Informal support to first-parents after childbirth: A qualitative study in low-income suburbs of Dar es Salaam, Tanzania

Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
BMC Pregnancy and Childbirth (Impact Factor: 2.19). 11/2011; 11:98. DOI: 10.1186/1471-2393-11-98
Source: PubMed


In Tanzania, and many sub-Saharan African countries, postpartum health programs have received less attention compared to other maternity care programs and therefore new parents rely on informal support. Knowledge on how informal support is understood by its stakeholders to be able to improve the health in families after childbirth is required. This study aimed to explore discourses on health related informal support to first-time parents after childbirth in low-income suburbs of Dar es Salaam, Tanzania.
Thirteen focus group discussions with first-time parents and female and male informal supporters were analysed by discourse analysis.
The dominant discourse was that after childbirth a first time mother needed and should be provided with support for care of the infant, herself and the household work by the maternal or paternal mother or other close and extended family members. In their absence, neighbours and friends were described as reconstructing informal support. Informal support was provided conditionally, where poor socio-economic status and non-adherence to social norms risked poor support. Support to new fathers was constructed as less prominent, provided mainly by older men and focused on economy and sexual matters. The discourse conveyed stereotypic gender roles with women described as family caretakers and men as final decision-makers and financial providers. The informal supporters regulated the first-time parents' contacts with other sources of support.
Strong and authoritative informal support networks appear to persist. However, poverty and non-adherence to social norms was understood as resulting in less support. Family health in this context would be improved by capitalising on existing informal support networks while discouraging norms promoting harmful practices and attending to the poorest. Upholding stereotypic notions of femininity and masculinity implies great burden of care for the women and delimited male involvement. Men's involvement in reproductive and child health programmes has the potential for improving family health after childbirth. The discourses conveyed contradicting messages that may be a source of worry and confusion for the new parents. Recognition, respect and raising awareness for different social actors' competencies and limitations can potentially create a health-promoting environment among families after childbirth.

Download full-text


Available from: Andrea Barnabas Pembe,
  • Source
    • "Economic resources in turn translated into social resources as the ability to earn an income made them socially valued in an informal economy where extended family is the main form of social security. Mbekenga et al. (2011: 98) examined under what conditions informal support was provided to first time mothers in a low-­‐income suburb in Tanzania and found '[i]nformal support was provided conditionally, where poor socio-­‐economic status and non-­‐ adherence to social norms risked poor support'. This would suggest that an intervention, which would enhance economic status and strengthen identities linked to social norms (as a mother, daughter, valued community member), would impact positively on social support. "

    Early Childhoods in the Global South, Edited by Jacqui O RIordan, Deirdre Horgan, Shirley Martin, 01/2013: chapter Children of Young Mothers Formerly Associated with Armed Forces or Groups in Sierra Leone, Liberia and northern Uganda.: pages 27-45; Peter Lang.
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE: to explore the wide-ranging sources of support that the maternal-infant dyad need or expect throughout the perinatal period in urban India. DESIGN: qualitative interviews and ethnographic approach. SETTING: homes and community settings in greater metropolitan Bangalore, South India. PARTICIPANTS: using in-depth interviews of 36 mothers from different socio-cultural and socio-economic backgrounds who had given birth within the past two years in a tertiary hospital, we explored the nature of support, advice and emotional sustenance through pregnancy, childbirth and the early child rearing period available to these women. FINDINGS: the overwhelming importance of women's own mothers in practical and emotional terms, the connectedness to 'native' place or 'ooru', the role of the diverse, extensive female network and the more contingent role of the husband emerged as major themes. The family was a major source of support as well as distress. While the support from their own mother was a constant, women used various forms of support throughout the perinatal continuum. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: we call for a more nuanced understanding of what women in urban India expect and need in terms of support throughout the perinatal period. Clinicians and policy makers need to understand the various players, their different roles at critical times through the perinatal continuum and be able to identify those who are vulnerable and in need of enhanced support. Although the health sector is not a strong player in the socio-cultural milieu in the perinatal period, their role as facilitators of this support is crucial.
    Midwifery 04/2013; 30(1). DOI:10.1016/j.midw.2013.03.003 · 1.57 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Our study seeks to untangle systemic influences on specific family dynamics understudied in a non-Western context. Specifically, we examine the associations between caregivers’ perceptions of neighborhood cohesion, neighborhood safety, and social support, and one aspect of parenting relevant to the South African community from which data were drawn, caregiver–youth communication about sex. Multivariate regression models demonstrate interactive relationships among our variables of interest (p ≤ .05). For caregiver–youth dyads (N = 99), living in a neighborhood caregivers perceived to be relatively cohesive or safe was associated with differential relationships (i.e., conditional effects; p ≤ .07) between caregiver social support and youth report of communication about sex. Our findings indicate that neighborhood and social-level influences on parenting are not universal. Moreover, cross-cultural adaptations of family-based behavioral interventions to prevent HIV should consider the role of caregiver social support within diverse neighborhood contexts.
    Journal of Community Psychology 08/2014; 42(6). DOI:10.1002/jcop.21644 · 0.99 Impact Factor
Show more