The social, cultural, and environmental factors that influence maternal health among the Soliga Open Access

Holmes, Kelsey (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/qb98mf66b?locale=en
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Abstract

Vivekananda Girijana Kalyana Kendra is a local non-government organization in Karnataka, India working to empower tribal groups through education and better access to healthcare. They have launched a study to investigate how to better contextualize The Safe Motherhood Program to be more inclusive to tribal women and to decrease maternal mortality. The Soliga tribe lives in Karnataka that has some of the poorest health indicators and highest rates of maternal mortality rates in the country1. A qualitative study of the maternal health practices of the Soliga women was conducted helped answer the question: What are the social, cultural, and environmental factors affecting maternal health in the Soliga community? A key theme that emerged was that maternal health was not solely the women's responsibility, she had a care team; maternal health is a shared responsibility among community members, family of the mother, and hospital workers. Participants also provided a list of their recommendations to improve the healthcare system. Among the recommendations were methods that described how to better improve the accessibility, acceptability, and accommodation of the healthcare system serving the Soliga. This included more home visits and community health education, and improving emergency transportation to the hospital for laboring mothers. Utilizing this information, The Safe Motherhood Program can be further developed to be better tailored towards the Soliga culture and help to reduce maternal mortality and morbidity.


Table of Contents

Table of Contents

Acknowledgments............................................................................................... 6

Introduction....................................................................................................... 8

Literature Review............................................................................................... 12

Introduction...................................................................................................... 12

Maternal Health in India..................................................................................... 14

National Rural Health Mission.............................................................................. 18

Current Maternal Health in Rural India.................................................................. 20

Scheduled Tribes (ST) and Scheduled Casts (SC)................................................... 23

The Soliga........................................................................................................ 24

Conclusion........................................................................................................ 26

Methods........................................................................................................... 28

Context of Study............................................................................................... 28

Study Design.................................................................................................... 28

Study Population............................................................................................... 29

Data Collection Methods..................................................................................... 30

Data Collection Process...................................................................................... 31

Participant Recruitment...................................................................................... 31

Focus Group Discussions.................................................................................... 33

In-depth Interview............................................................................................ 34

Data Analysis................................................................................................... 35

Data Quality and Study Limitations...................................................................... 36

Results............................................................................................................ 37

Care Team....................................................................................................... 38

Advice Giving................................................................................................... 39

Actions to Maintain Health................................................................................. 41

Barriers to Following Advice............................................................................... 46

How Complications were Overcome.................................................................... 48

Maternal Survival..............................................................................................50

Discussion....................................................................................................... 54

Key Messages.................................................................................................. 54

Context of Study in Regards to Other Literature................................................... 55

Limitations...................................................................................................... 60

Strengths........................................................................................................ 63

Recommendations............................................................................................ 63

Future Directions.............................................................................................. 66

Conclusion....................................................................................................... 69

References...................................................................................................... 70

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