Care for newborns and its diverse meanings.

The arrival of a newborn in a family brings with it many worries, together with baby-related tasks to keep family members busy, and sometimes paradoxically withdrawal. Funding from UNICEF enabled us to conduct an original anthropological study in five countries of sub-Saharan Africa (Benin, Burkina Faso, Mali, Mauritania, Togo), studying newborn care from birth to the seventh day of life. We focused on the various kinds of care provided to these babies and on their diverse meanings. We examined how the social status of newborns induced forms of care and of interpretations of particular disorders. This work shows that the conceptions of the newborn: vulnerable beings of uncertain social integration - engendered less investment by health care professionals at birth, but inversely, strong mobilization by members of the extended family. Despite the generalization of hospital births, care during the first days of life remained associated with the domestic household universe and was barely if at all medicalized. The heterogeneous integration of medical recommendations for newborn care in the first days of life can be analyzed as arising from divergent intentions around the birth and the reception of the newborn. This study also examined how changes in neonatal care may generate conflicts of influence and intrafamily power struggles and thus allowed us to explain how the adoption of some recommended neonatal care was compromised and how they need to be adapted locally. It thus showed how some changes in neonatal care helped to bring about the reexamination of family roles. This will lead us to discuss how to define "respectful care" for these subjects who cannot speak. Beyond quality of care based on good practice guidelines, it is important to underline how respect in the care relationship is indissociable from the local cultural construction of newborns.