Impact of ritual pollution on lactation and breastfeeding practices in rural West Bengal, India

<p>Abstract</p> <p>Background</p> <p>Breastfeeding in India is universal and prolonged. Several cultural practices are associated with lactation and breastfeeding in India, mainly revolving around the concept of ritual purity and 'hot and cold' foods, food avoidance, restricted diet after childbirth, and remaining in seclusion for a certain time period because of the polluting effects of childbirth. This study on breastfeeding practices explored how the concept of ritual pollution influenced practices after delivery, including during lactation and breastfeeding.</p> <p>Methods</p> <p>The study was conducted in four villages of West Bengal State in India, representing different levels of socioeconomic development, religion, and caste/tribe from September 1993 to April 1994. One hundred households with one woman respondent from each household were selected from each village. Both qualitative and quantitative methods were employed for data collection. A survey questionnaire was administered to 402 respondents and in-depth interviews were conducted with 30 women in the reproductive age group (13–49 years), and 12 case studies were documented with women belonging to different caste, religious, and tribal groups.</p> <p>Results</p> <p>Belief in 'impurity and polluting effects of childbirth' necessitated seclusion and confinement of mothers after childbirth in the study villages. Breastfeeding was universal and prolonged, and food proscriptions were followed by mothers after childbirth to protect the health of their newborn. Initiation of breastfeeding was delayed after birth because of the belief that mother's milk is 'not ready' until two-to-three days postpartum. Generally, colostrum was discarded before putting the infant to the breast in the study villages. Breastfeeding lasted up to five years, and the majority of women in the sample introduced supplementary food before six months. Most infants in the study villages were given a prelacteal feed immediately after birth, only a small number of women (35) exclusively breastfed – after giving a prelacteal feed – until six months in the study villages.</p> <p>Conclusion</p> <p>Cultural and traditional practices have considerable implications on lactation and breastfeeding, and in the overall well-being and health of mothers and infants. Breastfeeding programs should take into account traditional beliefs and concepts when communicating with families about practices such as food restriction and food avoidance.</p

Tackling complexities in understanding the social determinants of health: the contribution of ethnographic research

Abstract Objective The complexities inherent in understanding the social determinants of health are often not well-served by quantitative approaches. My aim is to show that well-designed and well-conducted ethnographic studies have an important contribution to make in this regard. Ethnographic research designs are a difficult but rigorous approach to research questions that require us to understand the complexity of people’s social and cultural lives. Approach I draw on an ethnographic study to describe the complexities of studying maternal health in a rural area in India. I then show how the lessons learnt in that setting and context can be applied to studies done in very different settings. Results I show how ethnographic research depends for rigour on a theoretical framework for sample selection; why immersion in the community under study, and rapport building with research participants, is important to ensure rich and meaningful data; and how flexible approaches to data collection lead to the gradual emergence of an analysis based on intense cross-referencing with community views and thus a conclusion that explains the similarities and differences observed. Conclusion When using ethnographic research design it can be difficult to specify in advance the exact details of the study design. Researchers can encounter issues in the field that require them to change what they planned on doing. In rigorous ethnographic studies, the researcher in the field is the research instrument and needs to be well trained in the method. Implication Ethnographic research is challenging, but nevertheless provides a rewarding way of researching complex health problems that require an understanding of the social and cultural determinants of health.</p

Nano preparation of Dy3+ substituted ceria via urea-formaldehyde gel combustion route

Nanocrystalline ceria powders have been synthesised via the gel combustion route, using for the first time urea formaldehyde as fuel for doping of dysprosium oxide. This synthesis route can produce well-crystallised powder within a one step combustion process, eliminating the need for further calcinations. The formation sequences have been described through differential scanning calorimetry-thermo gravimetric analysis study and the crystallinity of the powder was examined using X-ray diffraction, selected area electron diffraction and high resolution patterns. Lattice parameter was found to increase with doping concentration. Very fine grains in the size range of 3-5 nm are found to occur in the form of large and soft agglomerates (50-130 nm). The optical band gap suggests that those powders with low dopant concentration may have useful applications in UV-shielding and in transparent conducting film

Synthesis of nano-crystalline multifibrous zirconia needle

Zirconia needles have been successfully synthesized using a simple inorganic sol-gel process without using any template. The method employs mixture of zirconium oxychloride octahydrate and sulphuric acid in aqueous medium. This process requires heat treatment at 40 degrees C for 2 h in an oven for nucleus formation. Complete formation of needle occurs after 17 days. The green needle retained its original shape after calcination at 1200 degrees C. Fired needles were of 1-2 cm in length and 5-50 mu m in diameter and possess monoclinic phase. Needles are composed of multiple fibres. Depending on the heat treatment temperature, crystallite size varies in the range of 8 to around 300 nm. (C) 2013 Published by Elsevier Ltd

An evaluation of dietary intakes of a selected group of South Asian migrant women with gestational diabetes mellitus

Background: Women of South Asian descent have an increased risk of developing gestational diabetes mellitus (GDM), and type 2 diabetes mellitus compared to Caucasian women. Dietary advice provided by health practitioners to this group has been found to be culturally inappropriate. The aim of this study was to describe the dietary intakes of South Asian women with gestational diabetes and use this information to develop culturally appropriate dietary models for education and support of dietary management. Method: An in-depth diet and lifestyle survey was administered with 13 eligible women. Dietary histories were collected for pre-pregnancy, during pregnancy and post-GDM diagnosis to evaluate changes in dietary intake, diet and health beliefs and traditional foods consumed during pregnancy. Results: The diets of participants did not meet nutrient requirements for pregnancy; specific areas on concern were dietary fibre, calcium, iron, folate and iodine. Vegetarians were particularly at risk with regards to energy and protein intake. Generally dietary intakes of these women with GDM were not consistent with guidelines for management of GDM. Confusion about what they should eat for GDM, health practitioner advice and conflict with cultural expectations about foods to consume during pregnancy was evident. Conclusion: The dietary information collected from these women was used to model sample menus for GDM that were culturally appropriate and consistent with vegetarian and non-vegetarian eating patterns

Public and/or private health care: Tuberculosis patients' perspectives in Myanmar

<p>Abstract</p> <p>Background</p> <p>Tuberculosis is a major public health problem in Myanmar as in other developing countries. About 73% of TB patients seek care at private general practitioners' clinics before presenting to the public TB centre, raising questions about how best to prevent transmission and maintain treatment regimens.</p> <p>Method</p> <p>The study was conducted in two townships in Yangon Division in Myanmar in 2004, and examined treatment seeking behaviour of TB patients and their views towards public and private health care services. This was an <it>exploratory descriptive </it>study. Both quantitative and qualitative research methods were employed in data collection from TB patients, health care professionals, and members of various agencies involved in TB Control Programme.</p> <p>Results</p> <p>A considerable delay was found between the onset of symptoms of TB and seeking treatment (five days – two months). General practitioners were the first point of contact in all cases. Old TB patients influenced the treatment seeking behaviour and choice of treatment clinics of new TB patients. Most patients viewed the public health sector as a place to obtain free treatment and the private sector as a fee-paying, convenient and better place to seek treatment.</p> <p>Conclusion</p> <p>The involvement of private general practitioners is crucial for effective TB control in Myanmar. The selection of GPs for partnership with the public sector is vital to the success of public-private partnership in controlling TB.</p