Assessing the Importance of Gender Roles in Couples’ HomeBased Sexual Health Services in Malawi

Jessica D. Gipson, Carie J. Muntifering, Felluna K. Chauwa, Frank Taulo, Amy O. Tsui, Michelle J. Hindin

Abstract

To more effectively address individuals’ and couples’ sexual and reproductive health needs, innovative service delivery strategies are being explored. These strategies are logistically and ethically complicated, considering prevailing gender inequalities in many contexts. We conducted an exploratory study to assess the acceptability of couples’ home-based sexual health services in Malawi. We collected qualitative data from six focus group discussions and 10 husband-wife indepth interviews to gain a more thorough understanding of how gender norms influence acceptability of couples’ sexual health services. Findings reveal that women are expected to defer to their husbands and may avoid conflict through covert contraceptive use and non-disclosure of HIV status. Many men felt that accessing sexual health services is stigmatizing, causing some to avoid services or to rely on informal information sources. Gender norms and attitudes toward existing services differentially impact men and women in this setting, influencing the perceived benefits of couples’ sexual health services (Afr J Reprod Health 2010; 14[4]: 63-73).

 

Résumé

 

Evaluation de l’importance des rôles du  genre dans les services de santé sexuelle à domicile  des couples. Afin de s’occuper plus effectivement des besoins de santé sexuelle et de reproduction des individus et des couples, nous explorons des stratégies de la prestation des services innovateurs.  Ces stratégies sont compliquées du point de vue logistique et éthique étant donné les inégalités sexuelles actuelles dans plusieurs contextes. Nous avons mené une étude exploratrice pour évaluer l’acceptabilité des services de santé sexuelle à domicile dés couples au Malawi.  Nous avons collecté des données qualitatives à partir de six discussions à groupe cible et 10 interviews  en profondeur homme-femme afin d’avoir une compréhension plus approfondie de la manière dont les normes des sexes influent sur l’acceptabilité des services de santé sexuelle des couples.  Les résultats ont montré que les femmes doivent déférer à leurs maris et peuvent éviter du conflit à travers l’emploi couvert du contraceptif et le non révélation de l’état séropositif.  Plusieurs hommes ont pensé que l’accès aux services de santé sexuelle est stigmatisant, ce qui oblige certains d’entre eux d’éviter les services ou bien de dépendre des sources  d’information non formelles.  Les normes et des attitudes par rapport au  genre envers les services actuels ont des effets divers sur les hommes et les femmes dans ce milieu, tout en influençant les avantages perçus des services de santé sexuelle des couples (Afr J Reprod Health 2010; 14[4]: 63-73).

 

 

Keywords: Gender roles and gender issues, HIV/Aids, contraception, community-based programs and interventions,

Malawi, Africa

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