Table 2 Illustrative statements of participants on malaria prevention and treatment among pregnant women
A. Attitudes | B. Knowledge | C. Behaviours |
|---|---|---|
i. Malaria in pregnancy as a top concern [Malaria is important] because the fever doesn’t cure quickly and it takes the lives of both mother and fetus. –Pregnant woman, Jharkhand If someone suffers from malaria, it may be difficult to save the life of both mother and fetus. –Pregnant woman, Jharkhand Malaria… [it] can cause the mother’s death and the baby can die. –Pregnant woman, Chhattisgarh The life of mother and baby may be in danger due to the unavailability of proper treatment in case of malaria [and] possibly abortion. Malaria is a fatal disease. –ANM, Jharkhand You can die. If [you] don’t get proper treatment, [malaria] can harm the child. If you don’t treat it, both mom and child can get malaria and both can die. –TBA, Chhattisgarh ii. Concerns about treatment for malaria in pregnancy [Medicines for malaria] may be dangerous. They may lead to stillbirth or the baby may suffer from weakness or jaundice. –Pregnant woman, Jharkhand Malaria medications will harm the baby, it will affect the child’s brain. Their brain will become weak and they will not be able to develop properly. –Pregnant woman, Jharkhand [A pregnant woman] should get advice from doctor. Yes, [malaria treatment] can be dangerous. –Pregnant woman, Chhattisgarh They [pregnant women] are scared to take it [treatment for malaria]. They think miscarriage can happen. –ANM, Chhattisgarh Those who know about it [treatment for malaria] think that it is harmful for fetus. Those who do not know anything about medications think that the fetus may be disabled, their organs will not develop, or there may be an abortion. –ANC-based HCW, Jharkhand iii. Trust in doctors regarding malaria treatment I will take medicine that is advised by the doctor and nurse. If there is a need to buy medicine, I will buy it…. –Pregnant woman, Jharkhand Whatever the doctor will advise, I will take from the hospital, and purchase. –Pregnant woman, Chhattisgarh Pregnant women think malaria meds are harmful, especially Chloroquine, [but] if the doctor recommends it, she will take it, because they think that a doctor is god. –TBA, Jharkhand Yes….certain drugs are viewed more negatively than others…. [Pregnant women] think the baby will abort due to this. Yes, they will agree to take treatment on advice of the doctor because the doctor passes on the right information and they prescribe the right medicine. They [pregnant women] believe in the doctor. –ANC-based HCW, Jharkhand They [pregnant women] think they shouldn’t take it [malaria treatment], but if the doctor’s advice is to take it, then they will listen. –TBA, Chhattisgarh They ask [about] effects, but they think the doctor knows best, so they take it. –ANM, Chhattisgarh iv. Emphasis on malaria at ANC visits No [malaria is not emphasized]. They don’t tell us [about malaria], so I don’t understand. –Pregnant woman, Jharkhand No [malaria is not emphasized]. If they understood more about malaria they would definitely let us know. –Pregnant woman, Jharkhand They [care providers at ANC visits] just look at you and say everything is fine, and that’s it. –Pregnant woman, Chhattisgarh Special importance is not given to malaria. When pregnant women ask about it, then they will talk about it. –ANC-based HCW, Jharkhand Yes, importance is given to malaria because the fetus lives inside the mother’s womb. ANC-based CHW, Jharkhand No, doctors and nurses don’t say anything [about malaria]. –TBA, Chhattisgarh Yes, because it can affect both the baby and child. –ANM, Chhattisgarh | i. Correct understanding about malaria transmission By mosquito bite, you get malaria. –Pregnant woman, Chhattisgarh Malaria is caused by mosquito bite. –Pregnant woman, Jharkhand [A] mosquito bite causes malaria. It causes fever which comes and goes. –Pregnant woman, Jharkhand [Malaria infection is] due to mosquito bite, due to female Anopheles mosquito bite. –ANC-based HCW, Jharkhand [Malaria infection is caused by] a female mosquito (Anopheles) bite. –ANM, Chhattisgarh ii. Misunderstanding about malaria transmission [Malaria is caused] by eating leftover food, eating decayed fruits, eating foods sold on a trolley…. –Pregnant woman, Jharkhand [Malaria is caused] from dirtiness, from standing water in potholes because of dirty environment. –Pregnant woman, Chhattisgarh If a patient has a high fever and is sponged with a wet cloth, and if the same dried cloth is used on a healthy person, the healthy person gets malaria through the heat retained by the previous cloth. –TBA, Jharkhand [Malaria is caused from] drinking dirty water, allowing stagnant water near the house, by mosquito bite, [and] drinking polluted water. –ANM, Jharkhand [Malaria is caused from] using decayed/spoilt stuff, keeping unclean, drinking open water, holes filled with water. –TBA, Chhattisgarh If female Anopheles mosquito gives their larvae in clean water, and this water is used to drink, then they may suffer from malaria. –HCW, Jharkhand iii. Knowledge of methods to prevent malaria infection [To prevent malaria one] can use bednet, mortein coil and government sprays insecticide. –Pregnant woman, Jharkhand [How to prevent malaria?] Use mosquito coil, and bed nets. –Pregnant woman, Chhattisgarh [To prevent malaria], they should protect from mosquito; should use bednets; mortein coil should be burned. –TBA, Jharkhand [To prevent malaria, you need] mosquito net… and coils. –ANM, Chhattisgarh iv. Poor knowledge of malaria prevention Don’t know [how to prevent malaria]. –Pregnant woman, Jharkhand [To prevent malaria], keep clean around the home, should wash hands with soap, take care with food, [and] drink boiled water. –Pregnant woman, Chhattisgarh Using dried or raw chiraita leaves (a medicinal plant) for making tea. It may be used anytime for 5 days in a week as a drink which protects from malaria. –ANM, Jharkhand Make smoke by burning Karanj, Sinduwar leaves, [or] rice paddy dust, which repels the mosquitoes. – TBA, Jharkhand [You can] repel the mosquito by planting tulsi in the enclosed balcony and near window. Fresh air comes inside by planting fragrance flower, and then the mosquito can’t enter. Two drops of neem oil mixed [with] kerosene oil and used as a lamp for lighting. It repels the mosquito. – TBA, Jharkhand Eat carefully, keep things clean, don’t let water stand nearby…. –ANM, Chhattisgarh v. Poor understanding of malaria treatment [Malaria] treatment may be serious. It can affect the fetus and may lead to fetal death. –Pregnant woman, Jharkhand Yes, it is dangerous for the baby … it will affect the baby in the womb…. The baby’s brain will become weak and will not be able to develop properly. –Pregnant woman, Jharkhand The born child may be weak in health, may be disabled or not normal…. It may put a curse on the baby. –Pregnant woman, Chhattisgarh Yes, they’re dangerous [malaria medications], especially chloroquine and Lariago tablets [a chloroquine formulation]. …. –ANC-based HCW, Jharkhand They do not take it [treatment] because it will affect the baby in a bad way. Yes, they [pregnant women] think so. –ANM, Chhattisgarh Yes, it [malaria treatment] can be harmful to the unborn child…. I haven’t seen, so I don’t know about it. –TBA, Chhattisgarh | i. Use of modern methods to prevent malaria [To prevent malaria] I use a bed net for sleep, and a coil before sleeping. –Pregnant woman, Jharkhand [For malaria prevention] I use a bed net…. So, if a mosquito still bites, what can I do? –Pregnant woman, Chhattisgarh Pregnant women use bed nets and coils. They use screens in the windows of the houses for protection from malaria. –ANC-based HCW, Jharkhand [Pregnant women] use bed nets during sleep; if they have no bed nets, they make smoke. –TBA, Jharkhand Educated people use bed nets and uneducated people should be given advice. –ANC-based CHW, Chhattisgarh ii. Poor availability of modern methods to prevent malaria Pregnant women do not use coils in this area because of their economic condition. They have a scarcity of money. –Pregnant woman, Jharkhand [Regarding bed nets]: They are not easily available as I live 8 km away from the city. –Pregnant woman, Jharkhand I have heard about it [coil] and used it for 2 days about 5 months ago. I don’t use it now because I don’t have money. –Pregnant woman, Jharkhand [Regarding bed nets], you can get them easily at the store, [but] it is expensive. –Pregnant woman, Chhattisgarh I think it [insecticide spray] is expensive but…it is not even available here. If it were easily available here I would buy it, but the fact is it is not available here. –Pregnant woman, Chhattisgarh Bed nets? Poor people have a very hard time buying them. –TBA, Jharkhand [Coils for malaria prevention] are a little bit costly. Some people can’t afford them. –ANM, Chhattisgarh iii. Use of traditional preventive approaches Making smoke from paddy dust…..rub neem or karanch oil all over the body before sleeping….. –Pregnant woman, Jharkhand Smoke of neem leaves, cow dung. Drink pure water. Take care of food. –Pregnant woman, Chhattisgarh Boiling Tunj leaf and drinking its water for 3 months will prevent malaria from occurring. –ANM, Jharkhand Bhui Neem leaf is ground with water and is given after filtering in the morning on an empty stomach for 3 days for prevention. For prevention, if they drink this every month for 3 days, then pregnant women will not get malaria. This is given to pregnant women for both prevention and treatment. –TBA, Jharkhand Two drops of neem oil are mixed with kerosene oil and used as a lamp for lighting; it repels the mosquitoes. Kunain herbal medicine is used as a drink in rural areas. They also drink “chiraita.” –HCW, Jharkhand Drink boiled water, use neem smoke… in the village they drink ayurvedic syrup, by putting neem leaves in boiling water and drinking it. –ANM, Chhattisgarh iv. Use of traditional remedies for malaria by pregnant women The Bhagat reads mantras and provides herbal medicine. –Pregnant woman, Jharkhand The Bhagat traditional healer does witch doctoring (Jhad Fouk) to cure malaria in return for rice and money. –Pregnant woman, Jharkhand Yes [there are traditional remedies]. You go to a traditional healer, get magical healing done, put on neem oil, and [use] neem leaves…. –Pregnant woman, Chhattisgarh In this area, some do witch doctoring (Jhad-Fouk), some go to “Baidya”. Although they do not cure [malaria], but they still believe. They think that a pregnant woman is affected by some evil act like “Pang”. –ANM, Jharkhand The yolk of an egg is mixed with oil of “kunjari” and it is given as a drink. Kunjari is a fruit that grows in vine-like plants (climbing plants). Three drops of this is given as a drink … It may be given in the morning or evening on an empty stomach or full or partially full stomach—this cures malaria. –TBA, Jharkhand When pregnant women suffer from malaria then they are taken to the traditional healer. They cure malaria by lighting the earthen lamp, chanting mantras and doing witch doctoring. They also give herbal medicine [whereby] ground “Jhiti” root leaves with water and filtrate is given to the patient on an empty stomach. –TBA, Jharkhand [For malaria, you can] boil milk, mix with phurar stem, and drink it. –TBA, Chhattisgarh Put dhootvar plant’s on [the] head and wrap it. Brush teeth with neem brush. –ANM, Chhattisgarh [For malaria, you can] make drink of tulsi (mint) leaves, ginger, gud (sugar), black pepper. –ANC-based provider, Chhattisgarh v. Traditional remedy used with last fever I was afraid, because my mother-in-law told me that taking medicines during pregnancy may cause fetal loss. I drank turmeric in milk, because my mother-in-law [said it would cure me]. –Pregnant woman, Jharkhand I had garlic and oil warmed and applied. … [I drank] boiled water, ate rice and roti [and then] took herbal medicines [which was my mother’s advice]. –Pregnant woman, Jharkhand [I drank] boiled water, ate rice and roti…. No, I didn’t go [to the hospital]. –Pregnant woman, Chhattisgarh |