Socio-cultural Beliefs Research Articles

Provider bias and family planning in Upper Egypt: a simulated client approach

BackgroundProvider bias is a main barrier that extensively violates the right of free family planning method choice. Egypt is one of the countries that shows skewness in its method mix. Provider bias and insufficiency of alternative methods are identified as potential factors underlying this phenomenon which contributes to high unmet needs and discontinuation rates. Provider bias may be influenced by cultural beliefs and societal trends and is usually overlooked as a possible cause of this skewed method mix. This study aims to explore the presence of provider bias in rural Upper Egypt and its potential causes, a community with conservative cultural beliefs and least contraceptive prevalence rates.MethodsThis is a qualitative study using the “simulated client’s approach.” The study was conducted in 16 villages in Assiut and Sohag governorates in Egypt. The simulated clients visited 30 clinics, 15 in each governorate, including primary healthcare units and private clinics. Three scenarios were used to explore the physicians-imposed restrictions for contraceptive use with different clients’ eligibility criteria. Data was analyzed using the grounded theory methodology.ResultsRecommending a contraceptive method for the mystery clients was not based on informed choice. Most providers had method or client bias. Copper IUD was the most favorable contraceptive method recommended by providers, with negative attitude towards using hormonal contraception. Nulliparous and young clients were discouraged to use contraception before proving fertility or offered temporary methods as emergency contraception or condoms. Providers have shown misconceptions related to infertility-associated complications of contraceptive use, especially for the young and nulliparous women.ConclusionIn this study, providers had a clear bias towards recommending IUD rather than all other contraceptive methods, which was hindered in some cases by the lack of insertion skills. Interventions to reduce provider bias should go beyond technical training. Moreover, training on reproductive rights should be a main component of routine training. Providers should regularly receive research results and be oriented toward recent medical eligibility criteria of contraceptive methods use. Moreover, the sociocultural beliefs of providers that may affect their practice should be explored and addressed.

Funds of knowledge for synchronous online language teaching: a translanguaging view on an ESL teacher’s pedagogical practices

Abstract In recent years, there has been a significant increase in the integration of synchronous online teaching tools in language teaching. Recent research has explored how second language (L2) teachers utilise available resources to engage students’ learning within the virtual learning space. Nevertheless, there has been a lack of research exploring how L2 teachers bring in different funds of knowledge to connect the teaching of specific aspects of the L2 with some broader social-cultural issues and/or values. Further research is necessary to explore how the teaching of specific sociocultural values and beliefs is achieved through translanguaging, with the aim of enriching students’ L2 learning experiences. This study adopts translanguaging as an analytical perspective and investigates how different funds of knowledge are being incorporated into the online teaching processes in order to mediate the student’s L2 English learning and promote specific sociocultural values and beliefs to the student. Multimodal Conversation Analysis is used to analyse the online classroom data and the analysis is triangulated with the video-stimulated-recall-interview that is analysed using Interpretative Phenomenological Analysis. The findings demonstrate that the online language classroom is a virtual translanguaging space which affords classroom participants to bring with them diverse funds of knowledge for constructing new knowledge in online classrooms, bridging the gap between L2 learning and everyday life experience and promoting certain values and beliefs, as well as facts and practices, in the online classroom.

Kirant Folk Narratives: Exploring the Socio-Cultural Implications

The paper analyzes how folk narratives in Kirant Rai shape the socio-cultural and ritual practices and values in day-to-day life. The core meanings of the narratives profoundly impact the formation and structure of socio-cultural beliefs and behaviors not only on people in a particular community but also on people from around the globe. Based chiefly on the two folk narratives— Hechchhakuppa and Sumdima and Paruhang, the paper analyzes the narrative texts under certain thematic issues such as the institutionalization of the human society, ritual performative, and representation by using functional, and socio-cultural theory by Dundes and Bascom respectively to spot the underlying impacts of the narratives on communities and people. The narrative texts which have been collected through fieldwork and transcription of oral narratives serve as primary data for the paper. When analyzing the texts, the folk narratives have been found to have greatly contributed to developing and transferring the belief system, ritual practice, and societal norms in the society.

The reintegration of obstetric fistula survivors in Malawi: Perspectives of healthcare providers

ObjectiveIn Malawi, women face a high risk of obstetric fistulas. There are many socio-cultural implications for women suffering from the condition, many of which continue to affect them even after they have undergone treatment and attempt to reintegrate into their lives. The focus of this study was to explore the socio-cultural factors that influence the reintegration of obstetric fistula survivors in Malawi from the perspectives of healthcare providers. DesignThis qualitative study was conducted at a hospital in Central Malawi, which houses a non-governmental organization (NGO) that is wholly dedicated to the treatment and reintegration of obstetric fistula patients and survivors. In total, in-depth interviews was conducted with 15 healthcare providers. FindingsAfter surgery, survivors are given economic and social empowerment assistance to allow them to gain independence from their families. Counselling interventions help patients overcome their isolation and depression so they may begin to interact with others. In some circumstances, the initial surgeries may be unsuccessful, causing anxiety and doubt among the women. Some survivors no longer desired to bear children in the future, which negatively impacted their marriages and social status. Key conclusionIt is imperative to overcome the socio-cultural beliefs that impact the treatment of obstetric fistula. The perspectives of healthcare providers involved in obstetric fistula treatment can assist policy makers to conceptualize and implement effective policies and programmes that will improve the quality of care offered to obstetric fistula survivors after their treatment. Implications for practicesThese first-hand experiences and knowledge of healthcare providers are significant in identifying challenges and barriers that fistula survivors encounter during the reintegration process.

The impact of migration and settlement context on Iranian Women's agency in accessing and using reproductive healthcare services in Australia: A qualitative study.

This qualitative study aimed to understand how immigration and settlement context shape Iranian immigrants' agency in accessing and using reproductive healthcare services (RHCS). Twenty-one Iranian women of reproductive age (18-49 years) living in Australia were recruited in 2022 through social media platforms. The findings highlighted that although Iranian women's utilisation of RHCS in Australia is highly constrained by established sociocultural beliefs and values of their origin country, they become agents of making changes over their reproductive choices, reformulating beliefs and values, and taking control of reproductive health because of Australian sociocultural norms and context. This suggests a tension between the impacts of sociocultural contexts in their origin country and becoming agents of change after migrating to Australia. These findings need to be included in healthcare policy and practice to support greater consideration of cultural sensitivities and specific needs of immigrant women when accessing Australian RHCS.

Factors influencing fathers’ involvement in the care of hospitalized preterm newborns in Balaka, Malawi

BackgroundMalawi has one of the highest incidences of premature birth, with twice the mortality compared to full-term. Excluding fathers from preterm newborn care has negative consequences, including father feeling powerless, missed bonding opportunities with the newborn, additional strain on the mother, and negative family dynamics such as breakdown in communication, reduced trust, and strained relationships. In Malawi, there is no deliberate policy to have fathers involved in preterm care despite having high incidence of preterm birth and neonatal mortality. There is also limited literature on the factors that influence fathers’ involvement in the care. The aim of the study was to explore factors influencing fathers’ involvement in the care of hospitalized preterm newborns.MethodsA descriptive qualitative study design was used, guided by Theory of planned behaviour and the model proposed by Lamb on male involvement. Sixteen in-depth interviews were conducted with fathers of preterm infants purposively and conveniently sampled in June 2021. Interviews were digitally recorded and transcribed verbatim. Data were organized and analyzed using Nvivo software and thematic analysis approach was used because the approach allows deeper understanding of the data, identification of patterns and themes, and provides rich insights into participants’ experiences and perspectives.ResultsThe barriers and facilitators that influence a father’s involvement in the care of preterm newborn babies include: perceived difficulty with care activities and benefits of involvement, gender roles and socio-cultural beliefs, work and other family responsibilities, social support, baby’s physical appearance/nature and health status, feedback from the baby, multiple births, and hospital’s physical environment and provision of basic needs.ConclusionThe study found that fathers value their involvement in caring for hospitalized preterm newborns but face barriers. Evidence-based interventions like education programs, training sessions, and support groups can help fathers overcome barriers and promote better outcomes for infants and families.

Women's Views on Factors that Influence Utilisation of Postnatal Follow-Up in Oman: A descriptive, qualitative study.

Postnatal follow-up care (PNFC) is critical for promoting maternal and newborn health and well-being. In Oman, women's utilisation of postnatal follow-up services has declined, with rates as low as 0.29 (mean visits) in some governorates, and fails to meet the recommendation of postnatal follow-up visits at two and six weeks for assessment of the mother and her newborn. The reasons for this low utilisation are not well understood. This study aimed to explore women's views on and identify factors that influence their utilisation of postnatal follow-up services. Purposive sampling was employed and semi-structured telephone interviews were conducted with 15 women aged 20-39 years at six to eight weeks post-childbirth between May and August 2021. The data were analysed using Erlingsson and Brysiewicz's content analysis approach. The following six categories were identified as influencing PNFC utilisation: 1) need for information; 2) experiences and expectations; 3) family support, expectations and customs; 4) sociocultural beliefs and practice; 5) impact of the COVID-19 pandemic; and 6) the healthcare environment. Influencing factors derived from each category include the need to empower women, provide individualised care, address family and community expectations, offer alternatives to face-to-face clinic visits and provide organised and scheduled appointments. Women in Oman identified the need for consistent information from healthcare providers and a more organised postnatal follow-up service that includes scheduled appointments and a woman-centred approach to PNFC.

“Something has to change”

“Something has to change”

Enhancing critical reflective practice in science education through a STEAM approach

This article aimed to explore teachers’ beliefs on reflective practice in their professional life and envision perspectives for transforming their practice. I used auto/ethnography as a research methodology for critically reflecting on the self and others’ lived experiences of teaching science, mathematics, and technology in the context of Nepal. I explored that reflective practice is required for understanding and transforming our deep-seated dominant cultural practices. On becoming a critically reflective practitioners, we can incorporate a trans-disciplinary STEAM approach while designing and implementing a curriculum, pedagogy, and assessment system that helps understand learners’ sociocultural backgrounds, beliefs, values, assumptions, and feelings for authentic, inclusive, and meaningful learning.

Advance Care Planning and palliative care for patients with advanced cancer in Uganda

The study sought to identify the extent to which Advance Care Planning (ACP) is practised by palliative care health professionals providing care to patients with advanced cancer and their families in Uganda.A mixed methods study design using qualitative and quantitative methods was used for the assessment. In-depth interviews with a group of nine highly experienced health professionals were conducted using a semi-structured interview guide. Quantitative data were retrieved and analysed from a survey administered to 124 health professionals of whom only 57 (45.9%) responded. The qualitative data were analysed using inductive thematic analysis and descriptive analysis was used for the quantitative data.Of the 57 health professionals who participated in the survey, 87% were aware of ACP and 55% reported regular practice. Fifty-five (55%) percent reported regular provision of ACP for their patients and 46% reported engaging in informal ACP practices. However, 58.5% resp. 37.5% reported that they routinely provide ACP to more than 50% resp. 75% of their patients. A group of nine highly experienced palliative care professionals had a pooled ACP prevalence of only 1.2%. There was a generally good attitude towards ACP with 98.2% acknowledging that patients should be able to determine their future care. However, 32% reported being uncomfortable withholding or withdrawing life sustaining treatment. There are a number of socio-cultural beliefs and barriers, for instance that discussing death and dying is a “taboo”, as well as witchcraft, family influence in decision-making, religious beliefs that do not agree with palliative care practices and a preference to use aggressive treatment like chemotherapy for terminally ill, etc. Institutional barriers like lack of a legal framework for ACP, limited time for health professionals to engage in ACP and other patient factors such as denial of diagnosis and collusion to withhold information from patients were reported by 78.2% resp. 84% of the respondents.Despite the good awareness and attitude to ACP, there is a range of barriers that are affecting the implementation of ACP in Uganda. There is need for development of a legal framework for ACP, more research to understand the contextual barriers and develop appropriate education and public sensitisation programs.

Knowledge exchange sessions on primary health care research findings in public libraries: A qualitative study with citizens in Quebec.

Little is known about knowledge transfer with the public. We explored how citizens, physicians, and communication specialists understand knowledge transfer in public spaces such as libraries. The initial study aimed at evaluating the scaling up of a program on disseminating research findings on potentially inappropriate medication. Twenty-two citizen workshops were offered by 16 physicians and facilitated by 6 communication specialists to 322 citizens in libraries during spring 2019. We did secondary analysis using the recorded workshop discussions to explore the type of knowledge participants used. Participants described four kinds of knowledge: biomedical, sociocultural beliefs, value-based reasoning, and institutional knowledge. Biomedical knowledge included scientific evidence, research methods, clinical guidelines, and access to research outcomes. Participants discussed beliefs in scientific progress, innovative clinical practices, and doctors' behaviours. Participants discussed values related to reliability, transparency, respect for patient autonomy and participation in decision-making. All categories of participants used these four kinds of knowledge. However, their descriptions varied particularly for biomedical knowledge which was described by physician-speakers and communication specialists-facilitators as scientific evidence, epidemiological and clinical practice guidelines, and pathophysiological theories. Communication specialists-facilitators also described scientific journalistic sources and scientific journalistic reports as proxies of scientific evidence. Citizens described biomedical knowledge in terms of knowledge to make informed decisions. These findings offer insights for future scientific knowledge exchange interventions with the public.

Socio-cultural beliefs on drought in Talensi Ghana: insights for environmental management, social vulnerability, early warning systems and coping and adaptation

Socio-cultural beliefs on drought in Talensi Ghana: insights for environmental management, social vulnerability, early warning systems and coping and adaptation

A mixed-method study examined the reasons why pregnant women late initiate antenatal care in Northeast Ethiopia.

Timely initiation of antenatal care visits is crucial for ensuring optimal care and health outcomes for women and children. However, late antenatal care initiation among pregnant women in low-income countries including Ethiopia is acknowledged in the literature. Therefore, this study examined why pregnant women initiate antenatal care late in Northeast Ethiopia. This study was done using a mixed design approach that included phenomenology and retrospective cross-sectional designs. A retrospective cross-sectional study was deployed among randomly selected 632 medical charts of women who had antenatal care visit in Legambo District primary hospital and health centers. Kaplan Meier curve was used to estimate survival time. Bi-variable and multivariable Cox-proportional hazard regression models were fitted using R-studio-1.2.5033 to identify independent predictors of antenatal care initiation time. Six vignette-based focused group discussions were held with pregnant women who had been purposefully selected. Then, a qualitative content analysis that was informed by the phenomenological theory was done. This study indicated that only 195 (30.9%) of women timely initiated their antenatal care follow-up. In a survival analysis, all 632 women contributed 12,474 person-weeks giving a timely antenatal care initiation rate of 15.6 per 1000 person-weeks. According to the multivariable Cox regression models, late antenatal are initiation was found among pregnant women with an unknown last normal menstruation period, no living children, no bad obstetric history, not accompanied by their partner during antenatal care visit, and who lived in a >5-kilometer radius of health facility. In a qualitative analysis, being uncertain whether the pregnancy had occurred, believing that they have a very low probability of experiencing any complications, negative experience with healthcare providers, negative influence from their immediate contacts such as the mother and mother-in-law, and socio-cultural beliefs like "Qare" were found as major reasons why they started antenatal care follow-up late. Most pregnant women in Legambo district, northeastern Ethiopia, initiate their antenatal care visits late. Based on the findings of this study, strengthening the pregnant women identification program and performing regular pregnant women's conference will help to achieve early initiation of antenatal care visits. To lessen the negative influence of their immediate contacts, it will also good to include these old moms and husbands in the conference of pregnant women.

A Qualitative Investigation of the Psychosocial Impact of Chronic Low Back Pain in Ghana

IntroductionChronic low back pain (CLBP) is a global health concern associated with multidimensional/biopsychosocial levels of affectation in developed countries, with holistic management requiring consideration of these factors. There has been...

Child Sexual Abuse in Nigeria: Exploring Vulnerability and Prevention from a Policing Perspective

To date, literature on vulnerabilities of children and prevention of child sexual abuse (CSA) has relied on the contributions of child-care professionals, health practitioners, and other social workers, excluding police officers. The purpose of this study is to draw on the experiences and expert opinions of police officers in exploring the vulnerabilities of children to sexual abuse and prescribing preventive measures. Officers’ engagement is premised on their collaborative work with social service agents in improving responses to crimes of violence against children. This qualitative study was conducted with 24 police detectives of the sexual offenses units in the six zonal police commands of southwest Nigeria. From the thematic analysis of their narratives, findings indicated a link between socio-cultural and religious beliefs and children’s exposure to sexual abuse. Participants indicated believe that there is a growing number of men who are preferentially or solely sexually attracted to prepubescent females. In addressing CSA, participants suggested a specialist approach to policing CSA, abolition of child marriage, community engagement in CSA policing, and legal instrumentations to govern socio-cultural practices. The study invite research that triangulates the perspectives of parents, community elders, and religious leaders in communities where considerable incidents of CSA have been reported.

Health Experiences of African American Mothers, Wellness in the Postpartum Period and Beyond (HEAL): A Qualitative Study Applying a Critical Race Feminist Theoretical Framework.

The objective of this study is to explore the cultural, social, and historical factors that affect postpartum primary care utilization among Black women with cardiometabolic risk factors and to identify the needs, barriers, and facilitators that are associated with it. We conducted in-depth interviews of 18 Black women with one or more cardiometabolic complications (pre-pregnancy chronic hypertension, diabetes, obesity, preeclampsia, or gestational diabetes) within one year of delivery. We recruited women from three early home-visiting programs in Baltimore, Maryland, between May 2020 and June 2021. We used Critical Race Feminism theory and a behavioral model for healthcare utilization as an analytical lens to develop a codebook and code interview transcripts. We identified and summarized emergent patterns and themes using textual and thematic analysis. We categorized our findings into six main themes: (1) The enduring influence of structural racism, (2) personally mediated racism in healthcare and beyond, (3) sociocultural beliefs about preventative healthcare, (4) barriers to postpartum care transitions, such as education and multidisciplinary communication, (5) facilitators of postpartum care transitions, such as patient-provider relationships and continuity of care, and (6) postpartum health and healthcare needs, such as mental health and social support. Critical race feminism provides a valuable lens for exploring drivers of postpartum primary care utilization while considering the intersectional experiences of Black women.

Doctors and Doctoring: An Analysis of the Cultural Discourses of Medicine


 
 
 
 The astonishing stories from the discourses of medicine portray the values of a doctor and the process of doctoring based on humanistic principles. Medical Humanities is an interdisciplinary field of study where one of the aims is to attempt to focus on the importance of empathy and kindness in medical practitioners who experience anguish, anxiety as well as professional satisfaction. Haris Qadeer introduces Medical Humanities, basically a Western thought, to the Indian context by compiling translated stories of illness and cure from the regional languages of India. The book, Medical Maladies: Stories of Disease and Cure from Indian Languages (2022), through nineteen fascinating short stories ranging from the early twentieth century to the contemporary period, discloses the various aspects of the cultural discourses of medicine in India. The translation of literary texts into other languages enhances their scope of obtaining a wider readership as well as reviews and critical analyses. A text like Medical Maladies opens the doors of regional Indian literatures so as to enable us to understand and study the vicissitudes of life portrayed in literatures in regional languages from all over the country. This paper attempts to analyse the impact of medical pluralism and medical paternalism on the treatment offered, changing medical gaze, the threats of the corporatization of medicine that makes doctoring a business, the influences of sociocultural beliefs in the suffering of women, and the challenges faced by the doctors, patients and other medical practitioners through a study of five stories from this collection. These include “Quarantine”, “A Day in the Labour Room”, “The Surgeon”, “Mantra”, and “Narova Kunjarova”
 
 
 

Commentary] Commentary on Sociocultural Beliefs and Systems Restricting Women’s Access to their Marital Property Rights in Pakistan

This paper examines the sociocultural beliefs and systems that restrict women’s access to their marital property rights in Pakistan. Despite constitutional and legal provisions that allow women the absolute right to own, acquire, inherit, and control property, there is a stark contradiction between individual beliefs and communal practices. The paper explores the parallel states of cognitive dissonance and consonance that arise from this contradiction, where positive awareness and attitude towards women accessing marital property do not translate into action. The paper also discusses the enculturation of belief systems, the epistemological role of power, misogyny, and patriarchy, and lastly, the role of cognitive empathy in catalysing action. The findings of this study have important implications for understanding the systemic barriers to women’s economic empowerment and security in Pakistan.

Biological, demographic, and health factors associated with HPV infection in Ecuadorian women.

The study aims to identify the correlation between human papillomavirus (HPV) infection and sociodemographic and sexual reproductive health factors in Ecuadorian women from March to August 2019. 120 women were randomly selected from two gynecological clinics to complete a questionnaire and provide a biospecimen. PCR-Hybridization was used to genotype 37 HPV serotypes in samples obtained by endo-cervical brushing for liquid-based cytology. Sociodemographic and sexual health data were collected through a validated questionnaire during a medical consultation. Mathematical modeling of HPV infection was done using bivariate logistic regression. 65.0% of the women sampled had an HPV infection; 74.3% of these women had co-infections with other HPV genotypes. Out of the women who were HPV positive, 75.6% were diagnosed with high-risk genotypes from HPV strains 18, 35, 52, and 66. Parity, immunosuppression, and use of oral contraception/intrauterine devices (IUDs) were identified as associated variables. The explanatory model had a sensitivity of 89.5% and a specificity of 73.8%. The predominant strains of HPV among Ecuadorian women are diverse. The risk of HPV infection is a complex phenomenon where biological and psychosocial variables are integrated into a model. In populations with limited access to health services, low socioeconomic status, and negative sociocultural beliefs about sexually transmitted infections (STIs), surveys can be used as a pre-screening step for HPV infections. The diagnostic value of the model should be tested in multicenter studies that include women from all over the country.

Relationship between Abstinence from Retrogressive Sociocultural Practices and Secondary School Students’ Levels of Moral Growth and Development

Education is one way to impart moral consciousness in individuals. One of the marks of moral growth is abstinence from retrogressive socio-cultural beliefs and practices. The study investigated the relationship between reasons given by teachers and students for abstaining from retrogressive socio-cultural practices and their levels of moral development, based on Kohlberg’s theory of moral development. The retrogressive socio-cultural practices were identified from Henry Ole Kulet’s novel Blossoms of the Savannah, which was selected purposively. The research was descriptive comparative by design. The study targeted 2227 Form Three students and 620 teachers of English from national secondary schools from Uasin Gishu, Nandi and Elgeyo Marakwet Counties. From this population, 339 students and 59 teachers were sampled using Taro Yamane’s formula and selected using simple random sampling. Data were collected using questionnaires, focus group discussions, classroom observations and content analysis. Quantitative data was analysed using SPSS (version 25) program. Qualitative data was analysed thematically. From the novel, four retrogressive practices were identified, namely female genital mutilation, polygamy, patriarchy along with male chauvinism, and arranged or early marriages. From the findings, majority of students and teachers’ reason at the post-convectional level of moral development, as evidenced from the various explanations they gave for abstaining from retrogressive socio-cultural practices. Therefore, teachers and students’ reason beyond the perspectives of society and recognize that laws must be consistent with individuals’ rights. Consequently, the government should select and approve literary texts as set-books that promote conventional or post-conventional level of moral reasoning in their readers.