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Health service utilization for perceived postpartum morbidity among poor women living in Karachi

Author

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  • Fikree, Fariyal F.
  • Ali, Tazeen
  • Durocher, Jill M.
  • Rahbar, Mohammad H.

Abstract

To explore traditional beliefs and practices, to assess puerperal morbidity, and to understand care-seeking behaviors, a qualitative and quantitative study was conducted in low socio-economic settlements of Karachi, Pakistan. Five focus group discussions and 15 in-depth interviews were conducted in July and August 2000. 525 Muslim women, who were 6-8 weeks post-partum, were then interviewed at home. Maternal care was relatively good--more than three-quarters of recent mothers sought antenatal care and more than half (267/525) delivered in a hospital or maternity home. Counseling to attend post-partum clinics among facility deliveries was 16% (43/267), of which only 26% (11/43) attended. Practices during the delivery and puerperium, such as massaging the vaginal walls with mustard oil during labor to facilitate delivery and inserting vaginal or rectal herbal pessaries to facilitate 'shrinkage of the uterus' and/or 'strengthening of the backbone', were pervasive. The core symptoms that are clinically significant during the puerperium are heavy vaginal bleeding and high fever, since they are potentially fatal symptoms if appropriate and timely care is not sought. About half of the study women (53.3%) reported at least one illness symptom, high fever (21.1%), heavy vaginal bleeding (13.9%), and foul smelling vaginal discharge (9.6%). Women did not know the underlying biologic cause of their perceived post-partum morbidity; weakness was frequently mentioned. Women sought care initially from close relatives or traditional healers and if they continued to suffer from their morbidity they finally approached a trained health care (allopathic) provider. The high prevalence of perceived post-partum morbidity illustrates the demand for post-partum community-based health care programs. We suggest promoting maternal health education that encourages women to seek appropriate and timely care by accessing public or private health services.

Suggested Citation

  • Fikree, Fariyal F. & Ali, Tazeen & Durocher, Jill M. & Rahbar, Mohammad H., 2004. "Health service utilization for perceived postpartum morbidity among poor women living in Karachi," Social Science & Medicine, Elsevier, vol. 59(4), pages 681-694, August.
  • Handle: RePEc:eee:socmed:v:59:y:2004:i:4:p:681-694
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    Cited by:

    1. de Kok, Bregje Christina & Widdicombe, Sue, 2008. "'I really tried': Management of normative issues in accounts of responses to infertility," Social Science & Medicine, Elsevier, vol. 67(7), pages 1083-1093, October.
    2. Rizwana Amin & Prof. Dr. Shahida Sajjad, 2017. "The Need of Educating Adolescent Females of Karachi, Pakistan regarding Reproductive Health," Proceedings of International Academic Conferences 5007120, International Institute of Social and Economic Sciences.
    3. Dodd, Warren & King, Nia & Humphries, Sally & Little, Matthew & Dewey, Cate, 2016. "Self-reported morbidity and health service utilization in rural Tamil Nadu, India," Social Science & Medicine, Elsevier, vol. 161(C), pages 118-125.
    4. Fatema, Kaniz, 2020. "Mass Media Exposure and Maternal Healthcare Utilization in South Asia," SocArXiv 5dhyr, Center for Open Science.
    5. Varley, Emma, 2010. "Targeted doctors, missing patients: Obstetric health services and sectarian conflict in Northern Pakistan," Social Science & Medicine, Elsevier, vol. 70(1), pages 61-70, January.

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