Change search
ReferencesLink to record
Permanent link

Direct link
Informal support to first-parents after childbirth: a qualitative study in low-income suburbs of Dar es Salaam, Tanzania
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). (Internationell kvinno- & mödrahälsovård/Essén)
Dept of Obstetrics and Gynaecology, School of Medicine, Muhimbili, University of Health and Allied Sciences, Dar es Salaam, Tanzania. (Internationell kvinno- & mödrahälsovård/Essén)
Karolinska Institute, Stockholm, Sweden. (Department of Women's and Children's health)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). (Internationell kvinno- & mödrahälsovård/Essén)
Show others and affiliations
2011 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, Vol. 11, 98- p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

In Tanzania, and many sub-Saharan African countries, postpartum health programs have received less attention compared to other maternity care programs and therefore new parents rely on informal support. Knowledge on how informal support is understood by its stakeholders to be able to improve the health in families after childbirth is required. This study aimed to explore discourses on health related informal support to first-time parents after childbirth in low-income suburbs of Dar es Salaam, Tanzania.

METHODS:

Thirteen focus group discussions with first-time parents and female and male informal supporters were analysed by discourse analysis.

RESULTS:

The dominant discourse was that after childbirth a first time mother needed and should be provided with support for care of the infant, herself and the household work by the maternal or paternal mother or other close and extended family members. In their absence, neighbours and friends were described as reconstructing informal support. Informal support was provided conditionally, where poor socio-economic status and non-adherence to social norms risked poor support. Support to new fathers was constructed as less prominent, provided mainly by older men and focused on economy and sexual matters. The discourse conveyed stereotypic gender roles with women described as family caretakers and men as final decision-makers and financial providers. The informal supporters regulated the first-time parents' contacts with other sources of support.

CONCLUSIONS:

Strong and authoritative informal support networks appear to persist. However, poverty and non-adherence to social norms was understood as resulting in less support. Family health in this context would be improved by capitalising on existing informal support networks while discouraging norms promoting harmful practices and attending to the poorest. Upholding stereotypic notions of femininity and masculinity implies great burden of care for the women and delimited male involvement. Men's involvement in reproductive and child health programmes has the potential for improving family health after childbirth. The discourses conveyed contradicting messages that may be a source of worry and confusion for the new parents. Recognition, respect and raising awareness for different social actors' competencies and limitations can potentially create a health-promoting environment among families after childbirth.

Place, publisher, year, edition, pages
2011. Vol. 11, 98- p.
Keyword [en]
informal support, first-time parents, postpartum, sexuality, qualitative, Tanzania
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-150871DOI: 10.1186/1471-2393-11-98ISI: 000298852600001OAI: oai:DiVA.org:uu-150871DiVA: diva2:409222
Available from: 2011-04-07 Created: 2011-04-06 Last updated: 2012-02-10Bibliographically approved
In thesis
1. Striving to Promote Family Health after Childbirth: Studies in Low-Income Suburbs of Dar es Salaam, Tanzania
Open this publication in new window or tab >>Striving to Promote Family Health after Childbirth: Studies in Low-Income Suburbs of Dar es Salaam, Tanzania
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Deeper understanding of family health and support after childbirth from the perspective of first-time parents and their informal support network is needed. Postpartum experiences and health concerns of first-time mothers and fathers and, discourses on sexuality and informal support after childbirth were explored in low-income, suburban areas in Ilala, Dar es Salaam, Tanzania. Individual qualitative interviews with first-time mothers (n=10) and fathers (n=10), and 14 focus group discussions with first-time parents (n=40) and informal support persons (n=42) provided the data, which were analyzed through qualitative content and discourse analysis.

First-time parents’ areas of concern were newborn care and hygiene, infant feeding, handling crying infant, maternal nutrition and hygiene, uncertain body changes for the mother and, sexuality. The mothers were burdened with caring responsibilities and fathers felt neglected and excluded from the care of the mother and infant after childbirth, both by the families and the health care system. Sexuality after childbirth created tension between new parents due to the understanding that abstinence would protect child health during the breastfeeding period, which could be several years. Women’s adherence to sexual abstinence was more emphasized compared to men’s. Men’s engagement with other sex partners and the risk of contraction HIV was a threat to family health.

First-time parents drew on support from both informal and formal sources. Informal support networks played a major role in providing information, materials, guidance and supervision while conveying stereotypic gender norms. Contradictions in the messages to parents within and between the support systems created uncertainties that might have negative implications for family health. Poor parents and those who did not adherence to the social norms were less likely to get informal support than others were.

There is a need for information and practical guidance on basic aspects of care for the mother and infant, male involvement, and the importance of social support to first-time parents, as new parents face physical, social and relational challenges after childbirth. The link between the health care system and informal networks need to be strengthened to enable them to complement each other in promoting family health after child health.

Place, publisher, year, edition, pages
Uppsala: Uppsala University, 2011. 54 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 668
Keyword
First-time parents, postpartum, Health promotion, sexuality, informal support, qualitative, suburban Tanzania
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-150924 (URN)978-91-554-8065-3 (ISBN)
Public defence
2011-05-24, Rosénsalen, Akademiska sjukhuset, ing 95/96, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2011-05-03 Created: 2011-04-07 Last updated: 2011-07-01Bibliographically approved

Open Access in DiVA

fulltext(263 kB)90 downloads
File information
File name FULLTEXT01.pdfFile size 263 kBChecksum SHA-512
a71919288495c9969b5f66f3a6a13de386844c61d089adea4a63f57f12deaae231935bd3b22f020708341da94934d9cb707d6c26aec5059473e97d50c37716be
Type fulltextMimetype application/pdf

Other links

Publisher's full text

Search in DiVA

By author/editor
Mbekenga, Columba KDarj, ElisabethOlsson, Pia
By organisation
International Maternal and Child Health (IMCH)
In the same journal
BMC Pregnancy and Childbirth
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 90 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 195 hits
ReferencesLink to record
Permanent link

Direct link