1
|
Surendran-Padmaja S, Khed VD, Krishna VV. What would others say? Exploring gendered and caste-based social norms in Central India through vignettes. WOMENS STUDIES INTERNATIONAL FORUM 2023. [DOI: 10.1016/j.wsif.2023.102692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
|
2
|
Stites E, Krystalli R, Humphrey A, Gathuoy NM. Cattle to cash: Changing marriage practices among displaced people in Bentiu, South Sudan. WOMENS STUDIES INTERNATIONAL FORUM 2022. [DOI: 10.1016/j.wsif.2022.102632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
3
|
Casey EA, Ihrig A, Roman M, Hoxmeier JC, Carlson J, Greer K. Life Course and Socioecological Influences on Gender-Equitable Attitudes Among Men: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:764-777. [PMID: 33267742 DOI: 10.1177/1524838020977140] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Emerging research suggests that holding gender-equitable attitudes (GEA) is associated with decreased risk of gender-based violence perpetration and increased willingness to engage in violence preventative actions among men. GEA, defined here as support for political, economic, and social equity across gender in both public and private spheres, may therefore constitute a protective factor against perpetration and a promotive factor in fostering healthy relationships and communities. Forces that shape GEA throughout boys' and young men's lives are less well articulated. The purpose of this exploratory, scoping review was to synthesize cross-disciplinary research to distill life-course influences on the development of GEA among men. Three databases and Google Scholar were searched to locate peer-reviewed studies that empirically examined GEA as an outcome of childhood, adolescent, or young adulthood factors. Sixty-nine articles were located that, collectively, used data from 97 different countries and identified 22 potential life-course influences on men's GEA. Across studies, facilitators of equitable attitudes included higher levels of education, exposure to gender transformative prevention programming, and having parents who held, modeled, and communicated gender-equitable beliefs. Hindrances to equitable attitudes included but were not limited to religiosity, the transition to fatherhood, and having mostly male peer groups. Findings suggest that opportunities to foster equitable attitudes exist across the life course and both inside and outside of formal prevention or education interventions.
Collapse
Affiliation(s)
- Erin A Casey
- School of Social Work and Criminal Justice, University of Washington, Tacoma, WA, USA
| | - Anna Ihrig
- School of Social Work and Criminal Justice, University of Washington, Tacoma, WA, USA
| | - Melinda Roman
- School of Social Work and Criminal Justice, University of Washington, Tacoma, WA, USA
| | - Jill C Hoxmeier
- Department of Health Sciences, Central Washington University, Ellensburg, WA, USA
| | - Juliana Carlson
- School of Social Welfare, University of Kansas, Lawrence, KS, USA
| | - Kelsey Greer
- School of Social Work and Criminal Justice, University of Washington, Tacoma, WA, USA
| |
Collapse
|
4
|
Goulart CM, Purewal A, Nakhuda H, Ampadu A, Giancola A, Kortenaar JL, Bassani DG. Tools for measuring gender equality and women's empowerment (GEWE) indicators in humanitarian settings. Confl Health 2021; 15:39. [PMID: 34001201 PMCID: PMC8127307 DOI: 10.1186/s13031-021-00373-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/27/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Effective measurement of Gender Equality and Women's Empowerment (GEWE) is challenging in low and middle-income countries (LMICs), and even more so in humanitarian settings. Conflict, natural disasters, and epidemics may increase gender inequities, but also present an opportunity to address them. This scoping review describes and identifies gaps in the measurement tools, methods, and indicators used to measure GEWE in humanitarian settings, and presents a dashboard that can be used by researchers, organizations and governments to identify GEWE measurement tools. METHODS Scientific articles published between January 2004 and November 2019 were identified using Embase, Medline, PsycInfo, CINAHL, Scopus, and PAIS index. Relevant non peer-reviewed literature was downloaded from the websites of humanitarian organizations. Publications on women and/or girls impacted by a humanitarian crisis in a LMIC, within 5 years of data collection, were included. Publications were double-screened in the title/abstract and full-text stages. We used a machine learning software during the title/abstract screening to increase the efficiency of the process. Measurement tools, sampling and data collection methods, gap areas (geographical, topical and contextual), and indicators were catalogued for easy access in an interactive Tableau dashboard. RESULTS Our search yielded 27,197 publications and 2396 non peer-reviewed literature reports. One hundred and seventy publications were included in the final review. Extracted indicators were categorized into seven domains: economic, health, human development, leadership, psychological, security and justice, and sociocultural. The vast majority of studies were observational, and over 70% utilized a cross-sectional study design. Thirty-eight toolkits and questionnaires were identified in this review, of which 19 (50%) were designed specifically for humanitarian settings. Sociocultural was the largest domain in number of studies and indicators in this review, with gender-based violence indicators reported in 66% of studies. Indicators of economic, human development and leadership were uncommon in the peer-reviewed literature. DISCUSSION While there has been some effort to measure GEWE in conflict-affected and other humanitarian settings, measurement has largely focused on violence and security issues. A more comprehensive framework for measuring GEWE in these settings is needed; objective measurement of women's empowerment and gender equality should be prioritized by organizations providing humanitarian aid.
Collapse
Affiliation(s)
- Céline M Goulart
- The Hospital for Sick Children, 686 Bay St, Toronto, ON, M5G 0A4, Canada.
| | - Amber Purewal
- The Hospital for Sick Children, 686 Bay St, Toronto, ON, M5G 0A4, Canada
| | - Humaira Nakhuda
- The Hospital for Sick Children, 686 Bay St, Toronto, ON, M5G 0A4, Canada
| | - Anita Ampadu
- The Hospital for Sick Children, 686 Bay St, Toronto, ON, M5G 0A4, Canada
| | - Amanda Giancola
- The Hospital for Sick Children, 686 Bay St, Toronto, ON, M5G 0A4, Canada
| | - Jean-Luc Kortenaar
- The Hospital for Sick Children, 686 Bay St, Toronto, ON, M5G 0A4, Canada
| | - Diego G Bassani
- The Hospital for Sick Children, 686 Bay St, Toronto, ON, M5G 0A4, Canada
| |
Collapse
|
5
|
Lawson DW, Schaffnit SB, Kilgallen JA, Kumogola Y, Galura A, Urassa M. He for she? Variation and exaggeration in men's support for women's empowerment in northern Tanzania. EVOLUTIONARY HUMAN SCIENCES 2021; 3:e27. [PMID: 37588561 PMCID: PMC10427278 DOI: 10.1017/ehs.2021.23] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Achieving gender equality fundamentally requires a transfer of power from men to women. Yet data on men's support for women's empowerment (WE) remains scant and limited by reliance on self-report methodologies. Here, we examine men's support for WE as a sexual conflict trait, both via direct surveys (n = 590) and indirectly by asking men's wives (n = 317) to speculate on their husband's views. Data come from a semi-urban community in Mwanza, Tanzania. Consistent with reduced resource competition and increased exposure to relatively egalitarian gender norms, higher socioeconomic status predicted greater support for WE. However, potential demographic indicators of sexual conflict (high fertility, polygyny, large spousal age gap) were largely unrelated to men's support for WE. Contrasting self- and wife-reported measures suggests that men frequently exaggerate their support for women in self-reported attitudes. Discrepancies were especially pronounced among men claiming the highest support for WE, but smallest among men who held a professional occupation and whose wife participated in wage labour, indicating that these factors predict genuine support for WE. We discuss the implications of these results for our understanding of both individual variation and patriarchal gender norms, emphasising the benefits of greater exchange between the evolutionary human sciences and global health research on these themes.
Collapse
Affiliation(s)
- David W. Lawson
- Department of Anthropology, University of California, Santa Barbara, California, USA
| | - Susan B. Schaffnit
- Department of Anthropology, University of California, Santa Barbara, California, USA
| | - Joseph A. Kilgallen
- Department of Anthropology, University of California, Santa Barbara, California, USA
| | | | - Anthony Galura
- Department of Anthropology, University of California, Santa Barbara, California, USA
| | - Mark Urassa
- National Institute for Medical Research, Mwanza, Tanzania
| |
Collapse
|
6
|
Vrana-Diaz CJ, Korte JE, Gebregziabher M, Richey L, Selassie A, Sweat M, Chemusto H, Wanyenze R. Socio-demographic predictors of gender inequality among heterosexual couples expecting a child in south-central Uganda. Afr Health Sci 2020; 20:1196-1205. [PMID: 33402966 PMCID: PMC7751526 DOI: 10.4314/ahs.v20i3.23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Gender inequality is a pervasive problem in sub-Saharan Africa, and has negative effects on health and development. OBJECTIVE Here, we sought to identify socioeconomic predictors of gender inequality (measured by low decision-making power and high acceptance of intimate partner violence) within heterosexual couples expecting a child in south-central Uganda. METHOD We used data from a two-arm cluster randomized controlled HIV self-testing intervention trial conducted in three antenatal clinics in south-central Uganda among 1,618 enrolled women and 1,198 male partners. Analysis included Cochran Mantel-Haenzel, proportional odds models, logistic regression, and generalized linear mixed model framework to account for site-level clustering. RESULTS Overall, we found that 31.1% of men had high acceptance of IPV, and 15.9% of women had low decision-making power. We found religion, education, HIV status, age, and marital status to significantly predict gender equality. Specifically, we observed lower gender equality among Catholics, those with lower education, those who were married, HIV positive women, and older women. CONCLUSION By better understanding the prevalence and predictors of gender inequality, this knowledge will allow us to better target interventions (increasing education, reducing HIV prevalence in women, targeting interventions different religions and married couples) to decrease inequalities and improve health care delivery to underserved populations in Uganda.
Collapse
Affiliation(s)
- Caroline J Vrana-Diaz
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite 303, Charleston, SC, USA 29425
| | - Jeffrey E Korte
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite 303, Charleston, SC, USA 29425
| | - Mulugeta Gebregziabher
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite 303, Charleston, SC, USA 29425
| | - Lauren Richey
- Section of Infectious Disease, Department of Medicine, Louisiana State University Health Sciences Center, 1542 Tulane Avenue, Suite 331, New Orleans, LA 70112
| | - Anbesaw Selassie
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite 303, Charleston, SC, USA 29425
| | - Michael Sweat
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 176 Croghan Spur Road, Suite 104, Charleston, SC 29407
| | | | - Rhoda Wanyenze
- School of Public Health, College of Health Sciences, Makerere University, New Mulago Hill Road, Mulago, Kampala, Uganda
| |
Collapse
|
7
|
Belaid L, Bayo P, Kamau L, Nakimuli E, Omoro E, Lobor R, Samson B, Dimiti A. Health policy mapping and system gaps impeding the implementation of reproductive, maternal, neonatal, child, and adolescent health programs in South Sudan: a scoping review. Confl Health 2020; 14:20. [PMID: 32313550 PMCID: PMC7155266 DOI: 10.1186/s13031-020-00258-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 02/06/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Pregnant women, neonates, children, and adolescents are at higher risk of dying in fragile and conflict-affected settings. Strengthening the healthcare system is a key strategy for the implementation of effective policies and ultimately the improvement of health outcomes. South Sudan is a fragile country that faces challenges in implementing its reproductive, maternal, neonatal, child, and adolescent health (RMNCAH) policies. In this paper, we map the key RMNCAH policies and describe the current status of the WHO health system building blocks that impede the implementation of RMNCAH policies in South Sudan. METHODS We conducted a scoping review (39 documents) and individual interviews (n = 8) with staff from the national Ministry of Health (MoH) and implementing partners. We organized a workshop to discuss and validate the findings with the MoH and implementing partner staff. We synthesized and analyzed the data according to the WHO health system building blocks. RESULTS The significant number of policies and healthcare strategic plans focused on pregnant women, neonates, children, and adolescents evidence the political will of the MoH to improve the health of members of these categories of the population. The gap in the implementation of policies is mainly due to the weaknesses identified in different health system building blocks. A critical shortage of human resources across the blocks and levels of the health system, a lack of medicines and supplies, and low national funding are the main identified bottlenecks. The upstream factors explaining these bottlenecks are the 2012 suspension of oil production, ongoing conflict, weak governance, a lack of accountability, and a low human resource capacity. The combined effects of all these factors have led to poor-quality provision and thus a low use of RMNCAH services. CONCLUSION The implementation of RMNCAH policies should be accomplished through innovative and challenging approaches to building the capacities of the MoH, establishing governance and accountability mechanisms, and increasing the health budget of the national government.
Collapse
Affiliation(s)
- Loubna Belaid
- Family Medicine Department, McGill University, 5858 Chemin de la Côte des Neiges, Montréal, Québec Canada
| | | | - Lynette Kamau
- African population and health research center, Nairobi, Kenya
| | - Eva Nakimuli
- Partners in Population and Development Africa Regional Office, Kampala, Uganda
| | - Elijo Omoro
- Torit State Ministry of Health, Juba, South Sudan
| | - Robert Lobor
- WHO, South Sudan Country Office, Juba, South Sudan
| | | | - Alexander Dimiti
- Department of Reproductive of Health, Ministry of Health, Juba, South Sudan
| |
Collapse
|
8
|
Lusey H, San Sebastian M, Christianson M, Edin KE. Prevalence and correlates of gender inequitable norms among young, church-going women and men in Kinshasa, Democratic Republic of Congo. BMC Public Health 2018; 18:887. [PMID: 30016960 PMCID: PMC6050660 DOI: 10.1186/s12889-018-5742-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 06/22/2018] [Indexed: 11/10/2022] Open
Abstract
Background Prolonged political instability may have exacerbated gender inequitable beliefs in the Democratic Republic of Congo (DRC). The aim of this study was to assess attitudes related to gender-equitable norms and its determinants among young, church-going women and men in Kinshasa, DRC. Method Data were collected through a cross-sectional survey with 291 church-going women and 289 men aged 18–24 years old, residing in three disadvantaged communes of Kinshasa. Variables included sociodemographic characteristics, attitudes towards gender equality, and responses to issues related to the gender-equitable men (GEM) scale. The GEM scale is a 24 item-questionnaire developed to measure attitudes towards gender equitable norms. Logistic regression was applied to discover the associations between the independent variables and the GEM outcome. Results Our study reflected the existence of attitudes hampering gender equality that were endorsed by both women and men. For example, 91.4% of women and 83% of men agreed with the statement “a woman’s most important role is to take care of her home and cook for her family”. Similarly, 88.3% of women and 82.9% of men concurred with the idea that men need more sex than women. These findings coexisted with a few equitable norms, because 93.7% of women and 92.3% of men agreed that a man and a woman should decide together if they want to have children. A positive association was found in both women and men between being educated, being single and separated and having supportive attitudes towards gender equality and a higher GEM scale score. Residency in Camp Luka and Masina was also a significant social determinant associated with equitable gender norms among men whilst job status was only significant among women. Conclusion While both women and men had high levels of gender inequitable norms, those with more education, single, and with supportive attitudes to gender equality had high GEM scale scores. The results highlight an urgent need for the church to challenge and change gender norms among church youths.
Collapse
Affiliation(s)
- Hendrew Lusey
- World Council of Churches, Ecumenical HIV and AIDS Initiative and Advocacy (EHAIA), Central Africa regional office, C/o Salvation Army Headquarters, Avenue colonel Ebeya No. 23, B.P: 8636, Kinshasa Gombe, Democratic Republic of Congo. .,Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. .,Sexual and Reproductive Health, Department of Nursing, Umeå University, Umeå, Sweden.
| | - Miguel San Sebastian
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Monica Christianson
- Sexual and Reproductive Health, Department of Nursing, Umeå University, Umeå, Sweden
| | - Kerstin E Edin
- Sexual and Reproductive Health, Department of Nursing, Umeå University, Umeå, Sweden
| |
Collapse
|
9
|
Hayden MH, Barrett E, Bernard G, Toko EN, Agawo M, Okello AM, Gunn JKL, Ernst KC. Barriers and Opportunities to Advancing Women in Leadership Roles in Vector Control: Perspectives from a Stakeholder Survey. Am J Trop Med Hyg 2018; 98:1224-1227. [PMID: 29557326 PMCID: PMC5953369 DOI: 10.4269/ajtmh.17-0693] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Increasing the active participation of professional women in vector control (VC) activities may help promote greater gender equity in the workplace and reduce the burden of vector-borne diseases. This stakeholder survey examined the current roles and perspective of professionals employed in the VC sector in Kenya, Indonesia, India, and other countries. The largest barriers that women face in pursuing leadership roles in the VC sector include lack of awareness of career opportunities, limitations based on cultural norms, and the belief that VC is men’s work. These barriers could be addressed through improving education and recruitment campaigns, as well as supporting higher education and mentoring programs. Females were almost six times more likely to be encouraged to pursue leadership positions in their organization compared with male respondents (odds ratio = 5.9, P > 0.03, 95% confidence interval: 1.19, 29.42). These findings suggest that once women are recruited into the VC workforce, they face minimal discrimination and have increased leadership opportunities.
Collapse
Affiliation(s)
- Mary H Hayden
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, Colorado
| | - Erika Barrett
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Guyah Bernard
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno, Nyanza, Kenya
| | - Eunice N Toko
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno, Nyanza, Kenya
| | - Maurice Agawo
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno, Nyanza, Kenya
| | - Amanda M Okello
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Jayleen K L Gunn
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Kacey C Ernst
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| |
Collapse
|
10
|
Kane S, Kok M, Rial M, Matere A, Dieleman M, Broerse JE. Social norms and family planning decisions in South Sudan. BMC Public Health 2016; 16:1183. [PMID: 27876018 PMCID: PMC5120474 DOI: 10.1186/s12889-016-3839-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 11/15/2016] [Indexed: 11/28/2022] Open
Abstract
Background With a maternal mortality ratio of 789 per 100,000 live births, and a contraceptive prevalence rate of 4.7%, South Sudan has one of the worst reproductive health situations in the world. Understanding the social norms around sexuality and reproduction, across different ethnic groups, is key to developing and implementing locally appropriate public health responses. Methods A qualitative study was conducted in the state of Western Bahr el Ghazal (WBeG) in South Sudan to explore the social norms shaping decisions about family planning among the Fertit community. Data were collected through five focus group discussions and 44 semi-structured interviews conducted with purposefully selected community members and health personnel. Results Among the Fertit community, the social norm which expects people to have as many children as possible remains well established. It is, however, under competitive pressure from the existing norm which makes spacing of pregnancies socially desirable. Young Fertit women are increasingly, either covertly or overtly, making family planning decisions themselves; with resistance from some menfolk, but also support from others. The social norm of having as many children as possible is also under competitive pressure from the emerging norm that equates taking good care of one’s children with providing them with a good education. The return of peace and stability in South Sudan, and people’s aspirations for freedom and a better life, is creating opportunities for men and women to challenge and subvert existing social norms, including but not limited to those affecting reproductive health, for the better. Conclusions The sexual and reproductive health programmes in WBeG should work with and leverage existing and emerging social norms on spacing in their health promotion activities. Campaigns should focus on promoting a family ideal in which children become the object of parental investment, rather than labour to till the land — instead of focusing directly or solely on reducing family size. The conditions are right in WBeG and in South Sudan for public health programmes to intervene to trigger social change on matters related to sexual and reproductive health; this window of opportunity should be leveraged to achieve sustainable change.
Collapse
Affiliation(s)
- Sumit Kane
- KIT Health, Royal Tropical Institute, Mauritskade 63, Amsterdam, 1090 HA, The Netherlands.
| | - Maryse Kok
- KIT Health, Royal Tropical Institute, Mauritskade 63, Amsterdam, 1090 HA, The Netherlands
| | - Matilda Rial
- Independent Consultant, Wau, Western Bahr el Ghazal, South Sudan
| | - Anthony Matere
- School of Public and Environmental Health, University of Bahr el Ghazal, Wau, Western Bahr el Ghazal, South Sudan
| | - Marjolein Dieleman
- KIT Health, Royal Tropical Institute, Mauritskade 63, Amsterdam, 1090 HA, The Netherlands.,Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Jacqueline Ew Broerse
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
11
|
Newmann SJ, Rocca CH, Zakaras JM, Onono M, Bukusi EA, Grossman D, Cohen CR. Does Integrating Family Planning into HIV Services Improve Gender Equitable Attitudes? Results from a Cluster Randomized Trial in Nyanza, Kenya. AIDS Behav 2016; 20:1883-92. [PMID: 26837632 DOI: 10.1007/s10461-015-1279-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study investigated whether integrating family planning (FP) services into HIV care was associated with gender equitable attitudes among HIV-positive adults in western Kenya. Surveys were conducted with 480 women and 480 men obtaining HIV services from 18 clinics 1 year after the sites were randomized to integrated FP/HIV services (N = 12) or standard referral for FP (N = 6). We used multivariable regression, with generalized estimating equations to account for clustering, to assess whether gender attitudes (range 0-12) were associated with integrated care and with contraceptive use. Men at intervention sites had stronger gender equitable attitudes than those at control sites (adjusted mean difference in scores = 0.89, 95 % CI 0.03-1.74). Among women, attitudes did not differ by study arm. Gender equitable attitudes were not associated with contraceptive use among men (AOR = 1.06, 95 % CI 0.93-1.21) or women (AOR = 1.03, 95 % CI 0.94-1.13). Further work is needed to understand how integrating FP into HIV care affects gender relations, and how improved gender equity among men might be leveraged to improve contraceptive use and other reproductive health outcomes.
Collapse
|
12
|
Understanding Factors that Shape Gender Attitudes in Early Adolescence Globally: A Mixed-Methods Systematic Review. PLoS One 2016; 11:e0157805. [PMID: 27341206 PMCID: PMC4920358 DOI: 10.1371/journal.pone.0157805] [Citation(s) in RCA: 198] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 06/06/2016] [Indexed: 12/18/2022] Open
Abstract
Background Early adolescence (ages 10–14) is a period of increased expectations for boys and girls to adhere to socially constructed and often stereotypical norms that perpetuate gender inequalities. The endorsement of such gender norms is closely linked to poor adolescent sexual and reproductive and other health-related outcomes yet little is known about the factors that influence young adolescents’ personal gender attitudes. Objectives To explore factors that shape gender attitudes in early adolescence across different cultural settings globally. Methods A mixed-methods systematic review was conducted of the peer-reviewed literature in 12 databases from 1984–2014. Four reviewers screened the titles and abstracts of articles and reviewed full text articles in duplicate. Data extraction and quality assessments were conducted using standardized templates by study design. Thematic analysis was used to synthesize quantitative and qualitative data organized by the social-ecological framework (individual, interpersonal and community/societal-level factors influencing gender attitudes). Results Eighty-two studies (46 quantitative, 31 qualitative, 5 mixed-methods) spanning 29 countries were included. Ninety percent of studies were from North America or Western Europe. The review findings indicate that young adolescents, across cultural settings, commonly express stereotypical or inequitable gender attitudes, and such attitudes appear to vary by individual sociodemographic characteristics (sex, race/ethnicity and immigration, social class, and age). Findings highlight that interpersonal influences (family and peers) are central influences on young adolescents’ construction of gender attitudes, and these gender socialization processes differ for boys and girls. The role of community factors (e.g. media) is less clear though there is some evidence that schools may reinforce stereotypical gender attitudes among young adolescents. Conclusions The findings from this review suggest that young adolescents in different cultural settings commonly endorse norms that perpetuate gender inequalities, and that parents and peers are especially central in shaping such attitudes. Programs to promote equitable gender attitudes thus need to move beyond a focus on individuals to target their interpersonal relationships and wider social environments. Such programs need to start early and be tailored to the unique needs of sub-populations of boys and girls. Longitudinal studies, particularly from low-and middle-income countries, are needed to better understand how gender attitudes unfold in adolescence and to identify the key points for intervention.
Collapse
|