Harmful cultural practices during perinatal period and associated factors among women of childbearing age in Southern Ethiopia: Community based cross-sectional study

Introduction Although the maternal mortality ratio has decreased by 38% in the last decade, 810 women die from preventable causes related to pregnancy and childbirth every day, and two-thirds of maternal deaths occur in Sub-Saharan Africa alone. The lives of women and newborns before, during, and after childbirth can be saved by skilled care. The main factors that prevent women from receiving care during pregnancy and childbirth are harmful cultural practices. The aim of this study was to assess the level of harmful cultural practices during pregnancy, childbirth, and postnatal period, and associated factors among women of childbearing age in Southern Ethiopia. Methods A community-based cross-sectional study design was conducted in the Gurage zone, among representative sample of 422 women of reproductive age who had at least one history of childbirth. A simple random sampling technique was used to recruit participants. Data were collected by six experienced and trained data collectors using a pretested structured questionnaire with face to face interviews. Harmful cultural practices are assessed using 11 questions and those who participate in any one of them are considered as harmful cultural practices. Descriptive statistics were performed and the findings were presented in text and tables. Binary logistic regression was used to assess the association between each independent variable and outcome variable. Results Harmful cultural practices were found to be 71.4% [95%CI, 66.6–76.0]. The mean age of study participants was 27.6 (SD ± 5.4 years). Women with no formal education [AOR 3.79; 95%CI, 1.97–7.28], being a rural resident [AOR 4.41, 95%CI, 2.63–7.39], having had no antenatal care in the last pregnancy [AOR 2.62, 95%CI, 1.54–4.48], and pregnancy being attended by untrained attendants [AOR 2.67, 95%CI, 1.58–4.51] were significantly associated with harmful cultural practice during the perinatal period. Conclusion In this study we found that low maternal education, rural residence, lack of antenatal care and lack of trained birth attendant were independent risk factors associated with women employing harmful cultural practices during the perinatal period. Thus, strong multi-sectoral collaboration targeted at improving women’s educational status and primary health care workers should take up the active role of women’s health education on the importance of ANC visits to tackle harmful cultural practices.

A Rare Case of Generalized Tetanus Complicating Breast Cancer: A Consequence of Harmful Cultural Practices.

Tetanus infection is a public health disease and is still a cause of high morbidity and mortality in developing countries compared to the developed countries of the world. Apart from the traditional risk factors for tetanus, ignorance and harmful cultural practices greatly increase the risk and poor outcomes of tetanus in our country. We report this case of fatal generalized tetanus infection from necrotic fungating tumour following application of traditional herbal medication to highlight the link between a non-communicable disease, an infectious disease and poor health seeking behaviour in a global health context. We also reviewed similar cases reported in the literature. Patient consent was sought for before her death and patient confidentiality was assured.

Harmful cultural practices and HIV stigma as psychosocial issues in North Central Nigeria

Purpose The purpose of this study is to explore the influence of harmful cultural practices and its implications on stigmatization and the spread of HIV infection among people diagnosed with HIV in North Central Nigeria. It will help to identify the cultural values that pose a threat to the social, health and psychological well-being of the members of the society. This study will provide recommendations through educational teachings to community leaders and policymakers for health-care protection through Human Rights Act. Design/methodology/approach This study uses the qualitative phenomenological research design through a face-to-face in-depth interview to collect data using the audio recorder and field notes. Purposive sampling technique was used to recruit, from three selected hospitals, 20 participants aged 18 years–56 years who gave their consent by filling the informed consent form between April 2019 and July 2019. The data collected were analyzed through thematic analysis using ATLAS.ti 8 software. Also, thematic network analysis was used to visualize the themes, sub-themes and quotations. Findings The study findings indicate that sociocultural factors and HIV stigma in Nigeria are significant psychosocial problems that have adverse implications for health and psychological well-being. These problems contribute to the harmful traditional practices, thereby making people vulnerable to contracting HIV infection. The nontherapeutic practices of female genital mutilation, sexual intercourse during menstruation and tribal marks or scarification cause medical complications such as vesicovaginal fistula, rectovaginal fistula and HIV infection. Also, the practice of 18 months of sexual abstinence during breastfeeding predisposes couples to extramarital affairs and HIV infections. The findings also reveal that lack of education contributes to gender inequality. Originality/value The research uses a scientific method using ATLAS.ti 8 software for the transcription, organization and thematic analysis of the qualitative data. The study findings will benefit specifically the young girls and women who are usually the victims of the harmful cultural practices of female genital mutilation, gender inequality, sexual intercourse during menstruation and lack of female education in North Central Nigeria. Also, this study will serve as a relevant document and guide for policy implementation of Human and Child Rights Acts against all harmful cultural practices and gender inequality.

Harmful Cultural Practices in the Consultation Room: Dutch General Practitioners’ Views and Experiences

We discuss Dutch general practitioners’ responses to patients, mostly women of migrant background, with needs related to Harmful Cultural Practices. Our aim was to discover whether they encounter these kind of health issues and how they respond. We suspected that the patients concerned would not get the care they needed. We found that there is reason for concern, as based on general practitioners’ own accounts we conclude that notwithstanding their great commitment to these patients they were disinclined to intervene, because they were cautious to judge other cultures and because they may have over- or underestimated the women’s autonomy.

Competing intergenerational perspectives of living with albinism in Kenya and their implications for children’s lives

Vicious attacks on persons with albinism for rituals and subsequent lobbying by adults led to recognition of albinism as a disability in Kenya. The disability frame informed policies and programmes developed to safeguard the welfare of persons with albinism. Using generationing as a theoretical lens, this article explores how generational relationships mediate children’s experiences of living with albinism in the context of harmful cultural practices, disability politics and adult-defined activism. Three social institutions which structure generational interactions – the family, the school and the state – are analysed. Findings suggest that generation is a productive force with important implications for childhood experiences and policy-making.

A Qualitative Exploration of Access and Utilization of Focused Antenatal Care among Pastoral Community in North Eastern Kenya

Background: Ministry of Health Kenya has adopted new guidelines for FANC services emphasizing on four antenatal care visits, birth planning and emergency preparedness. In North eastern Kenya predominately occupied by Somali pastoralist Communities only 37% of women of reproductive age receive ANC service at least 4 times during pregnancy, which is considerably lower than the national rate of 58%. There is limited utilization of healthcare services among nomadic pastoralist compared to general population, this is due to several constraints stemming from their migratory way of life, poor social services and spatial disparities. Limited studies have adopted qualitative approaches to explore access and utilization FANC among pastoralist communities. The study explored access and utilization of FANC service among pastoralist community of North Eastern Kenya. Methodology: The study is an exploratory qualitative study, using a purposive sampling method forty eight women who give birth two years prior to the study were selected, sixteen male partners and three ANC providers. Data was collected using FGDs and KIIs and analyzed thematically. Results: There is low utilization of FANC among pastoralist communities, the proportion of respondents who had utilized was 83.3% but only few 39.6% had utilized the required four visits (FANC). There is delayed initiation of uptake of FANC services where majority respondents 55.0% had attended ANC in their second trimester while only 17.5% had utilized in their first trimester as recommended. Barrier that hampered FANC uptake are: long distance to health centre, transport cost, low level of FANC knowledge, TBAs practice, low income and harmful cultural practices. Major facilitators identified are free FANC charges, good attitude of a care giver and fear of pregnancy complication. Access challenges range from inadequate infrastructure, lack of skilled health attendants and logistical constraints to harmful cultural practices. Conclusion: There is need to reduce travelling time to the health facility by conducting regular outreach services targeting nomads with no near facility, improve culturally sensitive FANC to increase accessibility, involving all health stakeholders and community representatives to increase cultural acceptability and also help priorities policies that increases FANC service uptake.

A Qualitative Study Exploring Harmful Cultural Practices and HIV Stigma in North Central Nigeria

Harmful cultural practices have psychosocial implications on stigmatization and vulnerability to HIV infection among HIV positive living in North Central Nigeria. To understand this, we conducted qualitative interviews with purposively selected 20 diagnosed HIV positive to explore how culture influences stigmatization and HIV transmission. Data was collected using audio-recorder, transcribed, and analyzed through thematic analysis using ATLAS.ti8 software to code and analyze interview transcripts. The coded data were presented using thematic network analysis to visualize the theme, sub-themes, and quotations in a model. The findings reveal that lack of education was a significant determinant for the continual practice of harmful cultural rites, thereby increasing the risk of HIV infection and stigmatization. Hence, six cultural facilitators have been identified to include female genital mutilation, lack of education, tribal marks and scarification, postpartum sexual abstinence during breastfeeding, sexual intercourse during menstruation, and gender inequality, polygamy, and inheritance law. We conclude that educational teachings and advocacy campaigns be organized in rural schools and public places on the implications of harmful cultural practice to health and psychological well-being. We recommend that the social workers and behavioral scientists should collaborate with other agencies to employ a behavioral-based intervention in eliminating cultural practices and HIV stigma.