Assessing Cultural Equivalence of a Translated Birth Preparedness and Complications Readiness Education Manual among Hehe Pregnant Women in Southern Tanzania

Assessing Cultural Equivalence of a Translated Birth Preparedness and Complications Readiness Education Manual among Hehe Pregnant Women in Southern Tanzania | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessing Cultural Equivalence of a Translated Birth Preparedness and Complications Readiness Education Manual among Hehe Pregnant Women in Southern Tanzania Rosalia Batista Mwenda, Saada Ali Seif, Rehema Ogha Stephano, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8873294/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Background: Effective Birth Preparedness and Complications Readiness (BPC) communication depends on culturally and linguistically equivalent terminologies. In Tanzania, PPCR materials are often translated into Swahili without systematic assessment of cultural equivalence, which may prevent their cultural relevance and effectiveness. Guided by Cultural Equivalence Theory, aimed to explore locally appropriate language that accurately conveys the intended meaning of BPCR. Methods: A descriptive qualitative study design using focus group discussion in seven villages in two districts in Iringa, Southern Tanzania. Seven FGDs were conducted in Swahili using an interview guide developed from Swahili-translated BPCR content to explore pregnant women’s interpretations of Swahili BPCR concepts. It included 58 women purposively sampled until data saturation was achieved. Data were analyzed thematically to identify patterns of cultural equivalence in terminologies and concepts. Results: The mean age of the women was 28.4 years; they experienced two to three pregnancies and completed primary school. Five themes emerged: (1) cultural and linguistic adaptation enhances comprehension of BPCR concepts; (2) experiential and contextual re-expressing shapes understanding of danger signs; (3) sociolinguistic norms and modesty influenced health communication; (4) partial semantic equivalence and gaps in medical concepts: cord prolapse and neonatal cyanosis; (5) supplement explanatory strategies to bridge conceptual gaps. Conclusion: The findings show that effective BPCR education requires more than word-for-word translation; it must be adapted to the local culture by incorporating local language, real-life experiences, and social language norms and supplementing visual aids with contextual explanations to improve understanding and acceptance. Policymakers and program designers should prioritize culturally responsive revisions of BPCR materials to strengthen maternal and newborn health outcomes in rural and linguistically diverse settings. BPCR cultural equivalence ANC maternal health education pregnant women linguistic adaptation Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 16 May, 2026 Reviewers agreed at journal 09 May, 2026 Reviews received at journal 06 May, 2026 Reviewers agreed at journal 06 May, 2026 Reviewers agreed at journal 14 Apr, 2026 Reviewers agreed at journal 10 Apr, 2026 Reviewers invited by journal 02 Apr, 2026 Editor invited by journal 14 Mar, 2026 Editor assigned by journal 14 Mar, 2026 Submission checks completed at journal 12 Mar, 2026 First submitted to journal 11 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8873294","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":617713056,"identity":"26e3fd6c-23fd-4d0a-a0ce-e197ba1de7b3","order_by":0,"name":"Rosalia Batista Mwenda","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5UlEQVRIiWNgGAWjYFCDA8wHH3xgYEggRQtbsuEMErXwmEnzEKPFvL394aObbTZ5fMfPGBvbttnl8bM3MH74mINbi8wZoMrctrRiyTNphY9z25KLJXsOMEvO3IZbi4REDpt07rbDiRsOJG8G6mVO3HAjgY2ZF6+W9Oe/c7f9T9xw/oGZtGVbPTFaEsyYc7cdAKpMMZNmbDtMhBaeM8bSuf+SE2feeJZs2HPueOLMnoPN+P3C3v7wc84Zu8S+88kHH/woq07sZ28++OEjHi2ogJENTDYQqx4E/pCieBSMglEwCkYKAAD61lolv0eoMgAAAABJRU5ErkJggg==","orcid":"","institution":"the University of Dodoma","correspondingAuthor":true,"prefix":"","firstName":"Rosalia","middleName":"Batista","lastName":"Mwenda","suffix":""},{"id":617713057,"identity":"f7103c58-a795-46d8-8bd1-fd74a8efcd7b","order_by":1,"name":"Saada Ali Seif","email":"","orcid":"","institution":"the University of Dodoma","correspondingAuthor":false,"prefix":"","firstName":"Saada","middleName":"Ali","lastName":"Seif","suffix":""},{"id":617713060,"identity":"18692c9a-43eb-497f-b358-925e898f48dd","order_by":2,"name":"Rehema Ogha Stephano","email":"","orcid":"","institution":"the University of Dodoma","correspondingAuthor":false,"prefix":"","firstName":"Rehema","middleName":"Ogha","lastName":"Stephano","suffix":""},{"id":617713062,"identity":"e66d378f-6246-4b8e-8c9e-a0ba05e47b7d","order_by":3,"name":"Fabiola Vincent Moshi","email":"","orcid":"","institution":"the University of Dodoma","correspondingAuthor":false,"prefix":"","firstName":"Fabiola","middleName":"Vincent","lastName":"Moshi","suffix":""}],"badges":[],"createdAt":"2026-02-13 15:08:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8873294/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8873294/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106364154,"identity":"1bf4cba9-4e09-4fb3-b042-cfa7a45462f1","added_by":"auto","created_at":"2026-04-07 22:09:42","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":573673,"visible":true,"origin":"","legend":"","description":"","filename":"RESEARCHMANUSCRIPT.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8873294/v1_covered_64660b1a-235d-4630-8829-8a4979d0ddb5.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessing Cultural Equivalence of a Translated Birth Preparedness and Complications Readiness Education Manual among Hehe Pregnant Women in Southern Tanzania","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"BPCR, cultural equivalence, ANC, maternal health education, pregnant women, linguistic adaptation","lastPublishedDoi":"10.21203/rs.3.rs-8873294/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8873294/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e \u003cp\u003eEffective Birth Preparedness and Complications Readiness (BPC) communication depends on culturally and linguistically equivalent terminologies. In Tanzania, PPCR materials are often translated into Swahili without systematic assessment of cultural equivalence, which may prevent their cultural relevance and effectiveness. Guided by Cultural Equivalence Theory, aimed to explore locally appropriate language that accurately conveys the intended meaning of BPCR.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e \u003cp\u003eA descriptive qualitative study design using focus group discussion in seven villages in two districts in Iringa, Southern Tanzania. Seven FGDs were conducted in Swahili using an interview guide developed from Swahili-translated BPCR content to explore pregnant women\u0026rsquo;s interpretations of Swahili BPCR concepts. It included 58 women purposively sampled until data saturation was achieved. Data were analyzed thematically to identify patterns of cultural equivalence in terminologies and concepts.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e \u003cp\u003eThe mean age of the women was 28.4 years; they experienced two to three pregnancies and completed primary school. Five themes emerged: (1) cultural and linguistic adaptation enhances comprehension of BPCR concepts; (2) experiential and contextual re-expressing shapes understanding of danger signs; (3) sociolinguistic norms and modesty influenced health communication; (4) partial semantic equivalence and gaps in medical concepts: cord prolapse and neonatal cyanosis; (5) supplement explanatory strategies to bridge conceptual gaps.\u003c/p\u003e\u003ch2\u003eConclusion:\u003c/h2\u003e \u003cp\u003eThe findings show that effective BPCR education requires more than word-for-word translation; it must be adapted to the local culture by incorporating local language, real-life experiences, and social language norms and supplementing visual aids with contextual explanations to improve understanding and acceptance. Policymakers and program designers should prioritize culturally responsive revisions of BPCR materials to strengthen maternal and newborn health outcomes in rural and linguistically diverse settings.\u003c/p\u003e","manuscriptTitle":"Assessing Cultural Equivalence of a Translated Birth Preparedness and Complications Readiness Education Manual among Hehe Pregnant Women in Southern Tanzania","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-07 22:09:33","doi":"10.21203/rs.3.rs-8873294/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-16T06:36:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"150200575500059605913867029695593709134","date":"2026-05-09T07:54:26+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-06T11:31:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"166328606479002287011258834378767955738","date":"2026-05-06T09:15:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"287545520787432348228753004707502926414","date":"2026-04-14T07:58:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"267786535497006755135406526013852071101","date":"2026-04-10T06:22:36+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-02T06:14:57+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-14T18:24:18+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-14T05:23:09+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-12T04:39:56+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Public Health","date":"2026-03-11T22:34:55+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"79ffb7bc-8d96-4dde-ae02-d538456469b8","owner":[],"postedDate":"April 7th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-16T06:36:05+00:00","index":96,"fulltext":""},{"type":"reviewerAgreed","content":"150200575500059605913867029695593709134","date":"2026-05-09T07:54:26+00:00","index":95,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-06T11:31:55+00:00","index":91,"fulltext":""},{"type":"reviewerAgreed","content":"166328606479002287011258834378767955738","date":"2026-05-06T09:15:12+00:00","index":90,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-07T22:09:33+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-07 22:09:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8873294","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8873294","identity":"rs-8873294","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}