Individual and community perceptions of surgical care in Sierra Leone

Trop Med Int Health. 2014 Jan;19(1):107-16. doi: 10.1111/tmi.12215. Epub 2013 Nov 8.


Objectives: To determine themes and beliefs that influence health-seeking behaviour and barriers to accessing surgical care.

Methods: In January 2012 in Western Area Province of Sierra Leone, six Focus Group Discussions (FGDs) were conducted. The FDGs consisted of three male only and three female only groups in an urban, a slum and a rural setting. Researchers investigated a wide range of topics including definitions of surgery, types of surgical procedures, trust, quality of care, human resources, post-operative care, permission-seeking and traditional beliefs.

Results: Although many individual beliefs were expressed, common fears were as follows: becoming half human after surgery; complications from procedures; stigma from having a scar; and financial burdens resulting from the cost of care. Participants also expressed concern about the quality of the care available in Sierra Leone.

Conclusions: The concept of being half human after surgery, previously not documented in the literature, is noteworthy and should be explored more fully. Qualitative research in other parts of Sierra Leone and other LMICs into beliefs of the local population could improve programmes for access and delivery of surgical care.

Keywords: Sierra Leone; barriers to care; focus group discussion; half human; healthcare seeking behaviour; surgery.

MeSH terms

  • Attitude to Health*
  • Fear / psychology
  • Female
  • Focus Groups
  • Health Services Accessibility*
  • Humans
  • Male
  • Poverty Areas
  • Quality of Health Care*
  • Rural Population
  • Sierra Leone
  • Social Stigma
  • Surgical Procedures, Operative / economics
  • Surgical Procedures, Operative / psychology*
  • Surgical Procedures, Operative / standards