Understanding the socio-ecological factors that impact the health and well-being of Ebola survivors in sub-Saharan Africa – a narrative review.

Abstract

Background Ebola Virus Disease (EVD) is a rare but often fatal illness. Since its discovery in 1976, it has been causing recurrent outbreaks of varying degrees throughout mostly subSaharan Africa. If patients survive, they face numerous internal and external limitations in their every-day life. Currently, most Ebola responses are focused around the acute outbreak, creating a gap towards survivor-centred information and action. Methods A narrative literature review was conducted to gain an understanding of the factors that impact the health and well-being of EVD survivors and existing programmes. The findings were grouped according to the levels of the socio-ecological framework. Results On each level of the socio-ecological framework, factors impacting health and wellbeing of EVD survivors negatively as well as positively have been identified. On the intrapersonal level: (-) Reduced physical and mental health, trauma, sexual and reproductive health complaints, financial difficulties. (+) Taking action, faith. On the interpersonal level: (-) Loss of family and partners and abandonment. (+) Support from family and survivor groups. On the community level: (-) Stigma. (+) Re-integration, empowerment, education. On the institutional level: (-) Stigma, abandonment, previous negative experiences, structural barriers. (+) Support programmes, health information, compassion, working in healthcare. On the public policy level: (-) Guidelines, lack of government initiative, limited access to care. (+) Effective programmes, collaboration with communities. Conclusions A variety of factors influence the health and well-being of EVD survivors. Future research and programmes need to be evidence based, centred around the needs of survivors and be accessible.