Table 1
Study population ratios and sociodemographic characteristics of participants (n = 500).
A Study population ratios by residence.
| POPULATION CATEGORY | URBAN (BO GOVERNMENT HOSPITAL), N | RURAL (TIKONKO MATERNITY HOME), N | URBAN: RURAL RATIO |
|---|---|---|---|
| Pregnant women | 238 | 56 | 4.25:1 |
| Mothers of children under 5 | 136 | 70 | 1.94:1 |
| Children under 5 (total) | 137 | 73 | 1.94:1 |
| Children under 5—Male | 64 | 38 | 1.73:1 |
| Children under 5—Female | 73 | 35 | 2.18:1 |
B Sociodemographic characteristics of participants.
| CHARACTERISTIC | CATEGORY/MEASURE | N (%) | STATISTICAL SUMMARY |
|---|---|---|---|
| Age of pregnant women (years) | Mean | – | 24.83 ± 4.74 (SE = 0.28; Range: 16–45; 95% CI: 24.29–25.37) |
| Median | – | 25 | |
| Mode | – | 25 | |
| Age of mothers (years) | Mean | – | 24.07 ± 4.34 (SE = 0.30; Range: 17–45; 95% CI: 23.47–24.67) |
| Median | – | 23 | |
| Mode | – | 20 | |
| Educational level | No formal education | 50 (10.0) | – |
| Primary education | 142 (28.4) | – | |
| Secondary education | 268 (53.6) | – | |
| Tertiary education | 40 (8.0) | – | |
| Monthly income (SLE) | Mean | – | 335.03 ± 668.49 (SE = 29.90; Range: 0–10,000; 95% CI: 276.29–393.77) |
| Pregnancies experienced | Mean | – | 1.83 ± 1.05 (SE = 0.05; Range: 1–7+; 95% CI: 1.74–1.92) |
[i] Note: Values are presented as n (%) for categorical variables and mean ± standard deviation (SD) for continuous variables. CI = confidence interval; SE = standard error; SLE = Sierra Leonean Leone.
Table 2
Predisposing factors influencing antenatal and postnatal care–seeking behavior and decision by residence (multiple responses, n = 500).
| PREDISPOSING FACTOR | URBAN (BO GOVERNMENT HOSPITAL) N (%) | RURAL (TIKONKO MATERNITY HOME) N (%) | TOTAL N (%) | ODDS RATIO (OR) | 95% CI | χ² | P‑VALUE | CRAMÉR’S V |
|---|---|---|---|---|---|---|---|---|
| Any predisposing factor reported | 363 (97.1) | 124 (98.4) | 487 (97.4) | 0.53 | 0.12–2.43 | 0.69 | 0.41 | 0.04 |
| Knowledge and health awareness | 305 (75.5) | 99 (24.5) | 404 (83.0) | Reference | – | – | – | – |
| Attitudes and beliefs | 45 (71.4) | 18 (28.6) | 63 (12.6) | 0.81 | 0.45–1.47 | 0.47 | 0.49 | 0.03 |
| Cultural factors | 3 (33.3) | 6 (66.7) | 9 (1.8) | 0.16 | 0.04–0.66 | 10.12 | 0.004 | 0.14 |
| Social support and norms | 10 (90.9) | 1 (9.1) | 11 (2.2) | 3.25 | 0.41–25.68 | 1.38 | 0.24 | 0.05 |
| Total predisposing reports | 363 (100) | 124 (100) | 487 (100) | – | – | – | – | – |
[i] Note: Odds ratios compare the likelihood of reporting each predisposing factor among urban versus rural respondents. OR = odds ratio; CI = confidence interval; χ² = Pearson’s Chi‑square test.
[ii] Effect size interpretation (Cramér’s V): ≈0.10 = small, ≈0.30 = moderate, ≥0.50 = large association.
Table 3
Enabling factors influencing maternal healthcare access and decision by residence (multiple responses; n = 500).
| ENABLING FACTOR | URBAN FREQUENCY (N = 1,840) | RURAL FREQUENCY (N = 627) | TOTAL FREQUENCY | ODDS RATIO (OR) | 95% CI | χ² | P‑VALUE | CRAMÉR’S V |
|---|---|---|---|---|---|---|---|---|
| Health insurance coverage | 209 (86.36) | 33 (13.64) | 242 | 2.31 | 1.58–3.37 | 18.96 | <0.001 | 0.20 |
| Financial stability | 203 (82.52) | 43 (17.48) | 246 | 1.68 | 1.20–2.37 | 8.62 | 0.003 | 0.13 |
| Proximity to healthcare facilities | 162 (85.71) | 27 (14.29) | 189 | 2.15 | 1.41–3.26 | 12.75 | <0.001 | 0.16 |
| Transportation availability | 169 (78.60) | 46 (21.40) | 215 | 1.48 | 1.05–2.08 | 4.96 | 0.026 | 0.10 |
| Cultural competency in healthcare | 155 (83.78) | 30 (16.22) | 185 | 1.83 | 1.23–2.74 | 8.41 | 0.004 | 0.13 |
| Supportive social environment | 164 (86.32) | 26 (13.68) | 190 | 2.26 | 1.48–3.46 | 14.28 | <0.001 | 0.17 |
| Geographic accessibility | 48 (96.00) | 2 (4.00) | 50 | 8.37 | 2.03–34.54 | 11.22 | 0.001 | 0.15 |
| Cultural and social support (traditional) | 4 (16.67) | 20 (83.33) | 24 | 0.07 | 0.02–0.19 | 39.86 | <0.001 | 0.28 |
| Healthcare infrastructure adequacy | 10 (32.26) | 21 (67.74) | 31 | 0.16 | 0.07–0.34 | 27.45 | <0.001 | 0.23 |
| Language and communication support | 9 (31.03) | 20 (68.97) | 29 | 0.15 | 0.07–0.33 | 27.08 | <0.001 | 0.23 |
| Availability of preventive services | 28 (57.14) | 21 (42.86) | 49 | 0.45 | 0.25–0.79 | 7.06 | 0.008 | 0.12 |
| Community awareness and engagement | 33 (55.93) | 26 (44.07) | 59 | 0.42 | 0.25–0.71 | 10.01 | 0.002 | 0.14 |
[i] Note: Odds ratios compare the likelihood of reporting each enabling factor among urban versus rural respondents. OR = odds ratio; CI = confidence interval; χ² = Pearson’s Chi‑square test.
[ii] Effect size interpretation (Cramér’s V): ≈0.10 = small, ≈0.30 = moderate, ≥0.50 = large association.
Table 4
Illness‑level factors influencing maternal healthcare‑seeking behavior by residence (n = 500).
A Experienced Health Issues or Complications Requiring Care.
| RESPONSE CATEGORY | URBAN (BO GOVERNMENT HOSPITAL) N (%) | RURAL (TIKONKO MATERNITY HOME) N (%) | TOTAL N (%) | UNADJUSTED OR | 95% CI | χ² | P‑VALUE | CRAMÉR’S V |
|---|---|---|---|---|---|---|---|---|
| Yes | 261 (69.8) | 80 (63.5) | 341 (68.2) | 1.33 | 0.87–2.03 | 1.44 | 0.23 | 0.05 |
| No | 113 (30.2) | 46 (36.5) | 159 (31.8) | Reference | – | – | – | – |
[i] OR = odds ratio; CI = confidence interval; χ² = Pearson’s Chi‑square test.
[ii] Effect size interpretation (Cramér’s V): ≈0.10 = small, ≈0.30 = moderate, ≥0.50 = large association.
B Perceived Influence of Illness‑Level Factors on Healthcare‑Seeking Decisions (n = 341).
| INFLUENCE CATEGORY | URBAN N (%) | RURAL N (%) | TOTAL N (%) |
|---|---|---|---|
| Extremely influential | 3 (60.0) | 2 (40.0) | 5 (1.5) |
| Very influential | 93 (90.3) | 10 (9.7) | 103 (30.2) |
| Moderately influential | 119 (77.3) | 35 (22.7) | 154 (45.2) |
| Slightly influential | 42 (75.0) | 14 (25.0) | 56 (16.4) |
| Not influential | 4 (17.4) | 19 (82.6) | 23 (6.7) |
[i] Note: Cramér’s V is reported to support practical interpretation of residence‑based differences in perceived illness‑level influence.
[ii] Statistical test: Mann–Whitney U = 14,165.5.
[iii] p‑value: < 0.001.
[iv] Cramér’s V (converted for interpretive consistency): 0.21 (small‑to‑moderate effect).
Table 5
Factors influencing the decision to seek healthcare services for children by residence (n = 430; multiple responses = 1,425).
| FACTOR | URBAN (BO GOVERNMENT HOSPITAL) N (%) | RURAL (TIKONKO MATERNITY HOME) N (%) | TOTAL N (%) | ODDS RATIO (OR) | 95% CI | χ² | P‑VALUE | CRAMÉR’S V |
|---|---|---|---|---|---|---|---|---|
| Knowledge and awareness | 308 (73.5) | 111 (26.5) | 419 (29.4) | Reference | – | – | – | – |
| Cultural beliefs | 127 (82.5) | 27 (17.5) | 154 (10.8) | 0.31 | 0.19–0.50 | 31.02 | <0.001 | 0.27 |
| Financial resources | 149 (81.0) | 35 (19.0) | 184 (12.9) | 0.38 | 0.24–0.60 | 27.45 | <0.001 | 0.25 |
| Health insurance coverage | 125 (85.6) | 21 (14.4) | 146 (10.3) | 0.28 | 0.17–0.48 | 32.18 | <0.001 | 0.27 |
| Symptoms and perceived severity | 133 (76.0) | 42 (24.0) | 175 (12.3) | 0.42 | 0.27–0.66 | 20.57 | <0.001 | 0.22 |
| Medical advice from health workers | 174 (71.9) | 68 (28.1) | 242 (17.0) | 0.66 | 0.46–0.94 | 5.10 | 0.024 | 0.11 |
| Previous health experiences | 63 (60.0) | 42 (40.0) | 105 (7.4) | 0.28 | 0.18–0.44 | 27.66 | <0.001 | 0.25 |
[i] Note: Odds ratios compare the likelihood of reporting each factor among urban versus rural respondents. OR = odds ratio; CI = confidence interval; χ² = Pearson’s Chi‑square test.
[ii] Effect size interpretation (Cramér’s V): ≈0.10 = small, ≈0.30 = moderate, ≥0.50 = large association.
Table 6
Place of childbirth, ANC, and PNC utilization.
| Birth at Health Facility (N = 206) | ||
| Bo Government Hospital, n (%) | Tikonko Maternity Home, n (%) | |
| Yes | 135 (65.53) | 69 (33.50) |
| No | 1 (0.49) | 1 (0.49) |
| ANC utilization (N = 294) | ||
| Bo Government Hospital, n (%) | Tikonko Maternity Home, n (%) | |
| Yes | 235 (79.93) | 54 (18.37) |
| No | 3 (1.02) | 2 (0.68) |
| PNC utilization (N = 206) | ||
| Bo Government Hospital, n (%) | Tikonko Maternity Home, n (%) | |
| Yes | 134 (65.05) | 69 (35.50) |
| No | 2 (0.97) | 1 (0.49) |
Figure 1
Distribution of antenatal care visits among study participants.