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Explanatory models of stillbirth among bereaved parents in Afghanistan: Implications for stillbirth prevention

Authors :
Aliki Christou
Camille Raynes-Greenow
Adela Mubasher
Sayed Murtaza Sadat Hofiani
Mohammad Hafiz Rasooly
Mohammad Khakerah Rashidi
Neeloy Ashraful Alam
Source :
PLOS Global Public Health, Vol 3, Iss 6 (2023)
Publication Year :
2023
Publisher :
Public Library of Science (PLoS), 2023.

Abstract

Local perceptions and understanding of the causes of ill health and death can influence health-seeking behaviour and practices in pregnancy. We aimed to understand individual explanatory models for stillbirth in Afghanistan to inform future stillbirth prevention. This was an exploratory qualitative study of 42 semi-structured interviews with women and men whose child was stillborn, community elders, and healthcare providers in Kabul province, Afghanistan between October-November 2017. We used thematic data analysis framing the findings around Kleinman’s explanatory framework. Perceived causes of stillbirth were broadly classified into four categories–biomedical, spiritual and supernatural, extrinsic factors, and mental wellbeing. Most respondents attributed stillbirths to multiple categories, and many believed that stillbirths could be prevented. Prevention practices in pregnancy aligned with perceived causes and included engaging self-care, religious rituals, superstitious practices and imposing social restrictions. Symptoms preceding the stillbirth included both physical and non-physical symptoms or no symptoms at all. The impacts of stillbirth concerned psychological effects and grief, the physical effect on women’s health, and social implications for women and how their communities perceive them. Our findings show that local explanations for stillbirth vary and need to be taken into consideration when developing health education messages for stillbirth prevention. The overarching belief that stillbirth was preventable is encouraging and offers opportunities for health education. Such messages should emphasise the importance of care-seeking for problems and should be delivered at all levels in the community. Community engagement will be important to dispel misinformation around pregnancy loss and reduce social stigma.

Details

Language :
English
ISSN :
27673375
Volume :
3
Issue :
6
Database :
Directory of Open Access Journals
Journal :
PLOS Global Public Health
Publication Type :
Academic Journal
Accession number :
edsdoj.96aa6178ae64d1db610105acf5ff845
Document Type :
article