• M Tsawe and A Sathiya Susuman.
• Department of Statistics & Population Studies, University of the Western Cape, Cape Town, South Africa; Population Statistics Division, Statistics South Africa, Pretoria, South Africa. Electronic address: 2861022@myuwc.ac.za.
• Public Health. 2020 Mar 1; 180: 74-81.

ObjectivesMost African countries have poor maternal and reproductive health outcomes. This is due, in part, to many factors such as accessibility issues, which hinder women in developing countries from using life-saving maternal and reproductive health services. Therefore, this study considered two main objectives: (i) to examine prevalence of delivery care services in Sierra Leone; and (ii) to identify sociodemographic factors associated with the use of the aforementioned health services.Study DesignA secondary analysis was undertaken using data from the Sierra Leone Demographic and Health Surveys.MethodsBivariate and multivariate analyses were used to study the prevalence and factors associated with the use of delivery care services in Sierra Leone.ResultsThe findings show a general increase in the use of delivery care services between 2008 and 2013, although the use of these services remains quite low. The multivariate analysis shows that maternal age, marital status, socio-economic status, the number of living children, decision-making power, media exposure, skilled antenatal care, and geographic location are crucial factors in the use of delivery care services.ConclusionsUse of delivery care services remains low in Sierra Leone. It is possible that the introduction of the Free Healthcare Initiative played a vital role in increasing the use of these services. Further policy debates are needed to ensure universal coverage.Copyright © 2019 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

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