This Ethiopian study identified that it is not permitted to mourn a perinatal death as it is considered to be against God’s will.
In Ethiopia, supernatural forces are believed to cause perinatal death and dead babies are often buried in the house or in the backyard without any notification of birth or death. Likewise, studies from Ethiopia, Tanzania, Uganda and Ghana found similar perceptions among women and their families about neonatal and infant death. For example, Hmong women living in Australia believe that disharmony in personal health as well as in the supernatural world causes miscarriage, stillbirth and neonatal death. Perinatal deaths are linked to social, cultural and religious beliefs and values. Values and cultures are of course different in different societies. Traditions, social values and culture shape pregnancy and childbirth experiences and have a strong impact on women’s choice and control over both maternal and child health. The literature suggests that biological events such as pregnancy and childbirth are also socio-culturally constructed and therefore we need to understand tradition, society and culture and to examine the socio-cultural contexts of pregnancy and childbirth. There is little evidence examining the social determinants of poor perinatal health, particularly in the country’s most disadvantaged areas. Studies undertaken in Nepal are also focussed on medical causes of perinatal deaths and on epidemiological investigations of socio-demographic and health service utilisation variables and their distribution across the country.
However, strategies developed to tackle poor perinatal health are predominantly medically-oriented and emphasise the treatment of newborn infections and promotion of health facility births. Nepal’s national policies on maternal and child health acknowledge equity, rights-based approaches, family/community based care, woman-friendly, 24 hour birthing services, social inclusion in maternal and newborn care, and counting every perinatal death. These figures are equivalent to the highest mortality rates in Sub-Saharan countries. The mountain region has a neonatal mortality rate of 46 per 1,000 live births, with 85% of all neonatal deaths occurring within the first week after birth, while the perinatal mortality rate is likely to be higher due to the underestimation of stillbirths. Within Nepal, significant disparities exist in the distribution of perinatal mortality rates. National statistics from Nepal show that, despite significant progress over time, the rates of neonatal and perinatal deaths are still high at 33 per 1,000 live births and 37 per 1,000 live births respectively. These differences are principally attributed to the weak health systems and poor coverage of maternal and neonatal care provision in Africa and South Asia. Moreover, at current rates of reduction of the stillbirth rate, about 160 years and 100 years will pass before the average pregnant woman from Africa and South Asia respectively experience the same stillbirth rates as a woman in a developed country. With only a 2.7% annual rate of reduction in neonatal mortality rate (NMR) between 2000–2012, it is estimated that it will take 110 years for an African and about 80 years for a South Asian woman to experience a similar chance of saving their newborn baby as is currently experienced by the average woman in developed countries. Furthermore these regions have experienced slow progress in reducing perinatal mortality rates in the past two decades. Among developing countries, Sub-Saharan Africa and South Asian countries record over three-quarters of the world’s stillbirths and neonatal deaths. Worldwide, over 14,500 perinatal deaths occur each day almost 99% of them in developing countries. Perinatal deaths include both stillbirth and neonatal death. Poor perinatal health is a global public health problem and reflects issues of inequality and injustice. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper and its Supporting Information files.įunding: The principal author, MP, received financial support (research students' maintenance and postgraduate scholarship) from Flinders University to carry out the fieldwork for this study.Ĭompeting interests: The authors have declared that no competing interests exist. Received: NovemAccepted: FebruPublished: March 15, 2018Ĭopyright: © 2018 Paudel et al. PLoS ONE 13(3):Įditor: Ganesh Dangal, National Academy of Medical Sciences, NEPAL Citation: Paudel M, Javanparast S, Dasvarma G, Newman L (2018) Religio-cultural factors contributing to perinatal mortality and morbidity in mountain villages of Nepal: Implications for future healthcare provision.