Addressing anaemia in pregnancy in rural plains Nepal: A qualitative, formative study.
Addressing anaemia in pregnancy in rural plains Nepal: A qualitative, formative study.
复制标题
DOI：
10.1111/mcn.13170
复制
发表时间：
2021-07
影响因子：
3.4
通讯作者：
Hillman S
中科院分区：
文献类型：
--
作者：
Morrison J;Giri R;Arjyal A;Kharel C;Harris-Fry H;James P;Baral S;Saville N;Hillman S
低收入国家的孕产妇贫血患病率高得令人无法接受。我们的研究探讨了影响尼泊尔平原孕妇产前保健摄入、铁叶酸（IFA）摄入和富含微量营养素饮食消费的个人、家庭和社区因素。我们讨论了这些发现如何告知家访和社区动员干预的发展，以减少妊娠贫血。我们使用了一种由社会生态框架提供信息的定性方法，对最近怀孕的妇女和关键知情人进行了半结构化访谈，并与岳母和父亲进行了焦点小组讨论。我们发现，有害的性别规范限制了妇女获得营养丰富的食物，限制了她们的流动性和产前护理。这些规范还将父亲的作用限制为提供者，而不是照顾者。孕妇、岳母和父亲缺乏对富含铁的食物以及如何管理IFA副作用的认识。父亲对政府卫生设施缺乏信任，影响了获得保健的机会，也不信任IFA的效力。我们的研究通过以下方式为干预提供了信息：（1）为干预工具和培训的开发提供信息;（2）为干预重点提供信息，让岳母和男性参与进来，以改变行为;（3）表明需要在个人，家庭和社区层面协同工作，以解决权力和地位，性别规范，对卫生服务的信任和有害规范。宣传小组和家访将有助于制定和执行可行和可接受的战略，以解决家庭和背景问题，产生知识和有利于改变行为的环境。
Maternal anaemia prevalence in low‐income countries is unacceptably high. Our research explored the individual‐, family‐ and community‐level factors affecting antenatal care uptake, iron folic acid (IFA) intake and consumption of micronutrient‐rich diets among pregnant women in the plains of Nepal. We discuss how these findings informed the development of a home visit and community mobilisation intervention to reduce anaemia in pregnancy. We used a qualitative methodology informed by the socio‐ecological framework, conducting semi‐structured interviews with recently pregnant women and key informants, and focus group discussions with mothers‐in‐law and fathers. We found that harmful gender norms restricted women's access to nutrient‐rich food, restricted their mobility and access to antenatal care. These norms also restricted fathers' role to that of the provider, as opposed to the caregiver. Pregnant women, mothers‐in‐law and fathers lacked awareness about iron‐rich foods and how to manage the side effects of IFA. Fathers lacked trust in government health facilities affecting access to care and trust in the efficacy of IFA. Our research informed interventions by (1) informing the development of intervention tools and training; (2) informing the intervention focus to engaging mothers‐in‐law and men to enable behaviour change; and (3) demonstrating the need to work in synergy across individual, family and community levels to address power and positionality, gender norms, trust in health services and harmful norms. Participatory groups and home visits will enable the development and implementation of feasible and acceptable strategies to address family and contextual issues generating knowledge and an enabling environment for behaviour change.
登录
查看更多内容
影响因子：
4.2
作者：
Barker, Mary;Chorghade, Ginny;Fall, Caroline
通讯作者：
Fall, Caroline
影响因子：
2.8
作者：
Girard, Amy Webb;Olude, Oluwafunke
通讯作者：
Olude, Oluwafunke
影响因子：
3.5
作者：
Bloom, SS;Wypij, D;Das Gupta, M
通讯作者：
Das Gupta, M
影响因子：
3.4
作者：
Goudet, Sophie;Murira, Zivai;Busch-Hallen, Jennifer
通讯作者：
Busch-Hallen, Jennifer
影响因子：
5.4
作者：
GITTELSOHN, J
通讯作者：
GITTELSOHN, J