A Qualitative Study of Attitudes and Values Surrounding Stillbirth and Neonatal Mortality Among Grandmothers, Mothers, and Unmarried Girls in Rural Amhara and Oromiya Regions, Ethiopia: Unheard Souls in the Backyard

Abstract

Introduction:In Ethiopia, neonatal mortality and stillbirth are high and underreported. This study explored values related to neonatal mortality and stillbirth and the visibility of these deaths in rural Ethiopia among 3 generations of women. Methods:We conducted a qualitative study in 6 rural districts of the Oromiya and Amhara regional states during May 2012. We included 30 focus groups representing grandmothers, married women (mothers), and unmarried girls in randomly selected kebeles (villages). Results:Until the 40th day of life, neonates are considered to be strangers to the community (not human). Their deaths are not talked about; they are buried in the house or in the backyard. Mothers are forbidden to mourn their loss lest they offend God and bring on future neonatal losses. Women who repeatedly lose their neonates may be blamed, mistreated, and dishonored through divorce. Neonatal death and stillbirth are attributed to supernatural powers, although some women and girls associate these deaths with poverty and lack of education. The desire for increased visibility of neonatal death is mixed. Unlike the grandmothers and unmarried girls, most of the married women want death to be visible to draw the attention of policy makers. Women prefer home birth and consider themselves lucky to be able to give birth at home. At present, there is no national vital registration system. Discussion: Neonatal death and stillbirth are hidden and the magnitude is likely underrepresented. The delayed recognition of personhood, attribution of death to supernatural causes, social repercussions for women who experience a pregnancy loss, preference for home birth, and lack of a vital registration system all contribute to the invisibility of perinatal deaths. Increasing the visibility of (and counting) these deaths may require multifaceted behavior-change interventions.

Determinants of neonatal mortality in rural Northern Ethiopia: A population based nested case control study

“…The prevailing newborn mishandling compounded of traditional practices, had claimed the lives of newborns in the area [16]. These practices possibly contributed for the repeated newborn deaths in a family.…”

Multilevel Logistic Regression Analysis of the Determinants of Stillbirth in Ethiopia Using EDHS 2011 Data

“…Thus, β / is the average regression coefficient like β i is the average intercept. The first part of equation [15], β i + β / x / , is called the fixed part of the model whereas the second part U i + U / x / is called the random part of the model.…”

“…(Wukabi is a type of malevolent spirit that, when offended, will attack the beholder or his/her family). 15 At least half of all stillbirths in low income countries are associated with a maternal condition before delivery. 'Make every mother and child count', was the name of a WHO report from 2005.…”

Suporte aos pais que vivenciam a perda do filho neonato: revisão de literatura

“…Em um estudo selecionado, oriundo da França, 50 % dos pais entrevistados sobre a qualidade do atendimento durante o processo de morte/morrer do filho relataram ter tido autonomia e poder nas tomadas de decisões, tiveram boa comunicação com a equipe de saúde e perceberam que suas crianças receberam tratamento necessário: de beneficência, a princípio e posteriormente, sem possibilidades terapêuticas, foram ofertados cuidados de não maleficência, podendo confortar-se pelo interesse demonstrado pela criança (52).…”

“…Os autores afirmam que há a consciência da importância do registro desses óbitos para a saúde pública, mas, por convicções culturais, as famílias aceitam a imposição sobre manter o fato como inexistente, perpetuando a invisibilidade de seus bebês (52).…”