PERCEIVED IMPACT OF THE IRAQI GRANDMOTHER ON MATERNAL AND CHILD HEALTH IN A HOSPITAL IN WEST MOSUL, IRAQ

Background:

Nablus Hospital is an MSF Hospital operating out of West Mosul and serves a predominantly Sunni Arab community through its ER, Maternity, Mental Health, Neonatal and Paediatric departments. It is common that an elder female caregiver escorts a woman or child to hospital for care. We wanted to assess the perceived impact, among national and international MSF staff of this grandmother role, on the health of the mother and child.

Methods:

100 anonymous Arabic or English surveys were distributed to hospital users to enquire on their perception of the grandmother role on healthcare behaviours of mother and child. A follow up focus group was completed to explore the responses.

Results:

74/100 surveys were completed. Focus groups were carried out with a minimim of 10 per group.

National staff had positive perceptions, though cited negative aspects of access to ANC, hospital births, family planning and completion of paediatric inpatient treatment. Granmothers were cited as the cause of the harmful sagwa practice upon children. International medical staff had negative perceptions, ascribed to grandmothers imparting their decisions upon the care received by the mother and child and supplanting the place of the mother (obstructing breastfeeding). Mothers responded more positively in the focus group, citing `grandmother knows best` >10x. Similarly, the grandmothers self-rated highly with responses of, `the grandmother knows best (and so does what the doctor says)` in the focus group.

Discussion:

From the survey and focus groups it is clear that international and national staff differ in their perceptions of the grandmother role on maternal and child health. To address issues of: antenatal care, family planning, completion of medical treatment, breastfeeding, vaccinations - then the grandmother as a decision maker needs to be targeted by public health or targeted inpatient strategies.