Underreporting of stillbirths in Pakistan: perspectives of the parents, community and healthcare providers

Zakria Zakar M, Zakar R, Mustafa M, Jalil A, Fischer F (2018)
BMC Pregnancy and Childbirth 18(18): 302.

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Abstract / Bemerkung
Background Pakistan has the highest rate of stillbirths globally. Not much attention has been given so far to exploring the sociocultural factors hindering the reportage of stillbirths and the causes of death. Therefore, the aim of this study was to assess the perspectives of parents, communities and healthcare providers regarding the sociocultural practices and health system-related factors contributing to stillbirths and their underreporting. Methods This study used a qualitative approach including in-depth interviews and 14 focus group discussions to collect data from four districts of Pakistan. We conducted 285 in-depth interviews and 14 focus group discussions with health professionals – mainly active in the areas of maternal and child health – and parents who had experienced stillbirth. Constant comparative method and analytical induction method were performed to analyze the data. Results The results of this study show that stillbirth is frequently misclassified and, therefore, an underreported phenomenon in Pakistan. It is an outcome of sociocultural practices, such as the social meaning of stillbirth and their understanding about the conflict between cultural and medical anatomy. In addition to grief and psychological distress, it endangers the maternal identity and worth in society in contrast to the mothers of live-born children. Conclusion The misclassification of stillbirth, especially by healthcare providers, is a significant impediment to designing preventive strategies for stillbirth. We recommend that the reporting system for stillbirth should be aligned with the WHO definition of stillbirth to avoid its underreporting. Reporting procedures at a more administrative level need to be made uniform and simplified.
Erscheinungsjahr
Zeitschriftentitel
BMC Pregnancy and Childbirth
Band
18
Ausgabe
18
Art.-Nr.
302
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Article Processing Charge funded by the Deutsche Forschungsgemeinschaft and the Open Access Publication Fund of Bielefeld University.
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Zakria Zakar M, Zakar R, Mustafa M, Jalil A, Fischer F. Underreporting of stillbirths in Pakistan: perspectives of the parents, community and healthcare providers. BMC Pregnancy and Childbirth. 2018;18(18): 302.
Zakria Zakar, M., Zakar, R., Mustafa, M., Jalil, A., & Fischer, F. (2018). Underreporting of stillbirths in Pakistan: perspectives of the parents, community and healthcare providers. BMC Pregnancy and Childbirth, 18(18), 302. doi:10.1186/s12884-018-1924-9
Zakria Zakar, M., Zakar, R., Mustafa, M., Jalil, A., and Fischer, F. (2018). Underreporting of stillbirths in Pakistan: perspectives of the parents, community and healthcare providers. BMC Pregnancy and Childbirth 18:302.
Zakria Zakar, M., et al., 2018. Underreporting of stillbirths in Pakistan: perspectives of the parents, community and healthcare providers. BMC Pregnancy and Childbirth, 18(18): 302.
M. Zakria Zakar, et al., “Underreporting of stillbirths in Pakistan: perspectives of the parents, community and healthcare providers”, BMC Pregnancy and Childbirth, vol. 18, 2018, : 302.
Zakria Zakar, M., Zakar, R., Mustafa, M., Jalil, A., Fischer, F.: Underreporting of stillbirths in Pakistan: perspectives of the parents, community and healthcare providers. BMC Pregnancy and Childbirth. 18, : 302 (2018).
Zakria Zakar, Muhammad, Zakar, Rubeena, Mustafa, Mudasir, Jalil, Aisha, and Fischer, Florian. “Underreporting of stillbirths in Pakistan: perspectives of the parents, community and healthcare providers”. BMC Pregnancy and Childbirth 18.18 (2018): 302.
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