Format du dépôt |
Notice |
Type de dépôt |
Article dans une revue |
Résumé |
en
In Madagascar, a country where over 60% of deliveries are not attended by a healthcare professional, late or inadequate responses to complications during childbirth account for a great number of maternal deaths. In this article, we analyse local perceptions of birth-related risks and strategies used to avoid these risks or manage complications of childbirth. We conduct this analysis in light of the social meanings of childbirth and the social expectations placed upon women in a context of socioeconomic vulnerability and a challenged public health system. We conducted two separate studies in the district of Morondava (Menabe region) in June 2014 and March 2015, comprising semi-directive interviews with 111 people (59 mothers, 18 members of their immediate en-tourage and 34 institutional or healthcare stakeholders), and eight focus groups discussions-two with community leaders, and six with fathers. The results show that the social pressure exerted on women to give birth without complications leads them to practices aimed at avoiding a "big" baby including dietary restrictions, physical activity, and refusal of iron supplementation intake. During pregnancy, women are usually accompanied by a traditional birth attendant or matron (reninjaza). Further, they use the public health system by attending antenatal consultations. However, women are reluctant to deliver in a health facility, where the practices of health professionals are in discordance with the social realities of women and local beliefs around childbirth. If complications arise, they are explained by social causes. The parturient woman is only taken to a healthcare facility after carrying out rituals and if the problems do not resolve themselves. These findings support recommendations to reduce the cultural distance between health workers and childbearing women, strengthen the collaborations with reninjazas, and inform women and their decision makers (mother, reninjaza, spouse) about nutrition during pregnancy and signs of complications.
|
Titre |
en
Avoiding a "big" baby: Local perceptions and social responses toward childbirth-related complications in Menabe, Madagascar
|
Auteur(s)
|
Dolorès Pourette
1, 2, 3, 4
, Carole Pierlovisi
5
, Ranjatiana Randriantsara
6
, Elliot Rakotomanana
7
, Chiarella Mattern
7, 1
1
CEPED - UMR_D 196 -
Centre population et développement
( 86890 )
- 45 rue des Saints-Pères
75006 Paris
- France
-
Institut de Recherche pour le Développement ( 67872 )
;
-
Université Paris Descartes - Paris 5 UMR_D 196 ( 301664 )
2
UPD5 -
Université Paris Descartes - Paris 5
( 301664 )
- 12, rue de l'École de Médecine - 75270 Paris cedex 06
- France
3
IRD -
Institut de Recherche pour le Développement
( 67872 )
- Siège
Le Sextant
44, bd de Dunkerque
CS 90009
13572 Marseille cedex 02
- France
4
INSERM -
Institut National de la Santé et de la Recherche Médicale
( 303623 )
- 101, rue de Tolbiac, 75013 Paris
- France
5
MNHN -
Muséum national d'Histoire naturelle
( 7512 )
- 57, rue Cuvier - 75231 Paris Cedex 05
- France
6
Université d'Antananarivo
( 300866 )
- BP 566 - Antananarivo 101 - Madagascar
- Madagascar
7
IPM -
Unité d'Epidémiologie [Antananarivo, Madagascar]
( 164772 )
- BP 1274 101 Antananarivo Madagascar
- Madagascar
-
Institut Pasteur de Madagascar ( 55578 )
;
-
Réseau International des Instituts Pasteur ( 301247 )
|
Nom de la revue |
|
Vulgarisation |
Non
|
Comité de lecture |
Oui
|
Audience |
Internationale
|
Date de publication |
2018-12
|
Date de publication électronique |
2018-10-09
|
Volume |
218
|
Page/Identifiant |
52 - 61
|
Langue du document |
Anglais
|
Collaboration/Projet |
-
The authors would like to thank Amber Cripps, Astrid Knoblauch, Chris Gordon, Yandé Thiaw and the three reviewers of the paper.
-
We also thank the NGOs FAFED and FANOITRA. We would like to thank all those who participated in the studies, the fokontany presidents, healthcare professionals, reninjazas and traditional practitioners, and obviously all the women and men who shared their experience with us.
|
Financement |
-
The study "Reproductive health, therapeutic pathways, and healthcare uptake in the Morondava-Menabe region" was founded by Louvain Cooperation and the Pasteur Institute of Madagascar. The "Study on sociocultural determinants of stunting" was founded by the United States Agency for International Development. We wish to express our gratitude to them.
|
Domaine(s) |
-
Sciences de l'Homme et Société/Sociologie
-
Sciences du Vivant [q-bio]/Ecologie, Environnement/Santé
-
Sciences de l'Homme et Société/Anthropologie biologique
|
Mots-clés |
en
Anthropological approach, Childbirth-related complications, Local knowledge, Madagascar, Maternal mortality, Pregnant women's care pathways
|
DOI |
10.1016/j.socscimed.2018.10.002 |
Base Horizon |
fdi:010074477 |
Pubmed Id |
30340153 |