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Wak G, Bangha M, Aborigo R, Anarfi J, Kwankye S. Impact of kinship support on child mortality in the Upper East Region of Ghana: assessing the Grandmother Hypothesis. Int Health 2023; 15:744-751. [PMID: 37317981 PMCID: PMC10629956 DOI: 10.1093/inthealth/ihad041] [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: 10/05/2022] [Revised: 03/14/2023] [Accepted: 05/22/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The grandmother is an important kin member whose contribution to childcare and survival has been recognized in the literature, hence the Grandmother Hypothesis. This article examines the effect of the presence of a grandmother on child mortality. METHODS Data were obtained from the Navrongo Health and Demographic Surveillance System, located in the Upper East Region of Ghana. Children born between January 1999 and December 2018 were included in the analysis. Person-months lived for each child were generated. The multilevel Poisson regression technique was employed to investigate the effect of a grandmother on child survival. RESULTS In all, 57 116 children were included in the analysis, of which 7% died before age 5 y. Person-months were generated for the children, which produced 2.7 million records, with about 487 800 person-years. After controlling for confounders, results showed that children in households with paternal grandmothers are 11% less likely to die compared with those without paternal grandmothers. However, when other confounders were taken into accounts, the beneficial effect of maternal grandmothers disappeared. CONCLUSIONS We conclude that the presence of grandmothers improves child survival, thus sustaining the Grandmother Hypothesis. The experiences of these grandmothers should be tapped to improve child survival, particularly in rural areas.
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Affiliation(s)
- George Wak
- Navrongo Health Research Centre, Ghana
- School of Public Health, University of Health and Allied Sciences, Ghana
| | - Martin Bangha
- African Population and Health Research Center, Nairobi, Kenya
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Mwaka AD, Achan J, Orach CG. Traditional health practices: A qualitative inquiry among traditional health practitioners in northern Uganda on becoming a healer, perceived causes of illnesses, and diagnostic approaches. PLoS One 2023; 18:e0282491. [PMID: 37093797 PMCID: PMC10124846 DOI: 10.1371/journal.pone.0282491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/15/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND The practice of traditional and complementary medicine is increasing in most low-and middle-income countries especially for chronic communicable and non-communicable diseases. In this study, we aimed to understand how people gain healing power and become traditional health practitioners (THPs), perceived causes of illnesses, and how THPs diagnose illnesses. METHODS This was a cross-sectional qualitative interview-based study. We used semi-structured in-depth guides to collect data from THPs identified through the Acoli cultural institutions and snowball sampling technique. The study team visited the THPs and interviewed them in their homes. Some THPs allowed the study team to visit them more than once and as well observe their healing practices and medicines. Thematic analysis approach was used to analyze the data. Atlas.ti version 9.2 was used to support data analysis. RESULTS Twenty two THPs aged 39-80 years were included in the study. Most of the respondents were male, and married. We identified three main themes: (i) how people gain healing power and become traditional health practitioners; (ii) perceived causes of illnesses; and (iii) how illnesses are diagnosed. The majority of respondents reported that most people become THPs through: inheriting healing power from their parents or grandparents; transfer of healing powers from senior healers; instructions during visions and dreams; and, acquiring healing power during spirits possessions. Perceived causes of illnesses included: fate and natural causes, spirits attacks, curses by elders, witchcraft, contagion and infections, poor hygiene, heredity, and malevolent actions. THPs diagnose illnesses through various approaches including consultations with spirits, observing patterns of occurrences and events, evaluation of symptoms and signs of illnesses, use of bones from animals/birds and other objects to diagnose illnesses, performing diagnostic rituals, and using biomedical laboratory testing in health facilities. CONCLUSION Healing knowledge and powers are acquired in particular ways that can be traced to appraise authenticity of healers during registration and licensing to ensure safety of patients. Understanding perspectives of the THPS on causes of illnesses and how diagnoses are made potentially informs strategies for integration and or collaboration between the national biomedical health system and traditional health practices.
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Affiliation(s)
- Amos Deogratius Mwaka
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Faculty of Medicine, Department of Medicine, Gulu University, Gulu, Uganda
| | - Jennifer Achan
- School of Public Health, College of Health Sciences, Msakerere University, Kampala, Uganda
| | - Christopher Garimoi Orach
- School of Public Health, College of Health Sciences, Msakerere University, Kampala, Uganda
- Department of Community Health & Behavioral Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
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Abdullah A, Frederico M, Mensah F, Bentum H, Wang Y, Asare JL. Addressing Filicide in Ghana: Linking Cultural Understanding With the Law Against Filicide. Does the Law Work? Front Psychol 2022; 13:928963. [PMID: 35911014 PMCID: PMC9336680 DOI: 10.3389/fpsyg.2022.928963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionConsistent with international promulgation on the criminalization of filicide, Ghana’s Children’s Act 1998 (560) and the Criminal Justice Act criminalizes any form of torture against children. Yet, perpetrators of filicide in Ghana may go unpunished due to the beliefs in cultural norms that justify filicide acts. The cultural narratives of filicide can impede on the application and effectiveness of the laws of filicide.MethodThe study employed a vignette approach to explore the views of 19 adults, who were parents between 69 years of age and 30 years of age, in rural and urban Ghana on the laws of filicide in Ghana and filicide intervention measures. The interviewees were provided with narratives on two different vignettes (developed based on real life cases), followed by semi-structured questions to probe the narratives. The interviews were analyzed following Fraser’s narrative thematic analysis procedure.ResultsThe study identifies the association between cultural beliefs and the communities’ understanding of the concept of filicide. Though community members are aware of the criminalization of filicide acts, the majority of them were not informed about the laws against filicide in Ghana. Addressing filicide cases within the community was the most preferred option for the participants, as they believe that some children, termed “spirit children” (SC), deserve to be killed. Resorting to spiritual intervention from concoction men emerged as the normative pathway to obtain community approval for filicide. Police interventions were considered necessary in non-spiritual related filicides. Community members were only prepared to cooperate with the law in filicide cases if the filicide act has no connection with spirituality.ConclusionThe study adds to understanding of the concept of filicide outside western societies. The importance of intensive community campaigns against filicide acts, and norms that support filicide acts, has relevance for all counties.
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Affiliation(s)
- Alhassan Abdullah
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Sociology, Haverford College, Haverford, PA, United States
| | - Margarita Frederico
- Department of Occupational Therapy and Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
- *Correspondence: Margarita Frederico,
| | - Felix Mensah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Hajara Bentum
- The School of Arts and Humanities, Edith Cowan University, Joondalup, WA, Australia
| | - Yihang Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jennifer Litela Asare
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Abdullah A, Cudjoe E, Frederico M, Jordan LP, Chiu MYL, Asamoah E, Emery CR. Filicide as a cultural practice in Ghana: The qualitative understanding of a family tragedy and its implications for child protection practice. CHILD ABUSE & NEGLECT 2022; 127:105580. [PMID: 35255341 DOI: 10.1016/j.chiabu.2022.105580] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/08/2021] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Contrary to evidence from the Western literature, cases of filicide in Ghana are mostly unreported because they are rooted in cultural practices and hidden from the general public. OBJECTIVE The purpose of this study was to explore the cultural context of filicide in a rural community. Particularly, to provide an understanding of the spirit child (SC) phenomenon, how the killing of a SC is performed and to provide a general understanding of filicide within a particular context. PARTICIPANTS AND SETTING Four relatives of a family that engaged in a filicide incident took part in the study. The interviews were conducted in a rural community in Ghana where the incident occurred. METHODS Short written narratives were used to explore the experiences and perceptions of relatives whose family engaged in filicide. RESULTS Children with severe deformities are likely to be associated with matters of divinity which gives way for the conceptualization of the SC and its attendant filicide. The findings highlight the critical role of traditional healers in rural communities and the consequences of strong community beliefs and expectations that influence parents to commit filicide. CONCLUSION The study provides directions for child protection workers to address the stigma parents face for having children with severe deformities and to provide education on child welfare legislation.
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Affiliation(s)
- Alhassan Abdullah
- Department of Social Work and Social Administration, The University of Hong Kong, HKU Centennial Campus, Hong Kong; Department of Sociology, Haverford College, Haverford, PA, USA.
| | - Ebenezer Cudjoe
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong.
| | - Margarita Frederico
- Department of Occupational Therapy and Social Work and Social Policy, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering La Trobe University, Bundoora 3086, Australia.
| | - Lucy P Jordan
- Department of Social Work and Social Administration, The University of Hong Kong, HKU Centennial Campus, Hong Kong.
| | | | - Edward Asamoah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Ghana
| | - Clifton R Emery
- Department of Social Work and Social Administration, The University of Hong Kong, HKU Centennial Campus, Hong Kong.
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Historical Portrayal of Children with Disabilities and Exclusionary Practices in Northern Ghana. HUMAN ARENAS 2022. [DOI: 10.1007/s42087-021-00265-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Fonzi V, Sheriff B, Dalglish S, Anum A, Dwomo Agyei E, Diggs D, Eboigbe L, Owusu PG, Sakyi KS. The multifaceted care-seeking practices among caregivers of children with cerebral palsy: Perspectives from mothers and providers in Ghana. PLoS One 2021; 16:e0258650. [PMID: 34705843 PMCID: PMC8550440 DOI: 10.1371/journal.pone.0258650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 10/03/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Research on cerebral palsy (CP) has lacked emphasis on knowledge and treatment practices among caregivers, particularly in low- and middle-income countries where socio-cultural contexts encourage a variety of treatment alternatives. In this study, we explored the beliefs and experiences that motivate care-seeking practices among caregivers of children with CP in Ghana. METHODS Semi-structured interviews were conducted with 25 caregivers, 10 medical providers, and 5 alternative providers in the Greater Accra Region. Participant interviews were analyzed using principles adapted from grounded theory. A conceptual model was constructed to illustrate salient patterns and motivational factors influencing care-seeking practices. RESULTS Participants' experiences showed that caregivers initially sought physiotherapy and prescription medications from medical providers. Many of them then transitioned to alternative methods to search for a cure or address specific CP symptoms. Over time, most caregivers discontinued both medical and alternative care in favor of at-home treatment. A few withdrew completely from all forms of care. Cost of treatment, caregiver burden, and stigma strongly inhibited care-seeking outside the home. CONCLUSION Although caregivers were open to exploring a variety of treatment options, at-home treatment was preferred by long-time caregivers for its convenience, low cost, and adaptability to patient and caregiver needs.
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Affiliation(s)
- Victoria Fonzi
- Center for Learning and Childhood Development, Accra, Ghana
- College of Public Health, University of Georgia, Athens, Georgia, United States of America
| | - Blessed Sheriff
- Center for Learning and Childhood Development, Accra, Ghana
- Warren Alpert Medical School, Brown University, Providence, Rhode Island, United States of America
| | - Sarah Dalglish
- Center for Learning and Childhood Development, Accra, Ghana
- School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Adote Anum
- Center for Learning and Childhood Development, Accra, Ghana
- Department of Psychology, University of Ghana, Accra, Ghana
| | | | - Devin Diggs
- Center for Learning and Childhood Development, Accra, Ghana
| | | | | | - Kwame S. Sakyi
- Center for Learning and Childhood Development, Accra, Ghana
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, Michigan, United States of America
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Adama EA, Sundin D, Bayes S. Sociocultural Practices Affecting the Care of Preterm Infants in the Ghanaian Community. J Transcult Nurs 2020; 32:458-465. [PMID: 33225863 PMCID: PMC8404725 DOI: 10.1177/1043659620975098] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Introduction Although culture is an integral part of health, there is scarcity of evidence on the influence of culture on caregiving experiences of parents of preterm infants. The aim of this study was to explore the influence of sociocultural practices on caring for preterm infants in the Ghanaian community. Method Narrative inquiry was utilized to explore the influence of sociocultural practices on the care of preterm infants from 21 mothers, 9 fathers, and 12 household members. Data were collected through face-to-face semistructured interviews and observations at participants’ homes. Results Analysis of data resulted in three threads/themes—respect for the elderly, use of herbal medicines, and communal living. Discussion Community and extended family members have great influence on the care of preterm infants. Traditional herbal medicines are considered effective in treating traditional illnesses among preterm infants. Understanding the influence of culture on the care of vulnerable preterm infants in the community is essential in developing interventions for infant survival.
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Affiliation(s)
| | - Deborah Sundin
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Sara Bayes
- Edith Cowan University, Joondalup, Western Australia, Australia
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de Vries J, Landouré G, Wonkam A. Stigma in African genomics research: Gendered blame, polygamy, ancestry and disease causal beliefs impact on the risk of harm. Soc Sci Med 2020; 258:113091. [PMID: 32521416 PMCID: PMC7396479 DOI: 10.1016/j.socscimed.2020.113091] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/25/2020] [Accepted: 05/27/2020] [Indexed: 12/11/2022]
Abstract
A recurring concern in genomics research is the possibility that it could lead to stigma for participants, their families and the population groups they belong to. Little evidence exists to explain how and when this ought to be a concern in genomics research in Africa whilst there is growing international evidence drawing into question the direct link between stigma and genetics. In this paper, we interrogate practical instances from African genomics research where stigma was identified as a concern in an attempt to nuance and refine accounts of when stigma should be considered as an ethical issue. The paper describes examples involving gendered blame, polygamy, beliefs in supernatural disease causation and sensitive information about group lineage. We propose that the concern may not be about stigma so much as broader research-related harm, including for instance reputational harm to population groups. Furthermore, we propose to shift the analytical gaze from establishing causal relationships to exploring the intersection of genomics with pre-existing stigma. Finally, we emphasize the importance of ensuring genomics researchers are culturally competent, meaning able to recognise when cultural factors impact on the possibility that genomics research could cause harm.
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Affiliation(s)
- Jantina de Vries
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - Guida Landouré
- Faculté de Médecine et d'Odontostomatologie, USTTB, Bamako, Mali; Service de Neurologie, CHU du Point "G", Bamako, Mali
| | - Ambroise Wonkam
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Department of Pathology, Faculty of Health Sciences, University of Cape Town, South Africa
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Moseson H, Ouedraogo R, Diallo S, Sakho A. Infanticide in Senegal: results from an exploratory mixed-methods study. Sex Reprod Health Matters 2020; 27:1624116. [PMID: 31533577 PMCID: PMC7888053 DOI: 10.1080/26410397.2019.1624116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This article presents formative research on the practice of infanticide, the intentional killing or fatal neglect of a child less than one-year-old. We hypothesised that the abortion law in Senegal, one of the most restrictive in the world, contributes directly to the incidence of infanticide. We conducted a quantitative survey of 1016 women of reproductive age living in Senegal, and in-depth interviews with a sub-sample of 28 participants. Quantitative survey data were analysed to describe the frequencies, means, and ranges of key outcome variables. Qualitative data were analysed using modified grounded theory to identify key themes in the data. Awareness of infanticide was moderately high (60.3%) in the survey sample, and was primarily obtained through personal experience, rumours, and/or the media. Participants described two broad categories of infanticide, including passive infanticide through abandonment of the infant, versus active infanticide through suffocation, drowning or other means. Participants explicitly viewed infanticide as a direct result of the severe legal restrictions on abortion in Senegal, as well as the powerful social norms that dictate what is considered acceptable versus unacceptable childbearing in the country. Findings support the hypothesis that abortion laws and policies contribute to the occurrence of infanticide in Senegal, and suggest the need for additional, targeted research to better understand this link, and how findings can be used to inform policy reform.
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Affiliation(s)
- Heidi Moseson
- Associate/Epidemiologist , Ibis Reproductive Health , Oakland , CA , USA . Correspondence:
| | - Ramatou Ouedraogo
- Post-doctoral research scientist/Anthropologist , African Population Health Research Center , Nairobi , Kenya
| | - Soukeyna Diallo
- Juriste, member of Comité de plaidoyer pour l'accès à l'avortement médicalisé, and l'Association des Juristes Sénégalaises; activist , Dakar , Senegal
| | - Amy Sakho
- Coordinator , Comité de plaidoyer pour l'accès à l'avortement medicalisé , Dakar , Senegal
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Nyante GG, Carpenter C. The experience of carers of children with cerebral palsy living in rural areas of Ghana who have received no rehabilitation services: A qualitative study. Child Care Health Dev 2019; 45:815-822. [PMID: 31322764 DOI: 10.1111/cch.12706] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 07/09/2019] [Accepted: 07/11/2019] [Indexed: 11/28/2022]
Abstract
AIM This study aims to explore the experiences of carers of children with cerebral palsy living in rural areas of Ghana who have received no rehabilitation services. BACKGROUND Cerebral palsy is the most common chronic disability from childhood, which needs lifelong rehabilitation. Most of the population living in rural communities in Ghana have virtually no form of rehabilitation services for their chronic disabling conditions. Caring for children with disability are known to be challenging especially when coupled with environmental challenges in rural communities. RESULTS Purposive and snowball techniques were used to recruit 12 carers, age 22 to 68 years, of children with cerebral palsy aged 7 to 15 years. Two main themes, developing personal beliefs to support the caregiving role and the demands that shape the experience of caring, emerged from six subthemes and 25 theme clusters of the narratives of the carers. The essential structure of the phenomenon demonstrated the complex interaction of personal and environmental factors in harmony with the actual demands to influence the experiences of participants positively or negatively. Positively, carers achieved coping, committed to caring, hoped for the future, and accepted the condition. However, negatively, carers described the triggering factors of feeling of despair and sorrow as frustration and lack of understanding of the condition, felt stigmatized, and perceived the child was going through pain and suffering. CONCLUSIONS Carers derived strength from their religious and spiritual beliefs to balance the demands of caregiving. Findings could be used as basis for developing interventions to support carers and inform new strategies for rehabilitation service and sensitization of community members about inclusion of children with disabilities.
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Affiliation(s)
| | - Christine Carpenter
- The University of British Columbia, Vancouver, Canada.,Coventry University, Coventry, UK
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12
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Paudel M, Javanparast S, Dasvarma G, Newman L. Religio-cultural factors contributing to perinatal mortality and morbidity in mountain villages of Nepal: Implications for future healthcare provision. PLoS One 2018; 13:e0194328. [PMID: 29544226 PMCID: PMC5854484 DOI: 10.1371/journal.pone.0194328] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 02/28/2018] [Indexed: 01/25/2023] Open
Abstract
Objective and the context This paper examines the beliefs and experiences of women and their families in remote mountain villages of Nepal about perinatal sickness and death and considers the implications of these beliefs for future healthcare provision. Methods Two mountain villages were chosen for this qualitative study to provide diversity of context within a highly disadvantaged region. Individual in-depth interviews were conducted with 42 women of childbearing age and their family members, 15 health service providers, and 5 stakeholders. The data were analysed using a thematic analysis technique with a comprehensive coding process. Findings Three key themes emerged from the study: (1) ‘Everyone has gone through it’: perinatal death as a natural occurrence; (2) Dewata (God) as a factor in health and sickness: a cause and means to overcome sickness in mother and baby; and (3) Karma (Past deeds), Bhagya (Fate) or Lekhanta (Destiny): ways of rationalising perinatal deaths. Conclusion Religio-cultural interpretations underlie a fatalistic view among villagers in Nepal’s mountain communities about any possibility of preventing perinatal deaths. This perpetuates a silence around the issue, and results in severe under-reporting of ongoing high perinatal death rates and almost no reporting of stillbirths. The study identified a strong belief in religio-cultural determinants of perinatal death, which demonstrates that medical interventions alone are not sufficient to prevent these deaths and that broader social determinants which are highly significant in local life must be considered in policy making and programming.
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Affiliation(s)
- Mohan Paudel
- Southgate Institute of Health, Society and Equity, Flinders University, Adelaide, Australia
- * E-mail:
| | - Sara Javanparast
- Southgate Institute of Health, Society and Equity, Flinders University, Adelaide, Australia
| | - Gouranga Dasvarma
- College of Humanity, Arts and Social Sciences, Flinders University, Adelaide, Australia
| | - Lareen Newman
- Education Arts and Social Sciences Divisional Office, University of South Australia, Adelaide, Australia
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Joshi R, Faruqui N, Nagarajan SR, Rampatige R, Martiniuk A, Gouda H. Reporting of ethics in peer-reviewed verbal autopsy studies: a systematic review. Int J Epidemiol 2018; 47:255-279. [PMID: 29092034 DOI: 10.1093/ije/dyx216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2017] [Indexed: 11/14/2022] Open
Abstract
Introduction Verbal autopsy (VA) is a method that determines the cause of death by interviewing a relative of the deceased about the events occurring before the death, in regions where medical certification of cause of death is incomplete. This paper aims to review the ethical standards reported in peer-reviewed VA studies. Methods A systematic review of Medline and Ovid was conducted by two independent researchers. Data were extracted and analysed for articles based on three key areas: Institutional Review Board (IRB) clearance and consenting process; data collection and management procedures, including: time between death and interview; training and education of interviewer, confidentiality of data and data security; and declarations of funding and conflict of interest. Results The review identified 802 articles, of which 288 were included. The review found that 48% all the studies reported having IRB clearance or obtaining consent of participants. The interviewer training and education levels were reported in 62% and 21% of the articles, respectively. Confidentiality of data was reported for 14% of all studies, 18% did not report the type of respondent interviewed and 51% reported time between death and the interview for the VA. Data security was reported in 8% of all studies. Funding was declared in 63% of all studies and conflict of interest in 42%. Reporting of all these variables increased over time. Conclusions The results of this systematic review show that although there has been an increase in ethical reporting for VA studies, there still remains a large gap in reporting.
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Affiliation(s)
- Rohina Joshi
- George Institute for Global Health
- University of New South Wales
- University of Sydney, Sydney, NSW, Australia
| | - Neha Faruqui
- George Institute for Global Health
- University of Sydney, Sydney, NSW, Australia
| | | | | | - Alex Martiniuk
- George Institute for Global Health
- University of Sydney, Sydney, NSW, Australia
| | - Hebe Gouda
- School of Public Health
- Queensland Centre for Mental Health Research, University of Queensland, Brisbane, QLD, Australia
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Adama EA, Bayes S, Sundin D. Parents' experiences of caring for preterm infants after discharge with grandmothers as their main support. J Clin Nurs 2017; 27:3377-3386. [PMID: 28474752 DOI: 10.1111/jocn.13868] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2017] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore parents of preterm infants' experiences of caring for their preterm infants with the grandmother as their primary support after discharge. BACKGROUND Preterm delivery is the major cause of high neonatal mortality in sub-Saharan Africa. There is poor neonatal health outcome in the Ghanaian community with some illnesses culturally classified as not-for-hospital. In the community, grandmothers or older women provide support for new parents and decide treatment options for sick infants. However, there is paucity of research on how parents of preterm infants experience this support in the Ghanaian community. METHOD Qualitative narrative inquiry methodology was used. Face-to-face interviews using semi-structured interview guide were used to collect data from 21 mothers and nine fathers. Participant observation and field notes were used to complement interview data. Thematic content analysis of data within the three-dimensional narrative space was employed. Analysis focussed on the relationship of time, place, person and cultural practices affecting the care of preterm infants in the community. RESULTS Three themes emerged from the data, namely (i) Grandmother's prescriptions, (ii) Fighting for the well-being of the infant and (iii) Being in a confused state. Cultural practices mainly initiated by grandmothers resulted in adverse health problems for preterm infants and disruption in parents' mental health. CONCLUSION As grandmothers perform their traditional role of supporting new parents to care for preterm infants after discharge, they give both positive and negative advice which can adversely affect the health of vulnerable preterm infants in the community. RELEVANCE TO CLINICAL PRACTICE Grandmothers are the main support providers of parents of preterm infants after neonatal unit discharge. Nurses should identify and include grandmothers in predischarge education in order to equip them to render appropriate support to parents and preterm infants.
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Affiliation(s)
- Esther Abena Adama
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia
| | - Sara Bayes
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia
| | - Deborah Sundin
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia
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Yeji F, Shibanuma A, Oduro A, Debpuur C, Kikuchi K, Owusu-Agei S, Gyapong M, Okawa S, Ansah E, Asare GQ, Nanishi K, Williams J, Addei S, Tawiah C, Yasuoka J, Enuameh Y, Sakeah E, Wontuo P, Jimba M, Hodgson A. Continuum of Care in a Maternal, Newborn and Child Health Program in Ghana: Low Completion Rate and Multiple Obstacle Factors. PLoS One 2015; 10:e0142849. [PMID: 26650388 PMCID: PMC4674150 DOI: 10.1371/journal.pone.0142849] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 10/26/2015] [Indexed: 01/05/2023] Open
Abstract
Background Slow progress has been made in achieving the Millennium Development Goals 4 and 5 in Ghana. Ensuring continuum of care (at least four antenatal visits; skilled birth attendance; postnatal care within 48 hours, at two weeks, and six weeks) for mother and newborn is crucial in helping Ghana achieve these goals and beyond. This study examined the levels and factors associated with continuum of care (CoC) completion among Ghanaian women aged 15–49. Methods A retrospective cross-sectional survey was conducted among women who experienced live births between January 2011 and April 2013 in three regions of Ghana. In a two-stage random sampling method, 1,500 women with infants were selected and interviewed about maternal and newborn service usage in line with CoC. Multiple logistic regression models were used to assess factors associated with CoC completion. Results Only 8.0% had CoC completion; the greatest gap and contributor to the low CoC was detected between delivery and postnatal care within 48 hours postpartum. About 95% of women had a minimum of four antenatal visits and postnatal care at six weeks postpartum. A total of 75% had skilled assisted delivery and 25% received postnatal care within 48 hours. Factors associated with CoC completion at 95% CI were geographical location (OR = 0.35, CI 0.13–0.39), marital status (OR = 0.45; CI 0.22–0.95), education (OR = 2.71; CI 1.11–6.57), transportation (OR = 1.97; CI 1.07–3.62), and beliefs about childhood illnesses (OR = 0.34; CI0.21–0.61). Conclusion The continuum of care completion rate is low in the study site. Efforts should focus on increasing postnatal care within 48 hours and overcoming the known obstacles to increasing the continuum of care completion rate.
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Affiliation(s)
- Francis Yeji
- Navrongo Health Research Centre, P.O. Box 114, Navrongo, Upper-East, Ghana
- * E-mail: ;
| | - Akira Shibanuma
- Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113–0033, Japan
| | - Abraham Oduro
- Navrongo Health Research Centre, P.O. Box 114, Navrongo, Upper-East, Ghana
| | - Cornelius Debpuur
- Navrongo Health Research Centre, P.O. Box 114, Navrongo, Upper-East, Ghana
| | - Kimiyo Kikuchi
- Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113–0033, Japan
| | - Seth Owusu-Agei
- Kintampo Health Research Centre, P.O. Box 200, Kintampo, Brong-Ahafo, Ghana
| | - Margaret Gyapong
- Dodowa Health Research Centre, P.O. Box DD1, Dodowa, Greater Accra, Ghana
| | - Sumiyo Okawa
- Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113–0033, Japan
| | - Evelyn Ansah
- Research and Development Division, Ghana Health Service, Accra MB 190, Ghana
| | | | - Keiko Nanishi
- Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113–0033, Japan
| | - John Williams
- Navrongo Health Research Centre, P.O. Box 114, Navrongo, Upper-East, Ghana
| | - Sheila Addei
- Dodowa Health Research Centre, P.O. Box DD1, Dodowa, Greater Accra, Ghana
| | - Charlotte Tawiah
- Kintampo Health Research Centre, P.O. Box 200, Kintampo, Brong-Ahafo, Ghana
| | - Junko Yasuoka
- Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113–0033, Japan
| | - Yeetey Enuameh
- Kintampo Health Research Centre, P.O. Box 200, Kintampo, Brong-Ahafo, Ghana
| | - Evelyn Sakeah
- Navrongo Health Research Centre, P.O. Box 114, Navrongo, Upper-East, Ghana
| | - Peter Wontuo
- Navrongo Health Research Centre, P.O. Box 114, Navrongo, Upper-East, Ghana
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113–0033, Japan
| | - Abraham Hodgson
- Research and Development Division, Ghana Health Service, Accra MB 190, Ghana
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Olusanya BO. Societal impact of bilirubin-induced hearing impairment in resource-limited nations. Semin Fetal Neonatal Med 2015; 20:58-63. [PMID: 25573775 DOI: 10.1016/j.siny.2014.12.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Infants with bilirubin-induced neurologic dysfunction (BIND) are characterized by several developmental disabilities including auditory impairments. This paper explores the societal impact of bilirubin-induced auditory impairments, inclusive of hearing impairments and auditory neuropathy spectrum disorders, on these infants, their families, and on the community in resource-limited countries (per capita income of US$6,000 or less). Auditory impairments have substantial emotional, social, and economic impact on the affected infants, their families and communities. The burden is exacerbated by widespread poverty, unfavorable community attitudes towards disabilities, and lack of requisite health, educational, and social services. Curtailing the incidence of avoidable severe hyperbilirubinemia through proactive and effective management of infants at risk or with severe hyperbilirubinemia is necessary at all levels of healthcare delivery. Early detection and intervention for unavoidable auditory impairments should be widely promoted to provide improved developmental trajectories for the affected infants.
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Affiliation(s)
- Bolajoko O Olusanya
- Centre for Healthy Start Initiative, 286A Corporation Drive, Dolphin Estate, Ikoyi, Lagos, Nigeria.
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Bayat M. The stories of 'snake children': killing and abuse of children with developmental disabilities in West Africa. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:1-10. [PMID: 24467696 DOI: 10.1111/jir.12118] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/12/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND Killing and abuse of children with disabilities are covert phenomena, occurring in some developing regions, such as in some African countries. Similar to the practice of ritual killing of spirit children in Ghana, the phenomenon of the snake child in Cote d'Ivoire (known as Ivory Coast), is the ritual abandonment or killing of children with intellectual disability (ID). METHOD This study is a qualitative ethnographic investigation into understanding this phenomenon. Three major questions were of interest: (1) Who are the snake children? (2) How are these children viewed and treated? (3) What are ways of changing negative attitudes towards children with developmental disabilities? RESULTS The practices of killing, abandonment and abuse of children with disabilities take place in Cote d'Ivoire today, although the extent is not known. CONCLUSION Killing and abuse of children with ID are explained within the context of indigenous African religions, animism and folk culture. The concept of disability 'otherness' and inferiority is also explored as a framework for reflection and ethical debate.
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Affiliation(s)
- Mojdeh Bayat
- College of Education, DePaul University, Chicago, IL, USA
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Aborigo RA, Allotey P, Tindana P, Azongo D, Debpuur C. Cultural imperatives and the ethics of verbal autopsies in rural Ghana. Glob Health Action 2013; 6:18570. [PMID: 24054087 PMCID: PMC3779354 DOI: 10.3402/gha.v6i0.18570] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 07/27/2013] [Accepted: 08/08/2013] [Indexed: 11/25/2022] Open
Abstract
Background Due to a paucity of statistics from vital registration systems in developing countries, the verbal autopsy (VA) approach has been used to obtain cause-specific mortality data by interviewing lay respondents on the signs and symptoms experienced by the deceased prior to death. In societies where the culture of mourning is adhered to, the use of VA could clash with traditional norms, thus warranting ethical consideration by researchers. Objective The study was designed to explore the ethics and cultural context of collecting VA information through a demographic and health surveillance system in the Kassena-Nankana District (KND) of Ghana. Study Design Data were collected through qualitative in-depth interviews (IDIs) with four field staff involved in the routine conduct of VAs, four physicians who code VAs, 20 selected respondents to the VA tool, and eight opinion leaders in the KND. The interviews were supplemented with observation by the researchers and with the field notes of field workers. Interviews were audio-recorded, and local language versions transcribed into English. Thematic analysis was performed using QSR NVivo 8 software. Results The data indicate that cultural sensitivities in VA procedures at both the individual and family levels need greater consideration not only for ethical reasons but also to ensure the quality of the data. Discussions of some deaths are culturally prohibited and therefore lead to refusal of interviews. Families were also concerned about the confidentiality of information because of the potential of blame for the death. VA teams do not necessarily engage in culturally appropriate bereavement practices such as the presentation of tokens. The desire by families for feedback on the cause of death, which is currently not provided by researchers, was frequently expressed. Finally, no standard exists on the culturally acceptable time interval between death and VA interviews. Conclusion Ethical issues need to be given greater consideration in the collection of cause of death data, and this can be achieved through the establishment of processes that allow active engagement with communities, authorities of civil registrations, and Institutional Review Boards to take greater account of local contexts.
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Affiliation(s)
- Raymond A Aborigo
- Navrongo Health Research Centre, Navrongo, Ghana; Global Public Health, MONASH University, Sunway Campus, Selangor, Malaysia; ;
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Engmann C, Adongo P, Aborigo RA, Gupta M, Logonia G, Affah G, Waiswa P, Hodgson A, Moyer CA. Infant illness spanning the antenatal to early neonatal continuum in rural northern Ghana: local perceptions, beliefs and practices. J Perinatol 2013; 33:476-81. [PMID: 23348868 DOI: 10.1038/jp.2012.151] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To explore community understanding of perinatal illness in northern Ghana. STUDY DESIGN A cross-sectional descriptive study design. RESULT 253 community members participated in in-depth interviews and focus group discussions, including women with newborn infants, grandmothers and health care providers. Four overarching themes emerged: (1) Local understanding of illness affects treatment practices. Respondents recognized danger signs of illness spanning antenatal to early neonatal periods. Understanding of causation often had a distinctly local flavor, and thus treatment sometimes differed from mainstream recommendations; (2) Mothers are frequently blamed for their infant's illness; (3) Healthcare decisions regarding infant care are often influenced by community members aside from the infant's mother and (4) Confidence in healthcare providers is issue-specific, and many households use a blended approach to meet their health needs. CONCLUSION Despite widespread recognition of danger signs and reported intentions to treat ill infants through the formal health care system, traditional approaches to perinatal illness remain common. Interventions need to be aligned with community perceptions if they are to succeed.
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Affiliation(s)
- C Engmann
- Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina Schools of Medicine and Public Health, Chapel Hill, NC 27599-7596, USA.
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20
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Why are babies dying in the first month after birth? A 7-year study of neonatal mortality in northern Ghana. PLoS One 2013; 8:e58924. [PMID: 23527050 PMCID: PMC3602544 DOI: 10.1371/journal.pone.0058924] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 02/08/2013] [Indexed: 12/04/2022] Open
Abstract
Objectives To determine the neonatal mortality rate in the Kassena-Nankana District (KND) of northern Ghana, and to identify the leading causes and timing of neonatal deaths. Methods The KND falls within the Navrongo Health Research Centre’s Health and Demographic Surveillance System (HDSS), which uses trained field workers to gather and update health and demographic information from community members every four months. We utilized HDSS data from 2003–2009 to examine patterns of neonatal mortality. Results A total of 17,751 live births between January 2003 and December 2009 were recorded, including 424 neonatal deaths 64.8%(275) of neonatal deaths occurred in the first week of life. The overall neonatal mortality rate was 24 per 1000 live births (95%CI 22 to 26) and early neonatal mortality rate was 16 per 1000 live births (95% CI 14 to 17). Neonatal mortality rates decreased over the period from 26 per 1000 live births in 2003 to 19 per 1000 live births in 2009. In all, 32%(137) of the neonatal deaths were from infections, 21%(88) from birth injury and asphyxia and 18%(76) from prematurity, making these three the leading causes of neonatal deaths in the area. Birth injury and asphyxia (31%) and prematurity (26%) were the leading causes of early neonatal deaths, while infection accounted for 59% of late neonatal deaths. Nearly 46% of all neonatal deaths occurred during the first three postnatal days. In multivariate analysis, multiple births, gestational age <32 weeks and first pregnancies conferred the highest odds of neonatal deaths. Conclusions Neonatal mortality rates are declining in rural northern Ghana, with majority of deaths occurring within the first week of life. This has major policy, programmatic and research implications. Further research is needed to better understand the social, cultural, and logistical factors that drive high mortality in the early days following delivery.
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Alvesson HM, Lindelow M, Khanthaphat B, Laflamme L. Shaping healthcare-seeking processes during fatal illness in resource-poor settings. A study in Lao PDR. BMC Health Serv Res 2012; 12:477. [PMID: 23259434 PMCID: PMC3543714 DOI: 10.1186/1472-6963-12-477] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 12/18/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are profound social meanings attached to bearing children that affect the experience of losing a child, which is akin to the loss of a mother in the household. The objective of this study is to comprehend the broader processes that shape household healthcare-seeking during fatal illness episodes or reproductive health emergencies in resource-poor communities. METHODS The study was conducted in six purposively selected poor, rural communities in Lao PDR, located in two districts that represent communities with different access to health facilities and contain diverse ethnic groups. Households having experienced fatal cases were first identified in focus group discussions with community members, which lead to the identification of 26 deaths in eleven households through caregiver and spouse interviews. The interviews used an open-ended anthropological approach and followed a three-delay framework. Interpretive description was used in the data analysis. RESULTS The healthcare-seeking behavior reported by caregivers revealed a broad range of providers, reflecting the mix of public, private, informal and traditional health services in Lao PDR. Most caregivers had experienced multiple constraints in healthcare-seeking prior to death. Decisions regarding care-seeking were characterized as social rather than individual actions. They were constrained by medical costs, low expectations of recovery and worries about normative expectations from healthcare workers on how patients and caregivers should behave at health facilities to qualify for treatment. Caregivers raised the difficulties in determining the severity of the state of the child/mother. Delays in reaching care related to lack of physical access and to risks associated with taking a sick family member out of the local community. Delays in receiving care were affected by the perceived low quality of care provided at the health facilities. CONCLUSIONS Care-seeking is influenced by family- and community-based relations, which are integrated parts of people's everyday life. The medical and normative responses from health providers affect the behavior of care-seekers. An anthropological approach to capture the experience of caregivers in relation to deciding, seeking and reaching care reveals the complexity and socio-cultural context surrounding maternal and child mortality and has implications for how future mortality data should be developed and interpreted.
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Affiliation(s)
- Helle M Alvesson
- Department of Public Health Sciences, Division of Global Health, Karolinska Institutet, Nobels väg 9, Stockholm, 171 77, Sweden
| | - Magnus Lindelow
- Human Development Department, The World Bank, Brazil SCN, Quadra 2, Lote A. Ed. Corporate Center, 7th andar, Brasilia, DF, 70712-900, Brazil
| | - Bouasavanh Khanthaphat
- Indochina Research Laos Ltd, IRL Building, 282/17 Phontong-Savath, PO Box 1887, Vientiane Capital, Chanthabouly District, Laos
| | - Lucie Laflamme
- Department of Public Health Sciences, Division of Global Health, Karolinska Institutet, Nobels väg 9, Stockholm, 171 77, Sweden
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Charlier P, Brun L, de la Grandmaison GL, Hervé C. Medical students from Parakou (Benin) and West-African traditional beliefs on death and cadavers. Afr Health Sci 2012; 12:443-5. [PMID: 23513075 DOI: 10.4314/ahs.v12i4.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- P Charlier
- Department of Forensic Medicine and Pathology, University Hospital R. Poincaré, Paris, France.
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Engmann C, Garces A, Jehan I, Ditekemena J, Phiri M, Thorsten V, Mazariegos M, Chomba E, Pasha O, Tshefu A, Wallace D, McClure EM, Goldenberg RL, Carlo WA, Wright LL, Bose C. Birth attendants as perinatal verbal autopsy respondents in low- and middle-income countries: a viable alternative? Bull World Health Organ 2011; 90:200-8. [PMID: 22461715 DOI: 10.2471/blt.11.092452] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 11/07/2011] [Accepted: 11/09/2011] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To assess the feasibility of using birth attendants instead of bereaved mothers as perinatal verbal autopsy respondents. METHODS Verbal autopsy interviews for early neonatal deaths and stillbirths were conducted separately among mothers (reference standard) and birth attendants in 38 communities in four developing countries. Concordance between maternal and attendant responses was calculated for all questions, for categories of questions and for individual questions. The sensitivity and specificity of individual questions with the birth attendant as respondent were assessed. FINDINGS For early neonatal deaths, concordance across all questions was 94%. Concordance was at least 95% for more than half the questions on maternal medical history, birth attendance and neonate characteristics. Concordance on any given question was never less than 80%. Sensitivity and specificity varied across individual questions, more than 80% of which had a sensitivity of at least 80% and a specificity of at least 90%. For stillbirths, concordance across all questions was 93%. Concordance was 95% or greater more than half the time for questions on birth attendance, site of delivery and stillborn characteristics. Sensitivity and specificity varied across individual questions. Over 60% of the questions had a sensitivity of at least 80% and over 80% of them had a specificity of at least 90%. Overall, the causes of death established through verbal autopsy were similar, regardless of respondent. CONCLUSION Birth attendants can substitute for bereaved mothers as verbal autopsy respondents. The questions in existing harmonized verbal autopsy questionnaires need further refinement, as their sensitivity and specificity differ widely.
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Affiliation(s)
- C Engmann
- Department of Pediatrics and Maternal and Child Health, University of North Carolina Schools of Medicine and Public Health, UNC Hospitals, UNC-Chapel Hill, Chapel Hill, NC 27599-7596, USA.
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Scior K, Furnham A. Development and validation of the Intellectual Disability Literacy Scale for assessment of knowledge, beliefs and attitudes to intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:1530-1541. [PMID: 21377320 DOI: 10.1016/j.ridd.2011.01.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 01/21/2011] [Indexed: 05/30/2023]
Abstract
Research into the general public's responses to individuals with intellectual disabilities has been dominated by attitudinal research. While this approach has unquestionably generated useful findings, it ignores important aspects, such as lay knowledge, explanatory models and beliefs about suitable interventions that can produce a multi-faceted understanding of public responses. This paper describes the development of a measure designed to assess respondents' intellectual disability literacy. Following a pilot with 114 participants, the IDLS was revised and then completed by 1376 members of the public (aged 18-78 years) from diverse cultural backgrounds. The measure was able to distinguish respondents who showed good intellectual disability literacy. Confirmatory factor analyses revealed four causal beliefs factors (adversity, biomedical, fate, environment) that accounted for 55% of the variance and three intervention beliefs factors (lifestyle, expert help, religion/spiritual,) that explained 52% of the variance. Test-retest reliability for these factors was good for all ethnic groups. The four-item social distance scale had good internal consistency for all ethnic groups and acceptable concurrent validity. The IDLS is a useful new tool to evaluate knowledge, beliefs and social distance to intellectual disability in lay people, is suitable for cross-cultural research and allows comparison of intellectual disability and mental health literacy in any given population.
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Affiliation(s)
- Katrina Scior
- Research Department of Clinical Educational & Health Psychology, University College London, 1-19 Torrington Place, London, United Kingdom.
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