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.
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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.
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.
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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, S53–S60 (2008). https://doi.org/10.1038/jp.2008.168
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