Research and Evaluation Division, BRAC, Dhaka, Bangladesh.
BMC Public Health. 2012 Sep 17;12:791. doi: 10.1186/1471-2458-12-791.
Worldwide urbanization has become a crucial issue in recent years. Bangladesh, one of the poorest and most densely-populated countries in the world, has been facing rapid urbanization. In urban areas, maternal indicators are generally worse in the slums than in the urban non-slum areas. The Manoshi program at BRAC, a non governmental organization, works to improve maternal, newborn, and child health in the urban slums of Bangladesh. This paper describes maternal related beliefs and practices in the urban slums of Dhaka and provides baseline information for the Manoshi program.
This is a descriptive study where data were collected using both quantitative and qualitative methods. The respondents for the quantitative methods, through a baseline survey using a probability sample, were mothers with infants (n = 672) living in the Manoshi program areas. Apart from this, as part of a formative research, thirty six in-depth semi-structured interviews were conducted during the same period from two of the above Manoshi program areas among currently pregnant women who had also previously given births (n = 18); and recently delivered women (n = 18).
The baseline survey revealed that one quarter of the recently delivered women received at least four antenatal care visits and 24 percent women received at least one postnatal care visit. Eighty-five percent of deliveries took place at home and 58 percent of the deliveries were assisted by untrained traditional birth attendants. The women mostly relied on their landladies for information and support. Members of the slum community mainly used cheap, easily accessible and available informal sectors for seeking care. Cultural beliefs and practices also reinforced this behavior, including home delivery without skilled assistance.
Behavioral change messages are needed to increase the numbers of antenatal and postnatal care visits, improve birth preparedness, and encourage skilled attendance at delivery. Programs in the urban slum areas should also consider interventions to improve social support for key influential persons in the community, particularly landladies who serve as advisors and decision-makers.
近年来，全球城市化已成为一个关键问题。孟加拉国是世界上最贫穷和人口最密集的国家之一，正面临着快速的城市化进程。在城市地区，贫民窟的产妇指标普遍比非贫民窟地区差。非政府组织 BRAC 的 Manoshi 项目致力于改善孟加拉国城市贫民窟的母婴、新生儿和儿童健康。本文描述了达卡城市贫民窟中与产妇相关的信仰和做法，并为 Manoshi 项目提供了基线信息。
这是一项描述性研究，通过定量和定性方法收集数据。定量方法的受访者是居住在 Manoshi 项目地区、有婴儿（n=672）的母亲，通过使用概率样本进行基线调查获得。除此之外，作为形成性研究的一部分，在同一时期，在上述两个 Manoshi 项目地区，对目前怀孕的妇女（n=18）和最近分娩的妇女（n=18）进行了 36 次深入的半结构式访谈。
基线调查显示，四分之一的最近分娩的妇女至少接受了四次产前保健访问，24%的妇女至少接受了一次产后保健访问。85%的分娩在家中进行，58%的分娩由未经培训的传统助产妇协助。妇女主要依靠女房东获取信息和支持。贫民窟社区的成员主要依靠廉价、易于获得和可用的非正式部门寻求护理。文化信仰和习俗也强化了这种行为，包括在家中没有熟练助手的情况下分娩。
需要传递行为改变信息，以增加产前和产后保健访问次数，提高生育准备水平，并鼓励熟练的分娩助手。城市贫民窟地区的项目还应考虑干预措施，以改善社区中关键有影响力人士的社会支持，特别是作为顾问和决策者的女房东。
