'I don't want all my babies to go to the grave': perceptions of preterm birth in Southern Malawi

Tolhurst, Rachel ORCID: https://orcid.org/0000-0002-3005-6641, Theobald, Sally ORCID: https://orcid.org/0000-0002-9053-211X, Kayira, E., Ntonya, C., Kafulafula, G., Nielson, J. and Van Den Broek, Nynke ORCID: https://orcid.org/0000-0001-8523-2684 (2008) ''I don't want all my babies to go to the grave': perceptions of preterm birth in Southern Malawi'. Midwifery, Vol 24, Issue 1, pp. 83-98.

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Abstract

Objective: to investigate perceptions of preterm birth, infections in pregnancy and perinatal mortality among women, men and health-care providers in Namitambo, Southern Malawi.
Design: a qualitative study using focus-group discussions, critical incidence narrative and key informant interviews. The framework approach to qualitative analysis was used.
Setting: Namitambo, a rural area in southern Malawi.
Participants: women who have experienced preterm delivery, groups of mothers, fathers and grandmothers, healthcare providers, traditional birth attendants and heaters.
Findings: four key inter-related themes grounded in community interpretative frameworks emerged: (1) community conceptualisations of preterm birth (the different terminologies used); (2) perceived causes of preterm birth (i.e. both 'modern' and 'traditional; illnesses, violence, witchcraft, ideas relating to impurity, heavy work, inadequate food and inappropriate use of medicine); (3) perceived strategies to prevent preterm birth (i.e. using format health services, treatment for sexually transmitted infections, using condoms and stopping violence); and (4) barriers to realising these strategies, such as lack of food, money and women's autonomy in health seeking.
Key conclusions: similarities and differences exist in understanding between healthcare providers and the community. Additional dialogue and action is needed within the health sector and community to address the problem of preterm births. This includes strategies to enable health-care providers and community members to reflect on their perceptions and practices (e.g. through action research and interactive drama); identify and build on areas of common concern (i.e. poor pregnancy outcome) and enter into partnerships with non-format providers. Action is also needed beyond the health sector (e.g. in campaigns to reduce gender-based violence). (c) 2006 Elsevier Ltd. All rights reserved.

Item Type:	Article
Uncontrolled Keywords:	pregnancy outcome premature birth malawi sub-saharan africa qualitative research sexually transmitted infections rural malawi community health malaria
Subjects:	WB Practice of Medicine > Medical Climatology > WB 710 Diseases of geographic areas WQ Obstetrics > Pregnancy Complications > WQ 240 Pregnancy complications (General) WA Public Health > WA 100 General works
Faculty: Department:	Groups (2002 - 2012) > Child & Reproductive Health Group Groups (2002 - 2012) > International Health Group
Digital Object Identifer (DOI):	https://doi.org/10.1016/j.midw.2006.09.003
Depositing User:	Faye Moody
Date Deposited:	16 Jul 2010 11:45
Last Modified:	08 Sep 2020 10:07
URI:	https://archive.lstmed.ac.uk/id/eprint/938

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