Teachers’ personal experiences of sexual initiation motivating their sexuality education messages in secondary schools in Kampala, Uganda

Little is known about how teachers’ personal sexual experiences influence their motivations and practices when teaching sexuality education. Cultural schema theory was used to explore teachers’ personal experience of the onset of sexual activity and explain how sexuality education teaching is influenced by such experiences. In-depth interviews were conducted with 40 secondary school teachers in Kampala, Uganda. The interviews were transcribed verbatim and analysed using principles of grounded theory. Findings show that while teachers’ personal experience of sexual initiation did not directly align with the content of their messages, due to the centrality and evocative function of these schemas these experiences strengthened teachers’ motivation to teach sexuality education because they enabled them to empathise with students. The study concludes that teachers’ personal experiences of sexual initiation provide intrinsic motivation for teaching sexuality education. The inclusion of dialogues and activities which encourage self-reflexivity in teacher education and training may improve the delivery of sex, sexuality and relationships education

Building a framework for theory-based ethnographies for studying intergenerational family food practices

AbstractThe growing rates of (childhood) obesity worldwide are a source concern for health professionals, policy-makers, and researchers. The increasing prevalence of associated diseases—such as diabetes, cardiovascular diseases, and psychological problems—shows the impact of obesity on people's health, already from a young age. In turn, these problems have obvious consequences for the health care system, including higher costs. However, the treatment of obesity has proven to be difficult, which makes prevention an important goal. In this study, we focus on food practices, one of the determinants of obesity.In recent years, it has become increasingly clear that interventions designed to encourage healthy eating of children and their families are not having the desired impact, especially among groups with a lower socioeconomic background (SEB). To understand why interventions fail to have an impact, we need to study the embedded social and cultural constructions of families. We argue that we need more than just decision-making theories to understand this cultural embeddedness, and to determine what cultural and social factors influence the decision-making process. By allowing families to explain their cultural background, their capabilities, and their opportunities, we will gain new insights into how families choose what they eat from a complex set of food choices. We have thus chosen to build a framework based on Sen's capability approach and the theory of cultural schemas. This framework, together with a holistic ethnographic research approach, can help us better understand what drives the food choices made in families. The framework is built to serve as a starting point for ethnographic research on food choice in families, and could contribute to the development of interventions that are embedded in the cultural realities of the targeted groups

Does early childbearing and a sterilization-focused family planning programme in India fuel population growth?

Recent stagnation in the reduction of infant mortality in India can arguably be attributed to early child bearing practices and the lack of progress in lengthening birth intervals. Meanwhile, family planning efforts have been particularly successful in the southern states such as Andhra Pradesh, although family limitation is almost exclusively by means of sterilisation at increasingly younger ages. This paper examines the population impact of the unprecedented convergence of early childbearing trajectories in India and quantifies the potential implications stemming from the neglect of strategies that encourage delaying and spacing of births. The effects of adopting a ‘later, longer and fewer’ family planning strategy are compared with the continuation of fertility concentrated in the younger age groups. Results from the cohort component population projections suggest that a policy encouraging later marriage and birth spacing would achieve a future total population which is about 52 million less in 2050 than if the current early fertility trajectory is continued.census, family planning, fertility, India, National Family Health Surveys, population policies, population projections, Sample Registration Systems, sterilisation

The Changing Nature of Home-Based Care for Older Adults in Goa’s Emigrant Households:Implications for Policy and Practice.

In developing countries such as India, the consequences of aging within underdeveloped social security systems coupled with traditional expectations on filial provision of care mean that families continue to remain primary caregivers for dependent older parents. Concerns abound regarding the increasing costs of healthcare, inadequate access to geriatric care, competing time constraints, and difficulties experienced by filial caregivers that could necessitate caregiver support to alleviate burden and provide respite. These concerns are further exemplified in emigration contexts in India where the emigration of the adult child alters traditional filial intergenerational care arrangements. Housed within strong notions of filial piety and a sociocultural reluctance to accept institutional care, this chapter focuses on Goa’s emigrant households where adult children emigration involves leaving behind older parents. We identify, describe, and reflect on the emergence of adaptive intergenerational care arrangements including the emergence of chaperoned provision of care for older parents through engagement of formal home-based older adult care services. While this could potentially offer respite to primary caregivers, it could also end up increasing family involvement in care and significantly impact family caregivers’ financial situation, lead to time constraints, and affect employability. In juxtaposing policy and practice, we abridge that while notions of filial responsibility are being redefined by processes such as modernization and emigration, the preference for home-based care prevails and is interestingly and increasingly becoming visible through adaptive intergenerational care arrangements that are effectuated through filially orchestrated home-based formal care services – an emerging area with regulatory as well as policy implications for both caregivers and care recipients

The Changing Nature of Home-Based Care for Older Adults in Goa’s Emigrant Households:Implications for Policy and Practice.

In developing countries such as India, the consequences of aging within underdeveloped social security systems coupled with traditional expectations on filial provision of care mean that families continue to remain primary caregivers for dependent older parents. Concerns abound regarding the increasing costs of healthcare, inadequate access to geriatric care, competing time constraints, and difficulties experienced by filial caregivers that could necessitate caregiver support to alleviate burden and provide respite. These concerns are further exemplified in emigration contexts in India where the emigration of the adult child alters traditional filial intergenerational care arrangements. Housed within strong notions of filial piety and a sociocultural reluctance to accept institutional care, this chapter focuses on Goa’s emigrant households where adult children emigration involves leaving behind older parents. We identify, describe, and reflect on the emergence of adaptive intergenerational care arrangements including the emergence of chaperoned provision of care for older parents through engagement of formal home-based older adult care services. While this could potentially offer respite to primary caregivers, it could also end up increasing family involvement in care and significantly impact family caregivers’ financial situation, lead to time constraints, and affect employability. In juxtaposing policy and practice, we abridge that while notions of filial responsibility are being redefined by processes such as modernization and emigration, the preference for home-based care prevails and is interestingly and increasingly becoming visible through adaptive intergenerational care arrangements that are effectuated through filially orchestrated home-based formal care services – an emerging area with regulatory as well as policy implications for both caregivers and care recipients

High prevalence of unwanted pregnancies and induced abortions among HIV-infected women from Western India:need to emphasize dual method use?

This study examines the prevalence, reasons, and predictors of unwanted pregnancies and induced abortions among ever married HIV-infected women attending a care facility in Maharashtra, Western India, and discusses its programmatic and policy implications. Retrospectively collected data of pregnancies conceived after the diagnosis of HIV were analyzed using descriptive and logistic regression techniques. Among the 622 women interviewed, 113 women had 158 pregnancies with known outcomes after HIV diagnosis. Among these pregnancies, 80 (51%) were unwanted and 79 (50%) were voluntarily terminated. Fear of transmitting HIV to the child was a frequently mentioned reason for an unwanted pregnancy (71.8%) and induced abortion (59.5%). Women from urban areas [OR 2.43 (95% CI 1.23-4.79)] and with two or more live births before HIV diagnosis [OR 3.33 (95% CI 1.36-8.20)] were significantly more likely to report an unwanted pregnancy. Women with two or more live births before HIV diagnosis [OR 3.16 (95% CI 1.20-8.35)], who did not know that HIV transmission to the baby can be prevented [OR 3.29 (95% CI 1.48-7.34)] and with an unwanted pregnancy [OR 4.82 (95% CI 2.33-10.00)], were significantly more likely to terminate the pregnancy. Despite increased coverage of antiretroviral treatment, effective provision of reproductive healthcare services to HIV-infected women remains challenging. A high prevalence of unwanted pregnancies and induced abortions and a low level of knowledge about prevention of mother to child transmission (PMTCT) underscore the need for preconception counseling and provision of comprehensive family planning services to HIV-infected women. Enrolling all HIV-infected pregnant women, irrespective of their decision to continue with their pregnancy, in the PMTCT program and discussing with HIV-infected women and their partners at HIV diagnosis a full array of contraceptive methods and not just consistent use of condoms might be helpful in reducing unwanted pregnancies.</p

Care Needs and Caregivers: Associations and Effects of Living Arrangements on Caregiving to Older Adults in India

As the ageing phenomenon continues in India, we explore the care needs of older adults and identify caregivers for specific care needs across living arrangements. Using the United Nations Population Fund (UNFPA) conducted Building Knowledge Base on Population Ageing in India (BKPAI 2011) data comprising 9850 older adults, we employed statistical methods to analyze the data, find associations and used binary logistic regression to model the adjusted and unadjusted effects of living arrangements on caregiving to older adults for specific care needs. Care-requiring situations considered were acute sickness, sickness requiring hospitalization, chronic morbidity, functional disability represented by ADL and IADL limitations, and locomotor disability. Results indicate that living arrangements of older adults were significantly associated with health, functional status and disability as well as caregiving patterns. Our results suggest that co-residence with children and all others was beneficial to older adults in obtaining care from a family caregiver for their hospitalization and chronic morbidity needs while living with spouse or living with a partner was advantageous for older adults in receiving care for their ADL limitations and during hospitalizations. Mean number of children was also significantly associated with the availability of a caregiver during hospitalization, locomotor disability, chronic morbidity and acute sickness. The study also highlights a little known phenomenon, that there was familial help available to older adults who lived alone. Notably, non-family sources of caregiving were steadily becoming visible (as high as 8–10 % of the caregiving component) especially among older adults living alone