The challenges of prenatal care for Bangladeshi women: a qualitative study.

BACKGROUND: Maternal and infant morbidity and mortality are major issues in developing countries, but the literature reveals there are limited studies on the sociocultural issues affecting adequate prenatal care in Bangladesh. AIM: To explore the sociocultural influences underlying perceived barriers to prenatal care among pregnant women in an urban area of Bangladesh. METHODS: A descriptive qualitative research was conducted with 20 women and 20 of their significant others in three purposively sampled hospitals using individual in-depth interview between November 2016 and March 2017. Content analysis was used for analysis. FINDINGS: Six themes emerged as follows: women's lack of opportunity to make decision; pregnancy as a normal life event; insufficient money for prenatal care; heavy family workload without family support; no permission to go to hospital without a guardian; and inconvenient transportation. DISCUSSION: Good prenatal care is vital for maternal and infant health, but our participants were challenged by a number of key issues as follows: they lacked empowerment to make their own pregnancy decisions, they were impoverished financially, struggled to get to their prenatal appointments by local transport and they lacked family understanding and support for necessary prenatal care. CONCLUSION AND POLICY IMPLICATIONS: Based on the findings, it is recommended that promoting prenatal care adequacy among pregnant women in Bangladesh needs socioculturally sensitive health education programmes which target are not only pregnant women, but also their significant others who are authorized persons in the family. It should be established remote PNC services. Empowerment of women is vital in the country and free antenatal education programmes are needed through a variety of media. Findings provide information for nursing and health policymakers to develop policies to improve adequacy of prenatal care among pregnant women.

Role conflict and rapid socio-economic change: breastfeeding among employed women in Thailand.

Conflicts between women's productive and reproductive roles are intensified by rapid development and social change. Women have a right to offer optimum nutrition to their babies through breastfeeding; they also are entitled to seek gainful employment. For many, furthermore, employment is essential to the economic survival of their families. This article derives from a combined qualitative and quantitative study conducted in Chiang Mai, Thailand. Interviews were carried out with 313 women to investigate the experiences of those who resumed employment within six months after delivery. The findings demonstrate that urban women in the modern workplace face many obstacles in their efforts to maintain lactation while simultaneously undertaking paid work. Current public policies do not address these obstacles effectively, which is of particular concern in today's volatile economic climate.

Breastfeeding practices among employed Thai women in Chiang Mai.

In many developing countries, labor force participation by women in the childbearing years has increased rapidly. Social and economic changes present new challenges for women attempting to combine their roles as workers and mothers. Little is known about how these challenges affect infant feeding choices. This multidisciplinary study investigated work and infant feeding decisions among 313 employed women in Chiang Mai, Thailand. Resumption of employment generally had negative affects on breastfeeding rates and duration. At 6 months postpartum, women who worked inside the home breastfed more than those working in the formal sector at jobs with inflexible hours (home, 80%; public sector, 37%; private sector, 39%). Women who were working outside the home for a long period or had shift jobs encountered many obstacles to maintaining breastfeeding, and most gave it up within 1 month after resuming employment. There is a need for multisectoral policies that address obstacles to breastfeeding among women in the paid labor force in Thailand.

Comparison of costs for reusable and disposable syringes.

The cost for reusable and disposable syringes was studied in Maharaj Nakorn Chiang Mai Hospital, a university hospital in the northern part of Thailand. The cost for operating reusable syringes includes that for cleaning and sterilization. This consists of labour, replacement for defective syringes, tap water, electricity, depreciation of instruments. The cost for disposable items was calculated from the number of syringes used multiplied by the price of the individual size. Results showed that 34,598 syringes were used monthly from August to October 1989. The cost for reusable syringes was 84,714 baht in comparison with 81,874 baht for disposable items. The latter was cheaper by 2,840 baht per month. It is concluded that disposable syringes are cheaper, at least in this university hospital.

Breastfeeding, work and women's health among Thai women in Chiang Mai.

Reconciling the conflicting rights and demands of women's productive and reproductive roles poses an increasing challenge to health policy formulation. This article derives from a combined qualitative and quantitative study conducted in Chiang Mai, Thailand. It discusses situations and difficulties relevant to the health of employed women who breastfed their infants. Three hundred and thirteen employed women were interviewed to explore their experiences as mothers, particularly their attempts to balance the demands of work and breastfeeding. The findings demonstrate the stresses and conflicts in combining breastfeeding with work that can affect both physical and emotional health. Some women developed negative feelings. Exhaustion or fatigue, lack of self care and not eating properly were the common physical problems reported by women in this study.