Date of Conferral





Public Health


John W. Oswald


Sierra Leone was heavily affected by the West African Ebola virus disease (EVD) epidemic from 2013 to 2016. Ongoing EVD transmission during the epidemic was connected to several factors including unsafe traditional burial practices. This phenomenological qualitative study addressed Kono members' perceived knowledge, attitudes, and beliefs regarding how burial practices influenced EVD transmission. Rosenstock's health belief model provided the framework for the study. The participants purposefully selected from various religions and professions were interviewed individually and in focus group settings. Similar phrases and comments were identified from the interview responses resulted which resulted in the following 5 main themes: (a) Kono community leaders and public health workers were cognizant of important EVD issues, but there was a knowledge deficit among Konos about EVD and its mode of transmission; (b) although customary burial rituals were temporarily banned from 2014 to 2016, they were practiced among the Konos to promote culture-driven dignity and respect for the dead; (c) many Konos harbored grudges and mistrusted government officials and public health workers; (d) infrastructural deficits were a barrier to health care as private and public sectors lacked training and equipment to mitigate the 2013-2016 EVD outbreak; and (e) participants were willing to adopt safer burial practices if EVD outbreaks were to reemerge. These findings indicated that EVD transmission was connected to unsafe burial practices. Findings may be used to improve community engagement and public health outreach efforts to promote safer burial practices, especially during periods of infectious disease outbreaks.