Abstract
Effective implementation of interventions targeting low birth weight (LBW) and preterm infants, who contribute 60 to 80% of all neonatal deaths, requires an understanding of local people's perceptions of birth weight. This study was conducted to understand how birth weight is perceived in a low-resource setting, including the etiology, signs and care given to infants of various weights. In this qualitative research study, in-depth interviews and focus group discussions were conducted with recently delivered women (RDW) and their families, as well as local health stakeholders in a rural North Indian community. Birth weight per se is not considered a determinant of newborn health. Instead, newborns are classified into types, and care is provided based on these types. Classification is based on observable criteria, including feeding, vigor and alertness, and interviewees did not always consider low weight a criterion for weak type. In communities that do not perceive birth weight to be an important determinant of health, public health programmes and practitioners must reframe messages regarding additional care for LBW infants at home and care seeking outside the home in locally relevant ways.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Lawn JE, Cousens S, Zupan J . 4 million neonatal deaths: when? where? why? Lancet 2005; 365: 891–900.
Rahmathullah L, Tielsch JM, Thulasiraj RD, Katz J, Coles C, Devi S et al. Impact of supplementing newborn infants with vitamin A on early infant mortality: community based randomised trial in southern India. BMJ 2003; 327 (7409): 254–259.
Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L . Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet 2005; 365 (9463): 977–988.
Mullany LC, Darmstadt GL, Coffey P, Khatry SK, LeClerq SC, Tielsch JM . A low cost, colour coded, hand held spring scale accurately categorises birth weight in low resource settings. Arch Dis Child 2006; 91: 410–413.
Darmstadt GL, Kumar V, Shearer J, Misra R, Mohanty S, Baqui AH et al. Validation of accuracy and community acceptance of the BIRTHweigh III scale for categorizing birth weigh in rural India. J Perinatol 2007; 27 (10): 602–608.
Nichter M, Nichter M . Acute respiratory illness: popular health culture and mother's knowledge in the Philippines. Med Anthropol 1994; 15: 353–375.
Perez-Cuevas R, Guiscafre H, Romero G, Rodriguez L, Gutierrez G . Mothers’ health-seeking behaviour in acute diarrhoea in Tlaxcala, Mexico. J Diarrhoeal Dis Res 1996; 14: 260–268.
Zaman K, Zeitlyn S, Chakraborty J, de Francisco A, Yunus M . Acute lower respiratory infections in rural Bangladeshi children: patterns of treatment and identification of barriers. Southeast Asian J Trop Med Public Health 1997; 28: 99–106.
Hill Z, Kendall C, Arthur P, Kirkwood B, Adjei E . Recognizing childhood illness and their traditional explanations: exploring options for care-seeking interventions in the context of the IMCI strategy in rural Ghana. Trop Med Intl Health 2003; 8: 668–676.
Szajnberg N, Ward MJ, Krauss A, Kessler DB . Low birth-weight prematures: preventive intervention and maternal attitude. Child Psychiatry Hum Dev 1987; 17: 152–165.
May KM, Hu J . Caregiving and help seeking by mothers of low birthweight infants and mothers of normal birthweight infants. Public Health Nurs 2000; 17: 273–279.
Lucas PJ, Roberts HM, Baird J, Kleijnen J, Law CM . The importance of size and growth in infancy: integrated findings from systematic reviews of scientific evidence and lay perspectives. Child Care Health Dev 2007; 33 (5): 635–640.
Darmstadt GL, Kumar V, Yadav R, Singh V, Singh P, Mohanty S et al. Introduction of community-based skin-to-skin care in rural Uttar Pradesh, India. J Perinatol 2006; 26: 597–604.
International Institute for Population Sciences (IIPS) and ORC Macro. National Family Health Survey (NFHS-2) 1998–99. IIPS: India, Mumbai, 2000.
Kleinman AM . Patient and Healers in the Context of Culture: An Exploration of the Border-land between Anthropology, Medicine and Psychiatry. University of California Press: Berkeley, 1980.
Strauss C, Quinn N . A Cognitive Theory of Cultural Meaning. Cambridge University Press: Cambridge, 1997.
Blum LS, Pelto GH, Pelto PJ . Coping with a nutrient deficiency: cultural models of Vitamin A deficiency in Northern Niger. Med Anthropol 2004; 23: 195–227.
Pelto PJ, Pelto GH . Studying knowledge, culture and behavior in applied medical anthropology. Med Anthropol Q 1997; 11: 147–163.
Brems S, Berg A . ‘Eating Down’ during Pregnancy: Nutrition, Obstetrics and Culture Considerations the Third World’, Discussion paper prepared for the UN Advisory Group on Nutrition, ACC Subcommittee on Nutrition, Population and Human Resource Division, Washington, DC, 1988.
Nichter M, Nichter M . The ethnophysiology and folk dietetics of pregnancy: a case Study from South India. In Nichter M (ed) Anthropology and International Health: South Asian Case Studies. Klwer Academic: Dordrecht, 1989, pp 30–56.
Hutter I . Reduction of food intake during pregnancy in rural South India. Trop Med Intl Health 1996; 1: 399–405.
Karim R, Bhat D, Troy L, Lamstein S, Levinson FJ . Determinants of food consumption during pregnancy in rural Bangladesh: examination of evaluative data from the Bangladesh Integrated Nutrition Project. Tufts University, 2003.
Acknowledgements
We thank the families and the community of Shivgarh for their participation, as well as our local field team for their dedication and hard work. Support for the study was provided by the Saving Newborn Lives initiative of Save the Children, United States, through a grant from the Bill & Melinda Gates Foundation. Support for the main trial in which this study was nested also came from the United States Agency for International Development (USAID) and the USAID India (New Delhi) Mission, through grants HRN-A-00-96-90006-00, Family Health and Child Survival Cooperative Agreement, and GHS-A-00-03-00019-00, Global Research Activity Cooperative Agreement to Johns Hopkins University.
Author information
Authors and Affiliations
Consortia
Corresponding author
Additional information
Disclosure
Shally Awasthi has recieved grant from the Indian Council for Medical Research and has a grant under negotiation with NIL. The remaining authors have declared no financial interests.
Rights and permissions
About this article
Cite this article
Darmstadt, G., Kumar, V., Yadav, R. et al. Community perceptions of birth weight in rural Uttar Pradesh, India: implications for care of low-birth-weight infants. J Perinatol 28 (Suppl 2), S53–S60 (2008). https://doi.org/10.1038/jp.2008.168
Published:
Issue Date:
DOI: https://doi.org/10.1038/jp.2008.168
This article is cited by
-
Perception and experiences of adolescent mothers and communities in caring for their preterm babies: findings from an in-depth study in rural Bangladesh
BMC Pregnancy and Childbirth (2024)
-
Facilitators, barriers, and key influencers of breastfeeding among low birthweight infants: a qualitative study in India, Malawi, and Tanzania
International Breastfeeding Journal (2023)
-
Birthweight measurement processes and perceived value: qualitative research in one EN-BIRTH study hospital in Tanzania
BMC Pregnancy and Childbirth (2021)
-
Methodology for a mixed-methods multi-country study to assess recognition of and response to maternal and newborn illness
Journal of Health, Population and Nutrition (2017)
-
Recognition and home care of low birth weight neonates: a qualitative study of knowledge, beliefs and practices of mothers in Iganga-Mayuge Health and Demographic Surveillance Site, Uganda
BMC Public Health (2014)