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Gender power dynamics in sexual and reproductive health. A qualitative study in Chiredzi District, Zimbabwe
Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis presents perspectives of men regarding abortion, contraceptive use and sexuality. Contrary to what we had expected, men expressed anxiety over abortion and contraceptive use, not because the issues concerned women’s health, but rather because men associated them with extramarital sexual activity they thought women were concealing. To understand the meanings of sexuality and factors shaping these meanings appeared to be a necessary step in promoting women’s health. We thus included in the study participants with different characteristics including men, women and adolescents, and used a variety of qualitative methods to explore in-depth these issues.

Men’s anxiety over wives’ sexuality seemed to be exacerbated by their separation from the family through labour migration, and their inability to play the expected role of the family breadwinner. The men described using different strategies to ensure their wives did not use contraceptives. Men’s perspectives and the related dynamics seem therefore to be a manifestation of contradictory experiences of gender power within contexts of spousal separation.

The thesis also illuminates the paradoxical situation of adolescents and adolescent sexual and reproductive health. As guardians, the men described how they are intolerant to premarital sex and pregnancy, which might threaten the expected bride wealth from the marriage of a daughter or sister. They therefore respond with violence. Ironically, information or service which would enable unmarried girls to prevent pregnancy is also denied. This is so in spite of the great concern by families over premarital pregnancy, and common knowledge that young girls are sexually abused by adult men. The men and boys described the pressure they exert on the girls for sex, but also how they then blame the girls for deliberately becoming pregnant in order to trap them into marriage. The boys are nevertheless anxious about pregnancy also for fear of family violence and the threat of being forced to terminate schooling. The girls expressed feeling trapped between the violence from guardians and partners, a situation which may lead to unsafe abortion.

The silence, denial and violence imply the young people generally cannot discuss sexual abuse or abortion with parents, or seek health care when needed. Rather, sexually transmitted infections may be ndured or even self-treated, and abortion sought in silence. Preventive actions such as condom use are similarly difficult for the youth. The knowledge the youth may have about AIDS may also simply become a burden when room for applying it is limited.

This thesis challenges public health promotion approaches that assume firstly a universal manifestation of gender power, and secondly ability of individuals to effect behaviour change once provided with information regardless of contextual factors. Whether in AIDS education or involvement of men in sexual and reproductive health, understanding social contexts and dynamics, and identities and experiences within these contexts is crucial.

Place, publisher, year, edition, pages
2004. , 63 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 876
Keyword [en]
Public health
Keyword [sv]
Folkhälsomedicin
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-202ISBN: 91-7305-600-6 (print)OAI: oai:DiVA.org:umu-202DiVA: diva2:142634
Public defence
2004-03-12, Umeå, 09:00 (English)
Available from: 2004-03-02 Created: 2004-03-02 Last updated: 2009-10-16Bibliographically approved
List of papers
1. The hide and seek game: men’s perspectives on abortion and contraceptive use within marriage in a rural community in Zimbabwe
Open this publication in new window or tab >>The hide and seek game: men’s perspectives on abortion and contraceptive use within marriage in a rural community in Zimbabwe
Show others...
2002 (English)In: Journal of Biosocial Science, ISSN 0021-9320, E-ISSN 1469-7599, Vol. 34, no 3, 317-332 p.Article in journal (Refereed) Published
Abstract [en]

This paper is based on a study aimed at understanding the perceptions of men to induced abortion and contraceptive use within marriage in rural Zimbabwe. Two qualitative methods were combined. Men were found to view abortion not as a reproductive health problem for women. Instead, they described abortion as a sign of illicit sexual activity and contraceptive use as a strategy married women use to conceal their involvement in extramarital sexual activity. Men felt anxious and vulnerable for lack of control over women. In the absence of verbal communication on sexual matters, women and men resort to what are called here 'hide-and-seek' strategies, where women acquire and use contraceptives secretly while men search for evidence of such use. It is concluded that promoting women's sexual and reproductive health requires both short- and long-term strategies. The short-term strategy would entail providing women with reproductive technology they can use without risking violence. The long-term strategy would entail understanding men's concerns and the way these are manifested. In turn this requires the use of methodologies that encourage dialogue with research participants, in order to capture their deep meanings and experiences.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-3766 (URN)10.1017/S0021932002003176 (DOI)12117212 (PubMedID)
Available from: 2004-03-02 Created: 2004-03-02 Last updated: 2015-04-29Bibliographically approved
2. Denial and violence: paradoxes in male perspectives to premarital sex and pregnancy in Rural Zimbabwe
Open this publication in new window or tab >>Denial and violence: paradoxes in male perspectives to premarital sex and pregnancy in Rural Zimbabwe
2003 In: Afr Soc Rev, Vol. 7, 53-72 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-3767 (URN)
Available from: 2004-03-02 Created: 2004-03-02Bibliographically approved
3. In the shadow of silenced sexuality: implications for safer sexual practices among school youth in rural Zimbabwe
Open this publication in new window or tab >>In the shadow of silenced sexuality: implications for safer sexual practices among school youth in rural Zimbabwe
Article in journal (Refereed) Submitted
Identifiers
urn:nbn:se:umu:diva-3768 (URN)
Available from: 2004-03-02 Created: 2004-03-02Bibliographically approved
4. Two decades into the AIDS pandemic: Concerns expressed in selfgenerated questions by school youth in a rural area in Zimbabwe
Open this publication in new window or tab >>Two decades into the AIDS pandemic: Concerns expressed in selfgenerated questions by school youth in a rural area in Zimbabwe
Article in journal (Refereed) Submitted
Identifiers
urn:nbn:se:umu:diva-3769 (URN)
Available from: 2004-03-02 Created: 2004-03-02Bibliographically approved

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