Towards an integrated conceptual framework for understanding intersecting gender inequities in academic scientific research career progression in higher education institutions in sub-Saharan Africa

The slow progression and under-representation of women in senior scientific career positions is a well-known and persistent global problem, especially among university-based academics, particularly in sub-Saharan Africa (SSA). To inform action for change, we need to go beyond numerical evidence of inequalities to understanding the underlying social, cultural and institutional drivers and processes producing gender inequities in science careers. This requires a theoretically rigorous gender analysis framework that is relevant to SSA and sufficiently accounts for variations among both women and men. Since no such framework is available, we conducted a literature review of emerging theories and empirical evidence on the dimensions of and reasons for the prevailing gender inequities in higher education institutions in SSA. Based on this, we propose an integrated conceptual framework, identify available empirical findings to support it and develop a preliminary explanation of observed inequities. Our findings demonstrate that women’s (lack of) progression in academic/scientific research careers is shaped by intersections between gender roles and social power relations of gender within the family, wider society and academic institutions themselves. We argue that this integrated model provides implications for theory, practice at institutional and policy level, and future research

‘I stayed with my illness’: a grounded theory study of health seeking behaviour and treatment pathways of patients with obstetric fistula in Kenya

Background: Obstetric fistula classic symptoms of faecal and urinary incontinence cause women to live with social stigma, isolation, psychological trauma and lose their source of livelihoods. There is a paucity of studies on the health seeking behaviour trajectories of women with fistula illness although women live with the illness for decades before surgery. We set out to establish the complete picture of women’s health seeking behaviour using qualitative research. We sought to answer the question: what patterns of health seeking do women with obstetric fistula display in their quest for healing? Methods: We used grounded theory methodology to analyse data from narratives of women during inpatient stay after fistula surgery in 3 hospitals in Kenya. Emergent themes contributed to generation of substantive theory and a conceptual framework on the health seeking behaviour of fistula patients. Results: We recruited 121 participants aged 17 to 62 years whose treatment pathways are presented. Participants delayed health seeking, living with fistula illness after their first encounter with unresponsive hospitals. The health seeking trajectory is characterized by long episodes of staying home with illness for decades and consulting multiple actors. Staying with fistula illness entailed health seeking through seven key actions of staying home, trying home remedies, consulting with private health care providers, Non-Governmental organisations, prayer, traditional medicine and formal hospitals and clinics. Long treatment trajectories at hospital resulted from multiple hospital visits and surgeries. Seeking treatment at hospital is the most popular step for most women after recognizing fistula symptoms. Conclusions: We conclude that the formal health system is not responsive to women’s needs during fistula illness. Women suffer an illness with a chronic trajectory and seek alternative forms of care that are not ideally placed to treat fistula illness. The results suggest that a robust health system be provided with expertise and facilities to treat obstetric fistula to shorten women’s treatment pathways

An intersectional gender analysis of familial and socio-cultural drivers of inequitable scientific career progression of researchers in Sub-Saharan Africa

Background Sub-Saharan Africa (SSA) suffers from a dearth of concrete information on the causes of women’s under-representation in scientific research workforce particularly at higher levels compared with the wealth of information that exists in the global north. The goal of this study was to illuminate familial and socio-cultural drivers that contribute to intersectional gender inequities in scientific career progression in SSA to inform strategies that could promote career equity for African scientific researchers. Methods This study was nested within the context of ‘Developing Excellence in Leadership, Training and Science in Africa’ (DELTAS Africa)—a health-based scientific research capacity strengthening initiative. It adopted an exploratory qualitative cross-sectional study design. In-depth interviews were conducted among 58 (32 Female and 26 Male) trainees/research fellows at various career stages, affiliated to three purposively selected African Research Consortia. The interviews were conducted between May and December 2018 in English. The data were analysed inductively based on emergent themes. Results The study participants were nationals of thirteen SSA countries. More female than male participants had young children. Four themes were identified. They illustrate women’s and men’s characterisation of the normative career pathway and progression requirements which calls for significant ‘time’ commitments (theme 1), and how social power relations of gender within the family and wider society shapes their participation in scientific research activities (theme 2). This culminates in researchers'' differential experiences of navigating between the ‘two different lives’—family and career, and the resultant implications for their career progression and personal well-being (theme 3). Women researchers made different and conscious trade-offs for navigating the ‘two different lives’ by utilising various metaphors such as the ‘biological clock and career clock’, the ‘glass ball and rubber ball’, and the concept of ‘sacrifice’ (theme 4). Conclusions This study is the first of its kind to demonstrate how intersectional gender analysis through use of qualitative research methods may provide novel insights into the hidden familial and socio-cultural drivers of gender inequitable scientific research career progression. It offers important policy and practice measures and approaches for fostering career equity for women and men scientists within research capacity strengthening initiatives in SSA

Enablers of gender equitable scientific career progression in Sub-Saharan Africa: Insights from the DELTAS Africa Initiative

Background: This paper present findings on current strategies utilised within selected Developing Excellence in Leadership, Training and Science in Africa’ (DELTAS Africa) consortia to promote gender equitable scientific career progression for researchers, as well as participants’ recommendations for change. Findings are drawn from a wider research study nested within this health-based scientific research capacity strengthening initiative that was aimed at gaining an in-depth understanding of the barriers and enablers of gender equitable scientific career progression for researchers in sub-Saharan Africa. Methods: We adopted an exploratory qualitative cross-sectional study design. The main method of data collection was in-depth interviews (IDIs) with trainees/research fellows at various career stages affiliated to three purposively selected DELTAS Africa Research Consortia. In addition, key informant interviews (KIIs) with consortia research leaders/directors, co-investigators, and management team were also conducted to corroborate information gathered from the IDIs, and to provide additional insights on the enabling factors/actions and policy processes that were currently in place or proposed to enhance gender equitable career progression. In total, fifty-eight IDIs (32 female and 26 male) and twenty KIIs (4 female and 16 male) were conducted. Interviews were carried out between May and December 2018 in English. Data were analysed inductively based on emergent themes, and aligned to the developed integrated conceptual framework. Results: Three overarching themes were identified. First: micro level efforts - individual coping mechanisms and familial level support. Second: Meso level efforts -existing enabling mechanisms at the institutional level. Third: proposed solutions for positive change towards enhancing gender equitable career progression at micro, meso and macro levels. Conclusions: These findings have implications for future research capacity strengthening programming, including DELTAS Africa II initiative (2021-2025); they provide valuable insights on potential strategies and actions aiming to narrow gender inequities in scientific career progression in the context of sub-Saharan African research institutions. Keywords: Researchers’ lived experiences; enabling mechanisms; gender equity; scientific career progression; Sub-Saharan Africa; DELTAS Africa; health research capacity strengthening

Institutional-level drivers of gender-inequitable scientific career progression in sub-Saharan Africa

BACKGROUND: This study sought to determine how institutional environments, including values, policies, and their implementation, shape inequities in scientific career progression for women and men, and their disadvantages in relation to their multiple social identities in sub-Saharan Africa (SSA). The findings are drawn from a wider research study that was aimed at gaining an in-depth understanding of the barriers and enablers of gender-equitable scientific career progression for researchers in SSA. This was nested within the context of the Developing Excellence in Leadership, Training and Science in Africa (DELTAS Africa) programme—a health-based scientific research capacity-strengthening initiative. METHODS: The study adopted an exploratory qualitative cross-sectional study design. In-depth interviews (IDIs) with trainees/research fellows at various career stages supported and/or affiliated to three purposively selected DELTAS Africa Research Consortia were the main method of data collection. In addition, key informant interviews (KIIs) with consortia research leaders/directors, co-investigators, and the consortia management team were also conducted to corroborate information gathered from the IDIs, and also to provide additional insights on the drivers of intersectional gender-inequitable career progression. In total, 58 IDIs (32 female and 26 male) and 20 KIIs (4 female and 16 male) were conducted. The interviews were carried out in English between May and December 2018. The data were analysed inductively based on emergent themes. RESULTS: Three interrelated themes were identified: first, characterization of the institutional environment as highly complex and competitive with regard to advancement opportunities and funding structure; second, inequitable access to support systems within institutions; third, informal rules—everyday experiences of negative practices and culture at the workplace, characterized by negative stereotypical attitudes, gender biases, sexual harassment, and bullying and intimidation. CONCLUSIONS: We contend that understanding and addressing the social power relations at the meso-institutional environment and macro-level contexts could benefit career progression of both female and male researchers by improving work culture and practices, resource allocation, and better rules and policies, thus fostering positive avenues for systemic and structural policy changes

Women’s empowerment and intra-household gender dynamics and practices around sheep and goat production in South East Kenya

Small ruminant production facets like decision-making, ownership, labour allocation, access to- and control over assets are gendered. This study investigates intra-household gender dynamics and practices around sheep and goat production among smallholder farmers in South East region of Kenya. A quantitative study was conducted on 358 dual-headed (married) households to generate gender- disaggregated data on ownership, decision-making and labour allocation around small ruminant production. Qualitative data was collected through focused group discussions to bring out the community perspectives. From the findings, the average number of small ruminants owned by the households as reported by men was slightly higher than women. The average number of small ruminants solely owned by men was significantly higher than by women. Men reported a relatively higher number of jointly owned small ruminants compared to women. More women than men reported that they could give as a gift, sell-off and slaughter jointly owned small ruminants without consulting their spouses. Small ruminants were considered the most important livestock asset in supporting a household’s livelihood by relatively more women than men. Men had more decision-making autonomy over jointly owned small ruminants compared to women. Production tasks around small ruminants such as feeding, watering, selling milk and cleaning housing structures were mostly performed by the women. Qualitative data identified men as the de facto owners of small ruminants with a higher power position in making the important production decisions. The study offers three implications on the design of livestock interventions to empower women, the interventions should ensure that; 1) women are not just owners of livestock assets but also share power and decision-making rights in all aspects of production, 2) production labour is shared equitably between men and women and, 3) women access benefits from livestock production even when animals are owned by men.Bill & Melinda Gates Foundation (BMGF)Global Affairs Canada (GAC

A critical assessment of the WHO responsiveness tool: lessons from voluntary HIV testing and counselling services in Kenya

<p>Abstract</p> <p>Background</p> <p>Health, fair financing and responsiveness to the user's needs and expectations are seen as the essential objectives of health systems. Efforts have been made to conceptualise and measure responsiveness as a basis for evaluating the non-health aspects of health systems performance. This study assesses the applicability of the responsiveness tool developed by WHO when applied in the context of voluntary HIV counselling and testing services (VCT) at a district level in Kenya.</p> <p>Methods</p> <p>A mixed method study was conducted employing a combination of quantitative and qualitative research methods concurrently. The questionnaire proposed by WHO was administered to 328 VCT users and 36 VCT counsellors (health providers). In addition to the questionnaire, qualitative interviews were carried out among a total of 300 participants. Observational field notes were also written.</p> <p>Results</p> <p>A majority of the health providers and users indicated that the responsiveness elements were very important, e.g. confidentiality and autonomy were regarded by most users and health providers as very important and were also reported as being highly observed in the VCT room. However, the qualitative findings revealed other important aspects related to confidentiality, autonomy and other responsiveness elements that were not captured by the WHO tool. Striking examples were inappropriate location of the VCT centre, limited information provided, language problems, and concern about the quality of counselling.</p> <p>Conclusion</p> <p>The results indicate that the WHO developed responsiveness elements are relevant and important in measuring the performance of voluntary HIV counselling and testing. However, the tool needs substantial revision in order to capture other important dimensions or perspectives. The findings also confirm the importance of careful assessment and recognition of locally specific aspects when conducting comparative studies on responsiveness of HIV testing services.</p

Factors Influencing Education and Age at First Marriage in an Arid Region: The Case of the Borana of Marsabit district, Kenya

The role of education in development is widely recognized in many countries. However, the value placed on formal education differs from one community to the next. In this paper I argue that among the Borana pastoralists of Marsabit District, Kenya, the value of formal education is based on wage-labor opportunities. High value placed on women's household labor and low accessibility to non-household employment places differential pressure on the education of Borana children. This leads to a higher dropout rate from school and earlier marriage for female than for the male children