Willing the Spirits to Reveal Themselves: Rural Kenyan Mothers' Responsibility to Restore Their Children's Health

Amuyunzu, M

doi:10.1525/maq.1998.12.4.490

Cited by 17 publications

(5 citation statements)

References 10 publications

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“…The importance of costs of accessing care at health units noted in this study has also been documented elsewhere as a significant factor determining treatment-seeking practices (Beckerleg, 1994;Amuyunzu, 1998;Nyamongo, 2001). These studies have shown that pregnant women make an assessment of several factors including costs before a treatment choice is made.…”

Section: Discussionsupporting

confidence: 73%

Treatment-Seeking Practices for Malaria in Pregnancy Among Rural Women in Mukono District, Uganda

2005

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Understanding treatment-seeking practices for malaria in pregnancy is necessary in designing effective programmes to address the high malaria morbidity in pregnancy. This study assessed women's perceptions on malaria in pregnancy, recognition of early signs of pregnancy and of malaria, and the cultural context in which treatment seeking takes place in Mukono District. Focus group discussions (FGD) and key informant interviews were conducted among pregnant women, non-pregnant women, adolescents and men. The results showed that malaria, locally known as omusujja, was perceived as the most common cause of ill health among pregnant women. Although malaria commonly presents with fever, some pregnant women feel hot in the womb with or without signs of fever and this illness, locally known as nabuguma, may lead to progressive weakness and occasionally to miscarriage and few respondents associated it with malaria. Primigravidae, adolescents and men were not considered at risk of omusujja or nabuguma. Similarly anaemia and low birth weight were not associated with malaria; in fact paleness was described as a normal sign of pregnancy. There are cultural and social pressures on married women to get pregnant and this forces them to conceal symptoms like feeling feverishness, backache, nausea, general weakness, loss of appetite and vomiting until they are sure these are due to pregnancy. Most women, however, could not differentiate symptoms of malaria from those of early pregnancy. There is a belief that omusujja is a normal sign of pregnancy and this is coupled with a strong cultural practice of using herbs and clays as a first resort to treat pregnancy ailments including malaria. The cultural beliefs and practices regarding delivery of twin and first births, coupled with the high cost of care, prevent women from delivering and using other services at health units.

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Section: Discussionsupporting

confidence: 73%

Treatment-Seeking Practices for Malaria in Pregnancy Among Rural Women in Mukono District, Uganda

2005

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“…The pattern of seeking care at health units and laboratory investigations is similar to previous findings on treatment seeking for malaria (6,10,27). It is not known whether self-treatment with inappropriate drugs and dosages leads to complete recovery or leads to reoccurrence of malaria and hence described as persistent.…”

Section: Discussionsupporting

confidence: 76%

Malaria in pregnancy, risk perceptions and care seeking practices among adolescents in Mukono district Uganda

Mbonye¹,

Neema²,

Magnussen³

2006

International Journal of Adolescent Medicine and Health

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Malaria in· pregnancy is a serious health problem that contributes greatly to maternal morbidity and mortality. This study investigated risk perceptions and care seeking practices for malaria in pregnancy among adolescents. Data were collected using focus group disusions( FGDs) and key informant interviews (KIIs). Results showed that malaria was perceived as the leading cause of morbidity and mortality among pregnant women. However, adolescent girls did not consider themselves at risk of malaria even when pregnant. Anaemia and low birth weight were not well understood and not related to malaria in pregnancy. Self-medication was common including over the counter drugs, herbs or a combination of both. When this failed, several options were taken such as seeking care at health units. People preferred to visit heath units with laboratory facilities, since investigations were valued and perceived useful. These investigations were locally known as okukebera omusayi, which translates to examining blood This local term is non-specific and used when patients are referred to laboratories to investigate diseases like HIV, syphilis and malaria. The use of this term however, discourages some people who are afraid of knowing their HIV status. Similarly, the notion that HIV/AIDS is spread thorough contaminated needles and syringes discourages people from giving blood for laboratory tests. In addition, the cost of investigations, fear of pain due to pricking, and the rudeness of laboratory technicians negatively influence seeking laboratory tests. Implications of these findings include developing a health promotion package that explains the dangers of self medication and advocates prompt seeking for malaria treatment especially for adolescents and Primigravidae. Policy decisions to introduce rapid diagnostic kits (RDTs) in primary care units including drug shops are required in order to improve effective treatment of malaria.

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“…In many rural African settings, gender - its intersectionality with other social axes - and family relations; strongly influence treatment decision-making processes for child illness [ 17 – 19 , 27 , 28 , 33 ]. Women are often held responsible for the health of their children, but many household members and other social network members can be involved in treatment seeking actions [ 17 , 18 , 23 , 26 , 33 – 35 ]. Whether or not mothers make independent decisions in relation to child illnesses is determined by a range of inter-related factors including: the nature and perceived severity of illness; who is perceived to own the child; what is perceived to have caused the illness; and intra-household roles and relations [ 27 , 28 , 33 ].…”

Section: Introductionmentioning

confidence: 99%

Perceptions of childhood undernutrition among rural households on the Kenyan coast – a qualitative study

et al. 2016

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BackgroundNutrition plays an important role in child survival and development. Treatment action in the management of child health and nutrition is influenced by perceptions of illness, and gender plays an important role. However, little is known about if and how moderate undernutrition is recognised among lay populations, or how local social norms and intra-household dynamics affect decisions to seek biomedical assistance for nutritional concerns. In this paper we describe how childhood nutritional problems are recognised and understood within rural households. We demonstrate how context influences local constructs of ‘normal’, and suggest the centrality of gender in the management of child health and nutrition in our research context.MethodsThis qualitative study was undertaken in Kilifi County on the Kenyan Coast. A set of 15 households whose children were engaged in a community-based nutrition intervention were followed up over a period of twelve months. Over a total of 54 household visits, group and individual in-depth interviews were conducted with a range of respondents, supplemented by non-participant observations. Eight in-depth interviews with community representatives were also conducted.ResultsLocal taxonomies of childhood undernutrition were found to overlap with, but differ from, biomedical categories. In particular, moderate undernutrition was generally not recognised as a health problem requiring treatment action, but rather as routine and manageable, typically seasonal, weight-loss. Where symptoms were considered more serious and requiring remedial action, household management strategies were typically based on perceived aetiology of the illness. Additionally, gender emerged as a potentially central theme in childhood nutrition problems and related management. Women reported that they have primary responsibility for ensuring children’s good health and nutritional status, and that they are often held accountable when their children are of sub-optimal health.ConclusionPerceptions of child nutrition and illness and gendered roles within households influence treatment action, and engagement with nutrition interventions. Community-based nutrition interventions must recognise these complex realities.

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Willing the Spirits to Reveal Themselves: Rural Kenyan Mothers' Responsibility to Restore Their Children's Health

Cited by 17 publications

References 10 publications

Treatment-Seeking Practices for Malaria in Pregnancy Among Rural Women in Mukono District, Uganda

Treatment-Seeking Practices for Malaria in Pregnancy Among Rural Women in Mukono District, Uganda

Malaria in pregnancy, risk perceptions and care seeking practices among adolescents in Mukono district Uganda

Perceptions of childhood undernutrition among rural households on the Kenyan coast – a qualitative study

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