Local understandings of vulnerability and protection during the neonatal period in Sylhet district, Bangladesh

A qualitative study

Peter John Winch, M. Ashraful Alam, Afsana Akther, Dilara Afroz, Nabeel Ashraf Ali, Amy A. Ellis, Abdullah Baqui, Gary L. Darmstadt, Shams El Arifeen, M. Habibur Rahman Seraji

Research output: Contribution to journalArticle

Abstract

Background: Understanding of local knowledge and practices relating to the newborn period, as locally defined, is needed in the development of interventions to reduce neonatal mortality. We describe the organisation of the neonatal period in Sylhet District, Bangladesh, the perceived threats to the well-being of neonates, and the ways in which families seek to protect them. Methods: We did 39 in-depth, unstructured, qualitative interviews with mothers, fathers, and grandmothers of neonates, and traditional birth attendants. Data on neonatal knowledge and practices were also obtained from a household survey of 6050 women who had recently given birth. Findings: Interviewees defined the neonatal period as the first 40 days of life (chollish din). Confinement of the mother and baby is most strongly observed before the noai ceremony on day 7 or 9, and involves restriction of movement outside the home, sleeping where the birth took place rather than in the mother's bedroom, and sleeping on a mat on the floor. Newborns are seen as vulnerable to cold air, cold food or drinks (either directly or indirectly through the mother), and to malevolent spirits or evil eye. Bathing, skin care, confinement, and dietary practices all aim to reduce exposure to cold, but some of these practices might increase the risk of hypothermia. Interpretation: Although fatalism and cultural acceptance of high mortality have been cited as reasons for high levels of neonatal mortality, Sylheti families seek to protect newborns in several ways. These actions reflect a set of assumptions about the newborn period that differ from those of neonatal health specialists, and have implications for the design of interventions for neonatal care.

Original languageEnglish (US)
Pages (from-to)478-485
Number of pages8
JournalThe Lancet
Volume366
Issue number9484
DOIs
StatePublished - Aug 6 2005

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Bangladesh
Newborn Infant
Mothers
Infant Mortality
Parturition
Skin Care
Midwifery
Hypothermia
Fathers
Air
Organizations
Interviews
Food
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Local understandings of vulnerability and protection during the neonatal period in Sylhet district, Bangladesh : A qualitative study. / Winch, Peter John; Alam, M. Ashraful; Akther, Afsana; Afroz, Dilara; Ali, Nabeel Ashraf; Ellis, Amy A.; Baqui, Abdullah; Darmstadt, Gary L.; El Arifeen, Shams; Seraji, M. Habibur Rahman.

In: The Lancet, Vol. 366, No. 9484, 06.08.2005, p. 478-485.

Research output: Contribution to journalArticle

Winch, PJ, Alam, MA, Akther, A, Afroz, D, Ali, NA, Ellis, AA, Baqui, A, Darmstadt, GL, El Arifeen, S & Seraji, MHR 2005, 'Local understandings of vulnerability and protection during the neonatal period in Sylhet district, Bangladesh: A qualitative study', The Lancet, vol. 366, no. 9484, pp. 478-485. https://doi.org/10.1016/S0140-6736(05)66836-5
Winch, Peter John ; Alam, M. Ashraful ; Akther, Afsana ; Afroz, Dilara ; Ali, Nabeel Ashraf ; Ellis, Amy A. ; Baqui, Abdullah ; Darmstadt, Gary L. ; El Arifeen, Shams ; Seraji, M. Habibur Rahman. / Local understandings of vulnerability and protection during the neonatal period in Sylhet district, Bangladesh : A qualitative study. In: The Lancet. 2005 ; Vol. 366, No. 9484. pp. 478-485.
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AU - Akther, Afsana

AU - Afroz, Dilara

AU - Ali, Nabeel Ashraf

AU - Ellis, Amy A.

AU - Baqui, Abdullah

AU - Darmstadt, Gary L.

AU - El Arifeen, Shams

AU - Seraji, M. Habibur Rahman

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