"Is she pregnant with Jesus?" exploring sociocultural obstacles to following medical advice in the context of stillbirth prevention in Nigeria.

IF 2.8 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Uchenna Gwacham-Anisiobi, Adetola Oladimeji, Victoria Yesufu, Jennifer J Kurinczuk, Manisha Nair, Jenny McLeish
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引用次数: 0

Abstract

Background: Each year 182,000 babies are stillborn in Nigeria, representing nearly 10% of the annual global stillbirth burden. Imo state in south-eastern Nigeria has one of the highest levels of maternal health service access in Nigeria, yet this has not translated into good pregnancy outcomes. Many stillbirth prevention initiatives in Nigeria focus on maternal health education but empirical evidence suggests that sociocultural factors impact healthcare choices and outcomes. This study aims to explore women's and health workers' perspectives of the sociocultural barriers to following medical advice during pregnancy and childbirth, and specifically how these barriers may contribute to an increased risk of stillbirth. This study is part of a broader community-based stillbirth prevention mixed-methods research in Imo State, Nigeria.

Methods: A qualitative descriptive study was conducted using in-depth interviews and focus group discussions. 38 participants were purposively recruited; 20 women and 18 health workers. Audio recordings were transcribed, translated and analysed using inductive thematic analysis.

Results: Four themes were identified: (1) trust, where scepticism about health worker motives or competence and trust in community informal networks were highlighted (2) power dynamics within families, with husbands and older female relatives influencing health decisions; (3) personal and community beliefs that undermine confidence in medical interventions, including a pervasive stigma associated with caesarean section; and (4) grassroots proposals for solutions, emphasising the importance of a whole-community approach to maternal health education, mobilising peer voices, engaging traditional leaders and training of traditional birth attendants.

Conclusion: This study provides insights into the sociocultural barriers to following medical advice during pregnancy in Nigeria, which include a lack of trust in health professionals, power dynamics within a woman's family, and entrenched cultural and religious beliefs that oppose medical intervention. Women's decisions about pregnancy and childbirth are heavily influenced by family and cultural norms. Culturally sensitive, community-wide interventions which aim to rebuild trust in the health system, involve women as decision-makers in antenatal care, and engage religious and traditional leaders would be beneficial for improving outcomes.

“她怀了耶稣吗?”探讨在尼日利亚预防死产的背景下,遵循医疗建议的社会文化障碍。
背景:尼日利亚每年有18.2万名婴儿死产,占全球每年死产负担的近10%。尼日利亚东南部的伊莫州是尼日利亚获得孕产妇保健服务水平最高的州之一,但这并没有转化为良好的妊娠结局。尼日利亚的许多死产预防举措侧重于孕产妇健康教育,但经验证据表明,社会文化因素影响医疗保健选择和结果。本研究旨在探讨妇女和卫生工作者对在怀孕和分娩期间遵循医疗建议的社会文化障碍的看法,特别是这些障碍如何可能导致死产风险增加。这项研究是尼日利亚伊莫州更广泛的以社区为基础的死产预防混合方法研究的一部分。方法:采用深度访谈和焦点小组讨论的方法进行定性描述性研究。有目的地招募了38名参与者;20名妇女和18名保健工作者。录音被转录,翻译和分析使用归纳主题分析。结果:确定了四个主题:(1)信任,其中对卫生工作者动机或能力的怀疑以及对社区非正式网络的信任被强调;(2)家庭内部的权力动态,丈夫和年长的女性亲属影响健康决策;(3)个人和社区的信念削弱了对医疗干预的信心,包括与剖腹产有关的普遍耻辱;(4)提出解决方案的基层建议,强调采用全社区方法进行孕产妇保健教育的重要性,调动同伴的声音,吸引传统领导人和培训传统助产士。结论:本研究提供了对尼日利亚怀孕期间遵循医疗建议的社会文化障碍的见解,其中包括对卫生专业人员缺乏信任,妇女家庭中的权力动态,以及反对医疗干预的根深蒂固的文化和宗教信仰。妇女关于怀孕和分娩的决定在很大程度上受到家庭和文化规范的影响。具有文化敏感性的、旨在重建对卫生系统的信任、让妇女作为决策者参与产前保健以及让宗教和传统领袖参与的全社区干预措施将有利于改善结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Pregnancy and Childbirth
BMC Pregnancy and Childbirth OBSTETRICS & GYNECOLOGY-
CiteScore
4.90
自引率
6.50%
发文量
845
审稿时长
3-8 weeks
期刊介绍: BMC Pregnancy & Childbirth is an open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth. The journal welcomes submissions on the biomedical aspects of pregnancy, breastfeeding, labor, maternal health, maternity care, trends and sociological aspects of pregnancy and childbirth.
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