Traditional belief and practice among the Pokot people of Kenya with particular reference to mother and child health: 2. Mother and child health

Kenya's Pokot people have evolved a range of traditions related to maternal and child health, all of which are intended to optimize the community's survival. While many of these customs succeed in enhancing health and welfare, others actually contribute to morbidity and mortality. A pregnant Pokot woman is regarded as vulnerable to disease and witchcraft, so there are numerous dietary taboos that contribute to a high incidence of low birthweight. At least 1 experienced midwife resides in each neighborhood. Most complications of labor are viewed as a reflection of something the mother has done (e.g., adultery), so there is little intervention. Customs for the postpartum period are concerned with ensuring that the mother is able to devote all her time and energy to caring for her newborn, thereby optimizing the infant's chances of survival. Customs related to the resumption of conjugal sexual relations after delivery reflect an awareness of the importance of spacing births to allow adequate weaning. Breastfeeding is continued until the child is old enough to go to a neighbor on an errand or the mother becomes pregnant. The median age at which breastfeeding is discontinued is 26 months. From the beginning, the newborn is given diluted cow's or goat's milk in addition. The median age for starting food supplementation is 8 months. The major problems at present seem to be inadequate management of complications of labor and the high rate of malnutrition among Pokot children. Attempts should be made to work more closely with traditional midwives, enabling them to develop their already considerable skills, and to implement a method of screening and referring mothers who are likely to have high-risk pregnancies. Malnutrition seems to be increasing as a result of development and the consequent erosion of traditional practices. Pokot society has been influenced by new opportunities in the economic, educational, and social spheres, especially since the introduction of a tarmac road through the district in 1983. Women are increasingly working outside the home and alcohol abuse is a major community problem, both of which have contributed to child neglect.