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Community perceptions of birth weight in rural Uttar Pradesh, India: implications for care of low-birth-weight infants

Journal of Perinatology volume 28, pages S53–S60 (2008)Cite this article

Abstract

Effective implementation of interventions targeting low birth weight (LBW) and preterm infants, who contribute 60 to 80% of all neonatal deaths, requires an understanding of local people's perceptions of birth weight. This study was conducted to understand how birth weight is perceived in a low-resource setting, including the etiology, signs and care given to infants of various weights. In this qualitative research study, in-depth interviews and focus group discussions were conducted with recently delivered women (RDW) and their families, as well as local health stakeholders in a rural North Indian community. Birth weight per se is not considered a determinant of newborn health. Instead, newborns are classified into types, and care is provided based on these types. Classification is based on observable criteria, including feeding, vigor and alertness, and interviewees did not always consider low weight a criterion for weak type. In communities that do not perceive birth weight to be an important determinant of health, public health programmes and practitioners must reframe messages regarding additional care for LBW infants at home and care seeking outside the home in locally relevant ways.

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References

  1. Lawn JE, Cousens S, Zupan J . 4 million neonatal deaths: when? where? why? Lancet 2005; 365: 891–900.

    Article  Google Scholar 

  2. Rahmathullah L, Tielsch JM, Thulasiraj RD, Katz J, Coles C, Devi S et al. Impact of supplementing newborn infants with vitamin A on early infant mortality: community based randomised trial in southern India. BMJ 2003; 327 (7409): 254–259.

    Article  Google Scholar 

  3. Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L . Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet 2005; 365 (9463): 977–988.

    Article  Google Scholar 

  4. Mullany LC, Darmstadt GL, Coffey P, Khatry SK, LeClerq SC, Tielsch JM . A low cost, colour coded, hand held spring scale accurately categorises birth weight in low resource settings. Arch Dis Child 2006; 91: 410–413.

    Article  CAS  Google Scholar 

  5. Darmstadt GL, Kumar V, Shearer J, Misra R, Mohanty S, Baqui AH et al. Validation of accuracy and community acceptance of the BIRTHweigh III scale for categorizing birth weigh in rural India. J Perinatol 2007; 27 (10): 602–608.

    Article  CAS  Google Scholar 

  6. Nichter M, Nichter M . Acute respiratory illness: popular health culture and mother's knowledge in the Philippines. Med Anthropol 1994; 15: 353–375.

    Article  CAS  Google Scholar 

  7. Perez-Cuevas R, Guiscafre H, Romero G, Rodriguez L, Gutierrez G . Mothers’ health-seeking behaviour in acute diarrhoea in Tlaxcala, Mexico. J Diarrhoeal Dis Res 1996; 14: 260–268.

    CAS  PubMed  Google Scholar 

  8. Zaman K, Zeitlyn S, Chakraborty J, de Francisco A, Yunus M . Acute lower respiratory infections in rural Bangladeshi children: patterns of treatment and identification of barriers. Southeast Asian J Trop Med Public Health 1997; 28: 99–106.

    CAS  PubMed  Google Scholar 

  9. Hill Z, Kendall C, Arthur P, Kirkwood B, Adjei E . Recognizing childhood illness and their traditional explanations: exploring options for care-seeking interventions in the context of the IMCI strategy in rural Ghana. Trop Med Intl Health 2003; 8: 668–676.

    Article  Google Scholar 

  10. Szajnberg N, Ward MJ, Krauss A, Kessler DB . Low birth-weight prematures: preventive intervention and maternal attitude. Child Psychiatry Hum Dev 1987; 17: 152–165.

    CAS  PubMed  Google Scholar 

  11. May KM, Hu J . Caregiving and help seeking by mothers of low birthweight infants and mothers of normal birthweight infants. Public Health Nurs 2000; 17: 273–279.

    Article  CAS  Google Scholar 

  12. Lucas PJ, Roberts HM, Baird J, Kleijnen J, Law CM . The importance of size and growth in infancy: integrated findings from systematic reviews of scientific evidence and lay perspectives. Child Care Health Dev 2007; 33 (5): 635–640.

    Article  CAS  Google Scholar 

  13. Darmstadt GL, Kumar V, Yadav R, Singh V, Singh P, Mohanty S et al. Introduction of community-based skin-to-skin care in rural Uttar Pradesh, India. J Perinatol 2006; 26: 597–604.

    Article  CAS  Google Scholar 

  14. International Institute for Population Sciences (IIPS) and ORC Macro. National Family Health Survey (NFHS-2) 1998–99. IIPS: India, Mumbai, 2000.

  15. Kleinman AM . Patient and Healers in the Context of Culture: An Exploration of the Border-land between Anthropology, Medicine and Psychiatry. University of California Press: Berkeley, 1980.

    Google Scholar 

  16. Strauss C, Quinn N . A Cognitive Theory of Cultural Meaning. Cambridge University Press: Cambridge, 1997.

    Google Scholar 

  17. Blum LS, Pelto GH, Pelto PJ . Coping with a nutrient deficiency: cultural models of Vitamin A deficiency in Northern Niger. Med Anthropol 2004; 23: 195–227.

    Article  Google Scholar 

  18. Pelto PJ, Pelto GH . Studying knowledge, culture and behavior in applied medical anthropology. Med Anthropol Q 1997; 11: 147–163.

    Article  CAS  Google Scholar 

  19. Brems S, Berg A . ‘Eating Down’ during Pregnancy: Nutrition, Obstetrics and Culture Considerations the Third World’, Discussion paper prepared for the UN Advisory Group on Nutrition, ACC Subcommittee on Nutrition, Population and Human Resource Division, Washington, DC, 1988.

  20. Nichter M, Nichter M . The ethnophysiology and folk dietetics of pregnancy: a case Study from South India. In Nichter M (ed) Anthropology and International Health: South Asian Case Studies. Klwer Academic: Dordrecht, 1989, pp 30–56.

    Chapter  Google Scholar 

  21. Hutter I . Reduction of food intake during pregnancy in rural South India. Trop Med Intl Health 1996; 1: 399–405.

    Article  CAS  Google Scholar 

  22. Karim R, Bhat D, Troy L, Lamstein S, Levinson FJ . Determinants of food consumption during pregnancy in rural Bangladesh: examination of evaluative data from the Bangladesh Integrated Nutrition Project. Tufts University, 2003.

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Acknowledgements

We thank the families and the community of Shivgarh for their participation, as well as our local field team for their dedication and hard work. Support for the study was provided by the Saving Newborn Lives initiative of Save the Children, United States, through a grant from the Bill & Melinda Gates Foundation. Support for the main trial in which this study was nested also came from the United States Agency for International Development (USAID) and the USAID India (New Delhi) Mission, through grants HRN-A-00-96-90006-00, Family Health and Child Survival Cooperative Agreement, and GHS-A-00-03-00019-00, Global Research Activity Cooperative Agreement to Johns Hopkins University.

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  1. G L Darmstadt, V Kumar, R Yadav, J C Shearer, A H Baqui, S Awasthi, J V Singh, H Mehrotra, K Srivastava, A Gupta, A Sharma, P J Winch and M Santosham: The Saksham Study Group is as follows: RC Ahuja, Shally Awasthi, Abdullah H Baqui, Mahendra Bhandari, Neetu Bharti, Robert E Black, Gary L. Darmstadt, Amit Gupta, Sanjay Gupta, Aarti Kumar, Vishwajeet Kumar, Gk Malik, Hina Mehrotra, Rajendra P Misra, Saroj Mohanty, MK Mitra, Mathuram Santosham, JV Singh, Kamlesh Singh, Pramod Singh, Richa Singh, Smita Singh, Vivek Singh, Peter J Winch, Ranjanaa Yadav.

Authors and Affiliations

  1. Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

    G L Darmstadt, V Kumar, J C Shearer, A H Baqui, P J Winch & M Santosham

  2. Clinical Epidemiology Unit, King George Medical University, Lucknow, India

    V Kumar, R Yadav, H Mehrotra, K Srivastava, A Gupta & A Sharma

  3. Department of Pediatrics, King George Medical University, Lucknow, India

    S Awasthi

  4. Department of Social and Preventive Medicine, King George Medical University, Lucknow, India

    J V Singh

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  1. G L Darmstadt
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  2. V Kumar
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  3. R Yadav
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and the Saksham Study Group

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Correspondence to G L Darmstadt.

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Shally Awasthi has recieved grant from the Indian Council for Medical Research and has a grant under negotiation with NIL. The remaining authors have declared no financial interests.

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Darmstadt, G., Kumar, V., Yadav, R. et al. Community perceptions of birth weight in rural Uttar Pradesh, India: implications for care of low-birth-weight infants. J Perinatol 28 (Suppl 2), S53–S60 (2008). https://doi.org/10.1038/jp.2008.168

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