News

    Some Traditional Practices May Affect Maternal Health in Sierra Leone

    A maternal and child health aid examines an expectant mother at a local clinic in Sierra Leone
    A maternal and child health aid examines an expectant mother at a local clinic in Sierra Leone

    Among many cultures in Africa, traditions protect the health of women and children, and the family. Some ethnic groups encourage women to breastfeed their infants for over a year, thus encouraging the safe practice of greater spacing between pregnancies.

    And in Sierra Leone, a Krio saying, “Bad children may not be thrown into the bush” (“Bush noh de foh trwoe bad pikin”) guarantees that children will not be disowned by the family, no matter how difficult they are.

    But other traditions and practices are harmful, say many health care professionals, and contribute to the country’s high rates of maternal and child mortality.

    Lack of power

    Dr. Ibrahim Thorlie, the consultant obstetrician and gynecologist at the Princess Christian Maternity Hospital in Freetown, says some traditions may prevent women from receiving needed medical treatment during a pregnancy.

    Thorlie sits behind a large wooden desk in his office at the hospital, in a white doctor’s coat and a stethoscope around his neck. The echo of crying infants drifts through the half-open door.

    For cultural and economic reasons, some families strive to have as many sons as possible
    For cultural and economic reasons, some families strive to have as many sons as possible

    He says he has found that women often have little control over whether they receive medical or hospital care during pregnancy.

    “Tradition says before you go anywhere, the husband must approve. I think that is [also a question of finances], because the husband in the traditional African home provides the funds. So if you want to go and if you don’t have funds,” he says, “you can’t go.”

    Studies by UNICEF and the World Health Organization confirm those views.

    A survey by the two UN agencies shows that most women in rural areas are prevented from receiving pre-natal care from qualified providers, in part because tradition bars them from interacting with anyone other than their spouse or female members of their family while pregnant.

    Some women, especially those who are circumcised, will refuse to allow themselves to be examined by a male doctor or by a nurse who is not circumcised.

    Little control over family size, health care

    Tradition also impacts the number of children a woman has and the frequency of births.  Women may have little say in these decisions, because they are typically made by male head of families.

    Some ethnic groups favor boys as a way to perpetuate the family name.  Sons are also usually responsible for the care of aging parents and for performing the parent’s burial rites, says the Inter-African Committee on Traditional Practices, an international network of non-governmental organizations working to improve health maternal and child care.

    Many families have large numbers of children in the belief that some will not live to adulthood. UNICEF figures show that half of the nearly nine million children under five who die each year are in sub-Saharan Africa.

    Culture and diet

    Tradition may affect the health of a woman in other ways. They may be among the last to eat nutritious food at the family table. In some ethnic groups, the woman is discouraged from eating meat and eggs during pregnancy, says Brima Abdulai Sheriff, director of Amnesty International in Sierra Leone.

    In some traditions, pregnant women are discouraged from eating healthy foods, like chicken or eggs. In others, men often receive the best, and most nutritious, foods at the family table.
    In some traditions, pregnant women are discouraged from eating healthy foods, like chicken or eggs. In others, men often receive the best, and most nutritious, foods at the family table.

    “If she prepares a chicken,” he says, “all she can eat is wings, feet, the neck and the head. The fleshy and nutritious part is given to the husband. This is a show of love to your husband. In some communities, [it is believed] if you [give a pregnant woman] meat, she will give birth to a child who is a witch.”

    He says pregnant women may harm their unborn child by fasting, which he says can deprive the fetus of needed nutrients.

    Stifling debate

    Traditions may also discourage open debate about maternal care.

    Women are not to complain, says Dr. Peter Sikana, describing the private nature of pregnancy and childbirth. Sikana is a reproductive health and emergency obstetric care technical advisor for the UN Population Fund in Freetown.

    “There are some tribes where a woman is left alone to go through the process of labor, and she’s not supposed to make noise even if she’s in pain; it’s believed to be [a sign of] strength that [tends to work] against quality care for a woman.” Going to a clinic, he says, is a sign of moral failure.

    UNICEF says Sierra Leone leads the world in maternal mortality, with 2,100 deaths for every 100,000 births
    UNICEF says Sierra Leone leads the world in maternal mortality, with 2,100 deaths for every 100,000 births

    Sometimes, traditional beliefs in Sierra Leone blame women for difficult pregnancies.

    One saying equates women to a calabash. When a woman dies during childbirth, the calabash is said to be “broken,” and shame is brought on the community. In some parts of the country, complications during delivery are attributed to infidelity, according to a recent Amnesty International report, Out of Reach: The Cost of Maternal Health in Sierra Leone.

    “Often, time and energy are wasted in trying to obtain a confession instead of ensuring that the woman, who is in agony as the baby fails to emerge, has access to the necessary obstetric care,” says the study.

    Maternal and child health may also be influenced by spiritual values, says Dr. Sikana.

    “There may be religious influences,” he says, “where people believe whatever God gives you is what you have. Whatever happens is attributed to God – you must have a certain [predetermined] number of children, so people don’t go for family planning.” The life or death of the mother and infant may be God’s will, with little attention paid to the support of health care workers.

    Not all cultural practices are harmful to mothers and infants, says Dr. Donald Bash-Taki, a prominent private medical practitioner at one of Sierra Leone’s oldest medical institutions, Connaught Hospital in the busy center of Freetown.

    The answer, he says, is to use medical providers who share the same cultural norms as their patients.

    “There are some ethnic groups [that], because of their own beliefs, do not like women to [go to] public [care centers] to have deliveries,” he says. “But (if) you use [health care workers from] those ethnic groups, it can overcome that problem to see that, yes, all care and delivery occurs within the community. So again, if you work within the community, give more community ownership [of] these programs, and then it will work.”

    Pregnant women waiting to see nurse at Kroo Bay Community Health Centre in Freetown, Sierra Leone
    Pregnant women waiting to see nurse at Kroo Bay Community Health Centre in Freetown, Sierra Leone

    Community leadership

    Powerful traditional figures, such as local chiefs, can play a big role in ensuring that superstitions and cultural practices do not stand in the way of maternal and child health, says Mohammed Mansere, a supervisor of traditional birth attendants.

    “We should use the influence of the paramount chiefs, the section chiefs, to give them a mandate that whenever a woman is pregnant, she should immediately go to the health facility, instead of wasting time.”

    He also says medical information should be translated into local languages for the mother and health care workers.

    Women’s rights activists say one key to reducing the influence of harmful practices lies in enhancing women’s political clout. Many are working with local women’s groups to help elect women to office.

    They say a stronger voice of women in government and within families will help create a new tradition of better health for pregnant women and their babies in Sierra Leone.

    This is part 7 of our 15 part series, A Healthy Start: On the Frontlines Maternal and Infant Care in Africa

    « Prev: Birth Attendants Series Index Next: Emergency Care »

     

    This forum has been closed.
    Comments
         
    There are no comments in this forum. Be first and add one

    Featured Videos

    Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
    German Artists to Memorialize Refugees with Life Jacket Exhibiti
    X
    Hamada Elsaram
    February 05, 2016 4:30 PM
    Sold in every kind of shop in some Turkish port towns, life jackets have become a symbol of the refugee crisis that brought a million people to Europe in 2015.  On the shores of Lesbos, Greece, German artists collect discarded life jackets as they prepare an art installation they plan to display in Germany.  For VOA, Hamada Elrasam has this report from Lesbos, Greece.
    Video

    Video German Artists to Memorialize Refugees with Life Jacket Exhibit

    Sold in every kind of shop in some Turkish port towns, life jackets have become a symbol of the refugee crisis that brought a million people to Europe in 2015.  On the shores of Lesbos, Greece, German artists collect discarded life jackets as they prepare an art installation they plan to display in Germany.  For VOA, Hamada Elrasam has this report from Lesbos, Greece.
    Video

    Video E-readers Help Ease Africa's Book Shortage

    Millions of people in Africa can't read, and there's a chronic shortage of books. A non-profit organization called Worldreader is trying to help change all that one e-reader at a time. VOA’s Deborah Block tells us about a girls' school in Nairobi, Kenya where Worldreader is making a difference.
    Video

    Video Genius Lets World Share Its Knowledge

    Inspired by crowdsourcing companies like Wikipedia, Genius allows anyone to edit anything on the web, using its web annotation tool
    Video

    Video Former Drug CEO Martin Shkreli Angers Lawmakers

    A former U.S. pharmaceutical business executive has angered lawmakers by refusing to explain why he raised the price of a life-saving pill by 5,000 percent. Martin Shkreli was removed from a congressional hearing on Thursday after citing his Fifth Amendment right to stay silent. Zlatica Hoke has more.
    Video

    Video Super Bowl TV Commercials are Super Business for Advertisers

    The Super Bowl, the championship clash between the two top teams in American Football, is the most-watched sporting event of the year, and advertisers are lining up and paying big bucks to get their commercials on the air. In fact, the TV commercials during the Super Bowl have become one of the most anticipated and popular features of the event. VOA's Brian Allen has a sneak peek of what you can expect to see when the big game goes to commercial break, and the real entertainment begins.
    Video

    Video In Philippines, Mixed Feelings About Greater US Military Presence

    In the Philippines, some who will be directly affected by a recent Supreme Court decision clearing the way for more United States troop visits are having mixed reactions.  The increased rotations come at a time when the Philippines is trying to build up its military in the face of growing maritime assertiveness from China.  From Bahile, Palawan on the coast of the South China Sea, Simone Orendain has this story.
    Video

    Video Microcephaly's Connection to Zika: Guilty Until Proven Innocent

    The Zika virus rarely causes problems for the people who get it, but it seems to be having a devastating impact on babies whose mothers are infected with Zika. VOA's Carol Pearson has more.
    Video

    Video Solar Innovation Provides Cheap, Clean Energy to Kenya Residents

    In Kenya, a company called M-Kopa Solar is providing clean energy to more than 300,000 homes across East Africa by allowing customers to "pay-as-you-go" via their cell phones. As Lenny Ruvaga reports from Kangemi, customers pay a small deposit for a solar unit and then pay less than a dollar a day to get clean energy to light up their homes or businesses.
    Video

    Video Stunning Artworks Attract Record Crowds, Thanks to Social Media

    A new exhibit at the oldest art museum in America is shattering attendance records. Thousands of visitors are lining up to see nine giant works of art that have gotten a much-deserved shot of viral marketing. The 150-year-old Smithsonian American Art Museum has never had a response quite like this. VOA's Julie Taboh reports.
    Video

    Video Apprenticeships Put Americans on Path Back to Work

    Trying to get more people into the U.S. workforce, the Obama administration last year announced $175 million in grants towards apprenticeship programs. VOA White House correspondent Aru Pande went inside one training center outside of Washington that has gained national recognition for helping put people on the path to employment.
    Video

    Video New Material May Reduce Concussion Effects

    As the 2016 National Football League season reaches its summit at the Super Bowl this coming Sunday (2/7), scientists are trying to learn how to more effectively protect football players from dangerous and damaging concussions. Researchers at Cardiff and Cambridge Universities say their origami-based material may solve the problem. VOA’s George Putic reports.
    Video

    Video Saudi Arabian Women's Sports Chip Away at Stereotypes

    Saudi Arabian female athletes say that sports are on the front line of busting traditions that quash women’s voices, both locally and internationally. In their hometown of Jeddah, a group of basketball players say that by connecting sports to health issues, they are encouraging women and girls to get out of their homes and participate in public life. VOA’s Heather Murdock reports.
    Video

    Video A Year Later, Fortunes Mixed for Syrians Forging New Lives in Berlin

    In April of last year, VOA followed the progress of six young Syrian refugees -- four brothers and their two friends -- as they made their way from Libya to Italy by boat, and eventually to Germany. Reporter Henry Ridgwell caught up with the refugees again in Berlin, as they struggle to forge new lives amid the turmoil of Europe's refugee crisis.
    Video

    Video Zika Virus May be Hard to Stop

    With the Zika virus spreading rapidly, the World Health Organization Monday declared Zika a global health emergency. As Alberto Pimienta reports, for many governments and experts, the worst is yet to come.