title: Perceptions and experiences of community members on caring for preterm newborns in rural Mangochi, Malawi: a qualitative study.
abstract: BACKGROUND
  The number of preterm birth is increasing worldwide, especially in low income countries. Malawi has the highest incidence of preterm birth in the world, currently estimated at 18.1 percent. The aim of this study was to explore the perceived causes of preterm birth, care practices for preterm newborn babies and challenges associated with preterm birth among community members in Mangochi District, southern Malawi.
  
  
  METHODS
  We conducted 14 focus group discussions with the following groups of participants: mothers (n = 4), fathers (n = 6) and grandmothers (n = 4) for 110 participants. We conducted 20 IDIs with mothers to preterm newborns (n = 10), TBAs (n = 6) and traditional healers (n = 4). A discussion guide was used to facilitate the focus group and in-depth interview sessions. Data collection took place between October 2012 and January 2013. We used content analysis to analyze data.
  
  
  RESULTS
  Participants mentioned a number of perceptions of preterm birth and these included young and old maternal age, heredity, sexual impurity and maternal illness during pregnancy. Provision of warmth was the most commonly reported component of care for preterm newborns. Participants reported several challenges to caring for preterm newborns such as lack of knowledge on how to provide care, poverty, and the high time burden of care leading to neglect of household, farming and business duties. Women had the main responsibility for caring for preterm newborns.
  
  
  CONCLUSIONS
  In this community, the reported poor care practices for preterm newborns were associated with poverty and lack of knowledge of how to properly care for these babies at home. Action is needed to address the current care practices for preterm babies among the community members.
authors.affiliation: Department of International Health, iLiNS Project, College of Medicine-Mangochi, University of Malawi and University of Tampere School of Medicine, Tampere, Finland. austridag@gmail.com.
authors.forename: Austrida
authors.initials: A
authors.lastname: Gondwe
authors.affiliation: Centre for Social Research, Chancellor College, University of Malawi, Zomba, Malawi. amunthali@cc.ac.mw.
authors.forename: Alister C
authors.initials: AC
authors.lastname: Munthali
authors.affiliation: Department of Paediatrics, Tampere University Hospital, University of Tampere School of Medicine, Tampere, Finland. per.ashorn@uta.fi.|Department of International Health, University of Tampere School of Medicine, Tampere, Finland. per.ashorn@uta.fi.
authors.forename: Per
authors.initials: P
authors.lastname: Ashorn
authors.affiliation: Department of International Health, University of Tampere School of Medicine, Tampere, Finland. ulla.ashorn@uta.fi.
authors.forename: Ulla
authors.initials: U
authors.lastname: Ashorn
mesh_terms: D005220:Fathers / Q000193:education*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007224:Infant Care; D007231:Infant, Newborn; D007407:Interviews as Topic; D008295:Malawi; D008297:Male; D009035:Mothers / Q000193:education*; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D047928:Premature Birth / Q000451:nursing*; D036301:Qualitative Research; D012424:Rural Population; D012944:Social Support