Barriers to Achieving Good Fetal, Infant, and Early Childhood Health in the East Central Region of Uganda Open Access
Greenspan, Julia Leigh (2016)
Abstract
Poor maternal and child health (MCH) can have many causes and both short- and long-term impacts on individuals and entire communities. In the East Central Region of Uganda, the current status of MCH is dire. High morbidity and mortality rates are directly related to poor MCH outcomes. A theory that has studied maternal mortality is the Three Delays Model, which outlines three delays related to the household, transportation, and medical care. Beginning at conception and ending at a child's second birthday, the First 1,000 Days has been shown to be a pivotal time to positively influence the health of fetuses, infants, and young children, and the impacts of this period can have life-long implications. This study aimed to examine if, in the East Central Region of Uganda, the Three Delays Model was applicable to the First 1,000 Days, and to identify the emic understandings of health and illness throughout the First 1,000 Days. With a local non-profit, seventeen in-depth interviews were completed with men and women through a systematic random sampling method. All three delays were found throughout pregnancy, infancy, and early childhood. Similar themes relating to the emic understandings of health and illness were found throughout the First 1,000 Days. Future interventions could use the Social Ecological Model, as it can address the complex barriers that participants identified. Interventions should focus on the first delay first, and can include the information gathered on emic understandings to ensure culturally appropriate language is used.
Table of Contents
Introduction 1
Problem Statement- Global Impacts of Poor MCH 1
Maternal and Child Health in Uganda 3
Theoretical Framework 4
Purpose 5
Literature Review 6
First 1,000 Days 6
Maternal and Child Health in Uganda 7
Three Delays Model 8
Limitations of the Three Delays Model 9
Research Purpose 11
Methods 12
Host Organization 12
Study Setting 13
Research Team 13
Sample and Recruitment Methods 13
Data Collection Methods 15
Analytic Methods 16
Evolution of Methods 17
Ethics/Protection of Participants 18
Results 19
A note on language 19
A note on timeframes 19
RESEARCH QUESTION ONE: How do different barriers to achieving good health impact fetuses, infants, and young children? 21
Delay One 21
Delay Two 28
Delay Three 35
RESEARCH QUESTION TWO: What are the emic understandings of fetal, infant, and early childhood health and illness? 44
Fetal/Maternal 44
Labor and Delivery 47
Infancy/Early Childhood 50
Discussion 54
Findings for each research question 54
How do different barriers to achieving good health impact fetuses, infants, and young children? 54
What are the emic understandings of fetal, infant, and early childhood health and illness? 56
Limitations 56
Future interventions 59
Conclusion 61
Appendix I- Female Interview Guide 62
Appendix II- Male Interview Guide 67
Appendix III: Participant Demographic Information 72
Appendix IV: Code Tree and Code Book 74
Code Tree 74
Code Book 76
Works Cited 81
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