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肯尼亚基利菲地区社区对孕妇和产后妇女的高温和天气预警的看法。

Community perspectives of heat and weather warnings for pregnant and postpartum women in Kilifi, Kenya.

机构信息

Environmental Health And Governance Centre, School of Business, African International University, Nairobi, Kenya.

Institute for Human Development, Aga Khan University, Nairobi, Kenya.

出版信息

PLoS One. 2024 Nov 19;19(11):e0313781. doi: 10.1371/journal.pone.0313781. eCollection 2024.

Abstract

BACKGROUND

Extreme weather is a recognised risk factor for stillbirth and preterm birth, disrupts women's access to healthcare during pregnancy and childbirth, and negatively affects the care of newborns. Reliable and accessible heat and weather warning systems are key in alerting individuals to undertake protective measures. There is a notable gap in understanding how women and caregivers in rural East Africa perceive and utilize weather information. We investigated community members' heat and weather warning information-seeking behaviour, identified available sources, assessed their reliability and utility, and examined their influence on behaviour.

SETTINGS

Our research was conducted in rural Kilifi County in Kenya's coastal region. The area experiences temperatures exceeding 23°C throughout the year, with extended periods of extreme temperatures [> 40°C] and long and severe droughts.

METHODS

We conducted in-depth interviews [IDI] with pregnant and postpartum women [n = 21] and held six focus group discussions [FGDs] involving mothers-in-law and community health volunteers [CHVs]. The data were analysed in NVivo 12 using both inductive and deductive approaches.

RESULTS

We found significant gaps concerning pregnant and post-partum women, and their caregivers, having timely access to weather forecasts and heat information from health or meteorological authorities. Information on heat and weather warnings is disseminated through various channels, including television, radio, mobile phones, and word of mouth, which are facilitated by community influencers such as CHVs and local chiefs. Indigenous methods of weather forecasting, such as cloud observation, consulting local "rainmakers", and studying the behavioural patterns of amphibians, are employed in conjunction with warnings from the Kenyan Meteorological Department (KMD). Barriers to accessing weather information include the cost of television and smartphones and a lack of segmented information in local languages.

CONCLUSIONS

National and county meteorological services need to enhance public participation, communication, and the delivery of heat and weather information to guide community-level response measures and individual behaviour change. They should also collaborate with health professionals to address heat risks for vulnerable groups. Further research is needed to empower indigenous weather predictors with modern weather information and revise national policies to deliver tailored messages to vulnerable populations like pregnant and postpartum women.

摘要

背景

极端天气是导致死产和早产的公认风险因素,它会干扰妇女在怀孕期间和分娩期间获得医疗保健的机会,并对新生儿护理产生负面影响。可靠和可访问的高温和天气预警系统是提醒个人采取保护措施的关键。目前,人们对东非农村地区的妇女和照顾者如何感知和利用天气信息知之甚少。我们调查了社区成员对高温和天气预警信息的查询行为,确定了可用的信息来源,评估了它们的可靠性和实用性,并研究了它们对行为的影响。

地点

我们的研究在肯尼亚沿海地区的基利菲县农村进行。该地区全年气温超过 23°C,有长时间的极端高温(> 40°C)和严重的干旱。

方法

我们对 21 名孕妇和产后妇女进行了深入访谈(IDI),并举行了六次焦点小组讨论(FGD),参与者包括婆婆和社区卫生志愿者(CHVs)。使用 NVivo 12 软件对数据进行了分析,采用了归纳和演绎方法。

结果

我们发现,孕妇和产后妇女及其照顾者及时获得卫生或气象当局发布的天气预报和高温信息方面存在重大差距。有关高温和天气预警的信息通过电视、广播、手机和口口相传等各种渠道传播,社区影响者,如 CHVs 和当地酋长,促进了信息的传播。土著的天气预报方法,如观察云、咨询当地的“造雨者”和研究两栖动物的行为模式,与肯尼亚气象局(KMD)的预警结合使用。获取天气信息的障碍包括电视和智能手机的成本以及当地语言缺乏细分信息。

结论

国家和县级气象部门需要加强公众参与、沟通和高温及天气信息的传递,以指导社区层面的应对措施和个人行为改变。他们还应与卫生专业人员合作,解决弱势群体的高温风险。需要进一步研究如何利用现代天气信息增强土著天气预报员的能力,并修订国家政策,向孕妇和产后妇女等弱势群体提供量身定制的信息。

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Deliver on Your Own: Disrespectful Maternity Care in rural Kenya.自行分娩:肯尼亚农村不受尊重的孕产妇保健。
PLoS One. 2020 Jan 7;15(1):e0214836. doi: 10.1371/journal.pone.0214836. eCollection 2020.

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