1
|
Ibrahimi J, Mumtaz Z. Ultrasound imaging and the culture of pregnancy management in low-and middle-income countries: A systematic review. Int J Gynaecol Obstet 2024; 165:76-93. [PMID: 37743802 DOI: 10.1002/ijgo.15097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Obstetric ultrasound imaging is a relatively new, but rapidly expanding, technology in low- and middle-income countries (LMICs). Given that new technologies modify practices, the influence of ultrasound on pregnancy management in LMICs is not comprehensively understood. OBJECTIVES To map how ultrasound technology may be modulating the culture of pregnancy management in LMICs. SEARCH STRATEGY A search of five databases up to November 18, 2022. SELECTION CRITERIA Original, peer-reviewed articles from LMICs, published in English from 2000 to 2022. DATA COLLECTION AND ANALYSIS All articles were assessed for quality using the GRADE approach. Data were analyzed thematically to generate new interpretive constructs and explanations. RESULTS Forty articles involving 113 000 respondents suggests that obstetric ultrasound is becoming the preferred method of pregnancy surveillance, replacing clinically important components of prenatal care. Mothers overestimate ultrasound as an all-powerful diagnostic and "therapeutic" tool that can deliver the perfect baby. For-profit providers are driving medically unnecessary scans while the poor do not receive the recommended scans. CONCLUSION Ultrasound technology has modified the culture of pregnancy management in LMICs in unintended and possibly harmful ways. Private health services are pushing the detrimental trends. Limitations include generalizability of qualitative studies and insufficient attention to inequities.
Collapse
Affiliation(s)
- Janat Ibrahimi
- School of Public Health, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
| | - Zubia Mumtaz
- School of Public Health, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
| |
Collapse
|
2
|
Popoola T, Skinner J, Woods M. 'Every Woman Wants to Know What Came out of Her Body': Grief Experiences of Women After Stillbirth in Nigeria. OMEGA-JOURNAL OF DEATH AND DYING 2024; 88:1275-1289. [PMID: 34996329 DOI: 10.1177/00302228211051823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Stillbirth commonly affects women in Nigeria, but their experiences of grief following stillbirth is under explored. This study aimed to describe Nigerian women's experiences of grief after stillbirth. Face-to-face, semi-structured interviews were conducted with 20 women in Nigeria who experienced stillbirth. The results from the thematic analysis suggest that mothers had an unmet need to see their stillborn baby, and they experienced communication challenges such as being blindsided/misled about the baby during their interactions with health personnel. The participants experienced emotional and psychological reactions to grief that manifested in the form of emotional pain, sadness, blame and shock, but having a sense of gratitude helped them cope. The findings of this study highlight gaps in bereavement care and suggest the need for basic bereavement training for health personnel.
Collapse
Affiliation(s)
- Tosin Popoola
- School of Nursing, Midwifery and Health Practice, Victoria University of Wellington, Wellington Regional Hospital, Wellington, New Zealand
| | - Joan Skinner
- School of Nursing, Midwifery and Health Practice, Victoria University of Wellington, Wellington Regional Hospital, Wellington, New Zealand
| | - Martin Woods
- School of Nursing, Midwifery and Health Practice, Victoria University of Wellington, Wellington Regional Hospital, Wellington, New Zealand
| |
Collapse
|
3
|
Khosla N, Hahn L, Tran C. US South Asian Youths' Perspectives on the Use of Complementary and Alternative Medicine (CAM). J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01672-9. [PMID: 37368189 DOI: 10.1007/s40615-023-01672-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023]
Abstract
Complementary and alternative medicine (CAM) includes varied medical and healthcare systems, healing practices, and products that are outside of allopathy/biomedicine. The aim of this study was to examine US South Asian youths' beliefs, practices, decision-making, and experiences of using CAM. Ten focus group discussions with 36 participants were conducted. Data were coded deductively and inductively by four coders, working in pairs. Thematic analysis was performed. Disagreements were resolved through consensus. The results showed that CAM was appealing because of its often low cost, ease of access, family traditions to use CAM, and the perception that it was safe to use. Participants exercised pluralistic health choices. Some responses suggested a hierarchy wherein allopathy was used for serious, acute issues, and CAM for much of the remaining issues. The high use of and trust in CAM among young US South Asians raises important issues (e.g., provider support and integration to prevent potential interactions and avoid delaying allopathic treatment). More exploration is needed about the decision-making processes of US South Asian youth, including the perceived benefits/limitations of allopathy and CAM. US healthcare practitioners should familiarize themselves with South Asian social and cultural beliefs about healing to provide culturally-appropriate services and enhance patient care.
Collapse
Affiliation(s)
- Nidhi Khosla
- Department of Public Health, California State University East Bay, Hayward, CA, USA.
| | - Lindsay Hahn
- Department of Public Health, California State University East Bay, Hayward, CA, USA
| | - Christine Tran
- Department of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|
4
|
Arach AAO, Nakasujja N, Rujumba J, Mukunya D, Odongkara B, Musaba MW, Napyo A, Tumwine JK, Nankabirwa V, Ndeezi G, Kiguli J. Cultural beliefs and practices on perinatal death: a qualitative study among the Lango community in Northern Uganda. BMC Pregnancy Childbirth 2023; 23:222. [PMID: 37013468 PMCID: PMC10069138 DOI: 10.1186/s12884-023-05550-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/27/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Perinatal death has profound psychosocial effects on women and their families. Sociocultural contexts influence the burden, rituals and bereaved's support. Little is known about cultural beliefs and practices related to perinatal death. This study explored the cultural perspectives of the Lango community on perinatal death. METHODS This study utilised a focused ethnographic design anchored on a symbolic interactionist framework to understand the meanings attached to beliefs and practices on stillbirth or neonatal death among the Lango community in Lira District, Northern Uganda. Participants were sampled purposively for FGD while key informants were identified through snowballing technique. Data were audio recorded in Lango, transcribed, and later translated, a codebook was developed and data entered into Atlas. ti version 8.4.26 and then coded. It was analysed both deductively and inductively into themes. RESULTS Stillbirth and early neonatal death both attract similar rituals as would an older child. Burial is not rushed and is attended by family members and close friends. Stillbirths and children that die before naming are buried without names. Bereaved families are comforted and encouraged about future pregnancies. Currently, Lango associates the deaths to biomedical explanations such as teenage pregnancies, inadequate pregnancy care, health system challenges and poor health-seeking behaviour, unlike previously when they were attributed to consequences of unacceptable social behaviours, superstitious beliefs and witchcraft. Antenatal care and health facility childbirths are currently preferred over traditional practices for good pregnancy outcomes. CONCLUSION Stillbirth or early neonatal death is viewed as the death of a child, different from other settings. Thus, rituals are performed to honour, create memory, and maintain the connection with deceased babies. Bereaved parents are supported. Health care workers need to provide culturally sensitive support to parents after perinatal loss. The prevailing beliefs of perinatal death cause in terms of biomedical explanations consistent with known determinants and preference for health facility care for prevention creates an opportunity for improving perinatal health.
Collapse
Affiliation(s)
- Anna Agnes Ojok Arach
- Department of Nursing and Midwifery, Faculty of Health Sciences, Lira University, P.O Box 1035, Lira, Uganda.
- Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Noeline Nakasujja
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Joseph Rujumba
- Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - David Mukunya
- Department of Public Health, Busitema University Faculty of Health Sciences, Mbale, Uganda
| | - Beatrice Odongkara
- Department of Paediatrics and Child Health, Gulu University Faculty of Medicine, Gulu, Uganda
| | - Milton W Musaba
- Department of Obstetrics and Gynaecology, Busitema University Faculty of Health Sciences, Mbale, Uganda
| | - Agnes Napyo
- Department of Public Health, Busitema University Faculty of Health Sciences, Mbale, Uganda
| | - James K Tumwine
- Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Victoria Nankabirwa
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
- Centre for Intervention Science and Maternal Child Health (CISMAC), Centre for International Health, University of Bergen, Bergen, Norway
| | - Grace Ndeezi
- Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Juliet Kiguli
- Department of Community Health and Behavioural Sciences, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| |
Collapse
|
5
|
Mwakawanga DL, Mwilike B, Kaneko M, Shimpuku Y. Local knowledge and derived practices of safety during pregnancy, childbirth and postpartum: a qualitative study among nurse-midwives in urban eastern Tanzania. BMJ Open 2022; 12:e068216. [PMID: 36521900 PMCID: PMC9756159 DOI: 10.1136/bmjopen-2022-068216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Maternal and newborn mortality are still high in low-income and middle-income countries despite global efforts to improve the quality of care by prioritising evidence-based practices and increasing the number of births attended by skilled personnel. During childbirth, women are hesitant to use the health facility services. Concerns about safety and risks during pregnancy, childbirth and postpartum period are deeply rooted in local health practices and beliefs. OBJECTIVE The aim of this study was to explore the perceptions of local health knowledge and derived practices among nurse-midwives in urban eastern Tanzania. METHODS An exploratory qualitative study design was carried out in a district hospital in eastern Tanzania. Twenty-one nurse-midwives participated in two focus group discussions. The data were analysed using qualitative content analysis. RESULTS Based on existing scientific data, local knowledge and derived practices were categorised as potentially beneficial, neither beneficial nor harmful and potentially harmful. Our study identified a wide range of local knowledge and derived practices used by women. These include to refrain from shouting or crying to prevent exhaustion during labour, drinks and foods restrictions during labour and after birth, and use of local herbs to stimulate labour. In addition, midwives reinforced the importance of integrating local knowledge and practices with potential benefits with evidence-based practices. Encouraging and listening to women would offer an opportunity to reduce harmful practices. CONCLUSIONS While non-harmful and beneficial practices for ensuring safety during pregnancy, childbirth and postpartum period should be accepted and supported as a part of our cultural richness, harmful practices should be discouraged. This can be achieved through antenatal health education and afterbirth health messages on hospital discharge to promote positive childbirth health outcomes.
Collapse
Affiliation(s)
- Dorkasi L Mwakawanga
- Department of Community Health Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Graduate School of Biomedical and Health Sciences, Department of Global Health Nursing, Hiroshima University, Hiroshima, Japan
| | - Beatrice Mwilike
- Department of Community Health Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Morie Kaneko
- Graduate School of Asian and African Area Studies, Center for African Area Studies, Kyoto University, Kyoto, Japan
| | - Yoko Shimpuku
- Graduate School of Biomedical and Health Sciences, Department of Global Health Nursing, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
6
|
Santi DR, Suminar D, Devy SR, Mahmudah M, Soedirham O, Prasetyorini A. Pregnant Women’s Perception of Pregnancy, Childbirth and Postpartum Care: Literature Review in Developing Countries. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background:
Approximately 10.7 million pregnant women have passed away from 1990 to 2015 due to obstetric complications. Nearly all of them (99% of global maternal deaths) take place in developing countries. As a matter of fact, most people in dveloping countries have implemented many cultural practices which bring about negative effects on pregnant women’s health behaviour to potentially have greater risk of obstetric complications. Unfortunately, no comprehensive research yet conducted especially on pregnant women’s perceptions of pregnancy, childbirth, and postpartum care (PC) in developing countries.
Objective:
To identify factors of pregnant women’s perception of pregnancy, childbirth, and postpartum care in developing countries
Method:
The research was carried out through Literature Review in which electronic database search the so-called database Science Direct, PubMed, Elsevier (SCOPUS), Springerlink, and Google Schoolar was conducted in January 2021. The steps of systematic review were through Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) method.
Results:
Modifying factors with pivotal role during the service of pregnancy, childbirth, and postpartum care in developing countries are knowledge, ethnicity, socioeconomics, and personality. Most individual beliefs in developing countries are perceived barriers. Whereas, Perceived susceptibility and severity of disease, perceived benefits, perceived self efficacy and perceived threat to make the most use of health service during pregnancy, childbirth, and postpartum care are also well-known with variables of external cues to action is among the most popular ones especially with personal experience and information from neighborhood with local habits and belief unsupportive to health service.
Conclusion:
Factors to influence perception, practice, and access during pregnancy, childbirth, and postpartum care in developing countries are culture, knowledge, distance, education, experience, mental stress, no decision making autonomy and social supports. Thus, comprehensive research on the influence of modifying factors of individual behavior and cues to action needs to be carried out.
Keywords: Perception, Pregnancy, Childbirth, Postpartum Care
Collapse
|
7
|
Stacey T, Haith-Cooper M, Almas N, Kenyon C. An exploration of migrant women's perceptions of public health messages to reduce stillbirth in the UK: a qualitative study. BMC Pregnancy Childbirth 2021; 21:394. [PMID: 34016084 PMCID: PMC8136107 DOI: 10.1186/s12884-021-03879-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stillbirth is a global public health priority. Within the United Kingdom, perinatal mortality disproportionately impacts Black, Asian and minority ethnic women, and in particular migrant women. Although the explanation for this remains unclear, it is thought to be multidimensional. Improving perinatal mortality is reliant upon raising awareness of stillbirth and its associated risk factors, as well as improving maternity services. The aim of this study was to explore migrant women's awareness of health messages to reduce stillbirth risk, and how key public health messages can be made more accessible. METHOD Two semi-structured focus groups and 13 one to one interviews were completed with a purposive sample of 30 migrant women from 18 countries and across 4 NHS Trusts. RESULTS Participants provided an account of their general awareness of stillbirth and recollection of the advice they had been given to reduce the risk of stillbirth both before and during pregnancy. They also suggested approaches to how key messages might be more effectively communicated to migrant women. CONCLUSIONS Our study highlights the complexity of discussing stillbirth during pregnancy. The women in this study were found to receive a wide range of advice from family and friends as well as health professionals about how to keep their baby safe in pregnancy, they recommended the development of a range of resources to provide clear and consistent messages. Health professionals, in particular midwives who have developed a trusting relationship with the women will be key to ensuring that public health messages relating to stillbirth reduction are accessible to culturally and linguistically diverse communities.
Collapse
Affiliation(s)
- Tomasina Stacey
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom.
- Calderdale and Huddersfield NHS Foundation Trust, Lindley, Huddersfield, United Kingdom.
| | | | - Nisa Almas
- Faculty of Heath Studies, University of Bradford, Bradford, United Kingdom
| | - Charlotte Kenyon
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
| |
Collapse
|