Journal of Urban Health: Bulletin of the New York Academy of Medicine, 2001
This article seeks to fill the gap in female condom acceptability research by examining family pl... more This article seeks to fill the gap in female condom acceptability research by examining family planning (FP) providers' attitudes and experiences regarding the female condom in three countries (South Africa, the US, and Nigeria) to highlight providers' potential integral role in the introduction of the female condom. The case studies used data drawn from three independent projects, each of which was designed to study or to change FP providers' attitudes and practices in relation to the female condom. The case study for New York City used data from semistructured interviews with providers in one FP consortium in which no special female condom training had been undertaken. The data from South Africa were drawn from transcripts and observations of a female condom training program and from interviews conducted in preparation for the training. The Nigerian study used observations of client visits before and after providers were trained concerning the female condom. In New York City, providers were skeptical about the contraceptive efficacy of the female condom, with only 8 of 22 providers (36%) reporting they would recommend it as a primary contraceptive. In South Africa, providers who had practiced insertion of the female condom as part of their training expressed concern about its physical appearance and effects on sexual pleasure. However, they also saw the female condom as a tool to empower clients to increase their capacity for self-protection. Structured observations of providers' counseling interactions with clients following training indicated that Nigerian providers discussed the female condom with clients in 80% of the visits observed. Despite the lack of a uniform methodology, the three case studies illuminate various dimensions of FP providers' perceptions of the acceptability of the female condom. FP providers must be viewed as a critical factor in female condom acceptability, uptake, and continued use. Designing training programs and other interventions that address sources of provider resistance and enhance providers' skills in teaching female condom negotiation strategies may help to increase clients' use of the female condom.
The narrative approach to identity has developed as a sophisticated philosophical response to the... more The narrative approach to identity has developed as a sophisticated philosophical response to the complexities and ambiguities of the human, lived situation, and is not-as has been naively suggested elsewhere-the imposition of a generic form of life or the attempt to imitate a fictional character. I argue that the narrative model of identity provides a more inclusive and exhaustive account of identity than the causal models employed by mainstream theorists of personal identity. Importantly for ethical subjectivity, the narrative model gives a central and irreducible role to the first-person perspective. I will draw the connection between narrative identity and ethical subjectivity by way of an exposition of work by Paul Ricoeur and Marya Schechtman, and a brief consideration of Korsgaard's work on practical identity and normative ethics. I argue that the first-person perspective-the reflective structure of human consciousness-arises from human embodiment, and therefore the model of identity required of embodied consciousness is more complex and irreducibly first-personal than that provided in a causal account. What is required is a self-constitution model of identity: a narrative model of identity.
Journal of Urban Health: Bulletin of the New York Academy of Medicine, 2001
This article seeks to fill the gap in female condom acceptability research by examining family pl... more This article seeks to fill the gap in female condom acceptability research by examining family planning (FP) providers' attitudes and experiences regarding the female condom in three countries (South Africa, the US, and Nigeria) to highlight providers' potential integral role in the introduction of the female condom. The case studies used data drawn from three independent projects, each of which was designed to study or to change FP providers' attitudes and practices in relation to the female condom. The case study for New York City used data from semistructured interviews with providers in one FP consortium in which no special female condom training had been undertaken. The data from South Africa were drawn from transcripts and observations of a female condom training program and from interviews conducted in preparation for the training. The Nigerian study used observations of client visits before and after providers were trained concerning the female condom. In New York City, providers were skeptical about the contraceptive efficacy of the female condom, with only 8 of 22 providers (36%) reporting they would recommend it as a primary contraceptive. In South Africa, providers who had practiced insertion of the female condom as part of their training expressed concern about its physical appearance and effects on sexual pleasure. However, they also saw the female condom as a tool to empower clients to increase their capacity for self-protection. Structured observations of providers' counseling interactions with clients following training indicated that Nigerian providers discussed the female condom with clients in 80% of the visits observed. Despite the lack of a uniform methodology, the three case studies illuminate various dimensions of FP providers' perceptions of the acceptability of the female condom. FP providers must be viewed as a critical factor in female condom acceptability, uptake, and continued use. Designing training programs and other interventions that address sources of provider resistance and enhance providers' skills in teaching female condom negotiation strategies may help to increase clients' use of the female condom.
The narrative approach to identity has developed as a sophisticated philosophical response to the... more The narrative approach to identity has developed as a sophisticated philosophical response to the complexities and ambiguities of the human, lived situation, and is not-as has been naively suggested elsewhere-the imposition of a generic form of life or the attempt to imitate a fictional character. I argue that the narrative model of identity provides a more inclusive and exhaustive account of identity than the causal models employed by mainstream theorists of personal identity. Importantly for ethical subjectivity, the narrative model gives a central and irreducible role to the first-person perspective. I will draw the connection between narrative identity and ethical subjectivity by way of an exposition of work by Paul Ricoeur and Marya Schechtman, and a brief consideration of Korsgaard's work on practical identity and normative ethics. I argue that the first-person perspective-the reflective structure of human consciousness-arises from human embodiment, and therefore the model of identity required of embodied consciousness is more complex and irreducibly first-personal than that provided in a causal account. What is required is a self-constitution model of identity: a narrative model of identity.
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