Self-delay for Timely Antenatal Care, Rituals and Heavy-Handed in-laws: Cultural Practices Killing Pregnant Women in Zambia- Lundazi district

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DOI: 10.21522/TIJPH.2013.08.04.Art009

Authors : Patricia Mambwe


This study examined socio-cultural practices surrounding maternal deaths in Lundazi district –Zambia. The practices stealthily affect antenatal care received by antenatal women with subsequent maternal complications and deaths. Four Focus Group Discussions involving 40 members of Small Motherhood Action Groups (SMAGs) were conducted in March 2018.This study found that pregnant women in Lundazi district- Zambia delay to initiate antenatal care until 6th or 7th month of their pregnancy. The reasons given include fear of witchcraft stealing the human embryo for magic. Pregnant women are delayed further as they seek traditional medicines from Traditional Healers for pregnancy protection. Other pregnant women cannot attend antenatal care consistently because their mothers-in-law want them to do what is considered beneficial for a woman traditionally- do house chores or join the team going to the maize field. Late antenatal initiation is a crisis. It is an emergency in waiting for which some pregnant women never recover.


[1].   Machel. G (2010), Foreword in the Maternal Health: Investing in the Lifeline of Healthy Societies & Economies. Africa Progress Panel Policy Brief September 2010.

[2].   Sigh, A (2008), Refraining Maternal Health Role of Ayurveda in Public Health Care. Ancient science of Life. 28 (1): 5-15.

[3].   Meticalfe, Q, M.R.2010, Understanding women’s Empowerment and maternal mortality in the Ugandan context: Effects of mitigative intervention strategies Dissertation Simon Fraser University.

[4].   Ronsmans, C G, Wendy, J (2006), Maternal Survival 1: Maternal mortality: who, when, where and why. The Lancet 368:1189-1200.

[5].   WHO, 2019, Maternal Mortality.

[6].   WHO, 2007, Maternal Mortality in 2005: Estimates developed by WHO, UNICEF, INFPA and the World Bank. WHO: Geneva.

[7].   WHO, 2001, Prevention of Maternal Mortality Report of a World Organisation Inter- Regional. Geneva WHO.

[8].   World Health Organisation. 1992, International Classification of Diseases. ICD 10, Geneva: WHO

[9].   Zambia Demographic and Health Survey 2013-2014.

[10].  National Health Strategic Plan 2017-2021 Ministry of Health Zambia.

[11].  Ministry of Health, 2008, Annual Statistical Bulletin.

[12].  Provincial Integrated Management Meeting 26th September, 2019.

[13].  Lauderdale, D.S (2003). Culture and Maternal Mortality. London: Sage.

[14].  Adams, G. 2005, The Cultural Grounding of Personal Relationship: Enemyship in North American and West African Worlds. Journal of Personality and Social Psychology 2005, Vol. 88, No. 6, 948–968 0022-3514/05/$12.00 DOI: 10.1037/0022-3514.88.6.948.

[15].           Dawson, S. Manderson, L. Tallo, V. L. (1993). A Manual for the Use of Focus Groups. Boston: INFDC.

[16].           Sialubanje, C. Massar, K., Horstkotte, L., Hammer, D.H., Ruiter, R.A.C (2017), Increasing Utilization of skilled facility-based maternal health care services in rural Zambia: the role of Safe Motherhood Action Groups Reproductive Health 14:81 DOI:10.1186/s12978-017-0342-1.

[17].  Naidu, M. 2013, Indigenous mothers: An Ethnographic Study of using the Environment during pregnancy. Ethno Med, 7(2):127-135. Accessed on the 16th of October, 2018.

[18].  Da Fonseca, C.R Strufaldi, M.W., de Carvalho, L.R., Puccini, R.F. 2014, Adequanncy of antenatal care and its relationship with low birth weight in Botucatu, Sao Paulo, Brazil: a case-control study. BMC Pregnancy Childbirth 2014; 4:255.

[19].  Triratnawati, A, Izdiha, A. 2018, Family Intervention in the Problem of Maternal Death: A case study of pregnant women in Mbojo, Bima, West Nuso doi:org/10.22146/jh.v30:3.36682.

[20].  Yarney, L (2019), Does knowledge on socio-cultural factors associated with maternal mortality affect maternal health decisions? A cross-sectionalstudy of the Greater Accra region of Ghana BMC Pregnancy and Childbirth 19,47

[21].  WHO, 2016, Antenatal Guidelines.

[22].  Chimatiro, C. S., Hajison, P., Chipeta, E., Muula,A.S (2018), Understanding barriers preventing pregnant women from starting antenatal clinic in the first trimester of pregnancy in Ntcheu District- Malawi Reproductive Health 15:158 https://doi:org/10.1186/s12978-018-0605-5.

[23].  Mgata, S. Maluka, S.O 2019, Factors for late initiation of antenatal care in Dar es Salaam, Tanzania: A qualitative study. BMC Pregnancy and Childbirth 19,415

[24].  Tufa, G. Tsegaye, R., Seyoum, D. 2020, Fcators Associated with Timely Antenatal Care Booking among Pregnant Women in Remote Area of Bule Hora District, Southern Ethiopia. International Journal of Women’s Health vol. 12 pg 657-666

[25].  Gidey, G ET AL., 2017, Timing of First Focused antenatal care booking and associated factors among pregnant mothers who attend antenatal care in Central Zone, Tigray, Ethiopia. BMC Res Notes 2017(1):608. Doi:10.1186/s13104-017-2938-5.

[26].  USAID. National Guidelines for Antenatal Care for Service Providers 2018. Available at 2018.pdf.

[27].  Mogawane, M. Mothiba, Malema, R., N 2015, Indigenous practices of pregnant women at Dilokong hospital in Limpopo province, South Africa Curationis 38(2), Art#1553,8 pages.

[28].  Asowa-Omorodion F.I(1997), Women’s perceptions of the complications of pregnancy and childbirth in two Esan communities, Edo state, Nigeria. Soc Sci Med.1997;4(12): 1817-1824. doi:10.1016/s0277-9536(96)00291-2

[29].  Simkhada, B. Porter, M. A., Teijling, E. R van (2010), The role of Mothers-in-law in antenatal care decision-making in Nepal: a qualitative study BMC Pregnancy and Childbirth 2010,10:34