Traditional and Modern Maternal and Child Health Care Practices and Effects among Rajbanshi Community in Nepal

Abstract

This is a descriptive and cross-sectional study on the Rajbanshi of Nepal in 2010. The common theories in Ethnographic/Indigenous Psychological perspective, Social Construction theories and Public Health perspectives have navigated the study. This study poses both qualitative and quantitative methods: interviews, observations and examinations. Household samples were randomly taken and clusters taken by purposive sampling method. Altogether 1514 people accounted in samples. Tools were semi-structured questionnaires, checklists, EPDS, weighing machine and measuring tape. Rajbanshi community is one of the marginalized indigenous people resided in the southeastern part of Nepal. They have unique tradition and culture. They have owned traditional health care practices. Guru Gosai and Gosai are traditional healers. In the Rajbanshi tradition, the causes of diseases and illnesses are deities, witchcraft, evil spirits, the touch of pithiya/chhatka and dirty environment or poor sanitation. They diagnose disease by looking at jokhana. After the findings, they treat patients by chanting of mantra or jharphuk, jadibuti, buti, ferani or bhakal. They are mainly taking modern care services from different levels private clinics/nursing home/hospitals and public health post/hospitals simultaneously. In the study 93.87% samples adopted modern and traditional dual practices concurrently. 74.14% samples visited local medical clinics, and 14.41% visited hospitals for the treatment at first. Total 28% samples adopted solely modern care where nobody adopted solely traditional practices. However, 11.50% samples took traditional care at first for the mother and the child care. 16% pregnant took first care from traditional healers. The study also identified the trend of traditional and modern care practices. Hospital delivery increased from 30.67% to 69.33% between first and last deliveries where home delivery decreased to 29.23% from 69.33%. In spite of good access to modern care services the maternal and child mortality rates estimated high in those who are very poor, illiterate, remote and traditional practicing families in the community. Likewise, children with underweight were in an alarming situation (72.53%) in those who are very poor, labor, illiterate, rural and traditional practicing. Postpartum depression in mothers associated with their stress and sleeplessness were statistically significant. The PPD in mothers also tested with husband's smoking habit and find statistically highly significant (p=<.0001). Women of three groups are vulnerable: 1. Pithiya is a woman whose baby is died or still birth. 2. Chhatka is a mother who is suffering from abortion. 3. Tantra/mantra practicing women. These women are considered as causes of diseases. In such sociocultural circumstances, they become victims of social stigma. Traditional practices involve local barbers to cut the umbilical cord during delivery. They shave newborn‟s head with the traditional knives after few days of the delivery. They are unsafe and can cause infection including neonatal tetanus. They need training on using sterile blades. Awareness of reproductive rights in mothers needs to rise. They need integrated mental health program. More nutritional programs required for the children.