Community views on short birth interval in Northern Uganda: a participatory grounded theory

Autor: Laura Rojas-Rozo, Emmanuel Ochola, Janet Oola, Pontius Bayo, Christina Zarowsky, Eunice Atim, Isaac Wonyima Okello, Martin D. Ogwang, Loubna Belaid, Bruno Omara, Pamela Atim, Ivan Sarmiento, Neil Andersson, Kate Zinszer
Rok vydání: 2021
Předmět:
Adult
Male
Participatory research
Community-Based Participatory Research
medicine.medical_specialty
Adolescent
Sexism
Reproductive medicine
Participatory action research
Gender dynamics
Grounded theory
Developmental psychology
03 medical and health sciences
Birth Intervals
0302 clinical medicine
Pregnancy
Social Norms
medicine
Humans
Uganda
030212 general & internal medicine
Marriage
Child
Land tenure
Contraception Behavior
Community-led solutions
Reproductive health
Northern Uganda
Grounded emic theory
030219 obstetrics & reproductive medicine
business.industry
Research
Public health
Obstetrics and Gynecology
Short birth intervals
Gynecology and obstetrics
Focus group
Contraception
Reproductive Health
Reproductive Medicine
Grounded Theory
RG1-991
Anxiety
Female
medicine.symptom
business
Psychology
Maternal Age
Zdroj: Reproductive Health, Vol 18, Iss 1, Pp 1-11 (2021)
Reproductive Health
ISSN: 1742-4755
DOI: 10.1186/s12978-021-01144-5
Popis: Background Short birth interval is associated with adverse perinatal, maternal, and infant outcomes, although evidence on actionable factors underlying short birth interval remains limited. We explored women and community views on short birth intervals to inform potential solutions to promote a culturally safe child spacing in Northern Uganda. Methods Gendered fuzzy cognitive mapping sessions (n = 21), focus group discussions (n = 12), and an administered survey questionnaire (n = 255) generated evidence on short birth intervals. Deliberative dialogues with women, their communities, and service providers suggested locally relevant actions promote culturally safe child spacing. Results Women, men, and youth have clear understandings of the benefits of adequate child spacing. This knowledge is difficult to translate into practice as women are disempowered to exercise child spacing. Women who use contraceptives without their husbands’ consent risk losing financial and social assets and are likely to be subject to intra-partner violence. Women were not comfortable with available contraceptive methods and reported experiencing well-recognized side effects. They reported anxiety about the impact of contraception on the health of their future children. This fear was fed by rumors in their communities about the effects of contraceptives on congenital diseases. The women and their communities suggested a home-based sensitization program focused on improving marital relationships (spousal communication, mutual understanding, male support, intra-partner violence) and knowledge and side-effects management of contraceptives. Conclusions The economic context, gender power dynamics, inequality, gender bias in land tenure and ownership regulations, and the limited contraceptive supply reduce women’s capacity to practice child spacing. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01144-5.
Plain language summary The evidence on what increases birth spacing remains limited. This study explored community views on influences on short birth interval to promote a culturally safe child spacing in Northern Uganda. A participatory research process began by collating perspectives of causes of short birth intervals through fuzzy cognitive mapping. Focus group discussions clarified concepts emerging from the fuzzy cognitive mapping exercise. Fieldworkers administered a household survey to quantify reproductive health outcomes. In deliberative dialogue sessions involving women and their communities, shared and discussed these results and suggested potential actions to promote culturally safe child spacing. Women, men, and youth showed clear understandings of the benefits of adequate child spacing. This knowledge is difficult to translate into practice, however, as women feel they are unable to exercise child spacing. Women who use contraceptives without their husbands’ consent risk losing financial and social resources and are likely to face intra-partner violence. Women were not comfortable with contraceptive methods and reported experiencing side effects. The deliberative dialogues suggested a home-based sensitization program focused on improving marital relationships (spousal communication, mutual understanding, male support, intra-partner violence) and knowledge and side-effects management of contraceptives. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01144-5.
Databáze: OpenAIRE
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