title: 'I don't want all my babies to go to the grave': perceptions of preterm birth in Southern Malawi.
abstract: OBJECTIVE
  to investigate perceptions of preterm birth, infections in pregnancy and perinatal mortality among women, men and health-care providers in Namitambo, Southern Malawi.
  
  
  METHODS
  a qualitative study using focus-group discussions, critical incidence narrative and key informant interviews. The framework approach to qualitative analysis was used.
  
  
  METHODS
  Namitambo, a rural area in southern Malawi.
  
  
  METHODS
  women who have experienced preterm delivery, groups of mothers, fathers and grandmothers, health-care providers, traditional birth attendants and healers.
  
  
  RESULTS
  four key inter-related themes grounded in community interpretative frameworks emerged: (1) community conceptualisations of preterm birth (the different terminologies used); (2) perceived causes of preterm birth (i.e. both 'modern' and 'traditional; illnesses, violence, witchcraft, ideas relating to impurity, heavy work, inadequate food and inappropriate use of medicine); (3) perceived strategies to prevent preterm birth (i.e. using formal health services, treatment for sexually transmitted infections, using condoms and stopping violence); and (4) barriers to realising these strategies, such as lack of food, money and women's autonomy in health seeking.
  
  
  CONCLUSIONS
  similarities and differences exist in understanding between healthcare providers and the community. Additional dialogue and action is needed within the health sector and community to address the problem of preterm births. This includes strategies to enable health-care providers and community members to reflect on their perceptions and practices (e.g. through action research and interactive drama); identify and build on areas of common concern (i.e. poor pregnancy outcome) and enter into partnerships with non-formal providers. Action is also needed beyond the health sector (e.g. in campaigns to reduce gender-based violence).
authors.affiliation: Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Tolhurst
authors.forename: Sally
authors.initials: S
authors.lastname: Theobald
authors.forename: Edith
authors.initials: E
authors.lastname: Kayira
authors.forename: Chikondi
authors.initials: C
authors.lastname: Ntonya
authors.forename: George
authors.initials: G
authors.lastname: Kafulafula
authors.forename: Jim
authors.initials: J
authors.lastname: Nielson
authors.forename: Nynke
authors.initials: N
authors.lastname: van den Broek
mesh_terms: D000328:Adult; D000739:Anecdotes as Topic; D005260:Female; D005313:Fetal Death / Q000517:prevention & control; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007231:Infant, Newborn; D008295:Malawi; D008425:Maternal Behavior / Q000523:psychology*; D008519:Medicine, Traditional; D008880:Midwifery / Q000379:methods*; D009035:Mothers / Q000523:psychology; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D007752:Obstetric Labor, Premature / Q000451:nursing* / Q000517:prevention & control / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000523:psychology*; D011295:Prenatal Care / Q000379:methods; D012307:Risk Factors; D012424:Rural Population; D012649:Self Concept; D012944:Social Support; D012959:Socioeconomic Factors