This study explores how Traditional Birth Attendants (TBAs) in rural Zimbabwe care for babies’ umbilical cords, examining cultural practices associated with umbilical cord care. This study relies on a qualitative interpretive approach, guided by symbolic interactionist theory, involving 16 Key Informant Interviews (KIIs). The respondents were de jure (trained) and de facto (untrained) TBAs in Mawadza village in Mutasa District in Manicaland, Zimbabwe. The data from the KIIs were analysed using the framework analysis method. Umbilical cord care is embedded in cultural practices and symbolic meanings. There are various local substances, such as cooking oil, petroleum jelly, local herbs, mothers’ breast milk and vaginal discharge as well as pet (cat and chicken) dung, used for cord care. Many of the substances are harmful and associated with a high risk of child morbidity and mortality in the study area. Only a few TBAs revealed that they used bio-medically recommended substances. The finding suggests that the risks associated with harmful umbilical cord care methods are high in the study communities. This points to the need to strengthen concerted initiatives to improve universal access to modern postnatal healthcare to reduce neonatal mortality..
This chapter examines the social determinants of health (SDH) in Africa. It highlights some theoretical perspectives relevant to understanding the SDH, including the production of health and structural and system approaches. The chapter argues that the high prevalence of both communicable and noncommunicable diseases in Africa is a consequence of adverse social forces that predispose people to various diseases. Africans live in challenging social situations and have a comparatively high disease burden. Most are disadvantaged because the resources required for healthcare are insufficient. The high prevalence of poverty on the continent is significantly associated with poor population health caused by impoverished living and working conditions that negatively impact nutritional status, access to clean water, hygiene, healthcare services, and health status. In Africa, unequal healthcare access and outcomes among social groups are common, and vulnerable populations disproportionately bear the brunt of the disease burden.
This article explores experiences and perceptions of women concerning the utilising a waiting mothers’ shelter at Bonda Mission Hospital in the Manicaland province of Zimbabwe. It draws on a phenomenological qualitative research design. This incorporated in-depth interviews and key informant interviews with purposively selected fifteen women who have used the waiting mothers’ shelter since 2015 and eight healthcare practitioners respectively. The paper is guided by Alfred Schutz’s (1972) social phenomenology. While the findings reveal that most women acknowledged the importance of waiting mothers’ shelters in improving access to skilled birth attendance and maternal health outcomes, there are still factors that militate the use of such innovations. Several socio-cultural and economic factors such as constrained decision making among women, mistreatment and lack of privacy in the shelters are some of the deterrent factors. The article concludes that, although waiting mothers’ shelters are facilities proven to be beneficial in rural communities, they continually face the risk of not being used. There is a need for a multi-stakeholder approach to address the barriers that deter women from utilising the waiting mothers’ shelters and improve access to facility-based delivery, access to skilled birth attendants and enhance the maternal health outcomes in rural communities in Zimbabwe.
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