title: "Ebola kills generations": Qualitative discussions with Liberian healthcare providers.
abstract: OBJECTIVE
  the purpose of this study was to explore healthcare providers' perceptions and reactions to the Ebola Virus Disease (EVD) epidemic.
  
  
  METHODS
  a descriptive, qualitative study design was employed. Focus groups were conducted with Liberian healthcare providers who participated in care of patients with EVD.
  
  
  METHODS
  the study was conducted in Bong County, Liberia (population: 333,000), which was severely affected, with over 650 reported cases and close to 200 deaths by the end of 2015.
  
  
  METHODS
  the total sample of 58 participants, included 11 nurses, ten traditional birth attendants (TBAs), four midwives, 28 general community health volunteers, three physician assistants, one community member and one pharmacy dispenser.
  
  
  RESULTS
  five core themes related to changes in healthcare practices and interactions since the EVD outbreak were identified based on the results of the focus groups; fear, stigma, resource constraints, lack of knowledge and training, and shifting cultural practices.
  
  
  CONCLUSIONS
  this work represents a preliminary understanding of Liberian healthcare workers reactions to the EVD epidemic, and highlights the significant issues they faced as they attempted to care for patients and protect themselves.
  
  
  CONCLUSIONS
  while the EVD epidemic has been declared over, preparedness activities for future disease outbreaks must continue. This study can inform future healthcare policy initiatives as well as preparedness activities targeted towards healthcare workers in low resource settings.
authors.affiliation: University of Michigan School of Nursing, 400 North Ingalls, Rm 3340, Ann Arbor, MI 48109, United States. Electronic address: sabell@med.umich.edu.
authors.forename: Sue Anne
authors.initials: SA
authors.lastname: Bell
authors.affiliation: University of Michigan School of Nursing, 400 North Ingalls, Rm 3188, Ann Arbor, MI 48109, United States. Electronic address: mlmunro@umich.edu.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Munro-Kramer
authors.affiliation: Epidemiology, M5166 SPH II, 1415 Washington Heights, Ann Arbor, MI 48109-202, United States. Electronic address: marisae@umich.edu.
authors.forename: Marisa C
authors.initials: MC
authors.lastname: Eisenberg
authors.affiliation: Africare, 1000 Monrovia 10, Liberia. Electronic address: gwilliams@africare.org.
authors.forename: Garfee
authors.initials: G
authors.lastname: Williams
authors.affiliation: Africare, 1000 Monrovia 10, Liberia. Electronic address: pamarah@africare.org.
authors.forename: Patricia
authors.initials: P
authors.lastname: Amarah
authors.affiliation: University of Michigan School of Nursing, 400 North Ingalls Rm 3320A, Ann Arbor, MI 48109, United States. Electronic address: jrlori@umich.edu.
authors.forename: Jody R
authors.initials: JR
authors.lastname: Lori
mesh_terms: D000328:Adult; D000368:Aged; D004196:Disease Outbreaks; D005239:Fear; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000523:psychology*; D006295:Health Resources / Q000600:supply & distribution; D019142:Hemorrhagic Fever, Ebola / Q000401:mortality* / Q000523:psychology; D006801:Humans; D007988:Liberia; D008297:Male; D008875:Middle Aged; D010465:Perception; D036301:Qualitative Research
keywords: Delivery of health care; Ebola Virus Disease; Health care workers; Health resources/supply and distribution; Health services research