Religio-Cultural Concepts and Bangladeshi Women's Decisions to Seek Biomedical Care During Childbirth 公开

Haqqani, Nazish (2011)

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Religio-Cultural Concepts and Bangladeshi Women's Decisions to Seek Biomedical Care During Childbirth

Bangladesh's rates of maternal mortality of 320 per 100,000 and neonatal mortality 360 per 100,000 are among the highest in South Asia and in the world. The about 90% of Bangladeshi women give birth at home, where they may be assisted by relatives, neighbors, traditional birth attendants, or no one. Yet, home-based childbirth often results in high rates of complications, since the emergency services required for complications are typically available only at health facilities. In order to improve the rates of clinically based deliveries in order to yield better maternal and child health outcomes, it is necessary to identify the factors that prevent women from obtaining biomedical care during childbirth complications, especially in a timely manner. I apply the Delay Model on data obtained through the Lynn Sibley's project "Improving Recognition of and Initial Response to Prolonged Labor and Birth Asphyxia in Bangladesh" to argue that beliefs and practices related to three religio-cultural concepts can cause serious delays in Bangladeshi women's decisions in seeking timely care at biomedical facilities during reproductive complications. The specific concepts I analyze are purity/pollution, spiritual causation of illness, and sharam/pardah. I apply these ideas to offer suggestions on how the biomedical system can work within the religious and cultural worldviews of Bangladeshi women to increase their utilization of biomedical health services, especially during reproductive emergencies.

Table of Contents


Section 0.1: The Case of Bangladesh...2
Section 0.2: Community Sources in Improving Maternal and Child Health...4
Section 0.3: Research on Women's Beliefs & Response to Prolonged Labor and Birth Asphyxia in Bangladesh...7
Section 0.4: Analyses and Products of the PL/BA Research Data...10
Section 0.5: Framing Women's Reluctance to Seek Biomedical Care: The Delay Model...12
Section 0.6: Critique of the Use of "Culture" in Population Health...15
Section 0.7: A Discussion on Religio-Cultural Concepts & Their Influence on Women's Care Seeking Behavior During Childbirth...18
Section 0.8: My Application of the Delay Model to the PL/BA Data...21

Chapter I: The Concept of Purity and Pollution...25

Section 1.1: Defining and Applying the Concept of Purity and Pollution in South Asia...25
Section 1.2: The Islamic Concept of Purity/Pollution...28
Section 1.3: The Hindu Concept of Purity/Pollution...29
Section 1.4: Beliefs about Purity and Pollution in Bangladesh...30
Section 1.5: Implications for Health: Cases from the PL/BA Study...31

Chapter II: Belief in the Spiritual Causality of Illness...35

Section 2.1: Evil Spirits and Forces and Islam and Hinduism...35
Section 2.2: Religion in Practice: Bangladesh...37
Section 2.3: The Link Between Impurity and Malevolent Spirits and Forces...39
Section 2.4: Bangladeshi Rituals for the Repelling of Malevolent Evil Forces...39
Section 2.5: Implications for Health: Cases from the PL/BA Study...42

Chapter III: The Concept of Sharam and Pardah...45

Section 3.1: Constructing Sharam...45
Section 3.2: The Practice of Sharam and Pardah During Reproductive Events in Bangladesh...47
Section 3.3: Implications for Health: Cases from the PL/BA Study...49

Conclusion: Suggestions for the Biomedical System for Working with Religio-Cultural Concepts...54

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