Bregje de Kok

Dr Bregje de Kok

Early Career Fellow 2013

Loss in Childbearing in Malawi: Interpretations of Accountability and Blame

Loss in childbearing (maternal mortality; induced and spontaneous abortions; perinatal mortality) is an important problem in sub-Saharan Africa (SSA), specifically, in Malawi. Regardless of sustained global initiatives, maternal mortality (MM) and pregnancy loss are unacceptably common. In Malawi, life-time risk of maternal death is 1 in 18 (UK: 1 in 8200). Delays in seeking and receiving care are important contributors to the burden. They are not fully explained by practical (e.g. costs, distance) and cognitive (lack of knowledge) barriers. We need more insight into how local rationales affect use and provision of care, in particular interpretations of responsibility, blame and women’s entitlement to care.

More information

Research outcomes

de Kok, B. C. (2019).

Between orchestrated and organic: Accountability for loss and the moral landscape of childbearing in Malawi. Social Science & Medicine, 220, 441-449.

Uny, I., de Kok, B., & Fustukian, S. (2019).

Weighing the options for delivery care in rural Malawi: community perceptions of a policy promoting exclusive skilled birth attendance and banning traditional birth attendants. Health policy and planning, 34(3), 161-169.

Pot, H., de Kok, B. C., & Finyiza, G. (2018).

When things fall apart: local responses to the reintroduction of user-fees for maternal health services in rural Malawi. Reproductive health matters, 26(54), 126-136.

Cook, S., de Kok, B., & Odland, M. L. (2017).

‘It’s a very complicated issue here’: understanding the limited and declining use of manual vacuum aspiration for postabortion care in Malawi: a qualitative study. Health Policy and Planning, 32(3), 305-313.

De Kok, B. (2015).

Global maternal health: from women’s survival to respectful care. BJOG: An International Journal of Obstetrics & Gynaecology, 122(2), 248-248.

Simwaka, A. N. K., De Kok, B., & Chilemba, W. (2014).

Women’s perceptions of nurse-Midwives’ caring behaviours during perinatal loss in Lilongwe, Malawi: an exploratory study. Malawi medical journal, 26(1), 8-11.

Areas of interest

Anthropology Healthcare Medical Sociology Psychology Public Health Malawi Southern Africa East Africa Maternity Sexual Reproduction

Cohort

ECF1

Biography

Bregje de Kok received a PhD (2007) and MSc in Psychology (2002) from the University of Edinburgh and an MA in Psychology (cum laude) from the Radboud University Nijmegen. Before joining the University of Amsterdam, she was lecturer at the Institute for Global Health and Development (IGHD) at Queen Margaret University. From 2006 until 2008 she worked as postdoctoral researcher in Sociology at the University of Edinburgh on an interdisciplinary ESRC-MRC fellowship . Before that, she worked as researcher in Nursing studies at the University of Edinburgh on a study examining changes in the health visiting service in Scotland and whether it addressed the needs of Pakistani and Chinese mothers in Scotland.

Central themes in her research are care and morality in the area of reproductive and maternal health. More specifically, she is interested in the normative and moral aspects of sexual, reproductive and maternal health and how these affect community members’ and health professionals’ behaviours, and the interaction between them. She also studies care as practice, and different notions of ‘good’ care. Through ethnography, discourse and conversation analysis, she seeks to illuminate how policies, interventions and care play out on the ground, and contribute to the development of health systems, policies and interventions tailored to local concerns and realities.

Biographical details correct as of 14.01.25