Socio-cultural determinants of anticipated acceptance of an oral cholera vaccine in Western Kenya

Determinants of anticipated acceptance of an oral cholera vaccine (OCV) were studied in urban and rural communities of Western Kenya. An explanatory model interview administered to 379 community residents assessed anticipated vaccine acceptance at various prices from no cost to full-cost recovery, socio-cultural features of cholera and social characteristics. Nearly all (99%) residents indicated willingness to accept a no-cost OCV, 95% at a price of US$0·8, 73$ 4·2 and 59% at US$ 8·4. Logistic regression models analysed socio-cultural determinants of anticipated OCV acceptance. Prominence of non-specific symptoms for cholera was negatively associated with acceptance. A cholera-specific symptom (thirst), self-help referring to prayer, income and education were positively associated. In the high-cost model, education was no longer significant and reliance on herbal treatment was a significant determinant of vaccine non-acceptance. Findings suggest high motivation for OCVs, if affordable. Socio-cultural determinants are better predictors of anticipated acceptance than socio-demographic factors alon

Cultural practices during pregnancy and birth among the Giriama community in coastal Kenya: a qualitative study

Pregnancy and childbirth are almost universally associated with culturally based ceremonies and rituals. Although the importance of giving birth in a healthcare facility is recognized among the Giriama community, many mothers continue to give birth in the village with traditional midwives. This ethnographic study explored the cultural context and practices of birthing among the indigenous Giriama of Kenya and how such practices may affect maternal and neonatal outcomes. DESIGN: We utilized qualitative interviews and focus group discussions. Study participants included 40 mothers and 5 traditional birth attendants (TBAs) also known as the traditional midwives. RESULTS: A majority of women who were interviewed shunned hospital delivery because it did not fit their cultural beliefs on what constitutes an acceptable pregnancy journey. The study revealed cultural practices that supported women's health and well-being and cultural practices that were harmful. According to Giriama culture, for a successful delivery, expectant mothers are supposed to avoid viewing dead bodies, to abstain from intercourse, and to observe certain dietary restrictions. Wives are required to continue to give birth until they reach menopause, when their eggs are "finished." Wives are also required to properly dispose of the placenta by burying it to ensure their future fertility. DISCUSSION: Identifying and understanding local customs, beliefs, and practices, particularly those that may be harmful to pregnant women, while leaving in place those that carry no harm, are critical to developing community-based strategies for improving maternal and neonatal health. Moreover, collaboration with the community may lead to changes in lieu of cultural practices in such a way that safety in childbirth is enhanced. There is need for awareness of the potential effects of the lack of decision-making power of women, particularly in relation to needed maternity care

Measures adopted by indigent mothers in Kilifi County to tackle maternal health challenges during the COVID-19 pandemic: a qualitative study

Many sub-Saharan African countries have experienced various challenges that threaten the quality of health services offered to the population. The COVID-19 pandemic disrupted access to healthcare services in many countries as they grappled with implementing measures to curb its spread. The consequences of COVID-19 have been catastrophic for maternal and newborn health. There is a dearth of information on expectant mothers' negotiation mechanisms to access maternal health services during COVID-19 in Kenya. This rapid qualitative study draws data from purposefully selected 15 mothers who were either pregnant or had newborn babies during the COVID-19 pandemic in Kilifi county in Kenya. Data were analyzed thematically and presented in a textual description. Women used the following alternatives to access maternal health: giving birth at the homes of traditional birth attendants (TBAs), substituting breastfeeding with locally available food supplements, relying on limited resources and neighbours for delivery and local savings and rotating credit associations. This study shows that urgent measures are needed to provide high quality maternal and child health services during and after the COVID-19 pandemic. These include but are not limited to developing special interventions for the pregnant women for any emergency and establishing trust between communities and individuals through the TBAs

Socio-cultural determinants of anticipated acceptance of an oral cholera vaccine in western Kenya

SUMMARYDeterminants of anticipated acceptance of an oral cholera vaccine (OCV) were studied in urban and rural communities of Western Kenya. An explanatory model interview administered to 379 community residents assessed anticipated vaccine acceptance at various prices from no cost to full-cost recovery, socio-cultural features of cholera and social characteristics. Nearly all (99%) residents indicated willingness to accept a no-cost OCV, 95% at a price of US$0.8, 73$ 4.2 and 59% at US$ 8.4. Logistic regression models analysed socio-cultural determinants of anticipated OCV acceptance. Prominence of non-specific symptoms for cholera was negatively associated with acceptance. A cholera-specific symptom (thirst), self-help referring to prayer, income and education were positively associated. In the high-cost model, education was no longer significant and reliance on herbal treatment was a significant determinant of vaccine non-acceptance. Findings suggest high motivation for OCVs, if affordable. Socio-cultural determinants are better predictors of anticipated acceptance than socio-demographic factors alon