Population Council, Nairobi, Kenya.
Population Council, Washington, DC, United States of America.
PLoS One. 2020 Nov 17;15(11):e0240852. doi: 10.1371/journal.pone.0240852. eCollection 2020.
Understanding communities' beliefs about the causes of illnesses in sick young infants (SYIs) is key to strengthening interventions and improving newborn health outcomes. This study explored communities' perception of the etiology of illnesses in SYIs 0-59 days old in four counties in Kenya.
We used an exploratory qualitative study design. Data were collected between August and September 2018 and involved 23 in-depth interviews with female caregivers aged 15-24years; 25 focus group discussions with female caregivers aged 15-18 years, 19-24 years and 25-45 years; and 7 focus group discussions with fathers aged 18-34 years and 35 or more years. Participants were purposely sampled, only those with SYIs 0-59 days old were eligible to participate. Data were analyzed using inductive thematic analysis framework approach.
Female caregivers and fathers attributed illnesses in SYIs 0-59 days old to natural (biomedical) and supernatural causes which sometimes co-existed. There were commonalities in perceived natural causes of illness in SYIs across sites, age groups and gender. Perceived natural causes of illness in SYIs include unfavorable environmental and hygiene conditions, poor maternal and child nutrition, and healthcare practices. Perceived supernatural causes of illness in SYIs such as 'evil eyes' were common across the four counties while others were geographically unique such as the belief that owls cause illnesses.
Communities' understanding of the etiology of illnesses in SYIs in the study settings overlapped between natural and supernatural causes. There is need for child health programmes to take into consideration communities' beliefs and practices regarding disease and health to improve newborn health outcomes.
了解社区对患病婴幼儿（SYI）病因的看法是加强干预和改善新生儿健康结果的关键。本研究探讨了肯尼亚四个县的社区对 0-59 天龄 SYI 疾病病因的看法。
我们采用了探索性定性研究设计。数据收集于 2018 年 8 月至 9 月之间，涉及 23 名 15-24 岁女性照顾者的深入访谈；25 个 15-18 岁、19-24 岁和 25-45 岁女性照顾者的焦点小组讨论；以及 7 个 18-34 岁和 35 岁或以上男性父亲的焦点小组讨论。参与者是经过精心挑选的，只有 0-59 天龄的 SYI 患儿的照顾者才有资格参加。数据采用归纳主题分析框架方法进行分析。
女性照顾者和父亲将 0-59 天龄 SYI 的疾病归因于自然（生物医学）和超自然原因，有时这两种原因同时存在。不同地点、年龄组和性别之间对 SYI 疾病的自然病因有共同的认识。认为 SYI 疾病的自然病因包括不利的环境和卫生条件、母婴营养不良以及医疗保健做法。认为 SYI 疾病的超自然病因如“邪眼”在四个县都很常见，而其他病因则具有地域独特性，如认为猫头鹰会引起疾病。
研究背景下社区对 SYI 疾病病因的理解在自然和超自然原因之间存在重叠。儿童健康方案需要考虑社区对疾病和健康的信仰和做法，以改善新生儿健康结果。
