Cultural childbirth practices and beliefs in Zambia

Maimbolwa, Margaret; Yamba, Bawa; Diwan, Vinod; Ransjö‐Arvidson, Anna‐Berit

doi:10.1046/j.1365-2648.2003.02709.x

Cited by 95 publications

(82 citation statements)

References 21 publications

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“…61 In Zambia, the practice reported by women and midwives was to care for the baby only after the placenta was delivered. 66 In a study of 5411 home births in Nepal, 4% were wrapped within 5 min of birth. 64 Newborn is bathed soon after birth…”

Section: Newborn Is Not Dried or Wrapped Immediatelymentioning

confidence: 99%

“…61 In Zambia, mother and newborn are bathed together soon after birth. 66 In Nepal, where bathing is nearly universal, a study of 5411 newborns documented that 92% were bathed within an hour of birth. 64 Oil massage…”

Section: Newborn Is Not Dried or Wrapped Immediatelymentioning

confidence: 99%

“…As the risk to the mother's life is perceived to be higher, it is a common practice to focus attention primarily on the mother until the delivery of the placenta, while the newborn is left unattended, sometimes on the ground, leading to prolonged exposure. 67,77 Immediate drying and wrapping of the baby is not a common practice, 67,66,77 and leads to further heat loss. Early bathing is common, sometimes with vigorous scrubbing of the skin to remove the vernix, especially when local knowledge dictates that the vernix is a 'dirty' or polluting substance.…”

Section: Transportmentioning

confidence: 99%

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Neonatal hypothermia in low resource settings: a review

et al. 2009

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Background: Hypothermia is increasingly recognized as a major cause of neonatal morbidity and mortality in resource poor settings. High prevalence of hypothermia has been reported widely from warmer high mortality regions of Africa and South Asia. The World Health Organization recognizes newborn thermal care as a critical and essential component of essential newborn care; however, hypothermia continues to remain under-documented, under-recognized and under-managed.Objective: This review aims to provide a thorough patho-physioepidemiological discussion of neonatal hypothermia applied to local risk factors within the developing country context with particular emphasis on prevention, recognition and management.Method: All available published literature on neonatal hypothermia relevant to resource poor settings were reviewed. Studies from the developing country settings were primarily reviewed for epidemiology, domiciliary risk factors as well as potential interventions for thermal care.Result and Discussion: Functional integrity and efficiency of biological systems is critically dependent on an optimal and very narrow range of core body temperature. Risk factors for neonatal hypothermia differ markedly within low resource settings. A combination of physiological, behavioral and environmental factors universally put all newborns, irrespective of birth weight, at risk of hypothermia. The knowledge deficit along the continuum from health providers to primary care givers has sustained the silent epidemic of hypothermia. The challenges of recognition, understanding of local risk factors and communication have meant a lack of informed thermal care for newborns. Simple, feasible interventions exist, but need to be applied, based on local risk factors that disrupt the warm chain. Further research is needed to document local risk factors, develop better techniques for recognition, evaluation of thermal care within essential newborn care and communication strategies for program effectiveness. Keywords: hypothermia; skin-to-skin care; warm chain; community; newborn; neonatal health Introduction 'If a definition of life were required, it must be most clearly on that capacity, by which the animal preserves its proper heat under the various degrees of temperature of the medium in which it livesy a few degrees of increase or diminution of the heat of the system, produces disease and death' said James Currie some two centuries ago, recognizing the central importance of temperature regulation in health. 1 Although folklore associated with increased temperature or fever has been recorded throughout history across virtually every culture and civilization, a recognition of hypothermia and its clinical significance, particularly for newborn health is a relatively recent advance. 1,2 Moreover, progress toward thermal care of newborns in developed countries has far outstripped knowledge and practice in developing country settings, where 99% of global neonatal deaths occur. 3,4 Hypothermia during the newborn period is widely regarded as a...

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Section: Newborn Is Not Dried or Wrapped Immediatelymentioning

confidence: 99%

Section: Newborn Is Not Dried or Wrapped Immediatelymentioning

confidence: 99%

Section: Transportmentioning

confidence: 99%

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Neonatal hypothermia in low resource settings: a review

et al. 2009

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“…South Asia and sub-Saharan Africa have different labor/delivery and care-seeking practices, cord care practices, population densities, mortality rates, and cultural practices. [11][12][13][14][15] Evidence is, thus, needed from sub-Saharan Africa on the efficacy and effectiveness of chlorhexidine to inform umbilical cord care global policy; an effectiveness trial is being conducted in Zambia, and an efficacy trial is being conducted in Pemba Island, Tanzania.…”

Section: Introductionmentioning

confidence: 99%

Engagement of the Community, Traditional Leaders, and Public Health System in the Design and Implementation of a Large Community-Based, Cluster-Randomized Trial of Umbilical Cord Care in Zambia

Hamer¹,

Herlihy²,

Musokotwane³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Conducting research in areas with diverse cultures requires attention to community sensitization and involvement. The process of community engagement is described for a large community-based, cluster-randomized, controlled trial comparing daily 4% chlorhexidine umbilical cord wash to dry cord care for neonatal mortality prevention in Southern Province, Zambia. Study preparations required baseline formative ethnographic research, substantial community sensitization, and engagement with three levels of stakeholders, each necessitating different strategies. Cluster-specific birth notification systems developed with traditional leadership and community members using community-selected data collectors resulted in a post-natal home visit within 48 hours of birth in 96% of births. Of 39,679 pregnant women enrolled (93% of the target of 42,570), only 3.7% were lost to follow-up or withdrew antenatally; 0.2% live-born neonates were lost by day 28 of follow-up. Conducting this trial in close collaboration with traditional, administrative, political, and community stakeholders facilitated excellent study participation, despite structural and sociocultural challenges.

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“…Maternal health services in Zambia are provided by churches, private practitioners, industries and traditional practitioners, although MoH plays a dominant role (Maimbolwa, Yamba, Diwan & Ransjo-Arvidson, 2003). Provision of public health care services is found at: 1) health posts, 2) rural and urban health centres, 3) zonal health centres, 4) first level hospitals, 5) second level hospitals, and 6) third level or tertiary hospitals.…”

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confidence: 99%

Being in a Dilemma: Experiencing Birth in Zambia

Kwaleyela¹,

Greatrex-White²

2015

AJNM

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numerous publications investigating childbirth in sub-saharan Africa have overlooked the psychological and emotional elements that women experience, in favour of physical dimensions, such as maternal mortality. the aim of this study was to explore childbirth experiences, in order to better understand how women in Zambia experience and give meaning to the phenomenon. An interpretive phenomenological approach was utilised. through purposive sampling methods, fifty birthing women, aged between 16 and 38 years, from all the nine provinces of the country were recruited. Unstructured in-depth interviews were conducted. Analysis uncovered six structures. the main focus of this paper is 'Being in a dilemma'. The selection of this structure reflects its general interest and predominance in data analysis. It entailed experiencing the phenomenon without knowledge of whom or what one was going to encounter. the key themes were: 1) choosing where to birth, and 2) choosing the advice to adhere to. The findings illuminated a need for an attitudinal change in maternity care professionals, and a parallel need to build agency and autonomy in women. It is this intrinsic level that is undermining attempts to reduce high maternal mortality in Zambia.

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Cultural childbirth practices and beliefs in Zambia

Cited by 95 publications

References 21 publications

Neonatal hypothermia in low resource settings: a review

Neonatal hypothermia in low resource settings: a review

Engagement of the Community, Traditional Leaders, and Public Health System in the Design and Implementation of a Large Community-Based, Cluster-Randomized Trial of Umbilical Cord Care in Zambia

Being in a Dilemma: Experiencing Birth in Zambia

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