{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T09:28:33Z","timestamp":1780824513865,"version":"3.54.1"},"reference-count":19,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Glob Health"],"accepted":{"date-parts":[[2016,4,1]]},"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The recent Ebola virus disease (EVD) outbreak was unprecedented in magnitude, duration and geographic scope. Hitherto there have been no population-based estimates of its impact on non-EVD health outcomes and health-seeking behaviour.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We use data from a population-based panel survey conducted in the late-crisis period and two postcrisis periods to track trends in (1) the prevalence of adult and child illness, (2) subsequent usage of health services and (3) the determinants thereof.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The prevalence of child and adult illness remained relatively steady across all periods. Usage of health services for children and adults increased by 77% and 104%, respectively, between the late-crisis period and the postcrisis periods. In the late-crisis period, (1) socioeconomic factors weakly predict usage, (2) distrust in government strongly predicts usage, (3) direct exposure to the EVD outbreak, as measured by witnessing dead bodies or knowing Ebola victims, negatively predicts trust and usage and (4) exposure to government-organised community outreach predicts higher trust and usage. These patterns do not obtain in the post-crisis period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interpretation<\/jats:title>\n                  <jats:p>Supply-side and socioeconomic factors are insufficient to account for lower health-seeking behaviour during the crisis. Rather, it appears that distrust and negative EVD-related experiences reduced demand during the outbreak. The absence of these patterns outside the crisis period suggests that the rebound after the crisis reflects recovery of demand. Policymakers should anticipate the importance of demand-side factors, including fear and trust, on usage of health services during health crises.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjgh-2015-000007","type":"journal-article","created":{"date-parts":[[2016,5,18]],"date-time":"2016-05-18T22:39:33Z","timestamp":1463611173000},"page":"e000007","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":60,"title":["Patterns of demand for non-Ebola health services during and after the Ebola outbreak: panel survey evidence from Monrovia, Liberia"],"prefix":"10.1136","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5765-6110","authenticated-orcid":false,"given":"Ben","family":"Morse","sequence":"first","affiliation":[{"name":"Political Science Department, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen A","family":"Gr\u00e9pin","sequence":"additional","affiliation":[{"name":"Robert F. Wagner Graduate School of Public Service, New York University, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A","family":"Blair","sequence":"additional","affiliation":[{"name":"Department of Political Science and Watson Institute for International and Public Affairs, Brown University, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily","family":"Tsai","sequence":"additional","affiliation":[{"name":"Political Science Department, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,5,18]]},"reference":[{"key":"2025073013195697000_1.1.e000007.1","unstructured":"World Health Organization. Ebola Situation Report. apps.who.int. 2015; published online 5 August. http:\/\/apps.who.int\/ebola\/current-situation\/ebola-situation-report-5-august-2015 (accessed 10 Aug 2015)."},{"key":"2025073013195697000_1.1.e000007.2","doi-asserted-by":"crossref","first-page":"e255","DOI":"10.1016\/S2214-109X(15)70103-8","article-title":"Magnitude of Ebola relative to other causes of death in Liberia, Sierra Leone, and Guinea","volume":"3","author":"Helleringer","year":"2015","journal-title":"Lancet Glob Health"},{"key":"2025073013195697000_1.1.e000007.3","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2015-205959"},{"key":"2025073013195697000_1.1.e000007.4","unstructured":"The World Health Organization. Health worker Ebola infections in Guinea, Liberia and Sierra Leone. WHO, 2015; published online 21 May. http:\/\/www.who.int\/csr\/resources\/publications\/ebola\/health-worker-infections\/en\/ (accessed 29 May 2015)."},{"key":"2025073013195697000_1.1.e000007.5","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(15)00065-0"},{"key":"2025073013195697000_1.1.e000007.6","doi-asserted-by":"publisher","DOI":"10.1126\/science.aaa3438"},{"key":"2025073013195697000_1.1.e000007.7","doi-asserted-by":"crossref","first-page":"e130","DOI":"10.1016\/S2214-109X(15)70009-4","article-title":"Ebola crisis: the unequal impact on women and children's health","volume":"3","author":"Men\u00e9ndez","year":"2015","journal-title":"Lancet Glob Health"},{"key":"2025073013195697000_1.1.e000007.8","doi-asserted-by":"publisher","DOI":"10.1038\/519024a"},{"key":"2025073013195697000_1.1.e000007.9","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)70124-6"},{"key":"2025073013195697000_1.1.e000007.10","doi-asserted-by":"crossref","first-page":"N1","DOI":"10.1097\/QAD.0000000000000614","article-title":"Retention in care for HIV-infected patients in the eye of the Ebola storm: lessons from Monrovia, Liberia","volume":"29","author":"Tattevin","year":"2015","journal-title":"AIDS"},{"key":"2025073013195697000_1.1.e000007.11","first-page":"1082","article-title":"Ebola epidemic\u2014Liberia, March\u2013October 2014","volume":"63","author":"Nyenswah","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025073013195697000_1.1.e000007.12","doi-asserted-by":"crossref","first-page":"e0003706","DOI":"10.1371\/journal.pntd.0003706","article-title":"Community-centered responses to Ebola in Urban Liberia: the view from below","volume":"9","author":"Abramowitz","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"key":"2025073013195697000_1.1.e000007.13","unstructured":"Mundasad S . Ebola virus: busting the myths. BBC News . 2014; published online September 22."},{"key":"2025073013195697000_1.1.e000007.14","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czu065"},{"key":"2025073013195697000_1.1.e000007.15","doi-asserted-by":"crossref","unstructured":"Fast SM , Mekaru S , Brownstein JS , et al . The role of social mobilization in controlling Ebola virus in Lofa County, Liberia. PLoS Curr 2015;7. doi:10.1371\/currents.outbreaks.c3576278c66b22ab54a25e122fcdbec1","DOI":"10.1371\/currents.outbreaks.c3576278c66b22ab54a25e122fcdbec1"},{"key":"2025073013195697000_1.1.e000007.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60755-3"},{"key":"2025073013195697000_1.1.e000007.17","unstructured":"The Socio-Economic Impacts of Ebola in Sierra Leone. worldbank.org. http:\/\/www.worldbank.org\/en\/topic\/poverty\/publication\/socio-economic-impacts-ebola-sierra-leone (accessed 24 Aug 2015)."},{"key":"2025073013195697000_1.1.e000007.18","unstructured":"Himelein K , Kastelic JG . The socio-economic impacts of Ebola in Liberia. World Bank Working Paper 2015:1\u201319."},{"key":"2025073013195697000_1.1.e000007.19","unstructured":"MIT Governance Lab. Data for Ebola Recovery. Humanitarian Data Exchange. 2015; published online 1 June. https:\/\/data.hdx.rwlabs.org\/dataset\/data-for-ebola-recovery (accessed 15 Aug 2015)."}],"container-title":["BMJ Global Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjgh-2015-000007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T20:20:04Z","timestamp":1753906804000},"score":1,"resource":{"primary":{"URL":"https:\/\/gh.bmj.com\/lookup\/doi\/10.1136\/bmjgh-2015-000007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,5,18]]},"published-print":{"date-parts":[[2016,5]]}},"alternative-id":["10.1136\/bmjgh-2015-000007"],"URL":"https:\/\/doi.org\/10.1136\/bmjgh-2015-000007","relation":{},"ISSN":["2059-7908"],"issn-type":[{"value":"2059-7908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,5]]}}}