肯尼亚和南非与早产相关的文化考虑因素和信念。
Cultural considerations and beliefs surrounding preterm birth in Kenya and South Africa.
机构信息
Wits MRU (MatCH Research Unit), Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of the Witwatersrand, 11th Floor, Commercial City Building, 40 Dr AB Xuma Street, Durban, 4001, South Africa.
Albert Einstein School of Medicine, New York, USA.
出版信息
Reprod Health. 2023 Jun 12;20(1):87. doi: 10.1186/s12978-023-01633-9.
BACKGROUND
Preterm birth (PTB) is a global health epidemic, sub-Saharan Africa is severely impacted due to its limited healthcare resources. Pregnancy knowledge, cultural beliefs and practices play a role in the identification of risk and management of PTB. This study explored knowledge, understandings, cultural beliefs and attitudes to pregnancy and PTB, as well as cultural considerations for the introduction of an intravaginal device which could be used to identify PTB risk.
METHODS
Qualitative research was conducted in South Africa and Kenya. In-depth interviews were conducted using semi-structured guides with women with a history of PTB (n = 10), healthcare providers (n = 16) and health systems experts (n = 10); and 26 focus group discussions with pregnant women seeking antenatal care (n = 132) and community male partners/fathers (n = 54). Interviews/discussions were transcribed, translated, and analysed thematically.
RESULTS
Pregnancy knowledge, especially for first time pregnancies was poor, with many reporting late entry to antenatal care. Knowledge about PTB was understood in terms of gestational age, weight or small size of baby, with concerns about long term health and stigma. Various risk factors for PTB were described, including those related to traditions and beliefs of witchcraft/curses. Cultural practices, such as the use of traditional medicines and pica, and religion and its impact on health seeking behaviour were also viewed as risk factors. Although insertion of intravaginal devices was not widely acceptable in traditional communities, especially during pregnancy, it was felt that the use of one to detect risk of PTB would be accepted if proven effective in reducing PTB risk.
CONCLUSIONS
Various culturally-informed beliefs exist which explain understandings of and attitudes toward pregnancy, pregnancy risk, and PTB. An inclusive exploratory process is critical to facilitate an understanding of the beliefs and traditions which could impact the introduction and design of a product to detect the risk of PTB.
背景
早产（PTB）是一种全球性的健康流行疾病，由于撒哈拉以南非洲地区医疗资源有限，该地区受到的影响尤为严重。怀孕知识、文化信仰和习俗在识别风险和管理 PTB 方面发挥着作用。本研究探讨了与怀孕和 PTB 相关的知识、理解、文化信仰和态度，以及引入一种可用于识别 PTB 风险的阴道内装置时需要考虑的文化因素。
方法
在南非和肯尼亚开展了定性研究。对有早产史的女性（n=10）、医疗保健提供者（n=16）和卫生系统专家（n=10）进行了半结构式深入访谈；对 132 名寻求产前护理的孕妇（n=132）和 54 名社区男性伴侣/父亲（n=54）进行了 26 次焦点小组讨论。对访谈/讨论进行了转录、翻译和主题分析。
结果
怀孕知识，尤其是初次怀孕的知识非常匮乏，许多人报告说很晚才开始接受产前护理。人们从妊娠龄、婴儿体重或体型小的角度理解 PTB，担心长期健康和耻辱感。描述了各种 PTB 风险因素，包括与传统和巫术/诅咒观念相关的因素。文化习俗，如使用传统药物和异食癖，以及宗教及其对健康寻求行为的影响，也被视为风险因素。虽然阴道内装置的插入在传统社区中并不被广泛接受，尤其是在怀孕期间，但人们认为，如果证明该装置能有效降低 PTB 风险，那么使用该装置来检测 PTB 风险将被接受。
结论
存在各种文化因素导致的信仰，这些信仰解释了对怀孕、怀孕风险和 PTB 的理解和态度。包容性的探索性过程对于理解可能影响引入和设计用于检测 PTB 风险的产品的信仰和传统至关重要。
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