Abstract
BackgroundThe number of preterm birth is increasing worldwide, especially in low income countries. Malawi has the highest incidence of preterm birth in the world, currently estimated at 18.1 percent. The aim of this study was to explore the perceived causes of preterm birth, care practices for preterm newborn babies and challenges associated with preterm birth among community members in Mangochi District, southern Malawi.MethodsWe conducted 14 focus group discussions with the following groups of participants: mothers (n = 4), fathers (n = 6) and grandmothers (n = 4) for 110 participants. We conducted 20 IDIs with mothers to preterm newborns (n = 10), TBAs (n = 6) and traditional healers (n = 4). A discussion guide was used to facilitate the focus group and in-depth interview sessions. Data collection took place between October 2012 and January 2013. We used content analysis to analyze data.ResultsParticipants mentioned a number of perceptions of preterm birth and these included young and old maternal age, heredity, sexual impurity and maternal illness during pregnancy. Provision of warmth was the most commonly reported component of care for preterm newborns. Participants reported several challenges to caring for preterm newborns such as lack of knowledge on how to provide care, poverty, and the high time burden of care leading to neglect of household, farming and business duties. Women had the main responsibility for caring for preterm newborns.ConclusionIn this community, the reported poor care practices for preterm newborns were associated with poverty and lack of knowledge of how to properly care for these babies at home. Action is needed to address the current care practices for preterm babies among the community members.
Highlights
The number of preterm birth is increasing worldwide, especially in low income countries
Worldwide almost half of preterm newborns are born at home and even for those born in facilities; essential newborn care (ENC) is often lacking [2]
Some of the perceptions of preterm birth reported in our study, such as maternal factors are reported as risk factors for preterm birth in previous qualitative and epidemiological studies in Malawi and elsewhere [10,18,19,20,21]
Summary
The number of preterm birth is increasing worldwide, especially in low income countries. Malawi has the highest incidence of preterm birth in the world, currently estimated at 18.1 percent. Recent estimates indicate that there are 15 million preterm newborns annually and the number is increasing each year [1]. Worldwide almost half of preterm newborns are born at home and even for those born in facilities; essential newborn care (ENC) is often lacking [2]. Malawi has the highest incidence of preterm birth in the world, estimated at 18.1 percent [1]. A previous study about preterm birth in rural communities in Malawi, described that neonatal and perinatal mortality was twice as high in preterm newborns as compared to term newborns [6]. Most newborn deaths happen in the first week and half of those in the first 24 hours of life [8] and among preterm newborns the lack of ENC may lead to death [9]
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