Document Detail


Local understandings of vulnerability and protection during the neonatal period in Sylhet District, Bangladesh: a qualitative study.
MedLine Citation:
PMID:  16084256     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Understanding of local knowledge and practices relating to the newborn period, as locally defined, is needed in the development of interventions to reduce neonatal mortality. We describe the organisation of the neonatal period in Sylhet District, Bangladesh, the perceived threats to the well-being of neonates, and the ways in which families seek to protect them. METHODS: We did 39 in-depth, unstructured, qualitative interviews with mothers, fathers, and grandmothers of neonates, and traditional birth attendants. Data on neonatal knowledge and practices were also obtained from a household survey of 6050 women who had recently given birth. FINDINGS: Interviewees defined the neonatal period as the first 40 days of life (chollish din). Confinement of the mother and baby is most strongly observed before the noai ceremony on day 7 or 9, and involves restriction of movement outside the home, sleeping where the birth took place rather than in the mother's bedroom, and sleeping on a mat on the floor. Newborns are seen as vulnerable to cold air, cold food or drinks (either directly or indirectly through the mother), and to malevolent spirits or evil eye. Bathing, skin care, confinement, and dietary practices all aim to reduce exposure to cold, but some of these practices might increase the risk of hypothermia. INTERPRETATION: Although fatalism and cultural acceptance of high mortality have been cited as reasons for high levels of neonatal mortality, Sylheti families seek to protect newborns in several ways. These actions reflect a set of assumptions about the newborn period that differ from those of neonatal health specialists, and have implications for the design of interventions for neonatal care.
Authors:
Peter J Winch; M Ashraful Alam; Afsana Akther; Dilara Afroz; Nabeel Ashraf Ali; Amy A Ellis; Abdullah H Baqui; Gary L Darmstadt; Shams El Arifeen; M Habibur Rahman Seraji;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Lancet     Volume:  366     ISSN:  1474-547X     ISO Abbreviation:  Lancet     Publication Date:    2005 Aug 6-12
Date Detail:
Created Date:  2005-08-08     Completed Date:  2005-10-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  England    
Other Details:
Languages:  eng     Pagination:  478-85     Citation Subset:  AIM; IM    
Affiliation:
Project to Advance the Health of Newborns and Mothers (PROJAHNMO), Sylhet, Bangladesh. pwinch@jhsph.edu
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MeSH Terms
Descriptor/Qualifier:
Bangladesh / epidemiology
Culture
Data Collection
Female
Humans
Infant Care*
Infant Mortality
Infant, Newborn*
Male
Medicine, Traditional*
Midwifery
Parents
Pregnancy
Socioeconomic Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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