Medicine
The Influence of Cultural Beliefs on Maternal Health Care Utilization
Quick fact
In some communities, cultural beliefs such as the fear of the 'evil eye' or the importance of modesty can delay or prevent women from seeking hospital delivery, contributing to higher maternal mortality rates.
Why this is interesting
Why do two pregnant women facing the same medical risk make opposite choices—one rushes to a hospital, the other stays home? The answer may lie in their cultural beliefs.
Read the full explanation
Understanding The Influence of Cultural Beliefs on Maternal Health Care Utilization
Picture a woman in a rural village who is pregnant. She has heard about the hospital and its benefits, but her community holds strong beliefs about childbirth: it is a natural event that should not involve 'outsiders,' and a traditional birth attendant—a respected elder—knows the rituals to protect the mother and baby. These beliefs are not just individual; they are reinforced by her family and neighbors. When she goes into labor, she faces a choice. Her cultural script tells her that the traditional birth attendant is safe and respected, while the hospital is a place of fear, unknown procedures, and possibly being examined by male doctors, which violates modesty norms. This is how cultural beliefs work: they create a 'mental map' of what is safe, appropriate, and necessary, and this map directly influences whether she utilizes formal maternal health care. The same applies to antenatal check-ups: if a woman believes pregnancy is a private matter and that too much medical attention can bring misfortune, she may avoid clinics until a serious complication arises. Understanding this helps us see that healthcare utilization is not simply about availability or cost—it is also about whether the services feel culturally acceptable and aligned with the woman's social identity.
A deeper explanation
The underlying mechanism is that cultural beliefs operate as filters through which information about health care is interpreted. They shape three key things: perceived susceptibility (e.g., 'hospital births are for women who are weak or have problems'), perceived severity (e.g., 'bleeding after birth is normal' or 'a priest can heal this'), and perceived benefits and barriers (e.g., 'the hospital may save my life but at the cost of my dignity'). These perceptions enter a decision-making process that weighs social norms, trust in traditional healers, and past experiences with health systems. When a woman delivers at home with a traditional birth attendant, she is following a culturally endorsed path that offers social support and spiritual reassurance, even if it lacks the life-saving skills of a hospital. The clinical consequence is that cultural beliefs can contribute to 'three delays': the delay in deciding to seek care, the delay in reaching a facility, and the delay in receiving appropriate care once there. Recognizing this mechanism is vital for public health: simply telling communities to come to clinics is ineffective; instead, programs must respect and incorporate cultural beliefs—for example, by training community health workers from the same cultural background, partnering with traditional birth attendants, or adapting services to be culturally sensitive. This is why maternal health programs that ignore culture often fail, while those that engage with it succeed.