Local understandings of vulnerability and protection during the neonatal period in Sylhet district, Bangladesh: a qualitative study
Local understandings of vulnerability and protection during the neonatal period in Sylhet district, Bangladesh: a qualitative study
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DOI：
10.1016/s0140-6736(05)66836-5
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发表时间：
2005-08-06
期刊：
影响因子：
168.9
通讯作者：
Seraji, MHR
中科院分区：
文献类型：
--
作者：
Winch, PJ;Alam, MA;Seraji, MHR
背景：在制定降低新生儿死亡率的干预措施时，需要了解当地定义的与新生儿期有关的知识和做法。我们描述了孟加拉国锡尔赫特地区新生儿期的组织，对新生儿福祉的感知威胁，以及家庭寻求保护他们的方式。方法对新生儿的母亲、父亲、祖母和传统接生员进行了39次深度、非结构化、定性访谈。还从对6050名最近分娩的妇女的家庭调查中获得了关于新生儿知识和做法的数据。调查结果受访者将新生儿期定义为生命的前40天（胆氏din）。在第7天或第9天的noai仪式之前，最强烈地观察到母亲和婴儿的禁闭，包括限制在家外的活动，睡在分娩的地方而不是母亲的卧室里，睡在地板上的垫子上。新生儿被认为容易受到冷空气、冷食或冷饮（直接或间接通过母亲）的伤害，也容易受到恶灵或邪眼的伤害。沐浴、皮肤护理、坐月子和饮食习惯都旨在减少接触寒冷，但其中一些做法可能会增加体温过低的风险。尽管宿命论和文化上对高死亡率的接受被认为是新生儿高死亡率的原因，但Sylheti家庭试图通过几种方式保护新生儿。这些行动反映了一组不同于新生儿健康专家的关于新生儿期的假设，并对新生儿护理干预措施的设计产生影响。
Background Understanding of local knowledge and practices relating to the newborn period, as locally defined, is needed in the development of interventions to reduce neonatal mortality. We describe the organisation of the neonatal period in Sylhet District, Bangladesh, the perceived threats to the well-being of neonates, and the ways in which families seek to protect them.Methods We did 39 in-depth, unstructured, qualitative interviews with mothers, fathers, and grandmothers of neonates, and traditional birth attendants. Data on neonatal knowledge and practices were also obtained from a household survey of 6050 women who had recently given birth.Findings Interviewees defined the neonatal period as the first 40 days of life (chollish din). Confinement of the mother and baby is most strongly observed before the noai ceremony on day 7 or 9, and involves restriction of movement outside the home, sleeping where the birth took place rather than in the mother's bedroom, and sleeping on a mat on the floor. Newborns are seen as vulnerable to cold air, cold food or drinks (either directly or indirectly through the mother), and to malevolent spirits or evil eye. Bathing, skin care, confinement, and dietary practices all aim to reduce exposure to cold, but some of these practices might increase the risk of hypothermia.Interpretation Although fatalism and cultural acceptance of high mortality have been cited as reasons for high levels of neonatal mortality, Sylheti families seek to protect newborns in several ways. These actions reflect a set of assumptions about the newborn period that differ from those of neonatal health specialists, and have implications for the design of interventions for neonatal care.