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Religio-cultural factors contributing to perinatal mortality and morbidity in mountain villages of Nepal: implications for future healthcare provision

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dc.contributor.authorPaudel, M.
dc.contributor.authorJavanparast, S.
dc.contributor.authorDasvarma, G.
dc.contributor.authorNewman, L.
dc.contributor.editorDangal, G.
dc.date.issued2018
dc.descriptionData source: Supporting information, http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0194328#sec028
dc.description.abstractObjective and the context This paper examines the beliefs and experiences of women and their families in remote mountain villages of Nepal about perinatal sickness and death and considers the implications of these beliefs for future healthcare provision. Methods Two mountain villages were chosen for this qualitative study to provide diversity of context within a highly disadvantaged region. Individual in-depth interviews were conducted with 42 women of childbearing age and their family members, 15 health service providers, and 5 stakeholders. The data were analysed using a thematic analysis technique with a comprehensive coding process. Findings Three key themes emerged from the study: (1) ‘Everyone has gone through it’: perinatal death as a natural occurrence; (2) Dewata (God) as a factor in health and sickness: a cause and means to overcome sickness in mother and baby; and (3) Karma (Past deeds), Bhagya (Fate) or Lekhanta (Destiny): ways of rationalising perinatal deaths. Conclusion Religio-cultural interpretations underlie a fatalistic view among villagers in Nepal’s mountain communities about any possibility of preventing perinatal deaths. This perpetuates a silence around the issue, and results in severe under-reporting of ongoing high perinatal death rates and almost no reporting of stillbirths. The study identified a strong belief in religio-cultural determinants of perinatal death, which demonstrates that medical interventions alone are not sufficient to prevent these deaths and that broader social determinants which are highly significant in local life must be considered in policy making and programming.
dc.identifier.citationPLoS ONE, 2018; 13(3, article no. e0194328):1-22
dc.identifier.doi10.1371/journal.pone.0194328
dc.identifier.issn1932-6203
dc.identifier.issn1932-6203
dc.identifier.orcidDasvarma, G. [0000-0002-1784-7967]
dc.identifier.urihttps://hdl.handle.net/11541.2/131439
dc.language.isoen
dc.publisherPublic Library of Science
dc.relation.fundingFlinders University
dc.rightsCopyright 2018 Paudel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. (https://creativecommons.org/licenses/by/4.0/)
dc.source.urihttps://doi.org/10.1371/journal.pone.0194328
dc.subjectNepal
dc.subjectpregnancy
dc.subjectperinatal mortality
dc.subjectHumans
dc.subjectMorbidity
dc.subjectHealth Knowledge, Attitudes, Practice
dc.subjectMothers
dc.subjectQualitative Research
dc.subjectCulture
dc.subjectReligion
dc.subjectAdolescent
dc.subjectAdult
dc.subjectInfant, Newborn
dc.subjectRural Health
dc.subjectRural Health Services
dc.subjectPolicy Making
dc.subjectFemale
dc.subjectHealth Status Disparities
dc.subjectYoung Adult
dc.subjectPerinatal Death
dc.titleReligio-cultural factors contributing to perinatal mortality and morbidity in mountain villages of Nepal: implications for future healthcare provision
dc.typeJournal article
pubs.publication-statusPublished
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