”For this one, let me take the risk”: why surgical staff continued to perform caesarean sections during the 2014–2016 Ebola epidemic in Sierra Leone

Drevin, Gustaf; Mölsted Alvesson, Helle; van Duinen, Alex; Bolkan, Håkon A; Koroma, Alimamy P; Von Schreeb, Johan

To serve the aim of the study, an interview guide was developed using the WHO's six building blocks of health systems and a resilience framework by Kruk et al (online supplementary file 1). 9 36 Interviews started with openended questions on the routine function of surgery at participants' hospitals, continued with questions on the changes in patient flow, and ended with questions regarding changes in clinical practice and surgical system functions during the outbreak. A pilot interview was conducted with a SACHO in Freetown to ground the interview guide in the context. Interview locations were chosen to the comfort of participants and included offices, quiet corridors at hospitals and private clinics. Interviews were recorded and transcribed verbatim by GD, while one interview was transcribed by an assistant and later checked for content by GD. Field observations by GD and AvD from 14 public and private hospitals BMJ Global Health provided contextual insight into surgical team composition, operating room capacity and hospital infrastructure at the district, regional and national referral levels.