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Birth Across Borders: Exploring Contextual Education as a Catalyst for Improved
Birth Outcomes

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L. Dornan, L.Trainor, M. Sinclair, G. Kernohan, and J. McCoy 1
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Institute of Nursing and Health Research, Ulster University, United Kingdom
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Background: Maternal mortality and morbidity are complex global health challenges which have
a significant impact on the health and well-being of families. Understanding unique cultural and contextual
risk factors associated with poor maternal healthcare is critical to the design and implementation of
interventions to improve) maternal healthcare and education in remote and fragile settings.

Objective: To identify and implement a contextually designed, community-based educational meta-
intervention to address risk factors associated with maternal mortality in remote communities of Myanmar.

Methods: A mixed methods approach was implemented with surveys, focus groups and 1-1 interviews.
Samples included pregnant women, fathers, traditional birth attendants and health care
stakeholders. Research tools were designed to incorporate six key constructs: culture, context,
maternal and infant health, education, and entrepreneurship. Data was collected in seven village
tracts across three regions of Myanmar. Quantitative data analysis included descriptive and
inferential statistics using SPSS. Qualitive data were as analysed using a thematic analysis framework.
Ethical approval was granted by Ulster University Ethics Committee.

Results: Qualitative findings indicated that women’s birth experiences were impacted by low literacy
levels, limited access to services and reluctance to leave their communities. Home births and
breastfeeding are culturally accepted norms however, poor traditional birthing practices and limited
antenatal or skilled intra-natal care can contribute to sub-optimal birth outcomes. Quantitative
Oral Presentation Abstracts
findings identified a lack of resources, poor infrastructure and a shortage of trained health care staff
as well as ongoing conflict and a breakdown of multi-disciplinary communication creates critical
delays in care.

Conclusion: Mapping and integrating cultural and contextual barriers into education in regions
with poor infrastructure is critical for strengthening service delivery and improving maternal health
outcomes. Within fragile settings the importance of building strong and effective multi-disciplinary
partnerships is an essential first step in securing longer term implementation of evidence into reality.

Keywords: maternal and child health, educational research, health and global issues

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Correspondence: Lesley Dornan, Institute of Nursing and Health Research, Ulster University,
United Kingdom
E-mail: l.dornan@ulster.ac.uk

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