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Women's Experiences of Cultural Beliefs and Practices that Influence Their Use of Maternal Health Services in Nigeria

Abstract

Background: Cultural beliefs and practices are significant intergenerational norms that influence decisions on women’s use of maternal health services in Nigeria. Such cultural norms are determining factors in the high maternal mortality ratio of 1047 per 100,000 live births in Nigeria. However, due to biomedically focused international and national policies, there is limited understanding and address of women’s cultural needs and challenges around childbirth. Purpose and Objectives: The overall purpose was to explore the cultural beliefs and practices of Igala women in Kogi East, Nigeria, that influence their use of maternal health services around pregnancy and childbirth. Four objectives were employed: (a) To explore the cultural beliefs and practices among Igala women in Kogi East Nigeria with respect to pregnancy, delivery, and after delivery. (b). To explore the meaning of these cultural beliefs and practices to Igala women. (c). To explore how these cultural beliefs and practices influence women's decisions on the use of MHS during pregnancy, delivery, and after delivery. (d). To explore how diverse factors, such as individuals, communities, health facilities, and health workers, facilitate or limit these cultural norms and the use of MHS in primary health care facilities. Methods: The study was conducted in two primary healthcare facilities using a focused ethnographic methodology described by Roper and Shapira. Using purposive and snowballing techniques, data was gathered through participant observations, in-depth interviews, focus group discussions, field note and reflective note. All data was analyzed using the steps described by Roper and Shapira. Results: Findings were organized using the domains of the PEN-3 cultural model. Manuscript one: Cultural structures such as the language of communication, religion, prayer houses, lack of women’s autonomy, cultural perceptions, herbal medicine, and factors influencing the use of contraceptives were found to influence facility care around pregnancy and childbirth. Manuscript two: Explicit and implicit factors such as witchcraft, unspoken acquiescence to the culture, home delivery, rising matriarchs, cultural interpretation of the caesarean section and the placenta influence decisions made around pregnancy and childbirth. Manuscript three: Factors such as health workers' attitudes, the cost of maternal health services, facility factors, and contextual issues facilitate and limit cultural norms and practices around pregnancy and childbirth. Conclusion: This study's findings reveal critical cultural issues that are often taken for granted but are significant determinants of decisions made around pregnancy and birth. The findings of the study suggest the integration of culture in maternal health policies and interventions to enhance maternal health outcomes. Additionally, the reinvigoration of primary healthcare facilities is critical in areas of human, material, financial, and community engagement to enhance holistic care provision. Keywords: cultural beliefs, practices, maternal health, PEN 3 cultural model, Nigeria.  

Description

Keywords

cultural beliefs, practices, focused ethnographic research, maternal health, PEN 3 cultural model, Nigeria.

Citation

Degree

Doctor of Philosophy (Ph.D.)

Department

Nursing

Program

Nursing

Part Of

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DOI

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