0.0001). Health workers believed the motivating factors were the IYCN demonstrations and the free FP-services that continued to attract mothers despite the fear of Ebola.
Where the fully integrated 6mcp had been established attendance was more resilient during this emergency and mothers purposefully selected these PHUs when their own had closed which helped sustain routine child health services: VAS and immunization during this crisis.