TRADITION PATTERNS OF ANTENATAL CARE AND MATERNAL HEALTH IN MAMFE: UNDERSTANDING THE SOCIO-CULTURAL FACTOR OF MATERNAL MORTALITY IN RURAL CAMEROON

From the case study of Mamfe, this research has been tailored to highlight and examine the influence of traditional patterns of antenatal care on maternal morbidity and mortality in rural Cameroon. The country is one of the underachievers of the MDGs with strong socio-cultural attachment and a consequential high reliance on traditional patterns for antenatal care. Understanding the influence of this reliance gives a more complete view of the socio-cultural factor critical towards underlining the underlying determinants of maternal deaths. The rationales behind most traditional antenatal beliefs and practices, some of which have been highlighted in this work, scarcely correspond to the biomedical norms for useful maternal healthcare. They reportedly fulfill more superior and collective purposes that understandably prevail over maternal health. Non-respect for these traditional imperatives puts transgressors at odds with the community. Given their understandable vulnerability during pregnancy, expectant women are therefore predisposed to a higher risk of complications and death. The research was both cross-sectional and exploratory, constructed on a qualitative design. Non-probability purposive sampling was used to constitute a sample size of 140 participants. Research techniques employed included in-depth interviews, FGDs and direct observation. We discovered that expectant women widely attended conventional antenatal consultations but were rigorously constraint to respect and adhere to beliefs and practices for traditional maternal care. As such widespread facility-based deliveries in rural settings heralded as the ideal solution by many does not necessarily limit the influence of the socio-cultural factor on MMR. KEY WORDS: rural Cameroon, traditional patterns, influence, antenatal care, maternal mortality

ETHNOMEDICAL PERCEPTIONS OF PREGNANCY THREATS AND HOMEBIRTH PREFERENCE IN RURAL CAMEROON: THE CASE OF NCHANG, SOUTH WEST REGION

The principal objective of this research has been to highlight ethnomedical understanding of risk factors causing mishaps in childbirth as the fundamental determinant to low facility-based deliveries. Skilled obstetric assistance has been proven to significantly reduce maternal morbidity and mortality. Reliance on facility-based delivery is therefore fundamental to maternal wellbeing. However, preference for homebirth is still common and prevalent in rural Cameroon where socio-cultural perceptions still exert strong influence on health-seeking decisions and behaviors. Understanding the reasons for this preference is important to design targeted interventions for more effective maternal death control schemes. This qualitative research was carried out in all ten quarters of Nchang using both random and snowball sampling techniques to select participants. Forty in-depth interviews and four focus group discussions were conducted using corresponding research tools. Verbatim translation and transcription of audio recordings was done from pidgin or kenyang to English, followed by codification and a thematic analysis. Our findings reveal that low demand for obstetric assistance and its consequential correspondingly higher maternal mortality rates are fundamentally determined by socio-cultural perceptions of pregnancy threats. KEYWORDS: perceptions, facility-based delivery, obstetric assistance, homebirth, maternal mortality

Association Between Ov16 Seropositivity and Neurocognitive Performance Among Children in Rural Cameroon: a Pilot Study

Infection with Onchocerca volvulus was recently reported to increase the risk for epilepsy in Cameroonian children. We investigated whether infection with O. volvulus may alter the cognitive function of children who may or may not develop epilepsy later in their lifetime. Using rapid diagnostic tests, we determined the presence of Ov16 antibodies in 209 school-aged children without epilepsy recruited from three Cameroonian villages, as a proxy for onchocerciasis exposure. In addition, the neurocognitive performance of these children was assessed using a battery of validated tools. Participants were aged 6–16 years, and 46.4% were Ov16 seropositive. Upon standardizing age-specific neurocognitive scores and investigating predictors of neurocognitive performance using multiple linear regression models (adjusted for gender, education level, previous ivermectin use, and anthropometric parameters), we found that being Ov16-positive was significantly associated with reduced semantic verbal fluency (estimate –0.38; 95% confidence interval –0.65 to –0.11; p = 0.006) and lower scores on the International HIV Dementia Scale (estimate –0.31; confidence interval –0.56 to –0.04; p = 0.025). Furthermore, an increasing frequency of past ivermectin use was associated with increased neurocognitive scores. Our findings suggest that exposure to O. volvulus may affect neurocognitive performance of children.

Evaluating Women’s Empowerment in Rural Cameroon through the Abbreviated – Women’s Empowerment in Agriculture Index

Amartya Sen a Nobel laureate stressed the fact that empowering women and girls with more choices and more freedom is crucial to achieving a better future for all. This study evaluates the level of women’s empowerment in agriculture by assessing the empowerment gaps between male and female decision makers; and by comparing the level of women’s empowerment in agriculture across household types. Empowerment is assessed through the Five Domains of Empowerment (5DE) of the Abbreviated Women’s Empowerment in Agriculture Index (A-WEAI). Using data collected from 600 rural households in the West region of Cameroon, the outcomes from the 5DE show that empowerment gaps between men and women exist in all domains of empowerment. The empowerment gaps between men and women are more severe in the resource and income domains. Also, group membership, excessive workload and access to and decision about credit contribute the most to disempowerment for both men and women. The study shows more women in dual headed household (DHHs) achieve adequacy in terms of input in productive decisions, access to and decision about credit, group membership and workload as compared to other household types. Also, women’s empowerment in the production, resource and income domains depend on the household type. The results of the study highlight the need for the creation of governmental and non-governmental organisations that will promote women’s empowerment in agriculture and other aspects life.