A Cross-Cultural Study of Maternal Knowledge of Infant Health Care Issues 682

Abstract

Many infants in urban communities receive insufficient and inappropriate medical care. We were interested in exploring knowledge of and attitudes about infant health issues in two culturally disparate urban communities in order to gain further insight into causes of inadequate care. Methods: 20 Latino (East Harlem, NYC, delivered at Mount Sinai Medical Center) and 20 North African (Jerusalem, Israel, delivered at Sharei Zedek Medical Center) mothers were interviewed 1-2 days after birth of their infants (both primip& multip). The extensive survey tool (130 questions) sought to identify their understanding of the role of the health care system, knowledge of accepted medical practices, education, support systems, knowledge of childhood illnesses, and the role of their spiritual beliefs and cultural background. While both populations were urban and poor, the Israeli women and children all received comprehensive care through a socialized neighborhood clinic in which they were assigned a permanent nurse. The Harlem families primarily received their care at neighborhood or hospital clinics but also utilized emergency rooms and private MDs. Results: Common infant conditions(URI, diarrhea, constipation, etc.) were judged to be more serious by the American women and more likely to need medical care. The gap was most pronounced in the multips. There was no consensus on expected medical interventions for these conditions, yet 80% of Israeli mothers and 50% of American mothers would seekmedical care for a sick infant before other means of assistance(family help, home remedies, etc.). 95% of all mothers believed physicians had unique healing abilities, but this did not preclude other treatments. 95% of mothers prayed and 75% believed prayer was efficacious in healing sick infants. Folk medicine(95%), community-based healing(50%) and religious leaders(≈25%) were also considered important. Conclusions: Illness in infants is perceived differently than adult illness by caregivers and prompts a distinct response. While medical expertise is relied upon, a number of other avenues of care and support are utilized. Caregivers should be aware of the unique cultural and experiential understanding parents bring to pediatric care in order to provide the most efficacious treatment in a particular health system.