It is vital to understand community perceptions of ill health in pregnancy through a combination of both traditional and biomedical models of health. Death in the first four weeks of life accounts for almost 40 per cent of deaths in children under five years.
The causes of neonatal death in sub-Saharan Africa, in particular the contribution of pre-term birth, are poorly documented. Preliminary findings from Malawi suggest this is likely to be a significant problem occurring in 20-25 per cent of women in rural communities. The observed high incidence of pre-term labour may partly be explained by the frequency of genital tract infections and malaria in these groups.
In 2003-04 the Malaria Knowledge Programme worked with a community in Namitambo, rural Malawi, where pregnant women were found to experience high levels of pre-term delivery. A qualitative study was carried out to investigate the perceptions of women, men and health workers of pre-term labour, its causes and prevention strategies. This helped to identify a number of areas in which community dialogue and health communication could stimulate action to improve the situation.
Tolhurst, R.; van den Broek, N. Community perceptions of pre-term labour in rural Malawi. (2005)