Open Access Research article

Sociocultural influences on newborn health in the first 6 weeks of life: qualitative study in a fishing village in Karachi, Pakistan

Shahirose Premji12*, Shaneela Khowaja3, Salima Meherali4 and Rachelle Forgeron1

Author Affiliations

1 Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada

2 Faculty of Medicine, University of Calgary, TRW Building, 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada

3 School of Nursing and Midwifery, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan

4 Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, Alberta T6G ICP, Canada

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BMC Pregnancy and Childbirth 2014, 14:232  doi:10.1186/1471-2393-14-232

Published: 16 July 2014



Given regional variability and minimal improvement in infant mortality rates in Pakistan, this study aimed to explicate sociocultural influences impacting mothers’ efforts to maintain or improve newborn health.


We used a qualitative phenomenological approach. A total of 10 mothers and 8 fathers from a fishing village in Karachi, Pakistan were purposefully sampled and interviewed individually. A focus group was undertaken with four grandmothers (primary decision makers). Transcripts were independently reviewed using interpretive thematic analysis.


A multigenerational approach was used in infant care, but mothers did not have a voice in decision-making. Parents connected breast milk to infant health, and crying was used as cue to initiate feeding. Participants perceived that newborns required early supplementation, given poor milk supply and to improve health. There were tensions between traditional (i.e., home) remedies and current medical practices. Equal importance was given to sons and daughters.


Findings suggest that social and cultural influences within families and the community must be considered in developing interventions to improve newborn health. Introducing non-breast milk substances into newborn diets may reduce the duration of exclusive or partial breastfeeding and increase risks to infant health.

Caregiving environment; Community health care; Infant; Newborn; Qualitative; Pakistan