Primary Care Physicians’ Perceptions of Barriers To Preventive Reproductive Health Care In Rural Communities

The issue that underlies a worrying question of maternal and child health in Côte d'Ivoire is that of social logic. Social logic is perceived as "cultural constructions of actors with regard to morbidity that cause to adopt reproductive health care". Based on this understanding, the concept of social logic in reproductive health is similar to a paradigm that highlights the various factors that structure and organise sociological resistance to mothers' openness to healthy reproductive behaviours; that is, openness to change for sustainable reproductive health. Far from becoming and remaining a prisoner of blind culturalism with the social logic that generates the health of mothers, new-borns and children, practically-relevant questions are raised. Issues of "bad governance", socio-cultural representations and behaviours in conflict with modern epidemiological standards are addressed in a culturally-sensitive manner, an important issue for the provision of care focused on the needs of mothers seeking answers to health problems. Developing these original community characteristics helps to orient a reading list in a socioanthropological perspective with a view to explaining and understanding different problems encountered, experiences acquired by social actors during the implementation of antenatal, postnatal and family planning care. This context of building logic with regard to reproductive health care is key to identifying real bottlenecks in maternity services and achieving efficient management of maternal, new-born and child health care for the benefit of populations and actors in the public health sector.

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What methods and challenges for taking account of context when transferring complex interventions?

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1071 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

S Villadsen ◽

S Dias

Keyword(s):

Public Health ◽

Health Care ◽

Reproductive Health ◽

Health Care Providers ◽

Complex Interventions ◽

Health Interventions ◽

Care Providers ◽

Public Health Interventions ◽

Reproductive Health Care

Abstract For complex public health interventions to be effective their implementation needs to adapt to the situation of those implementing and those receiving the intervention. While context matter for intervention implementation and effect, we still insist on learning from cross-country comparison of implementation. Next methodological challenges include how to increase learning from implementation of complex public health interventions from various context. The interventions presented in this workshop all aims to improve quality of reproductive health care for immigrants, however with different focus: contraceptive care in Sweden, group based antenatal care in France, and management of pregnancy complications in Denmark. What does these interventions have in common and are there cross cutting themes that help us to identify the larger challenges of reproductive health care for immigrant women in Europe? Issues shared across the interventions relate to improved interactional dynamics between women and the health care system, and theory around a woman-centered approach and cultural competence of health care providers and systems might enlighten shared learnings across the different interventions and context. Could the mechanisms of change be understood using theoretical underpinnings that allow us to better generalize the finding across context? What adaption would for example be needed, if the Swedish contraceptive intervention should work in a different European setting? Should we distinguish between adaption of function and form, where the latter might be less important for intervention fidelity? These issues will shortly be introduced during this presentation using insights from the three intervention presentations and thereafter we will open up for discussion with the audience.

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