PhD Student Looks into Culture and Access to Health Care

University of Saskatchewan (USask) College of Nursing Doctor of Philosophy in Nursing (PhD) student Uchechi Opara is conducting research that will improve health-care in her home country of Nigeria. 

Following completion of her master's degree from the University of Worcester, where she explored women's knowledge and satisfaction with maternal health, Opara is spending her PhD diving even deeper into the exploration of how cultural belief and practice influence women's access of the health-care system. 

Her research findings suggest the more health-care professionals understand women's perception of the system, the better public health services can be planned, tailoring services to meet women where they are.  

These findings are even more useful when you consider Nigeria is the world's third-highest contributor to maternal death with a maternal mortality ratio of 1,047 per 100,000 live births. 

Focusing on women in Nigeria's Igala subculture (the country has approximately 250 ethnic groups), Opara completed her field work over four months. She had already spent 20 years as a clinical nurse midwife immersed in this culture, so she says it was almost more challenging to find ways to maintain objectivity than it was to connect. 

"I needed to make the familiar strange," she said. 

Speaking with women in many health-care settings, she looked at maternal health from all angles. 

For example, the role of ancestors in family planning, wherein a belief that a woman has to have the number of children God has planned or risk the deaths of males in their families, including their husbands.  

Another factor in maternal health is a patriarchal society in which women often have little say on decision-making around their own bodies, a fact that can lead to maternal death in some cases.  

Taking herbs is considered very important for pregnancy health, but the pregnancy itself is generally concealed until birth to prevent attacks. Finally, vaginal delivery is highly prized over Cesarean section, to the point where the latter is avoided as much as possible. 

All Opara’s research findings have potential to help inform health-care practitioners about women's attitudes towards maternal health, both in terms of creating public health education and having a practical knowledge of women's understanding and beliefs behind health-care approaches. 

Opara hopes to publish her research and share it through papers and seminars, as well as communicating with local health policy-makers within the community.  

She would like to continue her research with a pivot to focus on how health-care workers operate within this system, and also to help nursing schools become more aware of culturally appropriate models of care. 

Opara said she has enjoyed doing her research at USask College of Nursing, although settling in was a challenge in every respect, from acclimatizing to the culture, the weather, online learning, and even the academic writing style.  

She credits USask graduate learning specialist Jill MacMillan with helping with the latter, and the librarians who helped her source research and complete her literature review.   

"They taught us as international students how to go about writing academically and critically," she said. 

May 28 has been commemorated by women’s health advocates and communities as International Day for Action for Womens' Health.