{
  "abstract": "Background Premature birth is the leading cause of neonatal morbidity and mortality. Understanding perceptions, beliefs and attitudes towards preterm births, and how these factors influence care provision at health facilities and at home is crucial for improving preterm newborns’ health outcomes.Methods We conducted an exploratory qualitative study at Batu and Meki communities in the East Shewa Zone of Oromia Region, Ethiopia. We conducted in-depth interviews (n=81) and focus group discussions (n=8) using semistructured guides. The study participants included women who had preterm births, family members, community members, healthcare workers and expert stakeholders. We audio-recorded, transcribed the interviews and coded the transcripts. We employed the socioecological model to present perceptions, beliefs and attitudes towards preterm birth at individual, interpersonal, organisational and societal levels.Findings Giving birth to a preterm newborn is often associated with fear, stress, unhappiness, concern and worry. At the individual level, preterm newborns’ mothers often feel guilt and self-blame. Families tend to keep preterm birth a secret due to perceptions of ‘incompleteness’. At the interpersonal level, preterm newborns are often stigmatised and families are disappointed by mothers who give birth prematurely. However, some believe that preterm newborns are accepted within the community. At the organisational level, healthcare providers find the causes of preterm birth unpredictable, they do not consider preterm births prevalent, and consider some of them as abortion. There is also a common belief that preterm infants have a low survival rate, leading to the deprioritisation of their care. At the societal level, some believe preterm births are caused by divine will as punishment for sins committed by the mother, while others think they occur naturally. Preterm newborn’s death is often not acknowledged as true loss and families are discouraged from grieving.Conclusions Our study found that the beliefs, perceptions and attitudes surrounding preterm birth, held by families, communities, healthcare providers and society at large, influence the care that preterm newborn–mother dyads receive both at home and within health facilities. Addressing these requires a multifaceted approach targeted at deeply ingrained attitudes and perceptions.",
  "authors": [
    {
      "affiliations": [
        "Center for Implementation Sciences (CIS), Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia",
        "Department of Reproductive, Family, and Population Health, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Abiy Seifu Estifanos"
    },
    {
      "affiliations": [
        "Center for Implementation Sciences (CIS), Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Meron Addis Gelaw"
    },
    {
      "affiliations": [
        "Center for Implementation Sciences (CIS), Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia",
        "Department of Reproductive, Family, and Population Health, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Hewan Getachew"
    },
    {
      "affiliations": [
        "Center for Implementation Sciences (CIS), Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Beyene Roba Ireso"
    },
    {
      "affiliations": [
        "Center for Implementation Sciences (CIS), Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia",
        "Department of Pediatrics and Child Health, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Asrat Dimtse"
    },
    {
      "affiliations": [
        "Center for Implementation Sciences (CIS), Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia",
        "Department of Pediatrics and Child Health, St Paul’s Millennium Medical College, Addis Ababa, Ethiopia"
      ],
      "name": "Gesit Metaferia"
    },
    {
      "affiliations": [
        "Center for Implementation Sciences (CIS), Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia",
        "Department of Radiology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Tequam Debebe Woldehawariat"
    },
    {
      "affiliations": [
        "Center for Implementation Sciences (CIS), Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Miraf Walelegn"
    },
    {
      "affiliations": [
        "Harvard Medical School, Boston, Massachusetts, USA",
        "Maternal, Newborn, Child Nutrition and Health, Innovation to Scale, Africa Regional Office, Gates Foundation, Seattle, Washington, USA"
      ],
      "name": "Hema Magge"
    },
    {
      "affiliations": [
        "Center for Implementation Sciences (CIS), Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia",
        "Department of Reproductive, Family, and Population Health, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Meselech Assegid Roro"
    },
    {
      "affiliations": [
        "Center for Implementation Sciences (CIS), Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Rediet Gezahegn Gobena"
    },
    {
      "affiliations": [
        "Center for Implementation Sciences (CIS), Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia",
        "Department of Public Health Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Yakob Desalegn Nigatu"
    },
    {
      "affiliations": [
        "Center for Implementation Sciences (CIS), Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia",
        "Department of Public Health Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Yalemwork Mengistu"
    },
    {
      "affiliations": [
        "Center for Implementation Sciences (CIS), Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia",
        "Department of Public Health Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Bilal Shikur"
    },
    {
      "affiliations": [
        "Center for Implementation Sciences (CIS), Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia",
        "Department of Obstetrics and Gynecology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Rahel Demissew"
    },
    {
      "affiliations": [
        "Center for Implementation Sciences (CIS), Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Selemawit Asfaw Beyene"
    },
    {
      "affiliations": [
        "Maternal, Newborn, Child Nutrition & Health (MNCNH) Team, Gender Equality Division, Gates Foundation, Seattle, Washington, USA"
      ],
      "name": "Alison Tumilowicz"
    }
  ],
  "title": "Applying the socioecological model to examine the beliefs, perceptions and attitudes surrounding preterm birth in Ethiopia: a qualitative study",
  "uid": "107b328f-4025-5b01-9f15-7958f95c7d85"
}