Perceptions and practices related to birthweight in rural Bangladesh: Implications for neonatal health programs in low- and middle-income settings
Autoři:
Monjura Khatun Nisha aff001; Camille Raynes-Greenow aff001; Aminur Rahman aff002; Ashraful Alam aff001
Působiště autorů:
Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
aff001; Health Systems and Population Studies Division, icddr,b, Mohakhali, Dhaka, Bangladesh
aff002
Vyšlo v časopise:
PLoS ONE 14(12)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0221691
Souhrn
Background
Globally, low birthweight (LBW) infants (<2.5 kilograms) contribute up to 80% of neonatal mortality. In Bangladesh, approximately 62% of all births occur at home and therefore, weighing newborns immediately after birth is not feasible. Thus, estimates of birthweight in Bangladesh are mostly obtained based on maternal perception of the newborn’s birth size. Little is known about how birthweight is perceived in rural communities, and whether families associate birthweight with newborn’s health status. Our objective was to explore families’ perceptions of newborn’s birthweight, and preventive and care practices for a LBW newborn in rural Bangladesh.
Methods
We conducted a qualitative study in two rural settings of Bangladesh, including 32 in-depth interviews (11 with pregnant women, 12 with recently delivered women, 4 with husbands whose wives were pregnant or had a recent birth, 5 with mothers-in-law whose daughters-in-law were pregnant or had a recent birth), 2 focus group discussions with husbands and 4 key-informant interviews with community health workers. We used thematic analysis to analyse the data.
Results
Most participants did not consider birthweight a priority for assessing a newborn’s health status, although there was a desire for a healthy newborn. Recognition of different categories of birthweight was subjective and often included several physical descriptors including birth size of the newborn. LBW was not considered as a criterion of a newborn’s illness unless the newborn appeared unwell. Maternal poor nutrition, inadequate diet in pregnancy, anaemia, illness during pregnancy, short stature, twin births and influence of supernatural spirit were identified as the major causes of LBW. Women’s preventive practices for LBW or small newborns were predominantly constrained by a lack of awareness of birthweight and fear of caesarean section. As an effort to avoid caesarean section during birth, several women tended to perform potentially harmful practices in order to give birth to a small size newborn; such as avoiding nutritious food and eating less in pregnancy. Common practices to treat a LBW or small newborn who appeared ill included breastfeeding, feeding animal milk, feeding sugary water, feeding formula, oil massage, keeping the small newborn warm and seeking care from formal and informal care providers including a spiritual leader. Maternal lack of decision-making power, financial constraint, home birth and superstition were the major challenges to caring for a LBW newborn.
Conclusion
Birthweight was not well-understood in the rural community, which highlighted substantial challenges to the prevention and care practices of LBW newborns. Community-level health education is needed to promote awareness related to the recognition of birthweight in rural settings.
Klíčová slova:
Neonates – Neonatal care – Labor and delivery – Pregnancy – Diet – Birth weight – Health education and awareness
Zdroje
1. Wilcox AJ. On the importance—and the unimportance—of birthweight. International journal of epidemiology. 2001;30(6):1233–41. Epub 2002/02/01. doi: 10.1093/ije/30.6.1233 11821313.
2. World Health Organization. International Statistical Classification of Diseases and Related Health Problems - 10th revision. Instruction manual. Geneva: World Health Organization, 2011.
3. Kramer MS. The Epidemiology of Adverse Pregnancy Outcomes: An Overview. The Journal of Nutrition. 2003;133(5):1592S–6S. doi: 10.1093/jn/133.5.1592S 12730473
4. Wardlaw TM. Low birthweight: country, regional and global estimates: UNICEF; 2004.
5. UNICEF (2009) The state of the world's children 2009: maternal and newborn health: United Nations Children's Fund.
6. Dey AC, Ahmed FU, Mannan MA, Saha L, Barua CC, Mahmood CB. Small for Gestational Age Babies: Morbidity and Immediate Outcome in a Tertiary Care Hospital—A Prospective Study. Bangladesh Journal of Child Health. 2007;31(1–3):1–7. http://dx.doi.org/10.3329/bjch.v31i1.6066
7. Arifeen SE, Black RE, Caulfield LE, Antelman G, Baqui AH, Nahar Q, et al. Infant growth patterns in the slums of Dhaka in relation to birth weight, intrauterine growth retardation, and prematurity. The American journal of clinical nutrition. 2000;72(4):1010–7. Epub 2000/09/30. doi: 10.1093/ajcn/72.4.1010 11010945.
8. Klemm RD, Merrill RD, Wu L, Shamim AA, Ali H, Labrique A, et al. Low-birthweight rates higher among Bangladeshi neonates measured during active birth surveillance compared to national survey data. Maternal & child nutrition. 2015;11(4):583–94. Epub 2013/05/08. doi: 10.1111/mcn.12041 23647669.
9. Huang C, Martorell R, Ren A, Li Z. Cognition and behavioural development in early childhood: the role of birth weight and postnatal growth. International Journal of Epidemiology. 2013;42(1):160–71. doi: 10.1093/ije/dys207 PMC3600622. 23243117
10. Dalziel SR, Parag V, Rodgers A, Harding JE. Cardiovascular risk factors at age 30 following pre-term birth. International journal of epidemiology. 2007;36(4):907–15. doi: 10.1093/ije/dym067 17468503
11. Huxley R, Owen CG, Whincup PH, Cook DG, Colman S, Collins R. Birth weight and subsequent cholesterol levels: exploration of the "fetal origins" hypothesis. Jama. 2004;292(22):2755–64. Epub 2004/12/09. doi: 10.1001/jama.292.22.2755 15585736.
12. Huxley R, Neil A, Collins R. Unravelling the fetal origins hypothesis: is there really an inverse association between birthweight and subsequent blood pressure? Lancet (London, England). 2002;360(9334):659–65. Epub 2002/09/21. doi: 10.1016/s0140-6736(02)09834-3 12241871.
13. Phillips DI, Walker BR, Reynolds RM, Flanagan DE, Wood PJ, Osmond C, et al. Low birth weight predicts elevated plasma cortisol concentrations in adults from 3 populations. Hypertension (Dallas, Tex: 1979). 2000;35(6):1301–6. Epub 2000/06/17. doi: 10.1161/01.hyp.35.6.1301 10856281.
14. WHO, UNICEF. Low birthweight: country, regional and global estimates. Geneva, UNICEF and WHO. 2004.
15. World Health Organisation. World Health Assembly WHA Global Nutrition Targets 2025; Low birth weight policy brief. Geneva: World Health Organisation; 2014.
16. Lee AC, Kozuki N, Cousens S, Stevens GA, Blencowe H, Silveira MF, et al. Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21st standard: analysis of CHERG datasets. BMJ. 2017;358. doi: 10.1136/bmj.j3677 28819030
17. Walton KA, Murray LJ, Gallagher AM, Cran GW, Savage MJ, Boreham C. Parental recall of birthweight: A good proxy for recorded birthweight? European Journal of Epidemiology. 2000;16(9):793–6. doi: 10.1023/a:1007625030509 11297220
18. Catov JM, Newman AB, Kelsey SF, Roberts JM, Sutton-Tyrrell KC, Garcia M, et al. Accuracy and Reliability of Maternal Recall of Infant Birth Weight Among Older Women. Annals of Epidemiology. 2006;16(6):429–31. doi: 10.1016/j.annepidem.2005.09.004 16280248
19. Shakya KL SN, Bhatt MR, Hepworth S, Onta SR. Accuracy of low birth weight as perceived by mothers and factors influencing it: a facility based study in Nepal. Int J Med Res Health Sci. 2015;4(2):274–80. doi: 10.5958/2319-5886.2015.00051.X
20. Lule SA, Webb EL, Ndibazza J, Nampijja M, Muhangi L, Akello F, et al. Maternal recall of birthweight and birth size in Entebbe, Uganda. Tropical medicine & international health: TM & IH. 2012;17(12):1465–9. Epub 2012/09/22. doi: 10.1111/j.1365-3156.2012.03091.x 22994260; PubMed Central PMCID: PMC3627817.
21. Araujo CL, Dutra CL, Hallal PC. Validity of maternal report on birth weight 11 years after delivery: the 1993 Pelotas Birth Cohort Study, Rio Grande do Sul State, Brazil. Cadernos de saude publica. 2007;23(10):2421–7. Epub 2007/09/25. doi: 10.1590/s0102-311x2007001000017 17891302.
22. Li CY, Wei JN, Lu TH, Chuang LM, Sung FC. Mothers tended to overreport categorical infant birth weight of their children. Journal of clinical epidemiology. 2006;59(12):1319–25. Epub 2006/11/14. doi: 10.1016/j.jclinepi.2006.02.018 17098575.
23. Mbuagbaw L, Gofin R. Can recall of birth size be used as a measure of birthweight in Cameroon? Paediatric and perinatal epidemiology. 2010;24(4):383–9. Epub 2010/07/14. doi: 10.1111/j.1365-3016.2010.01128.x 20618728.
24. Blanc AKaW T Monitoring low birth weight: An evaluation of international estimates and an updated estimation procedure. Bulletin of the World Health Organization,. 2005;83:178–85. doi: /S0042-96862005000300010 15798841
25. Channon AA. Can mothers judge the size of their newborn? Assessing the determinants of a mother's perception of a baby's size at birth. Journal of biosocial science. 2011;43(5):555–73. Epub 2011/06/17. doi: 10.1017/S0021932011000198 21676278.
26. Aruldas K, Kant A, Mohanan PS. Care-seeking behaviors for maternal and newborn illnesses among self-help group households in Uttar Pradesh, India. Journal of health, population, and nutrition. 2017;36(Suppl 1):49–. doi: 10.1186/s41043-017-0121-1 29297413.
27. Hill Z, Kendall C, Arthur P, Kirkwood B, Adjei E. Recognizing childhood illnesses and their traditional explanations: exploring options for care-seeking interventions in the context of the IMCI strategy in rural Ghana. Tropical Medicine & International Health. 2003;8(7):668–76. doi: 10.1046/j.1365-3156.2003.01058.x 12828551
28. Darmstadt GL, Kumar V, Yadav R, Shearer JC, Baqui AH, Awasthi S, et al. Community perceptions of birth weight in rural Uttar Pradesh, India: implications for care of low-birth-weight infants. Journal of perinatology: official journal of the California Perinatal Association. 2008;28 Suppl 2:S53–60. Epub 2008/12/17. doi: 10.1038/jp.2008.168 19057569.
29. Koenraads M, Phuka J, Maleta K, Theobald S, Gladstone M. Understanding the challenges to caring for low birthweight babies in rural southern Malawi: a qualitative study exploring caregiver and health worker perceptions and experiences. BMJ Global Health. 2017;2(3):e000301. doi: 10.1136/bmjgh-2017-000301 29082008.
30. National Institute of Population Research and Training (NIPORT) MaA, and ICF International. Bangladesh Demographic and Health Survey 2014. Dhaka, Bangladesh, and Rockville, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2016.
31. Arifeen SE, Mullany LC, Shah R, Mannan I, Rahman SM, Talukder MRR, et al. The effect of cord cleansing with chlorhexidine on neonatal mortality in rural Bangladesh: a community-based, cluster-randomised trial. The Lancet. 2012;379(9820):1022–8.
32. Yaya S, Bishwajit G, Ekholuenetale M, Shah V. Awareness and utilization of community clinic services among women in rural areas in Bangladesh: A cross-sectional study. PLoS ONE. 2017;12(10):e0187303. doi: 10.1371/journal.pone.0187303 PMC5659786. 29077754
33. Alam A, Rasheed S, Khan NU, Sharmin T, Huda TM, Arifeen SE, et al. How can formative research inform the design of an iron-folic acid supplementation intervention starting in first trimester of pregnancy in Bangladesh? BMC Public Health. 2015;15(1):374. doi: 10.1186/s12889-015-1697-2 25887449
34. Nabiwemba EL, Atuyambe L, Criel B, Kolsteren P, Orach CG. Recognition and home care of low birth weight neonates: a qualitative study of knowledge, beliefs and practices of mothers in Iganga-Mayuge Health and Demographic Surveillance Site, Uganda. BMC Public Health. 2014;14(1):546. doi: 10.1186/1471-2458-14-546 24888464
35. Marsh DR, Darmstadt GL, Moore J, Daly P, Oot D, Tinker A. Advancing Newborn Health and Survival in Developing Countries: A Conceptual Framework. Journal Of Perinatology. 2002;22:572. doi: 10.1038/sj.jp.7210793 12368975
36. Imdad A, Bhutta ZA. Nutritional Management of the Low Birth Weight/Preterm Infant in Community Settings: A Perspective from the Developing World. The Journal of Pediatrics. 2013;162(3, Supplement):S107–S14.
37. Finlayson K, Downe S. Why Do Women Not Use Antenatal Services in Low- and Middle-Income Countries? A Meta-Synthesis of Qualitative Studies. PLoS Medicine. 2013;10(1):e1001373. doi: 10.1371/journal.pmed.1001373 PMC3551970. 23349622
38. Sinha B, Taneja S, Chowdhury R, Mazumder S, Rongsen-Chandola T, Upadhyay RP, et al. Low-birthweight infants born to short-stature mothers are at additional risk of stunting and poor growth velocity: Evidence from secondary data analyses. Maternal & child nutrition. 2018;14(1):e12504. doi: 10.1111/mcn.12504 28840655
39. Ara S, Mominul IM, Kamruzzaman M, Toufiq EM, Sk S, Sabir HM. Assessment of social, economic and medical determinant of safe motherhood in Dhaka City: a cross-sectional study. American Journal of Life Science. 2013;1(3):93–7.
40. Hutter I. Reduction of food intake during pregnancy in rural south India. Tropical medicine & international health: TM & IH. 1996;1(3):399–405. Epub 1996/06/01. doi: 10.1046/j.1365-3156.1996.d01-53.x 8673846.
41. Chowdhury A, Halder K, Haque I, Muhammad F, Hasan M. Status of Knowledge on the Risk Factors of Low Birth Weight among the Women of Reproductive Age in Rural Bangladesh. Epidemiology (Sunnyvale). 2017;7(292):2161–1165.1000292.
42. Chowdhury. M, Dibley. MJ, Alam. A, Kelly. PJ, Afsana. K, Raynes-Greenow. C. The impact of an antenatal balanced plate nutrition education intervention on infant birthweight: a cluster randomised controlled trial in rural Bangladesh. Unpublished. 2018.
43. World Health Organization. Optimal feeding of low birthweight infants in low-and middle-income countries World Health Organization, 2011.
44. Winch PJ, Alam MA, Akther A, Afroz D, Ali NA, Ellis AA, et al. Local understandings of vulnerability and protection during the neonatal period in Sylhet district, Bangladesh: a qualitative study. The Lancet. 2005;366(9484):478–85.
45. Smith ER, Hurt L, Chowdhury R, Sinha B, Fawzi W, Edmond KM, et al. Delayed breastfeeding initiation and infant survival: A systematic review and meta-analysis. PLOS ONE. 2017;12(7):e0180722. doi: 10.1371/journal.pone.0180722 28746353
46. Sacks E, Moss WJ, Winch PJ, Thuma P, van Dijk JH, Mullany LC. Skin, thermal and umbilical cord care practices for neonates in southern, rural Zambia: a qualitative study. BMC pregnancy and childbirth. 2015;15:149–. doi: 10.1186/s12884-015-0584-2 26177637.
47. Story WT, Burgard SA, Lori JR, Taleb F, Ali NA, Hoque DE. Husbands' involvement in delivery care utilization in rural Bangladesh: A qualitative study. BMC Pregnancy and Childbirth. 2012;12(1):28. doi: 10.1186/1471-2393-12-28 22494576
48. Story WT, Burgard SA. Couples’ reports of household decision-making and the utilization of maternal health services in Bangladesh. Social Science & Medicine. 2012;75(12):2403–11.
Článok vyšiel v časopise
PLOS One
2019 Číslo 12
- Metamizol jako analgetikum první volby: kdy, pro koho, jak a proč?
- Nejasný stín na plicích – kazuistika
- Masturbační chování žen v ČR − dotazníková studie
- Těžké menstruační krvácení může značit poruchu krevní srážlivosti. Jaký management vyšetření a léčby je v takovém případě vhodný?
- Fixní kombinace paracetamol/kodein nabízí synergické analgetické účinky
Najčítanejšie v tomto čísle
- Methylsulfonylmethane increases osteogenesis and regulates the mineralization of the matrix by transglutaminase 2 in SHED cells
- Oregano powder reduces Streptococcus and increases SCFA concentration in a mixed bacterial culture assay
- The characteristic of patulous eustachian tube patients diagnosed by the JOS diagnostic criteria
- Parametric CAD modeling for open source scientific hardware: Comparing OpenSCAD and FreeCAD Python scripts