Socio-Economic and Cultural Determinants of Maternal and Neonatal Mortality in Pakistan

Khan, Sarfraz; Haider, Syed Imran; Bakhsh, Rahim

doi:10.31703/grr.2020(v-i).01

Cited by 6 publications

(6 citation statements)

References 4 publications

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“…Cultural restrictions on women’s mobility are another barrier noted in our study. Restrictions on women’s mobility during obstetric emergencies may lead to a delay in seeking timely care [ 31 ]. The women were found to observe purdah (the veil) under all circumstances and were not allowed to travel outside the home without men even during a health emergency.…”

Section: Discussionmentioning

confidence: 99%

The influence of social and cultural practices on maternal mortality: a qualitative study from South Punjab, Pakistan

Omer

Zakar

et al. 2021

Reprod Health

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Background A disproportionately high rate of maternal deaths is reported in developing and underdeveloped regions of the world. Much of this is associated with social and cultural factors, which form barriers to women utilizing appropriate maternal healthcare. A huge body of research is available on maternal mortality in developing countries. Nevertheless, there is a lack of literature on the socio-cultural factors leading to maternal mortality within the context of the Three Delays Model. The current study aims to explore socio-cultural factors leading to a delay in seeking care in maternal healthcare in South Punjab, Pakistan. Methods We used a qualitative method and performed three types of data collection with different target groups: (1) 60 key informant interviews with gynaecologists, (2) four focus group discussions with Lady Health Workers (LHWs), and (3) ten case studies among family members of deceased mothers. The study was conducted in Dera Ghazi Khan, situated in South Punjab, Pakistan. The data was analysed with the help of thematic analysis. Results The study identified that delay in seeking care—and the potentially resulting maternal mortality—is more likely to occur in Pakistan due to certain social and cultural factors. Poor socioeconomic status, limited knowledge about maternal care, and financial constraints among rural people were the main barriers to seeking care. The low status of women and male domination keeps women less empowered. The preference for traditional birth attendants results in maternal deaths. In addition, early marriages and lack of family planning, which are deeply entrenched in cultural values, religion and traditions—e.g., the influence of traditional or spiritual healers—prevented young girls from obtaining maternal healthcare. Conclusion The prevalence of high maternal mortality is deeply alarming in Pakistan. The uphill struggle to reduce deaths among pregnant women is firmly rooted in addressing certain socio-cultural practices, which create constraints for women seeking maternal care. The focus on poverty reduction and enhancing decision-making power is essential for supporting women’s right to medical care.

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Section: Discussionmentioning

confidence: 99%

The influence of social and cultural practices on maternal mortality: a qualitative study from South Punjab, Pakistan

Omer

Zakar

et al. 2021

Reprod Health

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“… 16 The minimal knowledge of pregnant women and their families about pregnancy and maternal health services will increase the risk of complications for the mother and fetus. 56 …”

Section: Discussionmentioning

confidence: 99%

Maternal Health Care Utilization Behavior, Local Wisdom, and Associated Factors Among Women in Urban and Rural Areas, Indonesia

Damayanti¹,

Wulandari²,

Ridlo³

2023

IJWH

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Purpose Maternal mortality is one problem that still affects countries like Indonesia and others globally. The World Health Organization (WHO) notes that Southeast Asian countries have a high MMR. Indonesia’s maternal mortality ranks third highest in Southeast Asia, with a 177 maternal mortality rate per 100,000 live births in 2017. In 2018, the maternal mortality rate reached 91.45 per 100,000 live births. Pregnant women’s deaths can be caused inadequate medical care due to how frequently they seek treatment. This study intends to identify and analyze how knowledge, education, and myths affect pregnant women’s attitudes toward seeking health services. Materials and Methods The study involved 175 pregnant and postpartum women who visited 10 health public centers in two cities in East Java by accidental sampling. Data regarding intrapersonal, interpersonal, and local wisdom were collected through surveys with structured instruments and in-depth interviews. Data statistics used pathway analysis with a p -value of >0.05. Results Intrapersonal, interpersonal, and local wisdom variables have a significant direct or indirect effect on utilizing health services. Knowledge was the variable with the greatest influence (t-value, 27.96). Conclusion Myth and culture as local wisdom and intrapersonal factors significantly affect the pattern of utilizing health services.

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“…Sociocultural barriers can delay the treatment of rural women and as a result may become a threat to their lives. Barriers to women's movement to health centres during emergencies can lead to delays in accessing timely care [32,33].…”

Section: Discussionmentioning

confidence: 99%

Using the Theoretical Domains Framework to identify the barriers and enablers to access and use of primary and maternal healthcare services by rural Bangladeshi women: a qualitative study

Chanda,

Horne,

McHugh

2023

Preprint

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In Bangladesh, increasing the use of primary healthcare (PHC) and maternal healthcare (MHC) services is the main focus of achieving the United Nations Sustainable Development Goal-3, ensuring healthy lives and wellbeing for all. However, little is known about the sociocultural barriers and enablers to accessing and using PHC and MHC services among rural Bangladeshi women. This qualitative study aimed to identify sociocultural barriers and enablers to accessing and using PHC and MHC services among Bangladeshi rural women by using the Theoretical Domains Framework (TDF). This exploratory qualitative study used focus groups and interviews to collect data from women, their husbands and healthcare providers. Data were analysed using Framework approach underpinned by the TDF. Four main themes emerged from data analysis, of which key barriers were summarised in three themes: (i) family barriers including lack of family reinforcement, (ii) social barriers including gender of healthcare providers, and (iii) cultural barriers including superstition to access and use of healthcare services. The remaining theme, sociocultural support, included information about key enablers, such as family support, neighbourhood connection and media influence. Several key behavioural constructs that aligned with the TDF need to be targeted when developing an intervention to promote access and use of PHC and MHC services.

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Socio-Economic and Cultural Determinants of Maternal and Neonatal Mortality in Pakistan

Cited by 6 publications

References 4 publications

The influence of social and cultural practices on maternal mortality: a qualitative study from South Punjab, Pakistan

The influence of social and cultural practices on maternal mortality: a qualitative study from South Punjab, Pakistan

Maternal Health Care Utilization Behavior, Local Wisdom, and Associated Factors Among Women in Urban and Rural Areas, Indonesia

Using the Theoretical Domains Framework to identify the barriers and enablers to access and use of primary and maternal healthcare services by rural Bangladeshi women: a qualitative study

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