Factors contributing to drinking alcohol during pregnancy in rural Kilimanjaro Tanzania: a descriptive qualitative study

Mbuya, Bertha Kanuth

Factors contributing to drinking alcohol during pregnancy in rural Kilimanjaro Tanzania: a descriptive qualitative study

Master Thesis

2022

Abstract

Background: Understanding the factors that contribute to drinking alcohol during pregnancy is critical to supporting women's and children's health and wellness in rural Tanzania. The drinking of alcohol during pregnancy is a cause for concern in Tanzania. Due to high rates of foetal alcohol spectrum disorder (FASD) in the country, reducing alcohol use during pregnancy is a pressing public health priority. Purpose: Alcohol consumption is a major problem in Tanzania that needs immediate attention (Franscis, Weiss, Mshana, Baisley, Grosskurth & Kapiga, 2015). The purpose of this research was to investigate the factors that contribute to the drinking of alcohol among pregnant women in rural Kilimanjaro to inform the health promotion actions which the government, the health systems, and Tanzania Occupational Therapy Association (TOTA) need to take regarding drinking during pregnancy. Method: A qualitative research approach was used for the study, utilising a qualitative descriptive design. The study was located within the social constructivist theoretical framework (Creswell, 2013). Eight participants were selected for this study, who were eighteen years old and above, some of whom were pregnant and drinking alcohol, and some who were not currently pregnant but had engaged in drinking alcohol in previous pregnancies. In-depth interviews explored the participants' personal experiences with drinking during pregnancy, and community norms and attitudes towards maternal drinking and knowledge about FASD were observed using participant observation. Transcripts were analysed using an inductive, thematic data analysis approach. Findings: From the data analysis, three themes emerged: “Tangu enzi na enzi”(from generation to generation), “kua na muda mzuri” (to have a quality moment) and “mimi ni binadamu kama wengine”(I am a human like others). The first theme affirmed the contextual factors such as historical, cultural, physical, and social-political factors that contribute to women from rural Kilimanjaro drinking alcohol during pregnancy. This theme confirms the historical and pervasive presence of alcohol use during pregnancy. The second theme revealed social engagement and interactions, particularly due to deeply rooted values of ujamaa (familyhood/unity) in the community, as the factors influencing drinking alcohol among women during pregnancy. The third theme gave insight into how economic situations, conflicting knowledge, religion, and spirituality factors enhanced women's decision to drink alcohol during pregnancy. Implications: By examining the factors contributing to drinking alcohol during pregnancy, this study is contributing to the body of knowledge in assisting the Tanzania Occupational Therapy Association (TOTA) and the Tanzania Ministry of Health towards their goal of reducing the prevalence of FASD in rural Kilimanjaro. This research will also contribute to the capacitation of women about healthy choices regarding their drinking during pregnancy and substitution.

Keywords

Occupational Therapy

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