Traditional and Modern Maternal and Child Health Care Practices and their Effects on Rajbanshi Community in Nepal

Abstract

Background: Rajbanshi is one of the indigenous and underprivileged communities in Nepal. This is a descriptive and cross-sectional study on Rajbanshi Community. The study was an attempt to explore and examine the modern and traditional health care seeking practices and estimate their effects on mother and child health. 

Methods: Both qualitative and quantitative methodology was employed. Qualitative data were collected using in-depth interviews, FGD guideline, naturalistic observation, and case study approach. Quantitative data were collected using household questionnaire survey from 1514 participants. 

Results: Guru Gosai and Gosai were the main traditional healers in the sampled Rajbanshi community. Deities, witchcrafts, evil spirits, touching of pithiya/chhatka, dirt, or poor sanitation, were the major causes of diseases or illnesses. Healers identified such causes through the process of jokhana. Based on the findings, healers treat or heal the patients by chanting mantra, jharphuk, use of jadibuti, buti, ferani or making promises to the spirits, deities, or gods and goddesses. On the other hand, Rajbanshi people are shifting in their health seeking behavior by accepting modern health care services from different levels such as private clinics/nursing home, and public health post, hospitals, etc. This confirms the existence of dual health care practices among a large proportion (93.87%) of sampled Rajbanshi community. The trend of hospital delivery increased from 30.7% to 69.3%, whereas the trend of home delivery decreased from 69.3% to 29.2% between the first and last births. The microanalysis indicated that the trend to lean more on modern health care has increased significantly. Postpartum depression (PPD) among mothers associated with their stress and sleeplessness was statistically significant. PPD in mothers tested with husbands’ smoking habit and was found statistically highly significant (p=<.0001). 

Conclusion: Mortality rate of mother and child and proportion of underweight children was high in very poor, laborer, illiterate, rural and traditional care practicing families. Women suffering from reproductive health problems called pithiya, chhatka and the so-called tantra/mantra using women are stigmatized and vulnerable. Shaving of newborn's head and cutting of umbilical cord by barbers are risky cultural practices.