Healthcare providers on the frontlines: A qualitative investigation of the social and emotional impact of delivering health services during Sierra Leone's Ebola epidemic

Shannon A. McMahon, Lara S. Ho, Hannah Brown, Laura Miller, Rashid Ansumana, Caitlin E Kennedy

Research output: Contribution to journalArticle

Abstract

Although research on the epidemiology and ecology of Ebola has expanded since the 2014-15 outbreak in West Africa, less attention has been paid to the mental health implications and the psychosocial context of the disease for providers working in primary health facilities (rather than Ebola-specific treatment units). This study draws on 54 qualitative interviews with 35 providers working in eight peripheral health units of Sierra Leone's Bo and Kenema Districts. Data collection started near the height of the outbreak in December 2014 and lasted 1 month. Providers recounted changes in their professional, personal and social lives as they became de facto first responders in the outbreak. A theme articulated across interviews was Ebola's destruction of social connectedness and sense of trust within and across health facilities, communities and families. Providers described feeling lonely, ostracized, unloved, afraid, saddened and no longer respected. They also discussed restrictions on behaviors that enhance coping including attending burials and engaging in physical touch (hugging, handshaking, sitting near, or eating with colleagues, patients and family members). Providers described infection prevention measures as necessary but divisive because screening booths and protective equipment inhibited bonding or 'suffering with' patients. To mitigate psychiatric morbidities and maladaptive coping mechanisms-and to prevent the spread of Ebola-researchers and program planners must consider the psychosocial context of this disease and mechanisms to enhance psychological first aid to all health providers, including those in peripheral health settings.

Original languageEnglish (US)
Pages (from-to)1232-1239
Number of pages8
JournalHealth Policy and Planning
Volume31
Issue number9
DOIs
StatePublished - 2016

Fingerprint

Sierra Leone
Health Personnel
Health Services
Disease Outbreaks
Health Facilities
Health
Interviews
Burial
First Aid
Western Africa
Psychological Adaptation
Touch
Ecology
Psychiatry
Mental Health
Emotions
Epidemiology
Eating
Research Personnel
Psychology

Keywords

  • Ebola
  • frontline health workers
  • mental health and psychosocial support
  • qualitative research
  • Sierra Leone

ASJC Scopus subject areas

  • Health Policy

Cite this

Healthcare providers on the frontlines : A qualitative investigation of the social and emotional impact of delivering health services during Sierra Leone's Ebola epidemic. / McMahon, Shannon A.; Ho, Lara S.; Brown, Hannah; Miller, Laura; Ansumana, Rashid; Kennedy, Caitlin E.

In: Health Policy and Planning, Vol. 31, No. 9, 2016, p. 1232-1239.

Research output: Contribution to journalArticle

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