Paternal Involvement and Adverse Birth Outcomes in South Gujarat, India

Male involvement as a significant contributor for enhancing maternal and child health-care services: A scoping review

Men have conventionally been excluded from Maternal and Child Health (MCH) services, thereby reinforcing the erroneous notion that pregnancy and the processes leading to childbirth and child-rearing are the preserve of women. Participation of men in MCH is crucial for the reduction of infant and maternal mortality. This scoping review focuses on the contribution of male involvement to MCH care and explores the feasible strategies to improve it. Studies on male involvement in the crucial timelines of the MCH and strategies for implementing and improving male involvement in MCH care in India and other developing countries were obtained through a review of literature in PubMed databases using the medical subject headings (MeSH) terms and unpublished, grey literature during the year 1990-2020. Nearly 50 of the eligible articles were included and synthesized into a scoping review report. Findings revealed that the men's participation had a beneficial impact on all crucial timelines of MCH care. Yet, women perceived low male participation in most of the studies. Several different factors that influence have been identified, including education, socioeconomic status, traditional practices, negative stereotyping among males, and lack of male friendly health-care system. Utilization of community volunteers, male peer educators, workplace-based or mass media education, and men-friendly policy changes or health-care provider initiatives could be crucial in improving male involvement in MCH care. Despite worldwide acceptance as an essential contributor to enhancing MCH care, the scoping review revealed low male involvement levels in developing countries and identified strategies to address this lacuna.

Perceptions on preeclampsia and eclampsia among senior, older women, in rural Southwestern Uganda

Background

Eclampsia is among the leading causes of maternal mortality. It is a serious hypertensive complication of pregnancy and increases the risk of cardiovascular disease in later life. Pregnancy-related hypertension complications predispose to chronic hypertension and premature heart attacks. A significant proportion of women with preeclampsia/eclampsia does not reach the formal healthcare system or arrive too late because of certain traditional or cultural beliefs about the condition. The older, senior women in the community are knowledgeable and play a significant role in decision making regarding where mothers should seek maternal health care. Therefore, the purpose of this study was to explore the perceptions of older and senior women regarding the manifestation of, risk factors and possible causes of preeclampsia/eclampsia.

Methods

We conducted a qualitative study in rural Southwestern Uganda. The key informants were senior, older women including community elders, village health team members and traditional birth attendants who were believed to hold local knowledge and influence on birth and delivery. We purposively selected key informants and data were collected till we reached saturation point. We analyzed data using an inductive thematic approach to identify themes.

Results

We interviewed 20 key informants with four themes identified. The 'causes' theme emerged from the subthemes of confusion with other conditions, spiritual beliefs and high blood pressure. The 'risk factors' theme emerged from the subthemes of oedema-related illnesses, poverty-induced malnutrition, and strained relationships. The 'remedies' theme emerged from the consistent mention of traditional herbal treatment, seek medical help, spiritual healing, emotional healing and corrective nutrition as potential solutions. The theme 'effects of preeclampsia/eclampsia' emerged from the mention of pregnancy complications like premature delivery, child loss, operative delivery like caesarian section delivery as well as death. There was no identifiable local name from the interviews. Women carried several myths regarding the cause and these included little blood, witchcraft, ghost attacks and stress from strained relationships including marital tension. Women were generally aware of the outcomes of eclampsia, mainly that it kills.

Conclusions

Eclampsia is associated with significant myths and misconceptions in this rural community. We recommend interventions to increase awareness and dispel these myths and misconceptions, increase access to antenatal preeclampsia surveillance, and facilitate timely referral for basic maternity care as means for early detection and management of preeclampsia.