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

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...

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Autores principales: Christou, Aliki, Raynes-Greenow, Camille, Mubasher, Adela, Hofiani, Sayed Murtaza Sadat, Rasooly, Mohammad Hafiz, Rashidi, Mohammad Khakerah, Alam, Neeloy Ashraful
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10284382/
https://www.ncbi.nlm.nih.gov/pubmed/37343024
http://dx.doi.org/10.1371/journal.pgph.0001420
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author Christou, Aliki
Raynes-Greenow, Camille
Mubasher, Adela
Hofiani, Sayed Murtaza Sadat
Rasooly, Mohammad Hafiz
Rashidi, Mohammad Khakerah
Alam, Neeloy Ashraful
author_facet Christou, Aliki
Raynes-Greenow, Camille
Mubasher, Adela
Hofiani, Sayed Murtaza Sadat
Rasooly, Mohammad Hafiz
Rashidi, Mohammad Khakerah
Alam, Neeloy Ashraful
author_sort Christou, Aliki
collection PubMed
description 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.
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spelling pubmed-102843822023-06-22 Explanatory models of stillbirth among bereaved parents in Afghanistan: Implications for stillbirth prevention Christou, Aliki Raynes-Greenow, Camille Mubasher, Adela Hofiani, Sayed Murtaza Sadat Rasooly, Mohammad Hafiz Rashidi, Mohammad Khakerah Alam, Neeloy Ashraful PLOS Glob Public Health Research Article 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. Public Library of Science 2023-06-21 /pmc/articles/PMC10284382/ /pubmed/37343024 http://dx.doi.org/10.1371/journal.pgph.0001420 Text en © 2023 Christou et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Christou, Aliki
Raynes-Greenow, Camille
Mubasher, Adela
Hofiani, Sayed Murtaza Sadat
Rasooly, Mohammad Hafiz
Rashidi, Mohammad Khakerah
Alam, Neeloy Ashraful
Explanatory models of stillbirth among bereaved parents in Afghanistan: Implications for stillbirth prevention
title Explanatory models of stillbirth among bereaved parents in Afghanistan: Implications for stillbirth prevention
title_full Explanatory models of stillbirth among bereaved parents in Afghanistan: Implications for stillbirth prevention
title_fullStr Explanatory models of stillbirth among bereaved parents in Afghanistan: Implications for stillbirth prevention
title_full_unstemmed Explanatory models of stillbirth among bereaved parents in Afghanistan: Implications for stillbirth prevention
title_short Explanatory models of stillbirth among bereaved parents in Afghanistan: Implications for stillbirth prevention
title_sort explanatory models of stillbirth among bereaved parents in afghanistan: implications for stillbirth prevention
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10284382/
https://www.ncbi.nlm.nih.gov/pubmed/37343024
http://dx.doi.org/10.1371/journal.pgph.0001420
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