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Sudarsan A, V V. Unraveling the Determinants of Maternal Well-Being Among Tribal Populations of Kerala: A Systematic Review. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02032-x. [PMID: 38809468 DOI: 10.1007/s40615-024-02032-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 05/16/2024] [Accepted: 05/16/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Despite Kerala's noteworthy achievements in health indices, the tribal population in the state continues to face significant challenges in achieving optimal health outcomes. This is particularly evident in the realm of maternal health, where tribal communities struggle. In light of this paradox, a systematic review was conducted to identify the factors influencing the quality of tribal maternal health and their determinants. METHOD A comprehensive search strategy was employed, utilizing computer-backed searches of eminent bibliographic databases, along with the exploration of additional cited references and hand-searching of relevant journals. The methodological quality of the selected studies was rigorously assessed through a transparent cataloguing system and analysis by reviewers, resulting in the inclusion of thirty studies following the filtering process. The selected studies were subjected to detailed analysis to identify the determinants of maternal health among tribal populations. RESULTS Thematic analysis of thirty studies that met the inclusion criteria resulted in four sets of determinants that contribute to maternal health among tribal women; biological/demographic determinants, psychological determinants, social determinants, and cultural determinants. CONCLUSIONS This review provides a comprehensive picture of tribal maternal health in Kerala, shedding light on their multifaceted challenges. The study provides a basis for the formulation of initiatives by addressing the broader determinants of health and accounting unique socio-cultural factors influencing well-being of tribal communities.
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Affiliation(s)
- Amala Sudarsan
- Department of Applied Psychology, School of Behavioural Sciences, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, 610101, India
| | - Vithya V
- Department of Applied Psychology, School of Behavioural Sciences, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, 610101, India.
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Housseine N, Browne J, Maaløe N, Dmello BS, Ali S, Abeid M, Meguid T, Rijken MJ, Kidanto H. Fetal movement trials: Where is the evidence in settings with a high burden of stillbirths? BJOG 2023; 130:241-243. [PMID: 35686582 PMCID: PMC10084142 DOI: 10.1111/1471-0528.17249] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/16/2022] [Accepted: 05/25/2022] [Indexed: 01/12/2023]
Affiliation(s)
- Natasha Housseine
- Medical College East Africa, Aga Khan University, Dar es Salaam, Tanzania.,Julius Centre for Health Sciences and Primary Care, Julius Global Health, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Joyce Browne
- Julius Centre for Health Sciences and Primary Care, Julius Global Health, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Nanna Maaløe
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Brenda Sequeira Dmello
- Medical College East Africa, Aga Khan University, Dar es Salaam, Tanzania.,Comprehensive Community Based Rehabilitation in Tanzania, Dar es salaam, Tanzania
| | - Sam Ali
- Julius Centre for Health Sciences and Primary Care, Julius Global Health, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.,Research Department, Ernest Cook Ultrasound Research and Education Institute (ECUREI), Kampala, Uganda
| | - Muzdalifat Abeid
- Medical College East Africa, Aga Khan University, Dar es Salaam, Tanzania
| | - Tarek Meguid
- Child Health Unit, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Marcus J Rijken
- Julius Centre for Health Sciences and Primary Care, Julius Global Health, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.,Vrouw en Baby Department, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.,Obstetric Department, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Hussein Kidanto
- Medical College East Africa, Aga Khan University, Dar es Salaam, Tanzania
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Weller K, Housseine N, Khamis RS, Meguid T, Hofmeyr GJ, Browne JL, Rijken MJ. Maternal perception of fetal movements: Views, knowledge and practices of women and health providers in a low-resource setting. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000887. [PMID: 36989235 DOI: 10.1371/journal.pgph.0000887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 02/21/2023] [Indexed: 03/30/2023]
Abstract
The study assessed perception, knowledge, and practices regarding maternal perception of fetal movements (FMs) among women and their healthcare providers in a low-resource setting. Semi-structured interviews, questionnaires and focus group discussions were conducted with 45 Zanzibar women (18 antenatal, 28 postpartum) and 28 health providers at the maternity unit of Mnazi Mmoja Hospital, Zanzibar, Tanzania. Descriptive and thematic analyses were conducted to systematically extract subthemes within four main themes 1) knowledge/awareness, 2) behavior/practice, 3) barriers, and 4) ways to improve practice. Within the main themes it was found that 1) Women were instinctively aware of (ab)normal FM-patterns and healthcare providers had adequate knowledge about FMs. 2) Women often did not know how to monitor FMs or when to report concerns. There was inadequate assessment and management of (ab)normal FMs. 3) Barriers included the fact that women did not feel free to express concerns. Healthcare providers considered FM-awareness among women as low and unreliable. There was lack of staff, time and space for FM-education, and no protocol for FM-management. 4) Women and health providers recognised the need for education on assessment and management of (ab)normal FMs. In conclusion, women demonstrated adequate understanding of FMs and perceived abnormalities of these movements better than assumed by health providers. There is a need for more evidence on the effect of improving knowledge and awareness of FMs to construct evidence-based guidelines for low resource settings.
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Affiliation(s)
- Katinka Weller
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Natasha Housseine
- Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
- Division of Woman and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
| | - Rashid S Khamis
- School of Health and Medical Sciences, The State University of Zanzibar, Zanzibar, Tanzania
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tarek Meguid
- Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
- Child Health Unit, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Department of Maternal & Child Health, Medical School, University of Namibia, Windhoek, Namibia
| | - G Justus Hofmeyr
- Effective Care Research Unit, Eastern Cape Department of Health, University of the Witwatersrand/Walter Sisulu University, East London, South Africa
- Obstetrics and Gynecology Department, University of Botswana, Gaborone, Botswana
| | - Joyce L Browne
- Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marcus J Rijken
- Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
- Division of Woman and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
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