Weaved into the cultural fabric: a qualitative exploration of alcohol consumption during pregnancy among tribal women in Odisha, India

Abstract

BackgroundEvidence-based research has documented the association between alcohol intake during pregnancy and increased risk of miscarriage, stillbirth and congenital birth defects. Alcohol consumption is a complex behavior whose origins lay in cultural norms and the social structure. In tribal communities in India, alcohol misuse among women is a public health problem. This study is intended to explore perceptions and beliefs among tribal women and the community towards alcohol consumption during pregnancy.MethodsA qualitative study was conducted in a tribal-dominated district of Odisha, India. The WHO AUDIT tool was used to identify women who consumed alcohol during their pregnancies. In-depth interviews were conducted with 19 eligible women and 18 family members. Additionally, two focused group discussions were held with local community leaders and health workers. The data was transcribed, systematically coded and analyzed following the thematic framework approach.ResultsThe findings suggest that a complex interplay of drivers contributes to the unrestricted intake of alcohol by pregnant women. This could be attributed to: a lack of social monitoring, easy access to alcohol, low alcohol literacy and alcohol’s normative status in daily customs and traditions. Another contributing factor is a community-wide perception that home-made alcohol poses no ill effects.ConclusionAlcohol consumption is deeply embedded in the daily rituals of indigenous tribal women. To address this issue, community counselling utilizing platforms of RMNCHA and VHND could be Ideal. A well-designed, culture-based intervention encompassing alcohol researchers, mental health specialists, public health workers and anthropologists is necessary.

Shaping Alcohol Health Literacy: A Systematic Concept Analysis and Review

“…The 26 articles included in this review have undergone an evolutionary concept analysis of alcohol health literacy, which is shown in Table 2. In this article, we have adopted the term "alcohol health literacy" but the review shows that the term "alcohol literacy" is often used as a surrogate term (DeBenedittis, 2011;Fried & Dunn, 2012;Pati et al, 2018; Rundle-Thiele, Simieniako, Kubacki, & Deshpande, 2013) and similar terms adopted include "health literacy" (Anderson & Rehm, 2016;Barnard et al, 2014;Chisholm, Manganello, Kelleher, & Marshal, 2014) and "media literacy" (Chen, 2013;Dumbili & Henderson, 2017;Gordon, Howard, Jones, & Kervin, 2016;Radanielina Hita, Kareklas, & Pinkleton, 2018). The detailed concept analysis as shown in Figure 3 revealed a concept with many different attributes; the implications of those practice interventions are illustrated in Table 3.…”

“…The detailed concept analysis as shown in Figure 3 revealed a concept with many different attributes; the implications of those practice interventions are illustrated in Table 3. For many authors (Anderson & Rehm, 2016;Barnard et al, 2014;Chisholm et al, 2014;Miller, 2018;Pati et al, 2018;Rundle-Thiele et al, 2013;Sinclair & Searle, 2016), alcohol health literacy is the degree to which individuals have the capacity to obtain, process, and understand knowledge about alcohol content, units, strengths, and harms.…”

“…Reflecting also the situating of alcohol health literacy as a property of the individual and especially important for young people, several studies identify the importance of parents and schools in providing advice (Kheokao et al, (Austin & Johnson, 1997;Banerjee et al, 2015;Berey et al, 2017). Drinking is a social behavior and studies identify the importance of changing social norms (Pati et al, 2018;Radanielina Hita et al, 2018;Ratzan, 2016;Rundle-Thiele et al, 2013), community social control (Gordon et al, 2016;Pati et al, 2018), and developing skills required to manage social situations where there is alcohol involved (Austin et al, 2016;Bohman et al, 2004;Ratzan, 2016). Also identified is how marketing and label-ling of alcohol content and guidelines can contribute to alcohol health literacy (Anderson & Rehm, 2016;Corrigan et al, 2018;Kheokao et al, 2013) as well as control of distribution (Berey et al, 2017;Pati et al, 2018;Radanielina Hita et al, 2018;Ratzan, 2016).…”

“…Drinking is a social behavior and studies identify the importance of changing social norms (Pati et al, 2018;Radanielina Hita et al, 2018;Ratzan, 2016;Rundle-Thiele et al, 2013), community social control (Gordon et al, 2016;Pati et al, 2018), and developing skills required to manage social situations where there is alcohol involved (Austin et al, 2016;Bohman et al, 2004;Ratzan, 2016). Also identified is how marketing and label-ling of alcohol content and guidelines can contribute to alcohol health literacy (Anderson & Rehm, 2016;Corrigan et al, 2018;Kheokao et al, 2013) as well as control of distribution (Berey et al, 2017;Pati et al, 2018;Radanielina Hita et al, 2018;Ratzan, 2016). The consequences of alcohol health literacy are conceptualized as reducing alcohol-related harms (e.g., Anderson & Rehm, 2016;Corrigan et al, 2018;DeBenedittis, 2011) and reducing levels of consumption (Gordon et al, 2016;Kheokao et al, 2013;Pati et al, 2018), particularly risky and underage consumption (Austin et al, 2016; The literature shows that the concept of alcohol health literacy is currently being discussed predominantly with reference to children and young people and primarily within educational settings (e.g., Austin et al, 2016; Bohman et al, 2004;Chang et al, 2016;DeBenedittis, 2011;Gordon et al, 2016).…”

“…Also identified is how marketing and label-ling of alcohol content and guidelines can contribute to alcohol health literacy (Anderson & Rehm, 2016;Corrigan et al, 2018;Kheokao et al, 2013) as well as control of distribution (Berey et al, 2017;Pati et al, 2018;Radanielina Hita et al, 2018;Ratzan, 2016). The consequences of alcohol health literacy are conceptualized as reducing alcohol-related harms (e.g., Anderson & Rehm, 2016;Corrigan et al, 2018;DeBenedittis, 2011) and reducing levels of consumption (Gordon et al, 2016;Kheokao et al, 2013;Pati et al, 2018), particularly risky and underage consumption (Austin et al, 2016; The literature shows that the concept of alcohol health literacy is currently being discussed predominantly with reference to children and young people and primarily within educational settings (e.g., Austin et al, 2016; Bohman et al, 2004;Chang et al, 2016;DeBenedittis, 2011;Gordon et al, 2016). Those studies that discussed alcohol health literacy among the general or adult populations were less likely to reference media literacy as a component or media education as an intervention to increase alcohol health literacy (Corrigan et al, 2018;Miller, 2018;Rundle-Thiele et al, 2013).…”