Qualitative research on knowledge, attitudes, and practices related to women's reproductive health, Cochabamba, Bolivia.
This MotherCare working paper is concerned with summarizing the results of an in-depth study of 230 women's reproductive health knowledge, beliefs, and practices in urban and periurban areas of Cochabamba, Bolivia, in 1991. Also included are the recommendations for future MotherCare interventions which were discussed in a subsequent conference. The study objectives were to describe the population's perceptions of and behavior toward the formal health care systems and provide useful information for future intervention strategies to improve maternal and neonatal health. The analysis was conducted individually, by reproductive stage, and as a whole in order to provide an explanation for the way in which the Quechua-Aymara or ethnic groups understand the physiology of the human body and reproduction and to compare it with the biomedical model of the formal health system. The report includes sections on: study methodology, ethnophysiological model, and findings by stage of the reproductive cycle (pregnancy childbirth, birth of the placenta, the immediate postpartum period, newborn care, breast feeding, family planning, abortion, traditional birth attendants (TBAs) and other findings, and recommendations for project interventions. Appendices include a chart of the beliefs and practices of the Quechua-Aymara women during various stage of the reproductive cycle with emphasis on time and space, and strategy materials and the questionnaire. The sample population included users and nonusers of health services and TBAs. The findings were that the Quechua-Aymara woman is healthy when her important body parts are located and moving correctly according to warm or cold elements, and when she is well nourished and strong with an abundance of blood. A measure of health is whether she delivers her children without problems. In a home birth the infant receives little attention following the delivery; anise tea is given and breast feeding is delayed several days. Husbands assisted during childbirth. TBAs sometimes helped. Practices such as the use of oxytocin were not always beneficial. Family planning is accepted along with induced abortion. Barriers to use of services among nonusers were the perceived mistreatment of women, care that interfered with their modesty and ethnophysiology, lack of information given at clinic visits, and costs of services in time and money. 7 problems among the population practices or conditions in the health sector were targeted for intervention.