”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

resuLTs Two overarching themes were developed from the interviews with the Sierra Leonean CS providers. The subthemes of the main themes below are presented in table 3 . Participants highlighted that CS volumes relied on the ability to adapt to both exacerbated and new barriers to CS provision. First, they reported a high degree of internal motivation among CS providers to overcome the moral dilemmas posed by the outbreak, such as being overworked in a hazardous hospital environment. The main motivators were their medical duty and loyalty to the communities. Second, there had to be pervasive clinical adaptability of individual CS providers in order to adjust to the clinical challenges, altered healthcare-seeking behaviour, arrival of international actors and intensified resource scarcity. Meaning unit analysis and categorisation according to the WHO building blocks are found in the online supplementary material 2.