Kane Hélène
Sante Publique. 2020;HS1(S1):17-27. doi: 10.3917/spub.200.0017.
Driven by international programs specifically targeting neonatal survival, a set of recommended care practices is being promoted in West Africa. Using data from a multi-centered anthropological study, we enquire as to how local practices integrate the recommendations disseminated by these programs.
The surveys were conducted in rural localities in five countries : Benin, Burkina Faso, Mali, Mauritania, and Togo. In every site, the investigations combined ethnography of newborn care and in-depth interviews in maternity homes and homes.
The care of newborns is based on a set of local social representations and logics, where medical recommendations are integrated heterogeneously. In maternity wards, health professionals face difficulties in implementing recommended practices, and make various conciliations when faced with local material and social constraints. In private homes, the "messages" promoting life-saving care for newborns punctuate conversations, but lead to various interpretations and variations in care.
The irregular integration of medical recommendations in neonatal care is analyzed around three areas: the divergence of intentions around the birth, the dissonances between the recommended care and the local conceptions of the newborn, the influence of intra-family power relations. Considering the complexity of the changes in neonatal care, we argue for the implementation of programs that respect local cultures, and for health professionals to skillfully accommodate conflicting constraints.
在专门针对新生儿生存的国际项目推动下，西非正在推广一系列推荐的护理做法。我们利用一项多中心人类学研究的数据，探究当地做法如何融入这些项目所传播的建议。
调查在贝宁、布基纳法索、马里、毛里塔尼亚和多哥这五个国家的农村地区进行。在每个地点，调查结合了新生儿护理民族志以及在妇产医院和家庭中的深入访谈。
新生儿护理基于一套当地的社会观念和逻辑，医学建议在其中的融入方式各不相同。在产科病房，卫生专业人员在实施推荐做法时面临困难，并且在面对当地物质和社会限制时会进行各种协调。在私人家庭中，推广新生儿救生护理的“信息”穿插在对话中，但导致了护理方式的各种解读和差异。
围绕三个方面分析了医学建议在新生儿护理中融入不规律的情况：分娩前后意图的差异、推荐护理与当地新生儿观念之间的不一致、家庭内部权力关系的影响。考虑到新生儿护理变化的复杂性，我们主张实施尊重当地文化的项目，并让卫生专业人员巧妙地应对相互冲突的限制。
