Family planning for women with severe mental illness in rural Ethiopia: a qualitative study

Background: Family planning is a crucial issue for all women of reproductive age, but in women with severe mental illness (SMI) there may be particular challenges and concerns. As primary care-based mental health care is expanded in low- and middle-income countries (LMICs), there is an opportunity to improve family planning services for women with SMI. However, research exploring unmet family planning needs of women with SMI in such settings is scarce. Aim: To explore the family planning experiences, unmet needs and preferences of women with SMI who reside in a predominantly rural area of Ethiopia Methods: A qualitative study design was used. Women with SMI who were participating in the ongoing population-based cohort study in Butajira were selected purposively on the basis of responses to a quantitative survey of current family planning utilization. In-depth interviews were conducted with 16 women with SMI who were of reproductive age until theoretical saturation was achieved. Audio files were transcribed in Amharic, translated into English and analysed using a Framework Approach using Open Code qualitative data analysis software. Results: The findings were grouped into four main themes. The first theme focused on the broader context of intimate relationships and sexual life of women with SMI. Sexual violence, assault and exploitation were reported by several respondents, underlining the vulnerability of women with SMI. Lack of control over sexual contact was associated with unwanted pregnancies. The second theme (childbearing and SMI) was around attitudes towards childbearing in women with SMI. Respondents described negative views from community members and some health professionals about the capacity of a woman with SMI to give birth and bring up a child. In most cases, it was assumed that a woman with SMI should not have a child at all. In the third theme (family planning for women with SMI), respondents spoke of their low access to information about family planning and systematic exclusion from existing services. In the fourth theme (preferred family planning services), the respondents had concerns about the ability of primary care workers to understand their specific family planning needs, but also valued proximity of the service and privacy. The importance of addressing health worker and community attitudes was emphasized. Conclusion: This study has provided in-depth perspectives from women with SMI about the broader context of their family planning experience, needs, barriers and how integrated primary care services could better meet their needs. Empowerment of women with SMI to access information and services needs to be an important focus of future efforts to improve the reproductive experiences of this vulnerable group

Golden Handcuffs: Bill and Melinda Gates Foundation Accountability in Senegal

Honors (Bachelor's)Afroamerican and African StudiesDepartment of AfroAmerican and African StudiesUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/107785/1/jaclsylv.pd

Schooling With Racial Equity at the Center: A Case Study Exploration of One Elementary School-Based Leadership Team

Pre-K–12 schooling in the United States has historically and systemically promoted ideas of Black inferiority while safeguarding the characteristics of white supremacy culture embedded in all aspects of the education system. The notion of white dominance is evident throughout studies, policies, and reports from district, state, and federal officials who have been tasked with closing the achievement gap but instead have assigned blame to BIPOC (Black, Indigenous, and People of Color) students and families. An analysis of the history of U.S. public education reveals not a single achievement gap but multiple opportunity gaps that perpetuate the subjugation of Black students through educational injustice. This study employed critical race theory to examine how a pre-K–5 elementary school community located in the northeastern United States prioritized antiracism and applied a multilayered approach to racial equity. Case study methodology was utilized to unpack the nonlinear and continual racial equity efforts of a school-based leadership team while capturing the school’s journey toward a culture of achievement for Black students. The study’s findings revealed that a multilayered approach to racial equity is collaborative, complex, and context-specific. The study also found that though intentional antiracism efforts grounded in an understanding that racism is pervasive in U.S. education contributed to growth, a school culture of achievement for Black students was not yet realized in this case. Recommendations from this study may inform collaborative practices and processes that school-based leadership teams can leverage to prioritize racial equity and confront white supremacy within pre-K–12 education

“You have waked me all up”: New Women’s reformist utopian novels of the Progressive Era

This dissertation examines women utopian authors of the Progressive Era who depict New Women protagonists awakening to new possibilities for their work, marriages, and domestic responsibilities; these protagonists model the process for other female characters and by extension the novels’ readers. The texts I address in this dissertation are utopian because the female protagonists revise systems of labor, marriage, childcare, domesticity, and racial relations to improve women’s status and to ameliorate society. However, unlike many utopian texts, they do not present an alternative time or location with a revolutionized world, but rather a revised contemporary society, which I term a reformist utopia. While these works reinstate many of the same traditionally patriarchal and capitalist systems, the novels’ tempered radicalism can persuade a wider range of readers about their utopian visions. The New Women’s narratives of reformist utopias frequently begin with the protagonists’ newfound yearning to make money, an unconventional desire for many middle and upper-class women who more often participated in charitable labor. The novels highlight the benefits of women’s profitable work by showcasing its positive impact on individual women and the community. This entry into work could thwart romantic relationships, especially because so many men opposed this pursuit. However, the novels suggest that mutually supportive companionate partnerships fostered women’s autonomy, including their decision to continue wage-earning work after marriage. Although the pervasive racism of the period complicated matters for black women, black authors addressed this oppression by creating localized utopias removed from institutionalized racism. Managing domestic work and childcare while working for wages seemed particularly challenging for women authors to imagine in their contemporary culture, causing them to creating societies outside of the United States that lessen women’s work in the private sphere and enable their development in the public sphere. By demonstrating the potentially transformative consequences of women’s actions, these authors seek to wake up and empower their readers to work for self and community betterment

Liberating Self: An Autoethnographic Inquiry Into Black Male Mental Health

This autoethnography offers a first-person perspective on Black male mental health experiences. It incorporates personal narratives and academic research to explore the intersectionality of race, gender, and mental health, as well as the impact of historical and contemporary systemic racism and discrimination on Black males\u27 psychological and emotional well-being. The Black Liberation Psychology theoretical framework and Africana Studies Conceptual framework examined how cultural norms, hip-hop culture, stigma, and societal factors, including racism, discrimination, and stereotypes about Black masculinity, shape Black male mental health experiences. The study also highlights Black males\u27 development of coping mechanisms and resilience strategies to navigate these challenges. The researcher employs their clinical skills as a licensed clinical social worker to critically analyze firsthand experiences navigating the mental health system, illuminating Black males\u27 unique challenges and barriers throughout their lives. The findings suggest that Black male mental health is a complex issue, significantly impacted by white supremacy, patriarchy, and capitalism. Therefore, African-centered interventions are identified as the only remediation to counteract Eurocentrism\u27s harmful effects on Black males. The study calls for Black social work leadership professionals to create mental health programs that center on Black male experiences. Social work education should also educate prospective and current social work professionals on Black male experiences from a non-deficit perspective, promoting anti-racist practices through autoethnography and recognizing systemic racism and oppression

Embodied Critical Analysis: Exploring the Impact of Systemic Oppression on Black, Public School Educators Through Supervisor Relationships

This critical qualitative dissertation aimed to highlight the experiences and amplify the voices of Black, public school educators in the Boston metro area. Grounded in critical race theory and further defined by trauma and organizational/systems theories, this study illuminated the historical foundation of education as well as the dehumanizing treatment and resilience of Black Americans. This illumination provided a socio-political context that shaped the development of institutional injustice as well as Black educator well-being. With a specific focus on Black educator experiences with supervisors in public schools, specified methodology allowed for most impactful practice leveraging creativity through artistic means. Critical qualitative methodology explored data generation through phenomenological interviews, the selection and exploration of visual aids, and video recording. Embodied critical analysis (ECA), a method I developed and coined, included four phases where participants’ beliefs, feelings, and actions were explored as well as school culture and power. Finding Black educator sustainability and thus well-being have been impacted by direct supervisors, intrapersonal, interpersonal, cultural, and institutional levels were explored. Amidst these levels, racial trauma was present and spectrums of health remained highly subjective and non-binary. Broader themes from findings included that: a) a critical hierarchy of needs for the Black educator must be engaged in order to secure Black educator well-being and holistic sustainability at work, b) individual and community actualization as well as cultural perpetuity are key factors that lead toward self-fulfillment and support a whole-person paradigm grounded in one’s ethnic cultural identity, and c) critical reconstruction or re-imagination of systemic levels are needed to create a conducive environment toward Black educator well-being as well as healthier supervisor relationships. Thus, integrating a multi-dimensional approach to healing where focus on the Black educator, the supervisor, and the organization are interwoven serves as an integral implication for research and practice

Dismantling the Master’s Schoolhouse: The Rhetoric of Education in African American Autobiography and Fiction

This thesis examines rhetorical understandings of education for African Americans in literature of three important time periods of American history. From the post-Reconstruction South, to Northern cities in the 1950s, and finally to 1990s Los Angeles, this is an examination of how African American authors of fiction and autobiography have presented the relationship between literacy acquisition and identity. Underlying the historical and rhetorical examination is the argument that, for African American students, the virtue of the educational space is dubious. It is at once the gateway to the American dream of prosperity, and the venue for the reinforcement of systemic racial prejudice and oppression. This thesis interrogates the cultural belief that literacy is the key to freedom by illustrating ways in which authors complicate the definitions of both literacy and freedom

Theorizing Mental Health Courts

To date, no scholarly article has analyzed the theoretical basis of mental health courts, which currently exist in forty-three states. This Article examines the two utilitarian justifications proposed by mental health court advocates—therapeutic jurisprudence and therapeutic rehabilitation—and finds both insufficient. Therapeutic jurisprudence is inadequate to justify mental health courts because of its inability, by definition, to resolve significant normative conflict. In essence, mental health courts express values fundamentally at odds with those underlying the traditional criminal justice system. Furthermore, the sufficiency of rehabilitation, as this concept appears to be defined by mental health court advocates, depends on the validity of an assumed link between mental illness and crime. In particular, mental health courts view participants\u27 criminal behavior as symptomatic of their mental illnesses and insist that untreated mental illness serves as a major driver of recidivism. Drawing upon social science research and an independent analysis of mental health courts\u27 eligibility criteria, this Article demonstrates that these relationships may not hold for a substantial proportion of individuals served by mental health courts. The Article concludes by identifying alternative theories that may justify this novel diversion intervention

Key Topics on End-of-Life Care for African Americans

Racial classifications of human populations are politically and socially determined. There is no biological or genetic basis for these racial classifications. Health behaviors may be influenced by culture and poverty. Disparities in health outcomes, sometimes resulting in higher mortality rates for African-Americans appear to influence end of life decision-making attitudes and behaviors. To improve the quality of end of life care in African-American communities, health care professionals must better understand and work to eliminate disparities in health care, increase their own skills, knowledge and confidence in palliative and hospice care, and improve awareness of the benefits and values of hospice and palliative care in their patients and families