TY - JOUR
T1 - A Qualitative Assessment of Community Acceptability and Its Determinants in the Implementation of Minimally Invasive Tissue Sampling in Children in Quelimane City, Mozambique
AU - Magaço, Amilcar
AU - Alonso, Yara
AU - Maixenchs, Maria
AU - Ambrosio, Contardo
AU - Sitoe, Antonio
AU - Vitorino, Pio
AU - Blau, Dianna
AU - Garel, Mischka
AU - Breiman, Robert
AU - Amouzou, Agbessi
AU - Bassat, Quique
AU - Mandomando, Inacio
AU - Blevins, John
AU - Munguambe, Khatia
N1 - Funding Information:
Financial support: This study was funded by the Bill & Melinda Gates Foundation under the Grant OPP1126780 to Robert Breiman, subcontract SC00003286-S1, via CHAMPS Network. CISM is supported by the Government of Mozambique and the Spanish Agency for International Development Cooperation (AECID).
Funding Information:
Acknowledgments: We thank the study team members who dedicated themselves to the study design and training the social science assistants (Nelson Escritório, Yury Macete, and Raquel Mucor), who dedicated themselves to collecting data and transcription of the interviews. We also thank all study participants who took the time to answer the interviewers’ questions. We also acknowledge the support of Centro de Investigac¸ão em Saúde da Manhic¸a, which is supported by the Government of Mozambique and the Spanish Agency for International Development (AECID).
Publisher Copyright:
Copyright © 2023 The author(s)
PY - 2023/5
Y1 - 2023/5
N2 - The Countrywide Mortality Surveillance for Action project aims to implement a child mortality surveillance program through strengthening vital registration event reporting (pregnancy, birth, and death) and investigating causes of death (CODs) based on verbal autopsies. In Quelimane (central Mozambique), Minimally Invasive Tissue Sampling (MITS) procedures were added to fine-tune the COD approaches. Before the implementation of MITS, an evaluation of the acceptability and ethical considerations of child mortality surveillance was considered fundamental. A socioanthropological study was conducted in Quelimane, using observations, informal conversations, semi-structured interviews, and focus group discussions with healthcare providers, nharrubes (traditional authorities who handle bodies before the funeral), community and religious leaders, and traditional birth attendants to understand the locally relevant potential facilitators and barriers to the acceptability of MITS. Audio materials were transcribed, systematically coded, and analyzed using NVIVO12VR . The desire to know the COD, intention to discharge the elders from accusations of witchcraft, involvement of leaders in disseminating project information, and provision of transport for bodies back to the community constitute potential facilitators for the acceptability of MITS implementation. In contrast, poor community mobilization, disagreement with Islamic religious practices, and local traditional beliefs were identified as potential barriers. MITS was considered a positive innovation to determine the COD, although community members remain skeptical about the procedure due to tensions with religion and tradition. Therefore, the implementation of MITS in Quelimane should prioritize the involvement of a variety of influential community and religious leaders.
AB - The Countrywide Mortality Surveillance for Action project aims to implement a child mortality surveillance program through strengthening vital registration event reporting (pregnancy, birth, and death) and investigating causes of death (CODs) based on verbal autopsies. In Quelimane (central Mozambique), Minimally Invasive Tissue Sampling (MITS) procedures were added to fine-tune the COD approaches. Before the implementation of MITS, an evaluation of the acceptability and ethical considerations of child mortality surveillance was considered fundamental. A socioanthropological study was conducted in Quelimane, using observations, informal conversations, semi-structured interviews, and focus group discussions with healthcare providers, nharrubes (traditional authorities who handle bodies before the funeral), community and religious leaders, and traditional birth attendants to understand the locally relevant potential facilitators and barriers to the acceptability of MITS. Audio materials were transcribed, systematically coded, and analyzed using NVIVO12VR . The desire to know the COD, intention to discharge the elders from accusations of witchcraft, involvement of leaders in disseminating project information, and provision of transport for bodies back to the community constitute potential facilitators for the acceptability of MITS implementation. In contrast, poor community mobilization, disagreement with Islamic religious practices, and local traditional beliefs were identified as potential barriers. MITS was considered a positive innovation to determine the COD, although community members remain skeptical about the procedure due to tensions with religion and tradition. Therefore, the implementation of MITS in Quelimane should prioritize the involvement of a variety of influential community and religious leaders.
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U2 - 10.4269/ajtmh.22-0343
DO - 10.4269/ajtmh.22-0343
M3 - Article
C2 - 37037431
AN - SCOPUS:85159547752
SN - 0002-9637
VL - 108
SP - 56
EP - 65
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
ER -