Accessibility and Cultural Beliefs as Determinants of Maternal and Neonatal Health Outcomes in Gbarpolu County, Liberia

Maternal and neonatal mortality remain major public health challenges in low resource settings, particularly in rural Liberia. This study examined how accessibility limitations and cultural beliefs influence maternal and neonatal health outcomes in Gbarpolu County. A mixed methods design was employed, combining quantitative surveys of 200 women aged 15 to 49 years with qualitative interviews involving traditional birth attendants, elders, and healthcare workers. Quantitative data were analyzed using SPSS version 26 while qualitative data were thematically analyzed. Results showed that 85 percent of respondents reported poor road conditions as a major barrier to healthcare access, while 60 percent lived more than 10 km from the nearest health facility. Cultural reliance on traditional birth attendants was reported by 72 percent of women. Women who accessed skilled birth attendance had significantly better health outcomes with an odds ratio of 3.2 and a 95 percent confidence interval of 1.8 to 5.6. Neonatal mortality was higher among deliveries attended by traditional birth attendants. The study concludes that maternal and neonatal outcomes in Gbarpolu County are shaped by the combined effects of accessibility constraints and strong cultural beliefs. Culturally sensitive and infrastructure focused interventions are recommended to improve healthcare delivery in hard to reach communities