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Exploring women’s cultural experiences during pregnancy and childbirth among the Kalenjin in Kenya : towards a culturally driven safe care framework
Thesis (PhD)--Stellenbosch University, 2023.
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| Format: | Thesis |
| Language: | English |
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Stellenbosch : Stellenbosch University
2023
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| _version_ | 1867613858680537088 |
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| access_status_str | Open Access |
| author | Kemboi-Ngotie, Teckla Jebiwot |
| author2 | Kaura, Doreen Kainyu |
| author_browse | Kaura, Doreen Kainyu Kemboi-Ngotie, Teckla Jebiwot |
| author_facet | Kaura, Doreen Kainyu Kemboi-Ngotie, Teckla Jebiwot |
| author_sort | Kemboi-Ngotie, Teckla Jebiwot |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (PhD)--Stellenbosch University, 2023. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/128412 |
| institution | Stellenbosch University (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:42:49.487Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/128412 Exploring women’s cultural experiences during pregnancy and childbirth among the Kalenjin in Kenya : towards a culturally driven safe care framework Kemboi-Ngotie, Teckla Jebiwot Kaura, Doreen Kainyu Mash, Bob Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing and Midwifery. Pregnancy -- Social aspects -- Kenya Childbirth -- Social aspects -- Kenya Maternal health services -- Kenya Women -- Health and hygiene -- Kenya Medical anthropology -- Kenya Kalenjin -- Rites and ceremonies Kalenjin -- Social life and customs UCTD Thesis (PhD)--Stellenbosch University, 2023. ENGLISH SUMMARY: Globally, maternal deaths remain unacceptably high, with 830 deaths daily. In Sub-Saharan Africa, there are 546, and in Kenya, 362 deaths per 100,000 births. Despite the efforts made by international and national organisations, these trends are still worrying, especially in low- and middle-income countries. The leading causes of these deaths are preventable obstetric complications, and preventing complications is possible when precautionary modalities and early detection are in place for interventions. Apart from the deaths, women experience residual morbidities and dissatisfaction with care. Cultural factors have been associated with severe morbidities, mortalities, and dissatisfaction with care. Culture influences childbearing. During this period, women and families exhibit an increased expression of the cultural values, beliefs and behaviours aimed at protecting them, although some of these practices may be harmful. The existence of these cultural practices has made women prefer cultural interventions through Traditional Birth Attendants (TBAs) or Traditional Healers (TH) over the skilled birth attendant’s (SBAs) service. The preference for TBAs/THs is reinforced by the inadequate supply and/or absence of culturally sensitive skilled birth attendants. This study aimed to explore the complexities around the culturally lived experiences of women during pregnancy and birth, to develop a culturally driven safe care framework. An interpretive phenomenological study was used to explore the women’s experiences with cultural practices during pregnancy and birth. An iterative approach was utilised to engage with the experiences of women and that of Birth Attendants (BAs) with whom they interacted. The role of BAs was to explore the interpretation of the women’s experiences by negotiating between the women and the BAs. Data was collected through individual interviews with eighteen women, eleven SBAs and eight TBAs who were also THs. Data analysis involved an inductive thematic analysis which enabled the emerging themes following Van Manen’s five steps of thematic analysis while situating the process within the hermeneutic cycle tradition. Thematic content analysis was accomplished using the Atlas ti version 8.4.4 (1135) software. Four articles (two published and two submission-ready) were drafted based on the findings: SBAs’ awareness of the cultural practices, TBAs/THs’ responsiveness to cultural practices, BAs’ sensitivity to cultural practices, and women’s experiences with the cultural practices during pregnancy and birth. In conclusion, women experienced culturally safe care based on what they wanted during childbirth. Women wanted effective communication, coordinated care, and companionship. The companionship included engagement between the SBAs, the TBAs/THs, and family members. A framework to provide women-centred collaborative, culturally safe care has been suggested as an outcome of the study. Further, a more extensive research study of cultural safety based on what women want has been recommended based on the framework developed. AFRIKAANSE OPSOMMING: Wereldwyd bly sterftes wat verband hou met moeder gesondheid onaanvaarbaar hoog, met 830 sterftes daagliks. In Afrika suid van die Sahara is daar 546 en spesifiek in Kenia 362 sterftes per 100,000 geboortes. Ten spyte van pogings wat aangewend word deur internasionale en nasionale organisasies, is hierdie neiging kommerwekkend, veral in lae- en middel inkomste lande. Die hoofoorsaak van sulke sterftes hou verband met voorkomende obstetriese komplikasies. Voorkoming van sulke komplikasies is moontlik wanneer waarskuwende modaliteite en vroee opsporing in plek is om in te gryp. Behalwe die sterftes ervaar sulke vrouens ook oorblywende sterftes en probleme met hul versorging. Kulturele faktore hou ook verband met ernstige siektes, sterftes en ontevredenheid met versorging. Kulturele faktore beinvloed die swangerskap waar vrouens en hul familie sulke kulturele waardes, oortuigings en gedrag, wat daarop gerig is om hulle te beskerm, oorweeg, alhoewel party praktyke skadelik kan wees. Die voorkoms van kulturele praktyke veroorsaak dat vrouens kulturele ingrypings verkies wat toegepas word deur tradisionele geboorte assistente en tradisionele genesers. Die voorkeur van tradisionele gesondheid versorgers word versterk deur onvoldoende persone wat ook toegerus is om kulturele praktyke te verstaan. Hierdie studie ondersoek die kompleksiteite van kulturele geleefde ervaring van vrouens tydens swangerskap en tydens die geboorte van die baba om ‘n kultureel gedrewe veiligheids raamwerk te ontwikkel. ‘n Interpretiewe fenomenologiese studie was gebruik om die vrouens se kulturele ervarings tydens swangerskap en geboorte te ondersoek. ‘n Iteratiewe benadering was gebruik om die ervarings van die vrouens en hul interaksie met die persone wat by die geboorte bystand verleen te ondersoek. Die rol van die persone wat bystand verleen is ondersoek om te bepaal hoe hul die vrouens se ervarings interpreteer en om met hulle te onderhandel. Data was versamel deur middel van individuele onderhoude met agtien vrouens, elf persone wat die vroue bystaan en agt tradisionele bystand persone wat ook tradisionele gesondheidswerkers is. Data analise was gedoen met Atlas ti weergawe 9. Vier artikels (twee gepubliseer en twee gereed vir publikasie) was opgestel gebaseer op die bevindings, naamlik persone wat bystand verskaf se bewustheid van kulturele praktyke; hul reaksie en sensitiwiteit tot kulturele praktyke; asook die vrouens se ervaring met kulturele praktyke tydens swangerskap en geboorte. Ten slotte, vroue ervaar kulturele veilige versorging gebaseer op wat hul benodig het tydens die geboorteproses. Vrouens verwag effektiewe kommunikasie, gekoördineerde versorging en meelewing. Die meelewing sluit die betrokkenheid van al die persone betrokke by die geboorteproses, insluitend tradisionele gesondheidswerkers en familie in. ‘n Raamwerk wat voorsiening maak vir vrou-gesentreerde met voorsiening vir samewerking, en kulturele versorging word voorgestel as ‘n uitkoms van hierdie studie. Verdere, meer omvattende navorsing vir kulturele veiligheid gebaseer op wat vrouens nodig het word voorgestel gebaseer op die raamwerk wat ontwikkel is. Doctoral 2023-01-25T13:00:21Z 2023-08-30T13:06:16Z 2023-03-30 2023-01-25T13:00:21Z 2023-08-31T09:18:38Z 2023-01-25T13:00:21Z 2023-08-31T09:18:38Z Thesis https://scholar.sun.ac.za/handle/10019.1/128412 en Stellenbosch University application/pdf xvi, 291 pages : illustrations, maps, includes annexures application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Pregnancy -- Social aspects -- Kenya Childbirth -- Social aspects -- Kenya Maternal health services -- Kenya Women -- Health and hygiene -- Kenya Medical anthropology -- Kenya Kalenjin -- Rites and ceremonies Kalenjin -- Social life and customs UCTD Kemboi-Ngotie, Teckla Jebiwot Exploring women’s cultural experiences during pregnancy and childbirth among the Kalenjin in Kenya : towards a culturally driven safe care framework |
| title | Exploring women’s cultural experiences during pregnancy and childbirth among the Kalenjin in Kenya : towards a culturally driven safe care framework |
| title_full | Exploring women’s cultural experiences during pregnancy and childbirth among the Kalenjin in Kenya : towards a culturally driven safe care framework |
| title_fullStr | Exploring women’s cultural experiences during pregnancy and childbirth among the Kalenjin in Kenya : towards a culturally driven safe care framework |
| title_full_unstemmed | Exploring women’s cultural experiences during pregnancy and childbirth among the Kalenjin in Kenya : towards a culturally driven safe care framework |
| title_short | Exploring women’s cultural experiences during pregnancy and childbirth among the Kalenjin in Kenya : towards a culturally driven safe care framework |
| title_sort | exploring women s cultural experiences during pregnancy and childbirth among the kalenjin in kenya towards a culturally driven safe care framework |
| topic | Pregnancy -- Social aspects -- Kenya Childbirth -- Social aspects -- Kenya Maternal health services -- Kenya Women -- Health and hygiene -- Kenya Medical anthropology -- Kenya Kalenjin -- Rites and ceremonies Kalenjin -- Social life and customs UCTD |
| url | https://scholar.sun.ac.za/handle/10019.1/128412 |
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