title: Women’s empowerment, spousal communication and reproductive decision-making in Malawi

authors: Kavinya-Chimbiri, Agnes Mary

abstract: This study is focused on the relationship between women’s power, spousal interactions and reproductive decision-making. It examines the nature of Reproductive Decision-Making Processes (RDMP) and the effect of spousal interactions and power relations on women’s capacity to make autonomous reproductive decisions or to negotiate desired reproductive outcomes. The study questions whether or not women’s empowerment and spousal communication really matters for the spread of family planning in Malawi?

The major findings of the study show that social dynamics at the national, the community, the lineage and the family levels affect the nature of RDMP and their outcomes. A number of indices are identified as having a significant impact on women’s power to participate in RDMP and influence their outcomes. These factors include non-egalitarian lineage or marriage system, women’s perceived autonomy, spousal communication about family planning and exposure to modern ideas and lifestyles.

This study demonstrates that changes in the social context, particularly in the lineage power structures and relationships, influence women’s capacity to participate in deciding to space births, stop child bearing and use family planning methods. For example, the social change that has been taking place in Malawian societies has had an impact on family dynamics and structures. Urbanisation has continuously attracted men and women to migrate to cities leading to the fragmentation of lineages. De facto female-headed households have been on the increase. This has allowed married women to consider making autonomous reproductive decisions to space births using modern contraceptive methods. The reproductive decision-making power of lineage heads has been weakened. Nevertheless, married women are still not able to make autonomous decisions or convince their husbands to use modern contraceptive methods for the purpose of limiting family sizes.

The empirical findings of the study provide a paradox for research and public policies. Contrary to theoretical beliefs and the ‘Cairo Model’, less gender egalitarian lineage and marriage systems permit married women to make autonomous reproductive decisions, whereas more gender egalitarian lineage and marriage systems enable married women to negotiate desired reproductive behaviours and outcomes. In order to meet the needs of these categories of married women, public policies will require analyses that would provide in-depth understanding of the relationship between social change, spousal power relations, reproductive decision-making and family planning.

The few reproductive decision-making power variables identified in this study: lineage, type of union, perceived autonomy, perceived negotiating power, spousal communication and exposure to modern ideas, have only measured the degree of women’s reproductive decision-making power. A more in-depth understanding of why most married women do not have the capacity to make autonomous decisions or to influence their husbands to use modem family planning methods for limiting family sizes is essential. This thesis has partially brought about that understanding. But more in-depth analyses of the impact of men’s power, women’s power, couple power, higher levels of spousal communication and levels of socio-economic development on the nature and outcomes of reproductive decision-making processes is called for. There is need to develop more cultural and socio-economic-based women’s power measures that would allow for more gender and cultural-sensitive research, analyses and policy planning and implementation.

text: Women’s empowerment, spousal communication and reproductive decision-making in Malawi This study is focused on the relationship between women’s power, spousal interactions and reproductive decision-making. It examines the nature of Reproductive Decision-Making Processes (RDMP) and the effect of spousal interactions and power relations on women’s capacity to make autonomous reproductive decisions or to negotiate desired reproductive outcomes. The study questions whether or not women’s empowerment and spousal communication really matters for the spread of family planning in Malawi?

The major findings of the study show that social dynamics at the national, the community, the lineage and the family levels affect the nature of RDMP and their outcomes. A number of indices are identified as having a significant impact on women’s power to participate in RDMP and influence their outcomes. These factors include non-egalitarian lineage or marriage system, women’s perceived autonomy, spousal communication about family planning and exposure to modern ideas and lifestyles.

This study demonstrates that changes in the social context, particularly in the lineage power structures and relationships, influence women’s capacity to participate in deciding to space births, stop child bearing and use family planning methods. For example, the social change that has been taking place in Malawian societies has had an impact on family dynamics and structures. Urbanisation has continuously attracted men and women to migrate to cities leading to the fragmentation of lineages. De facto female-headed households have been on the increase. This has allowed married women to consider making autonomous reproductive decisions to space births using modern contraceptive methods. The reproductive decision-making power of lineage heads has been weakened. Nevertheless, married women are still not able to make autonomous decisions or convince their husbands to use modern contraceptive methods for the purpose of limiting family sizes.

The empirical findings of the study provide a paradox for research and public policies. Contrary to theoretical beliefs and the ‘Cairo Model’, less gender egalitarian lineage and marriage systems permit married women to make autonomous reproductive decisions, whereas more gender egalitarian lineage and marriage systems enable married women to negotiate desired reproductive behaviours and outcomes. In order to meet the needs of these categories of married women, public policies will require analyses that would provide in-depth understanding of the relationship between social change, spousal power relations, reproductive decision-making and family planning.

The few reproductive decision-making power variables identified in this study: lineage, type of union, perceived autonomy, perceived negotiating power, spousal communication and exposure to modern ideas, have only measured the degree of women’s reproductive decision-making power. A more in-depth understanding of why most married women do not have the capacity to make autonomous decisions or to influence their husbands to use modem family planning methods for limiting family sizes is essential. This thesis has partially brought about that understanding. But more in-depth analyses of the impact of men’s power, women’s power, couple power, higher levels of spousal communication and levels of socio-economic development on the nature and outcomes of reproductive decision-making processes is called for. There is need to develop more cultural and socio-economic-based women’s power measures that would allow for more gender and cultural-sensitive research, analyses and policy planning and implementation.

year: 2002

title: “We’re trying to heal, you know?” A mixed methods analysis of the spatial equity of General Practitioner services in the Waikato District Health Board region

authors: Whitehead, Jesse

subjects: spatial equity

abstract: Inequitable access to health services can cause and exacerbate inequities in health outcomes and should therefore be monitored regularly to ensure that service distributions match population needs. Health service accessibility includes several factors and can be monitored using both quantitative and qualitative methods. We present an exploratory analysis of the spatial equity of general practice services in the Waikato District Health Board region using a mixed methods approach. Geographic Information Systems are used to assess the spatial accessibility of GP services, and in-depth qualitative interviews provide a better understanding of not only where inequities exist, but why they occur.

text: “We’re trying to heal, you know?” A mixed methods analysis of the spatial equity of General Practitioner services in the Waikato District Health Board region Inequitable access to health services can cause and exacerbate inequities in health outcomes and should therefore be monitored regularly to ensure that service distributions match population needs. Health service accessibility includes several factors and can be monitored using both quantitative and qualitative methods. We present an exploratory analysis of the spatial equity of general practice services in the Waikato District Health Board region using a mixed methods approach. Geographic Information Systems are used to assess the spatial accessibility of GP services, and in-depth qualitative interviews provide a better understanding of not only where inequities exist, but why they occur.

year: 2020

title: Different coloured tears: Dual cultural identity and Tangihanga

authors: Edge, Kiri

subjects: bereavement

abstract: Although whānau/family that are configured by both Pākehā and Māori identities number significantly within New Zealand, there has been little or no attention paid to the ways in which these identities influence the bereavement processes that will inevitably impact upon the lives of these whānau/family. The present study explored the experiences of an individual, whose whānau/family included two life ways: Māori and Pākehā. Of specific focus was the ways in which these identities influenced his bereavement subsequent to the death of his beloved wife, who was of Māori descent. One elderly male Pākehā participant was interviewed, using an open ended narrative approach. The interview was semi-structured around five broad themes, but the focus was upon the participant’s experiences and his preference in expressing these. The data analysis utilised a thematic process which allowed the participant’s experiences to determine the emergent themes. The results depicted the diversity of issues that may be raised for dual cultural whānau/family within bereavement processes. Two central themes are discussed in relation to intercultural conflict and the eventual resolution that was created. Decision-making processes, cultural and language differences played significant roles within the conflict and exclusion experienced by the participant. Communication and compromise provided resolution to the prior conflicts experienced. This created positive and unexpected outcomes which resulted in increased understandings and the strengthening of links between the participant, his whānau/family and his wife’s marae.

text: Different coloured tears: Dual cultural identity and Tangihanga Although whānau/family that are configured by both Pākehā and Māori identities number significantly within New Zealand, there has been little or no attention paid to the ways in which these identities influence the bereavement processes that will inevitably impact upon the lives of these whānau/family. The present study explored the experiences of an individual, whose whānau/family included two life ways: Māori and Pākehā. Of specific focus was the ways in which these identities influenced his bereavement subsequent to the death of his beloved wife, who was of Māori descent. One elderly male Pākehā participant was interviewed, using an open ended narrative approach. The interview was semi-structured around five broad themes, but the focus was upon the participant’s experiences and his preference in expressing these. The data analysis utilised a thematic process which allowed the participant’s experiences to determine the emergent themes. The results depicted the diversity of issues that may be raised for dual cultural whānau/family within bereavement processes. Two central themes are discussed in relation to intercultural conflict and the eventual resolution that was created. Decision-making processes, cultural and language differences played significant roles within the conflict and exclusion experienced by the participant. Communication and compromise provided resolution to the prior conflicts experienced. This created positive and unexpected outcomes which resulted in increased understandings and the strengthening of links between the participant, his whānau/family and his wife’s marae.

year: 2011