227124 Paradox of cultural competency: Use of social marketing techniques in the 'medicalization' of granny midwives

Sunday, November 7, 2010

Lovetta Brown, MD, MPH , Office of Health Disparity Elimination, MS State Department of Health, Jackson, MS
Gerri A. Cannon-Smith, MD, MPH , School of Public Health, Jackson State University, Jackson, MS
Vincent Mendy, MPH, CPH , Mississippi Delta Health Collaborative, Mississippi State Department of Health, Greenwood, MS
Introduction. At the turn of the last century, infant and maternal mortality rates were astronomically high. Public health /medical approaches in infection control and in education are credited with improving the survival rates of mothers and their children. One of the strategies included the standardization of care given by midwives and involved trainings and required certifications. This session will review the history and the place of the granny midwifes within the culture of communities they served and summarize the trainings offered in terms of the levels of cultural competency and the use of social marketing techniques. The numbers of practicing midwives was markedly decreased by the required certification process as many of these gifted practitioners were not literate. Cultural proficiency and cultural humility represent one end of the spectrum of cultural competence with cultural destruction at the opposite end. This session will allow participants to assess the effects of the training on the practitioners and their communities within a framework of social justice ranking the training practices along the continuum of cultural competency.

Method. Historical literature review of the period was supplemented with of review of training manuals and teaching videos as well as a current literature review (Manual for Midwives, Mississippi State Board of Health, Underwood 1948; Trends in the Public Health activities among Negroes in 96 Southern Counties During the period 1930-1939, Cornely; The Negro: His Relation to Public Health in the South, Terry, 1912).

Learning Areas:
Communication and informatics
Diversity and culture
Other professions or practice related to public health
Public health or related education
Public health or related nursing
Social and behavioral sciences

Learning Objectives:
1. Describe the parallel development of public health nursing and certification of “granny” midwives, both initiated to address the high infant and maternal mortality rates. 2. Describe role of the “granny” midwives as practitioner, health educator and spiritual force in the community. 3. Analyze the culturally targeted practices of the midwifery certification program within the historical, medical, sociopolitical and economical milieu.

Keywords: Health Workers Training, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am the medical Director for Office of Health Disparity Elimination for the State of Mississippi and State Epidemiologist and District Health Officer
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.