Le SIDA en Afrique subsaharienne (serveur d'exploration)

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Continuing with “…a heavy heart” - consequences of maternal death in rural Kenya

Identifieur interne : 001459 ( Pmc/Curation ); précédent : 001458; suivant : 001460

Continuing 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 :

RBID : PMC:4423749

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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

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PMC:4423749

Le document en format XML

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<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>
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<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>
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<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>
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<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>
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<pmc article-type="research-article" xml:lang="en">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Reprod Health</journal-id>
<journal-id journal-id-type="iso-abbrev">Reprod Health</journal-id>
<journal-title-group>
<journal-title>Reproductive Health</journal-title>
</journal-title-group>
<issn pub-type="epub">1742-4755</issn>
<publisher>
<publisher-name>BioMed Central</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">26000827</article-id>
<article-id pub-id-type="pmc">4423749</article-id>
<article-id pub-id-type="publisher-id">1742-4755-12-S1-S2</article-id>
<article-id pub-id-type="doi">10.1186/1742-4755-12-S1-S2</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Research</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Continuing with “
<italic>…a heavy heart</italic>
” - consequences of maternal death in rural Kenya</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes" id="A1">
<name>
<surname>Pande</surname>
<given-names>Rohini Prabha</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
</contrib>
<contrib contrib-type="author" id="A2">
<name>
<surname>Ogwang</surname>
<given-names>Sheila</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
</contrib>
<contrib contrib-type="author" id="A3">
<name>
<surname>Karuga</surname>
<given-names>Robinson</given-names>
</name>
<xref ref-type="aff" rid="I3">3</xref>
</contrib>
<contrib contrib-type="author" id="A4">
<name>
<surname>Rajan</surname>
<given-names>Radha</given-names>
</name>
<xref ref-type="aff" rid="I4">4</xref>
</contrib>
<contrib contrib-type="author" id="A5">
<name>
<surname>Kes</surname>
<given-names>Aslihan</given-names>
</name>
<xref ref-type="aff" rid="I5">5</xref>
</contrib>
<contrib contrib-type="author" id="A6">
<name>
<surname>Odhiambo</surname>
<given-names>Frank O</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
</contrib>
<contrib contrib-type="author" id="A7">
<name>
<surname>Laserson</surname>
<given-names>Kayla</given-names>
</name>
<xref ref-type="aff" rid="I6">6</xref>
</contrib>
<contrib contrib-type="author" id="A8">
<name>
<surname>Schaffer</surname>
<given-names>Kathleen</given-names>
</name>
<xref ref-type="aff" rid="I7">7</xref>
</contrib>
</contrib-group>
<aff id="I1">
<label>1</label>
Independent Consultant, 7118 Willow Avenue, Takoma Park MD 20912, USA</aff>
<aff id="I2">
<label>2</label>
Kenya Medical Research Institute (KEMRI), Kisumu, Kenya</aff>
<aff id="I3">
<label>3</label>
LVCT Health, Tivoli Centre, P.O Box: 3294-40100, Kisumu, Kenya</aff>
<aff id="I4">
<label>4</label>
Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21231, USA</aff>
<aff id="I5">
<label>5</label>
International Center for Research on Women (ICRW), 1120 20th St NW, Suite 500 North, Washington, D.C. 20036, USA</aff>
<aff id="I6">
<label>6</label>
Global Disease Detection Program, Centers for Disease Control (CDC), 1600 Clifton Rd., Atlanta, GA 30329-4027, USA</aff>
<aff id="I7">
<label>7</label>
Family Care International, 588 Broadway #503, New York, NY 10012, USA</aff>
<pub-date pub-type="collection">
<year>2015</year>
</pub-date>
<pub-date pub-type="epub">
<day>6</day>
<month>5</month>
<year>2015</year>
</pub-date>
<volume>12</volume>
<issue>Suppl 1</issue>
<supplement>
<named-content content-type="supplement-title">True costs of maternal death</named-content>
<named-content content-type="supplement-editor">Jose Belizan and Suellen Miller</named-content>
<named-content content-type="supplement-sponsor">Publication charges for this supplement were funded by Family Care International and the FXB Center for Health and Human Rights. The articles have been through the journal's standard peer review process for supplements. The Supplement Editors declare that they have no competing interests.</named-content>
</supplement>
<fpage>S2</fpage>
<lpage>S2</lpage>
<permissions>
<copyright-statement>Copyright © 2015 Pande et al; licensee BioMed Central Ltd.</copyright-statement>
<copyright-year>2015</copyright-year>
<copyright-holder>Pande et al; licensee BioMed Central Ltd.</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0">
<license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<self-uri xlink:href="http://www.reproductive-health-journal.com/content/12/S1/S2"></self-uri>
<abstract>
<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>
</abstract>
<kwd-group>
<kwd>maternal death</kwd>
<kwd>Kenya</kwd>
<kwd>infant survival</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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