I find this very interesting. The underserved mother in less developed countries will benefit from the doula (whatever the appropriate name in that community is) to serve as adjunct to other skilled birth attendants. I will be following this thread as it is close to the issues that are close to my heart and profession.
Thank you Arjanna! I think one of the issues that is we neglect in the planning of health care delivery is the patient's behavior, attitude and beliefs about what we are offering, assuming of course that the medical services, developed in a cultural setting that is different from our patient, is not only better, but that the patient should instinctively see it as so. I work as a physician and in close contact with antenatal services, we continue to scratch our heads about why, in spite of the policies implemented for safe motherhood, (mostly assuming that the modern medicine and its services are better, and if we build more hospitals they will come) many Nigerian women living in cosmopolitan Lagos do not visit their OBGYN as many times are recommended by the WHO, or many times enough to qualify for bare minimum. The traditional birth attendant (who they prefer to visit) has a more enabling environment for our patient, it seems, and one thing they get right, apart from the customer intimacy, (easier to set up in a less professional setting), is the joint belief with the patient that the pregnancy is a natural phenomenon. Home births, sometimes unskilled, still abound because of the upheld fact that a woman's body is designed to give birth naturally. How does the modern physician agree with the patient, and yet get the patient on her/his side, and how will be affect the design of modern medicine services, antenatal services being a prototype for this? Thank you Arjanna
Thank you Bettina for sharing this program. An understanding of your patient as a whole person in the context of their native environment is an under-considered aspect of health care, and yet the yawning gap that exists a lot between the health care providers, especially physicians and patients is a phenomenon that we see manifest everyday, sometimes hampering to fatality, the consulting room experience. In my country, Nigeria, it is no wonder that women would rather still consult with a traditional birth attendant instead of a qualified medical doctor, and access to the hospital was not the panacea that the government was hoping that it would be, (and then built several primary health care centers). Antenatal care attendance in the community that I work in, mimics the situation that you describe. I lived briefly in New York, upper east side and I did observe the anomalies in income and cultural distribution. This project, whatever comes out it, interests me very much indeed, because of the similarities to my own environment and I will be following this closely. Thank you again, Bettina