Exploring Maternal and Child Health Among Tribal Communities in India: A Life Course Perspective.
Exploring Maternal and Child Health Among Tribal Communities in India: A Life Course Perspective.
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DOI：
10.5539/gjhs.v16n2p31
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Sabri B
中科院分区：
文献类型：
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作者：
Madankar M;Kakade N;Basa L;Sabri B
印度的孕产妇和婴儿死亡率和发病率很高，部落社区受到的影响尤其严重。部落人口往往生活在不利的社会经济条件下，社会健康指标不足，最终造成不利的健康后果。使用生命过程的角度来看，这一定性研究探讨了生命过程中的风险，有助于在印度部落人口的孕产妇和儿童健康问题。此外，该研究还审查了在怀孕和产后期间利用保健服务的障碍。数据收集发生在2017年至2019年之间，通过参与者观察，关键线人访谈（n = 7）和深入访谈（n = 68）以及与印度马哈拉施特拉邦Madia-Gond部落的部落妇女的焦点小组（n = 7）。此外，还对部落中三名已故妇女和五名婴儿的亲属进行了口头尸检。在不同的社会生态水平和生命的发展阶段，多种风险因素与部落中的孕产妇和儿童健康问题有关。这些问题包括坚持传统的有害做法，获得营养饮食的机会有限，妇女的健康因家务劳动和专业劳动的双重负担而受到忽视，以及缺乏方便和设备齐全的医疗设施。无法进入的原因包括极端贫困、地理位置偏远和医疗基础设施欠佳。有必要制定条款，促进获得护理的机会，并促进以证据支持的医疗保健为中心的教育和认识，特别是针对孕妇。实施营养支助方案可能有助于降低部落人口中普遍存在的孕产妇和儿童高死亡率和发病率。
India experiences high rates of maternal and infant mortality and morbidity, with tribal communities disproportionately affected. Tribal populations frequently live in unfavorable socio-economic conditions and deficient social health indicators, culminating in adverse health consequences. Using a life course perspective, this qualitative study explored risks over the life course that contribute to maternal and child health problems among tribal populations in India. Additionally, the study examined barriers to utilization of healthcare services during the pregnancy and postpartum periods. Data collection occurred between 2017 and 2019 through participant observation, key informant interviews (n = 7) and in-depth interviews (n = 68) and a focus group (n = 7) with tribal women from the Madia-Gond tribe in the Indian state of Maharashtra. Additionally, verbal autopsies were conducted with relatives of three deceased women and five infants from the tribe. Multiple risk factors operating at different socio-ecological levels and developmental stages of life were associated with maternal and child health problems among the tribe. These included adherence to traditional harmful practices, limited access to nutritional diet, women’s health neglected due to the double burden of domestic and professional labor, and a lack of accessible and well-equipped medical facilities. Inaccesibility stemmed from factors including extreme poverty, geographical isolation, and suboptimal healthcare infrastructure. There is need for provisions to promote access to care and to promote education and awareness centered on evidence-supported healthcare, particularly targeted towards expectant mothers. The implementation of nutritional support programs may help mitigate high maternal and child mortality and morbidity rates prevalent among tribal populations.