Advancing gender equality to improve HIV prevention: A study of practice

Addressing gender inequality as a social driver of HIV risk and vulnerability has become a key activity of non-governmental organisations (NGOs) in South Africa. This paper sheds light on the environmental factors that influence gender and HIV activities in this context. A multisite ethnographic study including 150 hours of participant observation and 32 in-depth interviews was conducted with 26 NGOs carrying out gender and HIV prevention interventions. Using thematic network analysis, 108 different intervention activities were identified, categorised and further analysed to explore environmental factors that influence the design and delivery of these activities. The findings highlight how practitioners draw on different theories of change about how to address the gender inequalities that contribute to HIV risk and vulnerability, which in turn influence the way interventions are delivered. Despite these theoretical differences, commonalities arise in practitioners' use of popular narratives about the right to health and lived experiences of AIDS to ensure interventions are contextually relevant and to gain buy-in from participants. Other environmental factors influencing intervention activities include the role that insecure funding for gender plays in undermining the capacity of practitioners to design interventions based on their local knowledge and experience by forcing NGOs to adapt to the priorities of international donors.

Critiques of health behaviour change programmes

Critics have raised concerns about health behaviour change programmes in the global South. However, there has been very little reflection about what those critiques are critical of and, in particular, what psychology has come to mean within those critiques. The aim of this article was threefold: to describe existing critiques of behaviour change programmes, to reflect on how psychology has been written into those critiques, and to determine what theoretical resources critiques overlook. This article identifies four types of critiques (efficacy, sociological, ethical, and governance) and argues that critiques tend be psychologised and miss important insights from resources related to discourse, gender, knowledge production, and resistance. It is hoped that this article will stimulate further debate about the role of psychology in behaviour change interventions in the global South.

Hearing the silences: Adult Nigerian women’s accounts of ‘early marriages’

‘Early marriage’ is a relatively common but under-researched global phenomenon, associated with poor physical and mental health and educational and occupational outcomes, particularly for young girls. In this article, we draw on qualitative interviews with six Nigerian women from Sokoto state, who were married between the ages of 8 and 15. The interviews explored young women’s experiences of the transition to marriage, being married, pregnancy and their understanding of the marital and parental role. Using interpretive phenomenological analysis, we explore women’s constrained articulations of their experiences of early marriage, as they are constituted within a social context where the identity of ‘woman’ is bound up in values and practices around marriage and motherhood. We explore the complexity of ‘hearing’ women’s experiences when their identities are bound up in culturally overdetermined ideas of femininity that function explicitly to silence and constrain the spaces in which women can speak.

Gender mainstreaming practice: considerations for HIV/AIDS community organisations

Gender is well recognised as a critical consideration for HIV/AIDS organisations. Since the 1990s, HIV/AIDS policy-makers, donors, non-governmental organisations and transnational corporations have adopted gender mainstreaming as the process for integrating gender into development programmes and institutions. There is an increasing body of literature on the successes and challenges of practicing gender mainstreaming within organisational environments, however, little has been said about this practice within HIV/AIDS-specific organisational environments. As a contribution to this gap, this reflective paper aims to generate debate about some of the considerations for gender mainstreaming practice in HIV/AIDS organisations. It draws on the author's experience conducting a gender mainstreaming review with a southern African HIV/AIDS capacity-strengthening organisation, as well as a review of the development literature on gender mainstreaming. The paper looks at three key issues facing gender mainstreaming: (1) donor requirements on disaggregating data by sex; (2) connecting gender mainstreaming with the priorities of community HIV/AIDS organisations; and (3) the role of resistance to gender mainstreaming as neo-colonial. Preliminary understandings of these issues suggest that current approaches to gender mainstreaming may not be flexible enough to consider the multiple ways gender and HIV/AIDS interact in different sociocultural contexts. There is an urgent need for further debate and in-depth research into these issues, given the challenge they pose for HIV/AIDS organisations and donors that have chosen to make gender mainstreaming a criterion for HIV/AIDS funding.

Beijing fifteen years on: the persistence of barriers to gender mainstreaming in health policy

In 2010, fifteen years after the Beijing declaration on women's rights, the UN Commission on the Status of Women met to review progress in gender mainstreaming. Reports on gender equality by member states revealed differences in the degree of change achieved in this period, while highlighting common barriers to gender mainstreaming. The same barriers have long been identified by academics and activists, but prove remarkably resistant to strategies to address gender inequalities. This paper reviews approaches to gender mainstreaming in the context of health policy, and suggests that a model of the obstacles to gender mainstreaming, which identifies barriers as essentially pragmatic, conceptual, or political in origin, might enable a more explicit discussion of the factors underlying this resistance and the ways in which they might be challenged.

The psychologization of humanitarian aid: skimming the battlefield and the disaster zone

Humanitarian aid's psycho-therapeutic turn in the 1990s was mirrored by the increasing emotionalization and subjectivation of fund-raising campaigns. In order to grasp the depth of this interconnectedness, this article argues that in both cases what we see is the post-Fordist production paradigm at work; namely, as Hardt and Negri put it, the direct production of subjectivity and social relations. To explore this, the therapeutic and mental health approach in humanitarian aid is juxtaposed with the more general phenomenon of psychologization. This allows us to see that the psychologized production of subjectivity has a problematic waste-product as it reduces the human to 'Homo sacer', to use Giorgi Agamben's term. Drawing out a double matrix of a de-psychologizing psychologization connected to a politicizing de-politicization, it will further become possible to understand psycho-therapeutic humanitarianism as a case of how, in these times of globalization, psychology, subjectivity and money are all interrelated.

The Millennium Development Goalposts

The United Nations’ Millenium Development Goals (MDGs) work in pervasive and powerful ways in the international imagination, by naturalising a strategic set of goals, indicators and targets, and in doing so, either opening up, or precluding and prescribing particular possibilities for understanding the state of the world and people's experiences. Our departure point for exploring the need for alternative research routes is therefore an engagement with the conceptualisation of ‘development’, the hopeful product of the 2015 target. This conceptual critique is three-fold: 1. There is a slippage in the discourse of the MDGs between ‘poverty’, ‘health’ and ‘development’ and consequently, the relations between different goals are poorly theorised. 2. There is an absence (or extreme paucity) of structural analysis. 3. While people are surely the centre of the developmental goals, in their formulation there is a remarkable absence both of specific groups of people and any conceptualisation of personhood in a more universal human sense. An alternative framework for understanding development and the relations between structure and agency is explored by theorising the themes of gender, national identity and childhood/youth. We then suggest that narrative methodologies may offer a productive research trajectory.