Causal Beliefs Affect Treatment Practices and Preferences for Neonatal Danger Signs in Northwest Ethiopia: A Qualitative Study

Bogale, Tariku Nigatu; Worku, Abebaw Gebeyehu; Yalew, Alemayehu Worku; Biks, Gashaw Andargie; Kebede, Zemene Tigabu

doi:10.4269/ajtmh.17-0824

Cited by 6 publications

(7 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This local illness diagnosis makes the community members perceive that newborn illnesses have no medical treatment from health facilities, and rely on the traditional medicines rather than seeking care from health facilities; developing misconception on treatment options. These findings are consistent with the findings of studies conducted in central and southern Ethiopia, Nigeria, and Bangladesh in that community members use herbal medicine to treat newborn illnesses [23][24][25][26][27][28]. This study also found that community members perceive newborn illnesses as non-severe which resolve spontaneously within a few days.…”

Section: Discussionsupporting

confidence: 91%

“…In both beliefs, if newborns are taken out of home for seeking treatment, PNC, or other issues before their date of baptism or taken to the witch for blessing, community members believe that newborns would face sickness from evil spirits or others. This finding is similar to the finding of a study conducted in Ethiopia which showed tradition recommends newborns to stay at home for 40 days because they are vulnerable to malevolent spirits [27,31]. This also underscores the need to conduct a behavioral change communication to change the behavior of the community members towards newborn illnesses and their treatment.…”

Section: Discussionsupporting

confidence: 87%

“…Specifically, the postnatal care (PNC) is essential for teaching caregivers how to recognize sick newborns, screening or identifying sick newborns and provide care on the riskiest periods, first day, and the week of life. Thus, HEWs are responsible to provide a home to home PNC service on the first, third, and seventh day to identify and treat illnesses in newborns with amoxicillin and gentamycin [9,18,27]. On the other hand, conducting pregnant women conference is used to promote the service and facilitates in developing health care seeking newborn illnesses [28].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Exploration of facilitators of and barriers to the community-based service utilization for newborn possible serious bacterial infection management in Debre Libanos District, Ethiopia: descriptive qualitative study

Tareke¹,

Koricha²,

Feyissa³

2020

BMC Pediatr

View full text Add to dashboard Cite

Background: Globally, possible serious bacterial infection [PSBI] is a cause for about 600,000 newborn deaths per year. To decrease the burden of this infection, a community-based management newborn PSBI when referral to hospital is not possible has been on implementation. Studies showed gaps in the service utilization and this study was aimed at exploring its barriers and facilitators. Methods: A descriptive qualitative study was conducted from March 11-April 7, 2019, in Debre Libanos District, Ethiopia. Study participants were recruited purposively. Women who gave birth within 2 months before data collection, health extension workers [HEW], health workers, religious leader, kebele chairman, and other community members were involved in the study. Five in-depth interviews, seven key informant interviews, and four focused group discussions were conducted with a total of fifty-two participants. The data were audio-recorded, transcribed verbatim and translated, and inductive thematic analysis was done using Atlas ti.7.1 software. Result: The availability of health workers trained on community-based newborn care [CBNC], Integrated Management of Newborn and Childhood Illness guidelines, availability of medical supplies and job aids, and performance review meetings were identified as facilitators. Communities perception that the newborn illness has no medical treatment, newborn illness is not severe and is self-resolution; the belief in healing power of traditional medicines, socio-cultural and religious beliefs, lack of awareness about service availability at the health post, poor supportive supervision or monitoring, shortage of HEW, the residency of HEWs outside the health post, a poor commitment of health workers and HEWs, and non-functionality of health developmental army were explored as barriers.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Exploration of facilitators of and barriers to the community-based service utilization for newborn possible serious bacterial infection management in Debre Libanos District, Ethiopia: descriptive qualitative study

Tareke¹,

Koricha²,

Feyissa³

2020

BMC Pediatr

View full text Add to dashboard Cite

show abstract

“…sunlight), newborn isolation from strangers until the newborn has been religiously blessed and ambiguous newborn personhood [7,14,17]. However, only three known studies assess the determinants of care for sick newborns in Amhara [6,18,19] with no known studies assessing household care seeking for neonatal PSBI in the region. Although findings are specific to the woredas sampled in this study, recommendations may be transferable by local and regional contexts.…”

Section: Introductionmentioning

confidence: 99%

Neonatal care and community-level treatment seeking for possible severe bacterial infection (PSBI) in Amhara, Ethiopia

Asfaha

Comeau

Spangler

et al. 2020

BMC Health Serv Res

View full text Add to dashboard Cite

Background: In Ethiopia, neonatal mortality accounts for approximately 54% of under-five deaths with the majority of these deaths driven by infections. Possible Severe Bacterial Infection (PSBI) in neonates is a syndromic diagnosis that non-clinical health care providers use to identify and treat newborns with signs of sepsis. In low-and middleincome countries, referral to a hospital may not be feasible due to transportation, distance or finances. Growing evidence suggests health extension workers (HEWs) can identify and manage PSBI at the community level when referral to a hospital is not possible. However, community-based PSBI care strategies have not been widely scaledup. This study aims to understand general determinants of household-level care as well as household care seeking and decision-making strategies for neonatal PSBI symptoms. Methods: We conducted eleven focus group discussions (FGDs) to explore illness recognition and care seeking intentions from four rural kebeles in Amhara, Ethiopia. FGDs were conducted among mothers, fathers and households with recruitment stratified among households that have had a newborn with at least one symptom of PSBI (Symptomatic Group), and households that have had a newborn regardless of the child's health status (Community Group). Data were thematically analyzed using MAXQDA software. Results: Mothers were described as primary caretakers of the newborn and were often appreciated for making decisions for treatment, even when the father was not present. Type of care accessed was often dependent on conceptualization of the illness as simple or complex. When symptoms were not relieved with clinical care, or treatments at facilities were perceived as ineffective, alternative methods were sought. Most participants identified the health center as a reliable facility. While designed to be the first point of access for primary care, health posts were not mentioned as locations where families seek clinical treatment.

show abstract

“…In Ethiopia, beliefs about the danger of newborn illness vary from views about pathogens to spirituality [ 40 ]. Our findings regarding the belief that small or sick newborns can survive varied by implementation strength.…”

Section: Discussionmentioning

confidence: 99%

Changes in attitudes and behaviors supportive of maternal and newborn health in Ethiopia: an evaluative case study

Story

Amare²,

Vaz

et al. 2021

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background Ethiopia’s high neonatal mortality rate led to the government’s 2013 introduction of Community-Based Newborn Care (CBNC) to bring critical prevention and treatment interventions closer to communities in need. However, complex behaviors that are deeply embedded in social and cultural norms continue to prevent women and newborns from getting the care they need. A demand creation strategy was designed to create an enabling environment to support appropriate maternal, newborn, and child health (MNCH) behaviors and CBNC. We explored the extent to which attitudes and behaviors during the prenatal and perinatal periods varied by the implementation strength of the Demand Creation Strategy for MNCH-CBNC. Methods Using an embedded, multiple case study design, we purposively selected four kebeles (villages) from two districts with different levels of implementation strength of demand creation activities. We collected information from a total of 150 key stakeholders across kebeles using multiple qualitative methods including in-depth interviews, focus group discussions, and illness narratives; sessions were transcribed into English and coded using NVivo 10.0. We developed case reports for each kebele and a final cross-case report to compare results from high and low implementation strength kebeles. Results We found that five MNCH attitudes and behaviors varied by implementation strength. In high implementation strength kebeles women felt more comfortable disclosing their pregnancy early, women sought antenatal care (ANC) in the first trimester, families did not have fatalistic ideas about newborn survival, mothers sought care for sick newborns in a timely manner, and newborns received care at the health facility in less than an hour. We also found changes across all kebeles that did not vary by implementation strength, including male engagement during pregnancy and a preference for giving birth at a health facility. Conclusions Findings suggest that a demand creation approach—combining participatory approaches with community empowering strategies—can promote shifts in behaviors and attitudes to support the health of mothers and newborns, including use of MNCH services. Future studies need to consider the most efficient level of intervention intensity to make the greatest impact on MNCH attitudes and behaviors.

show abstract

Causal Beliefs Affect Treatment Practices and Preferences for Neonatal Danger Signs in Northwest Ethiopia: A Qualitative Study

Cited by 6 publications

References 22 publications

Exploration of facilitators of and barriers to the community-based service utilization for newborn possible serious bacterial infection management in Debre Libanos District, Ethiopia: descriptive qualitative study

Exploration of facilitators of and barriers to the community-based service utilization for newborn possible serious bacterial infection management in Debre Libanos District, Ethiopia: descriptive qualitative study

Neonatal care and community-level treatment seeking for possible severe bacterial infection (PSBI) in Amhara, Ethiopia

Changes in attitudes and behaviors supportive of maternal and newborn health in Ethiopia: an evaluative case study

Contact Info

Product

Resources

About