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.
    Immigrant Delegate Marvels at Democratic Processi
    X
    Katherine Gypson
    July 27, 2016 6:21 PM
    It’s been a bitter and divisive election season – but first time Indian-American delegate Dr. Shashi Gupta headed to the Democratic National Convention with a sense of hope. VOA’s Katherine Gypson followed this immigrant with the love of U.S. politics all the way to Philadelphia.
    Video

    Video Immigrant Delegate Marvels at Democratic Process

    It’s been a bitter and divisive election season – but first time Indian-American delegate Dr. Shashi Gupta headed to the Democratic National Convention with a sense of hope. VOA’s Katherine Gypson followed this immigrant with the love of U.S. politics all the way to Philadelphia.
    Video

    Video A Life of Fighting Back: Hillary Clinton Shatters Glass Ceiling

    Hillary Clinton made history Thursday, overcoming personal and political setbacks to become the first woman to win the presidential nomination of a major U.S. political party. If she wins in November, she will go from “first lady” to U.S. Senator from New York, to Secretary of State, to “Madam President.” Polls show Clinton is both beloved and despised. White House Correspondent Cindy Saine takes a look at the life of the woman both supporters and detractors agree is a fighter for the ages.
    Video

    Video Dutch Entrepreneurs Turn Rainwater Into Beer

    June has been recorded as one of the wettest months in more than a century in many parts of Europe. To a group of entrepreneurs in Amsterdam the rain came as a blessing, as they used the extra water to brew beer. Serginho Roosblad has more to the story.
    Video

    Video First Time Delegate’s First Day Frustrations

    With thousands of people filling the streets of Philadelphia, Pennsylvania for the 2016 Democratic National Convention, VOA’s Kane Farabaugh narrowed in on one delegate as she made her first trip to a national party convention. It was a day that was anything but routine for this United States military veteran.
    Video

    Video Commerce Thrives on US-Mexico Border

    At the Democratic Convention in Philadelphia this week, the party’s presumptive presidential nominee, Hillary Clinton, is expected to attack proposals made by her opponent, Republican presidential nominee Donald Trump, to build a wall along the U.S.-Mexico border. Last Friday, President Barack Obama hosted his Mexican counterpart, President Enrique Peña Nieto, to underscore the good relations between the two countries. VOA’s Greg Flakus reports from Tucson.
    Video

    Video Film Helps Save Ethiopian Children Thought to be Cursed

    'Omo Child' looks at effort of African man to stop killings of ‘mingi’ children
    Video

    Video London’s Financial Crown at Risk as Rivals Eye Brexit Opportunities

    By most measures, London rivals New York as the only true global financial center. But Britain’s vote to leave the European Union – so-called ‘Brexit’ – means the city could lose its right to sell services tariff-free across the bloc, risking its position as Europe’s financial headquarters. Already some banks have said they may shift operations to the mainland. Henry Ridgwell reports from London.
    Video

    Video Recycling Lifeline for Lebanon’s Last Glassblowers

    In a small Lebanese coastal town, one family is preserving a craft that stretches back millennia. The art of glass blowing was developed by Phoenicians in the region, and the Khalifehs say they are the only ones keeping the skill alive in Lebanon. But despite teaming up with an eco-entrepreneur and receiving an unexpected boost from the country’s recent trash crisis the future remains uncertain. John Owens reports from Sarafand.
    Video

    Video Migrants Continue to Risk Lives Crossing US Border from Mexico

    In his speech Thursday before the Republican National Convention, the party’s presidential candidate, Donald Trump, reiterated his proposal to build a wall along the U.S.-Mexico border if elected. Polls show a large percentage of Americans support better control of the nation's southwestern border, but as VOA’s Greg Flakus reports from the border town of Nogales in the Mexican state of Sonora, the situation faced by people trying to cross the border is already daunting.
    Video

    Video In State of Emergency, Turkey’s Erdogan Focuses on Spiritual Movement

    The state of emergency that Turkish President Recep Tayyip Erdogan has declared is giving him even more power to expand a purge that has seen an estimated 60,000 people either arrested or suspended from their jobs. VOA Europe correspondent Luis Ramirez reports from Istanbul.
    Video

    Video Calm the Waters: US Doubles Down Diplomatic Efforts in ASEAN Meetings

    The United States is redoubling diplomatic efforts and looking to upcoming regional meetings to calm the waters after an international tribunal invalidated the legal basis of Beijing's extensive claims in the South China Sea. VOA State Department correspondent Nike Ching has the story.
    Video

    Video Scientists in Poland Race to Save Honeybees

    Honeybees are in danger worldwide. Causes of what's known as colony collapse disorder range from pesticides and loss of habitat to infections. But scientists in Poland say they are on track to finding a cure for one of the diseases. VOA’s George Putic reports.

    Special Report

    Adrift The Invisible African Diaspora