Malawi Medical Journal the Journal of Medical Association of Malawi, Sep 1, 2013
The rapid scale-up of free antiretroviral therapy has lead to decline in adult mortality at the p... more The rapid scale-up of free antiretroviral therapy has lead to decline in adult mortality at the population level and reduction of vertical transmission. Consequently, some couples living with HIV are maintaining their reproductive decisions; marrying and having children. This paper analyses policies and guidelines on HIV, AIDS and sexual and reproductive health in Malawi for content on marriage and childbearing for couples living with HIV.
This study explores re-marriage decisions of people living with human immunodeficiency virus (HIV... more This study explores re-marriage decisions of people living with human immunodeficiency virus (HIV) in matrilineal Chiradzulu and patrilineal Chikhwawa communities in Malawi. Specifically, it analyzes reasons and circumstances that come into play as they re-consider marriage relationships. Data were collected from July to December, 2010 using in-depth interviews from eighteen informants purposively sampled and was analyzed using content analysis method. Findings show four main issues; irrespective of kinship organization and despite resistance from kin, women decide to re-marry for financial support while men for physical care and emotional support. In the absence of widow inheritance, widows from patrilineal communities are not receiving the expected support from the deceased husband's relatives leading them to seek support through re-marriage. New marriages in patrilineal communities are supported through traditional marriage formalities. Suggesting that decisions to re-marry are influenced by socio-economic factors. Therefore, we recommend cultural sensitive health programmes embedded in these local realities that accept people living with HIV to remarry and continue to access prevention of mother to child transmission of HIV and antiretroviral therapy services without reprisal.
With wide access to antiretroviral therapy, people living with HIV are living longer. The reducti... more With wide access to antiretroviral therapy, people living with HIV are living longer. The reduction in the mother-to-child transmission of HIV has encouraged some people living with HIV to have children and remarry. However, some continue to have limited access to sexual and reproductive health services. The study explores barriers encountered by couples living with HIV in accessing sexual and reproductive health services using the social ecological model. Data were collected using in-depth interviews with twenty couples purposively sampled in matrilineal Chiradzulu and patrilineal Chikhwawa communities in Malawi from July to December 2010. Data were analyzed using framework analysis method. The study findings identify barriers across the five levels of the social ecological model indicating that the use of sexual and reproductive health services is influenced by diverse factors. We suggest three main areas for primary intervention: services must be located closer to their communities and integrated with existing antiretroviral services. In addition, information gatekeepers, both formal and informal, should be empowered with knowledge about sexual and reproductive health, including HIV and AIDS. Finally, there is a need to coordinate the flow of reproductive health, HIV, and AIDS information between Malawi Ministry of Health and formal and informal organizations.
In the context of increasing access to antiretroviral therapy (ART), the issue of childbearing am... more In the context of increasing access to antiretroviral therapy (ART), the issue of childbearing among people living with HIV is important. The little that is known originates from either studies conducted before widespread availability of highly active ART or has focused on women's or men's reproductive behaviours and experiences. This paper therefore explores factors that influence childbearing decisions of married couples living with HIV in patrilineal and matrilineal kinship communities in rural Malawi. Qualitative exploratory research was conducted in two rural districts in the southern part of Malawi. Data were collected using in-depth interviews from 20 couples purposively sampled in matrilineal (Chiradzulu) and patrilineal (Chikhwawa) communities from July to December 2010 and was analysed using the content analysis method. The research findings show that couples living with HIV continue having children despite knowledge of the risk associated with childbearing and resistance from others in the community. Furthermore, the findings suggest that men are driven to have children by the need to cement relationships (patrilineal and matrilineal communities) and to secure position (matrilineal communities) while women do not want to have children because they are afraid of the risks and a heavier childcare burden. Finally, the findings suggest that outcomes of the decisions are dominated by husbands' desires in both communities. This paper therefore extends the discourse on the value of childbearing beyond the question of adulthood expressed in varying ways according to gender and kinship organisation. We therefore recommend that intervention strategies for both reproductive health and HIV and AIDS must focus on husbands and be sensitive to local culture. The antiretroviral clinics must integrate family planning services in their routine activities and condom use must be complemented with other effective family planning methods to prevent future pregnancies.
nordmenn som reiser til utlandet for å få barn ved hjelp av surrogat, vekker stor oppmerksomhet o... more nordmenn som reiser til utlandet for å få barn ved hjelp av surrogat, vekker stor oppmerksomhet og debatt. Men hva vet vi om kvinnene som baerer fram og føder barn på vegne av andre, og om deres forhold til dem som står klare til å overta barnet ved fødsel? Og i hvilken grad er forskning fra vestlige land som usa og Israel relevant for den nye foretrukne destinasjonen for surrogati, India?
While the issue of caste is one of the major gate-keeping concepts in the ethnography from India,... more While the issue of caste is one of the major gate-keeping concepts in the ethnography from India, hereditary rank has not been given much attention in the studies of the neighbouring Buddhist societies. This article discusses the implications of hereditary low rank in Tibet, and focuses particularly on the limits of participation in various significant networks for cooperation as found in the agrarian Panam, in South-Central Tibet. Challenging local and academic explanations of hereditary low rank as being based in the distribution of work, the author develops a Maussian perspective of moralities of exchange, arguing that although there have been dramatic changes in the local organisation of work in which new types of participation for the low ranked has developed, these types have not included the major village networks, namely the long-lasting household-based mutual aid networks around which Tibetan sociality plays out.
This article discusses what in international literature has commonly been termed the 'vicious cir... more This article discusses what in international literature has commonly been termed the 'vicious circle' of poverty and disability. Our aim is to shed light on recent policies that attempt to break the vicious circle in rural areas in the People's Republic of China. Drawing on data produced from fieldwork conducted in the Inner Mongolia Autonomous Region, People's Republic of China, our approach is to explore experiences that households with people with disabilities have had with a newly implemented rural health insurance reform. The introduction of this reform is significant as lack of insurance and high healthcare expenses are currently perceived as crucial to causing poverty in rural China. We show that people with disabilities have been able to access this new insurance. At the same time, as currently practised, the new insurance does not prevent poor households from sinking deeper into poverty when using healthcare services as healthcare expenses increase.
This study explores re-marriage decisions of people living with human immunodeficiency virus (HIV... more This study explores re-marriage decisions of people living with human immunodeficiency virus (HIV) in matrilineal Chiradzulu and patrilineal Chikhwawa communities in Malawi. Specifically, it analyzes reasons and circumstances that come into play as they re-consider marriage relationships. Data were collected from July to December, 2010 using in-depth interviews from eighteen informants purposively sampled and was analyzed using content analysis method. Findings show four main issues; irrespective of kinship organization and despite resistance from kin, women decide to re-marry for financial support while men for physical care and emotional support. In the absence of widow inheritance, widows from patrilineal communities are not receiving the expected support from the deceased husband's relatives leading them to seek support through re-marriage. New marriages in patrilineal communities are supported through traditional marriage formalities. Suggesting that decisions to re-marry are influenced by socio-economic factors. Therefore, we recommend cultural sensitive health programmes embedded in these local realities that accept people living with HIV to remarry and continue to access prevention of mother to child transmission of HIV and antiretroviral therapy services without reprisal.
Page 1. Commoners and Nobles Hereditary Divisions in Tibet Heidi Fjeld TI noa n -& n &... more Page 1. Commoners and Nobles Hereditary Divisions in Tibet Heidi Fjeld TI noa n -& n <• .in° 3*1 s^H11 5fw"w"»-r 11 11 11 111 HI > ii« Page 2. Page 3. COMMONERS AND NOBLES Th± s One G7UT-Q1S-1GDP Page 4. NORDIC ...
Malawi Medical Journal the Journal of Medical Association of Malawi, Sep 1, 2013
The rapid scale-up of free antiretroviral therapy has lead to decline in adult mortality at the p... more The rapid scale-up of free antiretroviral therapy has lead to decline in adult mortality at the population level and reduction of vertical transmission. Consequently, some couples living with HIV are maintaining their reproductive decisions; marrying and having children. This paper analyses policies and guidelines on HIV, AIDS and sexual and reproductive health in Malawi for content on marriage and childbearing for couples living with HIV.
This study explores re-marriage decisions of people living with human immunodeficiency virus (HIV... more This study explores re-marriage decisions of people living with human immunodeficiency virus (HIV) in matrilineal Chiradzulu and patrilineal Chikhwawa communities in Malawi. Specifically, it analyzes reasons and circumstances that come into play as they re-consider marriage relationships. Data were collected from July to December, 2010 using in-depth interviews from eighteen informants purposively sampled and was analyzed using content analysis method. Findings show four main issues; irrespective of kinship organization and despite resistance from kin, women decide to re-marry for financial support while men for physical care and emotional support. In the absence of widow inheritance, widows from patrilineal communities are not receiving the expected support from the deceased husband's relatives leading them to seek support through re-marriage. New marriages in patrilineal communities are supported through traditional marriage formalities. Suggesting that decisions to re-marry are influenced by socio-economic factors. Therefore, we recommend cultural sensitive health programmes embedded in these local realities that accept people living with HIV to remarry and continue to access prevention of mother to child transmission of HIV and antiretroviral therapy services without reprisal.
With wide access to antiretroviral therapy, people living with HIV are living longer. The reducti... more With wide access to antiretroviral therapy, people living with HIV are living longer. The reduction in the mother-to-child transmission of HIV has encouraged some people living with HIV to have children and remarry. However, some continue to have limited access to sexual and reproductive health services. The study explores barriers encountered by couples living with HIV in accessing sexual and reproductive health services using the social ecological model. Data were collected using in-depth interviews with twenty couples purposively sampled in matrilineal Chiradzulu and patrilineal Chikhwawa communities in Malawi from July to December 2010. Data were analyzed using framework analysis method. The study findings identify barriers across the five levels of the social ecological model indicating that the use of sexual and reproductive health services is influenced by diverse factors. We suggest three main areas for primary intervention: services must be located closer to their communities and integrated with existing antiretroviral services. In addition, information gatekeepers, both formal and informal, should be empowered with knowledge about sexual and reproductive health, including HIV and AIDS. Finally, there is a need to coordinate the flow of reproductive health, HIV, and AIDS information between Malawi Ministry of Health and formal and informal organizations.
In the context of increasing access to antiretroviral therapy (ART), the issue of childbearing am... more In the context of increasing access to antiretroviral therapy (ART), the issue of childbearing among people living with HIV is important. The little that is known originates from either studies conducted before widespread availability of highly active ART or has focused on women's or men's reproductive behaviours and experiences. This paper therefore explores factors that influence childbearing decisions of married couples living with HIV in patrilineal and matrilineal kinship communities in rural Malawi. Qualitative exploratory research was conducted in two rural districts in the southern part of Malawi. Data were collected using in-depth interviews from 20 couples purposively sampled in matrilineal (Chiradzulu) and patrilineal (Chikhwawa) communities from July to December 2010 and was analysed using the content analysis method. The research findings show that couples living with HIV continue having children despite knowledge of the risk associated with childbearing and resistance from others in the community. Furthermore, the findings suggest that men are driven to have children by the need to cement relationships (patrilineal and matrilineal communities) and to secure position (matrilineal communities) while women do not want to have children because they are afraid of the risks and a heavier childcare burden. Finally, the findings suggest that outcomes of the decisions are dominated by husbands' desires in both communities. This paper therefore extends the discourse on the value of childbearing beyond the question of adulthood expressed in varying ways according to gender and kinship organisation. We therefore recommend that intervention strategies for both reproductive health and HIV and AIDS must focus on husbands and be sensitive to local culture. The antiretroviral clinics must integrate family planning services in their routine activities and condom use must be complemented with other effective family planning methods to prevent future pregnancies.
nordmenn som reiser til utlandet for å få barn ved hjelp av surrogat, vekker stor oppmerksomhet o... more nordmenn som reiser til utlandet for å få barn ved hjelp av surrogat, vekker stor oppmerksomhet og debatt. Men hva vet vi om kvinnene som baerer fram og føder barn på vegne av andre, og om deres forhold til dem som står klare til å overta barnet ved fødsel? Og i hvilken grad er forskning fra vestlige land som usa og Israel relevant for den nye foretrukne destinasjonen for surrogati, India?
While the issue of caste is one of the major gate-keeping concepts in the ethnography from India,... more While the issue of caste is one of the major gate-keeping concepts in the ethnography from India, hereditary rank has not been given much attention in the studies of the neighbouring Buddhist societies. This article discusses the implications of hereditary low rank in Tibet, and focuses particularly on the limits of participation in various significant networks for cooperation as found in the agrarian Panam, in South-Central Tibet. Challenging local and academic explanations of hereditary low rank as being based in the distribution of work, the author develops a Maussian perspective of moralities of exchange, arguing that although there have been dramatic changes in the local organisation of work in which new types of participation for the low ranked has developed, these types have not included the major village networks, namely the long-lasting household-based mutual aid networks around which Tibetan sociality plays out.
This article discusses what in international literature has commonly been termed the 'vicious cir... more This article discusses what in international literature has commonly been termed the 'vicious circle' of poverty and disability. Our aim is to shed light on recent policies that attempt to break the vicious circle in rural areas in the People's Republic of China. Drawing on data produced from fieldwork conducted in the Inner Mongolia Autonomous Region, People's Republic of China, our approach is to explore experiences that households with people with disabilities have had with a newly implemented rural health insurance reform. The introduction of this reform is significant as lack of insurance and high healthcare expenses are currently perceived as crucial to causing poverty in rural China. We show that people with disabilities have been able to access this new insurance. At the same time, as currently practised, the new insurance does not prevent poor households from sinking deeper into poverty when using healthcare services as healthcare expenses increase.
This study explores re-marriage decisions of people living with human immunodeficiency virus (HIV... more This study explores re-marriage decisions of people living with human immunodeficiency virus (HIV) in matrilineal Chiradzulu and patrilineal Chikhwawa communities in Malawi. Specifically, it analyzes reasons and circumstances that come into play as they re-consider marriage relationships. Data were collected from July to December, 2010 using in-depth interviews from eighteen informants purposively sampled and was analyzed using content analysis method. Findings show four main issues; irrespective of kinship organization and despite resistance from kin, women decide to re-marry for financial support while men for physical care and emotional support. In the absence of widow inheritance, widows from patrilineal communities are not receiving the expected support from the deceased husband's relatives leading them to seek support through re-marriage. New marriages in patrilineal communities are supported through traditional marriage formalities. Suggesting that decisions to re-marry are influenced by socio-economic factors. Therefore, we recommend cultural sensitive health programmes embedded in these local realities that accept people living with HIV to remarry and continue to access prevention of mother to child transmission of HIV and antiretroviral therapy services without reprisal.
Page 1. Commoners and Nobles Hereditary Divisions in Tibet Heidi Fjeld TI noa n -& n &... more Page 1. Commoners and Nobles Hereditary Divisions in Tibet Heidi Fjeld TI noa n -& n <• .in° 3*1 s^H11 5fw"w"»-r 11 11 11 111 HI > ii« Page 2. Page 3. COMMONERS AND NOBLES Th± s One G7UT-Q1S-1GDP Page 4. NORDIC ...
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