Perinatal risk and the cultural ecology of health in Bihar, India

Author:

Legare Cristine H.1ORCID,Akhauri Santosh2,Chaudhuri Indrajit2,Hashmi Faiz A.2,Johnson Tracy3,Little Emily E.1,Lunkenheimer Hannah G.1,Mandelbaum Alexandra4,Mandlik Harsh2,Mondal Sudipta2,Mor Nachiket5,Saldanha Neela6,Schooley Janine2,Sharda Priyam4,Subbiah Shalini4,Swarup Siddharta3,Tikkanen Mari4,Burger Oskar1

Affiliation:

1. Department of Psychology, The University of Texas at Austin, Austin, TX, USA

2. Project Concern International, San Diego, CA, USA

3. Bill and Melinda Gates Foundation, Seattle, WA, USA

4. Scope, Helsinki, Finland

5. Banyan Academy of Leadership in Mental Health at Kanchipuram, Tamil Nadu, India

6. Centre for Social and Behaviour Change, Ashoka University, Sonipat, Haryana, India

Abstract

The objective of the current study is to examine the cultural ecology of health associated with mitigating perinatal risk in Bihar, India. We describe the occurrences, objectives and explanations of health-related beliefs and behaviours during pregnancy and postpartum using focus group discussions with younger and older mothers. First, we document perceived physical and supernatural threats and the constellation of traditional and biomedical practises including taboos, superstitions and rituals used to mitigate them. Second, we describe the extent to which these practises are explained as risk-preventing versus health-promoting behaviour. Third, we discuss the extent to which these practises are consistent, inconsistent or unrelated to biomedical health practises and describe the extent to which traditional and biomedical health practises compete, conflict and coexist. Finally, we conclude with a discussion of the relationships between traditional and biomedical practises in the context of the cultural ecology of health and reflect on how a comprehensive understanding of perinatal health practises can improve the efficacy of health interventions and improve outcomes. This article is part of the theme issue ‘Ritual renaissance: new insights into the most human of behaviours’.

Funder

Bill and Melinda Gates Foundation

Publisher

The Royal Society

Subject

General Agricultural and Biological Sciences,General Biochemistry, Genetics and Molecular Biology

Reference45 articles.

1. World Health Organization United Nations Children's Fund United Nations Population Fund World Bank Group United Nations Population Division. 2019 Trends in maternal mortality: 2000 to 2017: estimates by WHO UNICEF UNFPA World Bank Group and the United Nations Population Division. Geneva Switzerland: World Health Organization. See https://www.unfpa.org/featured-Publication/trends-maternal-mortality-2000-2017.

2. World Bank Group. International Development Poverty & Sustainability. See https://data.worldbank.org/indicator/SP.DYN.IMRT.IN.

3. Roser M Ritchie H. 2019 Maternal mortality. World in Data. See https://ourworldindata.org/maternal-mortality.

4. Central Intelligence Agency. 2018 Infant mortality rate by country - Thematic Map - Europe. See https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html.

5. Census of India Website: Office of the Registrar General & Census Commissioner India. See https://censusindia.gov.in/.

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