{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T13:05:57Z","timestamp":1759496757362,"version":"3.40.5"},"reference-count":25,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2020,6,24]],"date-time":"2020-06-24T00:00:00Z","timestamp":1592956800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Biosoc. Sci."],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>While overall neonatal mortality rates are improving in Ghana, the Ashanti Region has the highest mortality rate in the country. The clinical causes of newborn deaths are well known, yet local beliefs about illness aetiology, cause of death and care-seeking are less well understood. This exploratory qualitative study sought to understand how community members perceive and respond to neonatal illness. Researchers worked with public health nurses, community health nurses and opinion leaders in the Ashanti Region of Ghana to identify women who had lost a baby, either during pregnancy or after delivery. In-depth interviews and focus group discussions were conducted about knowledge, attitudes and beliefs regarding neonatal mortality. The transcripts were coded and analysed using NVivo 10.0. A total of 100 participants were interviewed: 24% reported a previous stillbirth; 37% reported a previous miscarriage; and 45% reported losing a baby who was born alive. Nine per cent experienced more than one type of loss. The local illness of <jats:italic>asram<\/jats:italic> \u2013 an illness with supernatural causes \u2013 was cited as a leading cause of death of newborns. Every participant reported hearing of, knowing someone, or having a child who had become ill with <jats:italic>asram<\/jats:italic>. While women gave varying information on symptoms, method of contraction and treatment, all participants agreed that <jats:italic>asram<\/jats:italic> was common and often fatal. Four overarching themes emerged: 1) <jats:italic>asram<\/jats:italic> is not a hospital sickness; 2) there is both a fear of traditional healers as a source of <jats:italic>asram<\/jats:italic>, as well as a reliance upon them to cure <jats:italic>asram<\/jats:italic>; 3) there are rural\/urban differences in perceptions of <jats:italic>asram<\/jats:italic>; and 4) <jats:italic>asram<\/jats:italic> may serve as a mechanism of social control for pregnant women and new mothers. Local beliefs and practices must be better understood and incorporated into health education campaigns if neonatal mortality is to be reduced in Ghana.<\/jats:p>","DOI":"10.1017\/s0021932020000322","type":"journal-article","created":{"date-parts":[[2020,6,24]],"date-time":"2020-06-24T09:26:22Z","timestamp":1592990782000},"page":"497-507","source":"Crossref","is-referenced-by-count":7,"title":["\u2018<i>Asram<\/i> is really killing us here\u2019: attribution for pregnancy losses and newborn mortality in the Ashanti Region of Ghana"],"prefix":"10.1017","volume":"53","author":[{"given":"Ashura","family":"Bakari","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"April J.","family":"Bell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Oppong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Woodford","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Kaselitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5796-157X","authenticated-orcid":false,"given":"Cheryl A.","family":"Moyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,6,24]]},"reference":[{"key":"S0021932020000322_ref22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2008.00135.x"},{"key":"S0021932020000322_ref21","first-page":"369","article-title":"Neonatal mortality at the neonatal unit: the situation at a teaching hospital in Ghana","volume":"18","author":"Owusu","year":"2018","journal-title":"African Health Science"},{"key":"S0021932020000322_ref12","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2008.233"},{"key":"S0021932020000322_ref2","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/9020914"},{"key":"S0021932020000322_ref11","first-page":"36","article-title":"\u201cI don\u2019t know anything about their culture\u201d: the disconnect between allopathic and traditional maternity care providers in rural northern Ghana","volume":"18","author":"Hill","year":"2014","journal-title":"African Journal of Reproductive Health"},{"key":"S0021932020000322_ref16","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-9-10"},{"key":"S0021932020000322_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)66836-5"},{"key":"S0021932020000322_ref25","unstructured":"World Bank (2019) Mortality Rate, Neonatal (per 1,000 live births). 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