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Social determination of malaria in pregnancy in Colombia: a critical ethnographic study
BACKGROUND: The meanings and experiences related to malaria in pregnancy (MiP) and its processes of social determination of health (PSDH) have not been reported in the world scientific literature. The objective was to understand the meanings and experiences of MiP, and to explain their PSDH in an en...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10557150/ https://www.ncbi.nlm.nih.gov/pubmed/37803372 http://dx.doi.org/10.1186/s12936-023-04734-9 |
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author | Cardona-Arias, Jaiberth Antonio Higuita-Gutiérrez, Luis Felipe Carmona-Fonseca, Jaime |
author_facet | Cardona-Arias, Jaiberth Antonio Higuita-Gutiérrez, Luis Felipe Carmona-Fonseca, Jaime |
author_sort | Cardona-Arias, Jaiberth Antonio |
collection | PubMed |
description | BACKGROUND: The meanings and experiences related to malaria in pregnancy (MiP) and its processes of social determination of health (PSDH) have not been reported in the world scientific literature. The objective was to understand the meanings and experiences of MiP, and to explain their PSDH in an endemic area from Colombia, 2022. METHODS: Critical ethnography with 46 pregnant women and 31 healthcare workers. In-depth and semi-structured interviews, focus group discussions, participant and non-participant observations, and field diaries were applied. A phenomenological-hermeneutic analysis, saturation and triangulation was carried out. The methodological rigor criteria were reflexivity, credibility, auditability, and transferability. RESULTS: At the singular level, participants indicated different problems in antenatal care and malaria control programmes, pregnant women were lacking knowledge about MiP, and malaria care was restricted to cases with high obstetric risk. Three additional levels that explain the PSDH of MiP were identified: (i) limitations of malaria control policies, and health-system, geographic, cultural and economic barriers by MiP diagnosis and treatment; (ii) problems of public health programmes and antenatal care; (iii) structural problems such as monetary poverty, scarcity of resources for public health and inefficiency in their use, lacking community commitment to preventive actions, and breach of institutional responsibilities of health promoter entity, municipalities and health services provider institutions. CONCLUSION: Initiatives for MiP control are concentrated at the singular level, PDSH identified in this research show the need to broaden the field of action, increase health resources, and improve public health programmes and antenatal care. It is also necessary to impact the reciprocal relationships of MiP with economic and cultural dimensions, although these aspects are increasingly diminished with the predominance and naturalization of neoliberal logic in health. |
format | Online Article Text |
id | pubmed-10557150 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-105571502023-10-07 Social determination of malaria in pregnancy in Colombia: a critical ethnographic study Cardona-Arias, Jaiberth Antonio Higuita-Gutiérrez, Luis Felipe Carmona-Fonseca, Jaime Malar J Research BACKGROUND: The meanings and experiences related to malaria in pregnancy (MiP) and its processes of social determination of health (PSDH) have not been reported in the world scientific literature. The objective was to understand the meanings and experiences of MiP, and to explain their PSDH in an endemic area from Colombia, 2022. METHODS: Critical ethnography with 46 pregnant women and 31 healthcare workers. In-depth and semi-structured interviews, focus group discussions, participant and non-participant observations, and field diaries were applied. A phenomenological-hermeneutic analysis, saturation and triangulation was carried out. The methodological rigor criteria were reflexivity, credibility, auditability, and transferability. RESULTS: At the singular level, participants indicated different problems in antenatal care and malaria control programmes, pregnant women were lacking knowledge about MiP, and malaria care was restricted to cases with high obstetric risk. Three additional levels that explain the PSDH of MiP were identified: (i) limitations of malaria control policies, and health-system, geographic, cultural and economic barriers by MiP diagnosis and treatment; (ii) problems of public health programmes and antenatal care; (iii) structural problems such as monetary poverty, scarcity of resources for public health and inefficiency in their use, lacking community commitment to preventive actions, and breach of institutional responsibilities of health promoter entity, municipalities and health services provider institutions. CONCLUSION: Initiatives for MiP control are concentrated at the singular level, PDSH identified in this research show the need to broaden the field of action, increase health resources, and improve public health programmes and antenatal care. It is also necessary to impact the reciprocal relationships of MiP with economic and cultural dimensions, although these aspects are increasingly diminished with the predominance and naturalization of neoliberal logic in health. BioMed Central 2023-10-06 /pmc/articles/PMC10557150/ /pubmed/37803372 http://dx.doi.org/10.1186/s12936-023-04734-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Cardona-Arias, Jaiberth Antonio Higuita-Gutiérrez, Luis Felipe Carmona-Fonseca, Jaime Social determination of malaria in pregnancy in Colombia: a critical ethnographic study |
title | Social determination of malaria in pregnancy in Colombia: a critical ethnographic study |
title_full | Social determination of malaria in pregnancy in Colombia: a critical ethnographic study |
title_fullStr | Social determination of malaria in pregnancy in Colombia: a critical ethnographic study |
title_full_unstemmed | Social determination of malaria in pregnancy in Colombia: a critical ethnographic study |
title_short | Social determination of malaria in pregnancy in Colombia: a critical ethnographic study |
title_sort | social determination of malaria in pregnancy in colombia: a critical ethnographic study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10557150/ https://www.ncbi.nlm.nih.gov/pubmed/37803372 http://dx.doi.org/10.1186/s12936-023-04734-9 |
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