Evidence map›Paper›PMID 34172018›Full record

ArticleBMC pregnancy and childbirth2021

The impact of cultural beliefs and practices on parents' experiences of bereavement following stillbirth: a qualitative study in Uganda and Kenya.

Elizabeth Ayebare, Tina Lavender, Jonan Mweteise, Allen Nabisere, Anne Nendela, Raheli Mukhwana, Rebecca Wood, Sabina Wakasiaka, Grace Omoni, Birungi Susan Kagoda and 1 more

Open access · goldAbstract read
In one paragraph

Article in BMC pregnancy and childbirth, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 2 pooled it
4.4field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 59 citations in OpenAlex.

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  11. "You First Break the News to the Relative": Stillbirth Bereavement Care Practices in Nigeria.Journal of transcultural nursing : official journal of the Transcultural Nursing Society · 2026
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  12. A socio-ecological analysis of parents' experiences of stillbirth in Limpopo, South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 3 countries.

Elizabeth AyebareDepartment of Nursing, College of Health Sciences, Makerere University, P.O.BOX. 7072, Kampala, Uganda. lizayeby@gmail.com.
Tina LavenderCentre for Childbirth, Women's and Newborn Health, Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, United Kingdom.
Jonan MweteiseLugina Africa Midwives Research Network, Department of Nursing, College of Health, Makerere University, PO Box 7072, Kampala, Uganda.
Allen NabisereLugina Africa Midwives Research Network, Department of Nursing, College of Health, Makerere University, PO Box 7072, Kampala, Uganda.
Anne NendelaLugina Africa Midwives Research Network, C/o School of Nursing Sciences, University of Nairobi, PO Box 30197, Nairobi, Kenya.
Raheli MukhwanaLugina Africa Midwives Research Network, C/o School of Nursing Sciences, University of Nairobi, PO Box 30197, Nairobi, Kenya.
Rebecca WoodDepartment of Geography and Environmental Science, Liverpool Hope University, Hope Park, Liverpool, L16 9JD, UK.
Sabina WakasiakaSchool of Nursing Sciences, University of Nairobi, PO Box 30197, Nairobi, Kenya.
Grace OmoniSchool of Nursing Sciences, University of Nairobi, PO Box 30197, Nairobi, Kenya.
Birungi Susan KagodaMulago Specialised Women's and Neonatal Hospital, P.O. Box 7051, Kampala, Uganda.
Tracey A MillsCentre for Childbirth, Women's and Newborn Health, Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, United Kingdom.
University of Nairobi · KEMakerere University · UGLiverpool School of Tropical Medicine · GBLiverpool Hope University · GBMulago Hospital · UG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStillbirth is an extremely traumatic and distressing experience for parents, with profound and long-lasting negative impacts. Cultural beliefs and practices surrounding death vary considerably across different contexts and groups, and are a key influence on individual experiences, impacting grief, adjustment, and support needs. Few studies have explored cultural influences surrounding stillbirth in an African context. This study explored the influence of cultural beliefs and practices on the experiences of bereaved parents and health workers after stillbirth in urban and rural settings in Kenya and Uganda.

methodsA qualitative descriptive study design was employed. Face to face interviews were conducted with parents (N = 134) who experienced a stillbirth (≤ 1 year) and health workers (N = 61) at five facilities in Uganda and Kenya. Interviews were conducted in English or the participants' local language, audio-recorded and transcribed verbatim. Analysis was conducted using descriptive thematic analysis.

resultsCommonalities in cultural beliefs and practices existed across the two countries. Three main themes were identified: 1) Gathering round, describes the collective support parents received from family and friends after stillbirth. 2)'It is against our custom' addresses cultural constraints and prohibitions impacting parents' behaviour and coping in the immediate aftermath of the baby's death. 3) 'Maybe it's God's plan or witchcraft' summarises spiritual, supernatural, and social beliefs surrounding the causes of stillbirth.

conclusionsKinship and social support helped parents to cope with the loss and grief. However, other practices and beliefs surrounding stillbirth were sometimes a source of stress, fear, stigma and anxiety especially to the women. Conforming to cultural practices meant that parents were prevented from: holding and seeing their baby, openly discussing the death, memory-making and attending the burial. The conflict between addressing their own needs and complying with community norms hindered parents' grief and adjustment. There is an urgent need to develop culturally sensitive community programmes geared towards demystifying stillbirths and providing an avenue for parents to grieve in their own way.

Indexed as

BereavementCultureAdaptation, PsychologicalAdultFemaleHumansKenyaMaleParentsPregnancyQualitative ResearchRural PopulationSocial StigmaSocial SupportStillbirthUgandaBeliefsBereavementCultureEast AfricaExperiencesQualitativeStillbirth

Identifiers

PMID34172018
PMCPMC8228937
OpenAlexW3175824768

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.