BRAC James P Grant School of Public Health, BRAC University, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka 1212, Bangladesh.
Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747AD Groningen, The Netherlands.
Int J Environ Res Public Health. 2020 Aug 10;17(16):5781. doi: 10.3390/ijerph17165781.
Maternal and child survival is a major public health problem in haor areas in Bangladesh. Fathers feel responsible as expressed by their capability "to save the future". Using the Capability Framework for Child Growth, we aimed to identify what contextual factors underlie a father's real opportunities to secure a safe delivery, including social norms and beliefs. Parents from households having children less than two years old were asked to participate in two rounds of qualitative research. In total, 25 focus group discussions and eight in-depth interviews were conducted. Late admission to health facilities emerged as the overarching disabling factor for fathers' capability to save the lives of mothers and children. Poor communication about the mother's health condition between spouses and fear for caesarean birth were underlying this late admission. In addition, inadequate advice by local doctors, underdeveloped infrastructure, and seasonal extremities contributed to late admission to health care facilities. The participants indicated that mother's autonomy in haor to seek health care is a constraint. This capability analysis points towards relevant interventions. In addition to the need for an improved health infrastructure, programs to improve maternal and child survival in haor could focus on the gendered household responsibilities and poor communication between spouses.
母婴生存是孟加拉国 haor 地区的一个主要公共卫生问题。父亲们感到有责任，正如他们所说的那样，他们有能力“拯救未来”。我们使用儿童成长能力框架，旨在确定哪些背景因素是父亲确保安全分娩的真正机会的基础，包括社会规范和信仰。我们邀请了有两岁以下孩子的家庭的父母参加两轮定性研究。总共进行了 25 次焦点小组讨论和 8 次深入访谈。卫生机构的延迟收治是父亲挽救母亲和孩子生命的能力的主要障碍。夫妻之间对母亲健康状况沟通不畅以及对剖腹产的恐惧是导致这种延迟收治的原因。此外，当地医生提供的建议不足、基础设施不完善以及季节性极端天气也导致了卫生保健机构的延迟收治。参与者表示，母亲在 haor 地区自主寻求医疗保健是一个限制。这种能力分析指向了相关的干预措施。除了需要改善卫生基础设施外，为提高 haor 地区母婴生存而开展的项目还可以侧重于家庭中性别角色的责任以及夫妻之间沟通不畅的问题。
