Role of Traditional Birth-practices causing Maternal and Neonatal Mortality in Faisalabad: An Anthropological Approach of Household Decision Making

Abstract

Background: Anthropology is a holistic science that targets the study of man in its social, cultural, economic, psychological, political, geographical and ecological settings. Anthropology views major’s interventions in areas of health to be planned with the complete cognizance of cultural factors that largely effect the target populations regarding their participation in all such major interventions. The Social Impact Assessment (SIA) referred by Anthropology basically demand scientific verifications of all such hurdles that may later on impede the acceleration of such heavy funded programs.

Objective: The objective of the study was to investigate the decision-making regarding Safe Child Birthing Process among pregnant females and role of their in-laws. 

Study Design: Cross Sectional Study

Place and Duration of Study: This study was commissioned to the research team on behalf of Pakistan National Council on Ageing (PNCA) based in Islamabad. The data collection was done in the BHU of Chak # 474 GB, Tehsil Samundari, District Faisalabad. The study duration was three months and lasted from July 2012 to September 2012. 

Materials and Methods: Structured questionnaire was developed to collect information on child birth practices as well as opinion of females of respective sample area. In this regard, an extensive questionnaire was designed and pre-tested vigorously. Questionnaire contained bio-informatics including demographic information of clients and the second part covered areas of decision making, role, agents and other stakeholders. Questionnaires were filled with the help of LHVs and LHWs after getting the permission from their senior authorities.

Results: Results show that 29.2% of the respondents were illiterate, while 33.4% of the respondents pass their primary education. Ratio of birth attendant at last delivery was 58.1% for TBA/Dai and 17.2% respondents used the services of doctor for delivery proposes. Mother-in-law was the most influential decision maker in the family. As result explains that, for antenatal visit 118 time, for normal delivery 135 times and for EmONC 128 times decision taken by mother-in-law (n=267).

Conclusion: The decisions regarding child birth largely remain a female issue and rest with the mother-in-law mostly. The second dominant agents are husband and the father-in-law/brother-in-law. On statistical level, the result show strong association between clients and in-laws. The study verifies that the para-medical staff is also required to get training on the importance of cultural factors and means to convince the target population with threatening their cultural mind-set. A complete cognizance of such cultural variable may lead to promotion of safe child birthing as well as contributed in reducing the maternal mortality rates among the rural women.