Narrative Case study: The most essential determinants to child and maternal health in Sierra Leone

Abstract

was significantly associated with the less frequent use of dietary supplementation. The results call the attention for the importance of counseling on healthy lifestyle and appropriate supplement use before and during pregnancy. Key messages: Use of dietary supplementation is higher among pregnant women following a healthy way of lifestyle. The results reinforce the importance of lifestyle counseling during pregnant care. Background: Childbirth has been suggested to increase sickness absence (SA) and disability pension (DP). This may vary by occupation; however, knowledge in this field remains limited. We explored SA and DP in the years before and after childbirth among women in four occupational groups and among those without any occupation. Methods: We conducted a register-based study of nulliparous women aged 18-39 years, living in Sweden on December 31, 2004 (n = 492,504). Women were categorized into five skill-level based occupational groups and three childbirth groups; no childbirths within three years (B0), first childbirth in 2005 with no childbirth within three years (B1), and first childbirth in 2005 with at least one more birth within three years (B1+). We compared crude and standardized annual mean SA (in spells>14 days) and DP net days in the three years before and three years after first childbirth date. Results: Women in the highest skill level occupations and managers had generally lower mean SA/DP days e.g., B0: 11.3, B1: 11.6, B1+: 6.8 during the third year after first childbirth than the lowest skill level occupations group; B0: 28.1, B1: 22.8, B1+: 15.2 days. In B1 and B1+, absolute differences in mean SA/DP, particularly in SA, among occupational groups were highest during the year before childbirth. DP was most common in B0, regardless of group and year. Conclusions: We found that women's mean SA/DP days before and after first childbirth were higher with decreasing skill-level of the occupational group, with these differences being most pronounced in the year before childbirth. DP was most common among women not giving birth, regardless of occupational group. Key messages: Women's mean SA/DP days before and after first childbirth increased with decreasing skill-level of the occupational group and these differences were most pronounced in the year before childbirth. Narrative Case study: The most essential determinants to child and maternal health in Sierra Leone