Cultural considerations and beliefs surrounding preterm birth in Kenya and South Africa

Reproductive Health

Research

Emma Smith¹  Nicholas B. Thuo²  Nelly Mugo²  Sara Newmann³  Larry Rand³  Kenneth Ngure⁴  Cecilia Milford⁵  Mags Beksinska⁵  Nalinie Lazarus⁵ 

[1] Albert Einstein School of Medicine, New York, USA;Center for Clinical Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya;Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA;School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya;Wits MRU (MatCH Research Unit), Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of the Witwatersrand, 11th Floor, Commercial City Building, 40 Dr AB Xuma Street, 4001, Durban, South Africa;

关键词: Preterm birth;    Pregnancy;    Culture;    Beliefs;    South Africa;    Kenya;    Intravaginal device;   

DOI  :  10.1186/s12978-023-01633-9

 received in 2022-11-04, accepted in 2023-06-05,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPreterm birth (PTB) is a global health epidemic, sub-Saharan Africa is severely impacted due to its limited healthcare resources. Pregnancy knowledge, cultural beliefs and practices play a role in the identification of risk and management of PTB. This study explored knowledge, understandings, cultural beliefs and attitudes to pregnancy and PTB, as well as cultural considerations for the introduction of an intravaginal device which could be used to identify PTB risk.MethodsQualitative research was conducted in South Africa and Kenya. In-depth interviews were conducted using semi-structured guides with women with a history of PTB (n = 10), healthcare providers (n = 16) and health systems experts (n = 10); and 26 focus group discussions with pregnant women seeking antenatal care (n = 132) and community male partners/fathers (n = 54). Interviews/discussions were transcribed, translated, and analysed thematically.ResultsPregnancy knowledge, especially for first time pregnancies was poor, with many reporting late entry to antenatal care. Knowledge about PTB was understood in terms of gestational age, weight or small size of baby, with concerns about long term health and stigma. Various risk factors for PTB were described, including those related to traditions and beliefs of witchcraft/curses. Cultural practices, such as the use of traditional medicines and pica, and religion and its impact on health seeking behaviour were also viewed as risk factors. Although insertion of intravaginal devices was not widely acceptable in traditional communities, especially during pregnancy, it was felt that the use of one to detect risk of PTB would be accepted if proven effective in reducing PTB risk.ConclusionsVarious culturally-informed beliefs exist which explain understandings of and attitudes toward pregnancy, pregnancy risk, and PTB. An inclusive exploratory process is critical to facilitate an understanding of the beliefs and traditions which could impact the introduction and design of a product to detect the risk of PTB.

【 授权许可】

CC BY   
© The Author(s) 2023