Local illness concepts and their relevance for the prevention and control of malaria during pregnancy in Ghana, Kenya and Malawi: findings from a comparative qualitative study

Malaria Journal

Research

Robert Pool¹  Christopher Pell¹  Arantza Menaca²  Linda Kalilani³  Lucinda Manda-Taylor³  Nana A Afrah⁴  Harry Tagbor⁴  Samuel Chatio⁵  Abraham Hodgson⁵  Florence Were⁶  Peter Ouma⁶ 

[1] Centre de Recerca en Salut Internacional de Barcelona (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain;Centre for Social Science and Global Health, University of Amsterdam, Amsterdam, The Netherlands;Centre de Recerca en Salut Internacional de Barcelona (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain;Departamento de Antropología Social, Universidad Complutense de Madrid, Madrid, Spain;College of Medicine, University of Malawi, Blantyre, Malawi;Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;Navrongo Health Research Centre, Navrongo, Ghana;The Kenya Medical Research Institute (KEMRI) and Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu, Kenya;

关键词: Malaria;    Pregnancy;    Qualitative methods;    Local disease concepts;    Africa;   

DOI  :  10.1186/1475-2875-12-257

 received in 2013-05-07, accepted in 2013-07-17,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundIn sub-Saharan Africa, the burden of morbidity and mortality linked to malaria during pregnancy (MiP) is significant and compounded by its unclear symptoms and links with other health problems during pregnancy. Mindful of the biomedical and social complexity of MiP, this article explores and compares local understandings of MiP and their links with other pregnancy-related health problems.MethodsA comparative qualitative study was undertaken at four sites in three countries: Ghana, Malawi and Kenya. Individual and group interviews were conducted with pregnant women, their relatives, opinion leaders, other community members and health providers. MiP-related behaviours were also observed at health facilities and in local communities.ResultsAcross the four sites, local malaria concepts overlapped with biomedically defined malaria. In terms of symptoms, at-risk groups, outcomes and aetiology of malaria during pregnancy, this overlap was however both site-specific and partial. Moreover, the local malaria concepts were not monolithic and their descriptions varied amongst respondents. The symptoms of pregnancy and malaria also overlapped but, for respondents, symptom severity was the distinguishing factor. Malaria was generally, though not universally, perceived as serious for pregnant women. Miscarriage was the most widely known outcome, and links with anaemia, low birth weight and congenital malaria were mentioned. Nonetheless, amongst many potential causes of miscarriage, malaria was not recognized as the most important, but rather interacted with other pregnancy-related problems.ConclusionsGiven the overlap of common pregnancy problems with the symptoms of malaria, and the limited association of malaria with its main outcomes, a comprehensive antenatal care programme is the most appropriate strategy for the provision of health education, prevention and treatment for MiP. Variations in locally shared understandings of MiP must however be taken into account when designing and promoting MiP intervention strategies.

【 授权许可】

Unknown   
© Menaca et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.