Continuing with “…a heavy heart” - consequences of maternal death in rural Kenya
Identifieur interne : 003091 ( Ncbi/Checkpoint ); précédent : 003090; suivant : 003092Continuing with “…a heavy heart” - consequences of maternal death in rural Kenya
Auteurs : Rohini Prabha Pande [États-Unis] ; Sheila Ogwang [Kenya] ; Robinson Karuga [Kenya] ; Radha Rajan [États-Unis] ; Aslihan Kes [États-Unis] ; Frank O. Odhiambo [Kenya] ; Kayla Laserson [États-Unis] ; Kathleen Schaffer [États-Unis]Source :
- Reproductive Health [ 1742-4755 ] ; 2015.
Abstract
This study analyzes the consequences of maternal death to households in Western Kenya, specifically, neonatal and infant survival, childcare and schooling, disruption of daily household activities, the emotional burden on household members, and coping mechanisms.
The study is a combination of qualitative analysis with matched and unmatched quantitative analysis using surveillance and survey data. Between September 2011 and March 2013 all households in the study area with a maternal death were surveyed. Data were collected on the demographic characteristics of the deceased woman; household socio-economic status; a history of the pregnancy that led to the death; schooling experiences of surviving school-age children; and disruption to household functioning due to the maternal death. These data were supplemented by in-depth and focus group discussions. Quantitative data on neonatal and infant survival from a demographic surveillance system in the study area were also used. Descriptive and bivariate analyses were conducted with the quantitative data, and qualitative data were analyzed through text analysis using NVivo.
More than three-quarters of deceased women performed most household tasks when healthy. After the maternal death, the responsibility for these tasks fell primarily on the deceased’s husbands, mothers, and mothers-in-law. Two-thirds of the individuals from households that suffered a maternal death had to shift into another household. Most children had to move away, mostly to their grandmother’s home. About 37% of live births to women who died of maternal causes survived till age 1 year, compared to 65% of live births to a matched sample of women who died of non-maternal causes and 93% of live births to surviving women. Older, surviving children missed school or did not have enough time for schoolwork, because of increased housework or because the loss of household income due to the maternal death meant school fees could not be paid. Respondents expressed grief, frustration, anger and a sense of loss. Generous family and community support during the funeral and mourning periods was followed by little support thereafter.
The detrimental consequences of a maternal death ripple out from the woman’s spouse and children to the entire household, and across generations.
Url:
DOI: 10.1186/1742-4755-12-S1-S2
PubMed: 26000827
PubMed Central: 4423749
Affiliations:
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Wolfe Street, Baltimore, MD 21231, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21231</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Kes, Aslihan" sort="Kes, Aslihan" uniqKey="Kes A" first="Aslihan" last="Kes">Aslihan Kes</name><affiliation wicri:level="1"><nlm:aff id="I5">International Center for Research on Women (ICRW), 1120 20th St NW, Suite 500 North, Washington, D.C. 20036, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>International Center for Research on Women (ICRW), 1120 20th St NW, Suite 500 North, Washington, D.C. 20036</wicri:regionArea><wicri:noRegion>D.C. 20036</wicri:noRegion></affiliation></author><author><name sortKey="Odhiambo, Frank O" sort="Odhiambo, Frank O" uniqKey="Odhiambo F" first="Frank O" last="Odhiambo">Frank O. Odhiambo</name><affiliation wicri:level="1"><nlm:aff id="I2">Kenya Medical Research Institute (KEMRI), Kisumu, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Kenya Medical Research Institute (KEMRI), Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Laserson, Kayla" sort="Laserson, Kayla" uniqKey="Laserson K" first="Kayla" last="Laserson">Kayla Laserson</name><affiliation wicri:level="2"><nlm:aff id="I6">Global Disease Detection Program, Centers for Disease Control (CDC), 1600 Clifton Rd., Atlanta, GA 30329-4027, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Global Disease Detection Program, Centers for Disease Control (CDC), 1600 Clifton Rd., Atlanta, GA 30329-4027</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Schaffer, Kathleen" sort="Schaffer, Kathleen" uniqKey="Schaffer K" first="Kathleen" last="Schaffer">Kathleen Schaffer</name><affiliation wicri:level="2"><nlm:aff id="I7">Family Care International, 588 Broadway #503, New York, NY 10012, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Family Care International, 588 Broadway #503, New York, NY 10012</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author></analytic><series><title level="j">Reproductive Health</title><idno type="eISSN">1742-4755</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>This study analyzes the consequences of maternal death to households in Western Kenya, specifically, neonatal and infant survival, childcare and schooling, disruption of daily household activities, the emotional burden on household members, and coping mechanisms.</p></sec><sec><title>Methods</title><p>The study is a combination of qualitative analysis with matched and unmatched quantitative analysis using surveillance and survey data. Between September 2011 and March 2013 all households in the study area with a maternal death were surveyed. Data were collected on the demographic characteristics of the deceased woman; household socio-economic status; a history of the pregnancy that led to the death; schooling experiences of surviving school-age children; and disruption to household functioning due to the maternal death. These data were supplemented by in-depth and focus group discussions. Quantitative data on neonatal and infant survival from a demographic surveillance system in the study area were also used. Descriptive and bivariate analyses were conducted with the quantitative data, and qualitative data were analyzed through text analysis using NVivo.</p></sec><sec><title>Results</title><p>More than three-quarters of deceased women performed most household tasks when healthy. After the maternal death, the responsibility for these tasks fell primarily on the deceased’s husbands, mothers, and mothers-in-law. Two-thirds of the individuals from households that suffered a maternal death had to shift into another household. Most children had to move away, mostly to their grandmother’s home. About 37% of live births to women who died of maternal causes survived till age 1 year, compared to 65% of live births to a matched sample of women who died of non-maternal causes and 93% of live births to surviving women. Older, surviving children missed school or did not have enough time for schoolwork, because of increased housework or because the loss of household income due to the maternal death meant school fees could not be paid. Respondents expressed grief, frustration, anger and a sense of loss. Generous family and community support during the funeral and mourning periods was followed by little support thereafter.</p></sec><sec><title>Conclusion</title><p>The detrimental consequences of a maternal death ripple out from the woman’s spouse and children to the entire household, and across generations.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Ainsworth, M" uniqKey="Ainsworth M">M Ainsworth</name></author><author><name sortKey="Semali, I" uniqKey="Semali I">I Semali</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mutangadura, Gb" uniqKey="Mutangadura G">GB Mutangadura</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nyamukapa, C" uniqKey="Nyamukapa C">C Nyamukapa</name></author><author><name sortKey="Gregson, S" uniqKey="Gregson S">S Gregson</name></author></analytic></biblStruct><biblStruct><analytic><author><name 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Bryant</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ayuku, D" uniqKey="Ayuku D">D Ayuku</name></author><author><name sortKey="Embleton, L" uniqKey="Embleton L">L Embleton</name></author><author><name sortKey="Koech, J" uniqKey="Koech J">J Koech</name></author><author><name sortKey="Atwoli, L" uniqKey="Atwoli L">L Atwoli</name></author><author><name sortKey="Hu, L" uniqKey="Hu L">L Hu</name></author><author><name sortKey="Ayaya, S" uniqKey="Ayaya S">S Ayaya</name></author><author><name sortKey="Hogan, J" uniqKey="Hogan J">J Hogan</name></author><author><name sortKey="Nyandiko, W" uniqKey="Nyandiko W">W Nyandiko</name></author><author><name sortKey="Vreeman, R" uniqKey="Vreeman R">R Vreeman</name></author><author><name sortKey="Kamanda, A" uniqKey="Kamanda A">A Kamanda</name></author><author><name sortKey="Braitstein, P" uniqKey="Braitstein P">P Braitstein</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Embleton, L" uniqKey="Embleton L">L Embleton</name></author><author><name sortKey="Ayuku, D" uniqKey="Ayuku D">D Ayuku</name></author><author><name sortKey="Kamanda, A" uniqKey="Kamanda A">A Kamanda</name></author><author><name sortKey="Atwoli, L" uniqKey="Atwoli L">L Atwoli</name></author><author><name sortKey="Ayaya, S" uniqKey="Ayaya S">S Ayaya</name></author><author><name sortKey="Vreeman, R" uniqKey="Vreeman R">R Vreeman</name></author><author><name sortKey="Nyandiko, W" uniqKey="Nyandiko W">W Nyandiko</name></author><author><name sortKey="Gisore, P" uniqKey="Gisore P">P Gisore</name></author><author><name sortKey="Koech, J" uniqKey="Koech J">J Koech</name></author><author><name sortKey="Braitstein, P" uniqKey="Braitstein P">P Braitstein</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Asfaw, S" uniqKey="Asfaw S">S Asfaw</name></author><author><name sortKey="Davis, B" uniqKey="Davis B">B Davis</name></author><author><name sortKey="Dewbre, J" uniqKey="Dewbre J">J Dewbre</name></author><author><name sortKey="Handa, S" uniqKey="Handa S">S Handa</name></author><author><name sortKey="Winters, P" uniqKey="Winters P">P Winters</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Kenya</li><li>États-Unis</li></country><region><li>Géorgie (États-Unis)</li><li>Maryland</li><li>État de New York</li></region></list><tree><country name="États-Unis"><noRegion><name sortKey="Pande, Rohini Prabha" sort="Pande, Rohini Prabha" uniqKey="Pande R" first="Rohini Prabha" last="Pande">Rohini Prabha Pande</name></noRegion><name sortKey="Kes, Aslihan" sort="Kes, Aslihan" uniqKey="Kes A" first="Aslihan" last="Kes">Aslihan Kes</name><name sortKey="Laserson, Kayla" sort="Laserson, Kayla" uniqKey="Laserson K" first="Kayla" last="Laserson">Kayla Laserson</name><name sortKey="Rajan, Radha" sort="Rajan, Radha" uniqKey="Rajan R" first="Radha" last="Rajan">Radha Rajan</name><name sortKey="Schaffer, Kathleen" sort="Schaffer, Kathleen" uniqKey="Schaffer K" first="Kathleen" last="Schaffer">Kathleen Schaffer</name></country><country name="Kenya"><noRegion><name sortKey="Ogwang, Sheila" sort="Ogwang, Sheila" uniqKey="Ogwang S" first="Sheila" last="Ogwang">Sheila Ogwang</name></noRegion><name sortKey="Karuga, Robinson" sort="Karuga, Robinson" uniqKey="Karuga R" first="Robinson" last="Karuga">Robinson Karuga</name><name sortKey="Odhiambo, Frank O" sort="Odhiambo, Frank O" uniqKey="Odhiambo F" first="Frank O" last="Odhiambo">Frank O. Odhiambo</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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