Cultural Influence in Knowledge, Belief, and Practices Related to Pregnancy and Child Birth of Rural Women of Eastern Nepal-Asia

Purpose: Understand the cultural barrier in successful implementation of maternal and child health interventions.

Understand the theory of cultural diversity in health promotion initiatives

 Methods:

 Culture plays a major role in health promotion and disease prevention. The Nepali’s like many other cultural groups emigrated to U.S. According to Leinienger, nurses needs to be prepared to provide culturally competent and culturally congruent care. According to the Transcultural nursing theory, nurses can provide an effective care if they understand the similarities and diversities of each individual (Millender, 2012). The U.S. population is known for its cultural diversity. Nurses who care for this population must be culturally aware to provide culturally competent care (Rew et al., 2014). Therefore, it is vital to conduct research in transcultural nursing and cultural sensitive care.

Guided by the theory of Trans Cultural Nursing, a qualitative, ethnography study was undertaken among the selected rural and tribal population of the Eastern Region of Nepal, Asia. The investigator practiced midwifery and provided home-based midwifery care to the rural and tribal women of the selected area. Through cultural immersion and observation over three year period, issues like women’s health, prenatal care, labor process, and post natal practices were studied. 

Results:

 Though many practices are holistic and promote health, they are few practices that are unhealthy and injurious to both pregnant women and the new born. For example, prenatal care is delayed because of the belief in evil eye. Pregnancy and contraceptive use is determined by the husband or elders of the family. Women only prefer female health care providers. They follow hot and cold concepts in food and hygiene during pregnancy. Fruits are considered to be cold food and avoided during pregnancy. Pregnancy and child birth is considered as normal event therefor, seeking medical care is not considered important. Some tribes considered using contraceptives to prevent pregnancy is against God’s will. Child birth is considered unclean and women are not allowed to deliver inside the house where God’s live. Postnatal women and the newborn are not allowed inside the house. After labor, women are allowed to eat only certain types of diet mixed with meat, vegetables and herbs. Post-natal period is considered unclean and women are restricted to public activities. Sharp items like sickle or knife are placed under women’s bed to keep away evil spirits. In delayed placental separation, bamboo stick is tied at the end of the chord and women is asked to squat in a corner of the room. The belief is that the luck of the bamboo will bring out the placenta. Breast feeding is highly encouraged and women prefer to breast feeed their children at least for three years. 

Conclusion:

Culture plays a vital role in belief and practices of the rural and tribal people of Nepal. According to Leinienger cultural theory, nurses need to understand the culture of their patients for effective care and successful strategies. Culture defines an individual. Lack of sensitivity and ignorance of various culture by nurses creates stress and poor quality of care (Millender, 2012). Through this qualitative ethnographic study, the author asserts that the culture governs the health seeking behavior of the women. Nurses should take time to learn the culture of their patients for successful interventions.