Author
Tolhurst, R., Theobald, S., Kayira, E., Ntonya, C., Kafulafula, G., Nielson, J., van den Broek, N.
Journal
Midwifery
Volume
24
Issue ID
1
Page
83-98
Date
2008 Mar.
Keyword
Alternative medicine
Adult
Anecdotes as Topic
Female
Fetal Death/prevention & control
Focus Groups
Health Knowledge, Attitudes, Practice*
Humans
Infant, Newborn
Malawi
Maternal Behavior/psychology*
Medicine, Traditional
Midwifery/methods*
Mothers/psychology
Nurse’s Role
Nurse-Patient Relations
Obstetric Labor, Premature/nursing*
Obstetric Labor, Premature/prevention & control
Obstetric Labor, Premature/psychology*
Patient Acceptance of Health Care/psychology*
Patient Compliance/psychology
Pregnancy
Pregnancy Outcome/psychology*
Prenatal Care/methods
Risk Factors
Rural Population
Self Concept
Social Support
Socioeconomic Factors
Abstract
OBJECTIVE: to investigate perceptions of preterm birth, infections in pregnancy and perinatal mortality among women, men and health-care providers in Namitambo, Southern Malawi. DESIGN: a qualitative study using focus-group discussions, critical incidence narrative and key informant interviews. The framework approach to qualitative analysis was used. SETTING: Namitambo, a rural area in southern Malawi. PARTICIPANTS: women who have experienced preterm delivery, groups of mothers, fathers and grandmothers, health-care providers, traditional birth attendants and healers. FINDINGS: four key inter-related themes grounded in community interpretative frameworks emerged: (1) community conceptualisations of preterm birth (the different terminologies used); (2) perceived causes of preterm birth (i.e. both ‘modern’ and ‘traditional; illnesses, violence, witchcraft, ideas relating to impurity, heavy work, inadequate food and inappropriate use of medicine); (3) perceived strategies to prevent preterm birth (i.e. using formal health services, treatment for sexually transmitted infections, using condoms and stopping violence); and (4) barriers to realising these strategies, such as lack of food, money and women’s autonomy in health seeking. KEY CONCLUSIONS: similarities and differences exist in understanding between healthcare providers and the community. Additional dialogue and action is needed within the health sector and community to address the problem of preterm births. This includes strategies to enable health-care providers and community members to reflect on their perceptions and practices (e.g. through action research and interactive drama); identify and build on areas of common concern (i.e. poor pregnancy outcome) and enter into partnerships with non-formal providers. Action is also needed beyond the health sector (e.g. in campaigns to reduce gender-based violence).
Language
Eng
