'Milking the Cow': Young Women's Constructions of Identity, Gender, Power and Risk in Transactional and Cross-Generational Sexual Relationships

This report presents the findings of a qualitative study carried out in Maputo, Mozambique, among women engaged in cross-generational transactional sex. Cross-generational sex is contributing significantly to the spread of HIV/AIDS in Mozambique and as such is a key area for behaviour change interventinos, although few organisations are currently addressing the issue. The study reveals thta young women engaged in cross-generational and transactional sex have a complex sexual network involving multiple partners, including both transactional and non-transactional relationships.The study was carried out between October and November 2004, using the PEER (participatory ethnographic evaluation and research) method. PEER is an innovative approach to programme research, evaluation and design, based upon training members of the target group (peer researchers) to carry out in-depth qualitative interviews among their peers. Twenty young women in the age group 16-25 years, living in and around central Maputo were recruited as peer researchers. Each peer researcher interviewed three peers and conducted three separate interviews with each peer, with a total of 180 interviews carried out

A Conceptual Framework for the Social Analysis of Reproductive Health

The dominant conceptual framework for understanding reproductive behaviour is highly individualistic. In this article, it is demonstrated that such a conceptualization is flawed, as behaviour is shaped by social relations and institutions. Using ethnographic evidence, the value of a social analysis of the local contexts of reproductive health is highlighted. A framework is set out for conducting such a social analysis, which is capable of generating data necessary to allow health programmes to assess the appropriate means of improving the responsiveness of service-delivery structures to the needs of the most vulnerable. Six key issues are identified in the framework for the analysis of social vulnerability to poor reproductive health outcomes. The key issues are: poverty and livelihood strategies, gender, health-seeking behaviour, reproductive behaviour, and access to services. The article concludes by briefly identifying the key interventions and strategies indicated by such an analysis

Rights, health and power: A critical social analysis of the reproductive health and rights discourse.

"This thesis is a critique of the global reproductive health and rights and discourse, which emanated from the 1994 International Conference on Population and Development. The thesis argues that far from being a new population policy paradigm, the reproductive rights and health discourse is a reworking of a neo-Malthusian and neo-liberal policy agenda. The thesis begins with a consideration of the historical and political context in which international population policy has evolved, and questions the extent to which liberal notions of individual rights freedom and choice, enshrined in the reproductive health discourse, bears a relationship to the social, political and economic realities in which poor and socially marginalized people experience their sexual and reproductive health. Through a critical review of the literature the thesis questions the positivist/functionalist paradigms upon which mainstream demographic and reproductive health research is based. In rejecting both the positivism of mainstream demography as well as the relativism of much post-modernism, the thesis draws eclectically upon post-structuralist and practice theory to suggest a framework for "critical social analysis", which understands sexual and reproductive behaviour as both historically grounded and culturally contingent. Central to the framework is an exploration of how constructions of identity and difference shape social and political practice at the national and local level. Drawing upon case study material from Bolivia, the thesis explores how constructions of identity and difference are embedded in historical and structural conditions of inequality and exploitation. Through an ethnographic study the thesis considers how these structural conditions of inequality become embodied in and reproduced through everyday practices, which ultimately shape the experience of health and well being among poor migrant women. The thesis goes on to suggest a methodological approach entitled the "peer ethnographic method" for incorporating such an understanding of identity and difference into programme design and monitoring.

A Conceptual Framework for the Social Analysis of Reproductive Health

The dominant conceptual framework for understanding reproductive behaviour is highly individualistic. In this article, it is demonstrated that such a conceptualization is flawed, as behaviour is shaped by social relations and institutions. Using ethnographic evidence, the value of a social analysis of the local contexts of reproductive health is highlighted. A framework is set out for conducting such a social analysis, which is capable of generating data necessary to allow health programmes to assess the ap-propriate means of improving the responsiveness of service-delivery structures to the needs of the most vulnerable. Six key issues are identified in the framework for the analysis of social vulnerability to poor reproductive health outcomes. The key issues are: poverty and livelihood strategies, gender, health-seeking behaviour, reproductive behaviour, and access to services. The article concludes by briefly identifying the key interventions and strategies indicated by such an analysis

Dominican Republic (2009): Sexual debut, relationships and condom use among young people aged 15-19 years in the bateyes of Dominican Republic

This report presents results from a process of qualitative research and data synthesis carried out with male and female youth aged 15-19 years in two bateyes (Estrellas and Yabacao) in the Dominican Republic (DR). The work was carried out to provide an evidence base for PSI DR's behaviour change communications programme for HIV prevention for young people living in the bateyes. The PEER method was used to generate in-depth narrative data about the social and economic context of these communities; relationships (including marriage and pre-marital relationships); and perceptions of reproductive health, including family planning (FP) and HIV and AIDS. Data were processed and synthesised using the FoQus on Segmentation approach, producing the dashboard instruments. The dashboards are a synthesis of research findings, designed to help marketers and programmers develop and position products, services and behaviour change interventions that are better tailored to the target group

Researching sexual and reproductive behaviour: a peer ethnographic approach

In recent years, ethnographic research has challenged the notion within demography that fertility-related behaviour is the outcome of individualistic calculations of the costs and benefits of having children. Anthropology has further criticised the abstraction in demographic analysis of sexual behaviour and fertility decision-making from the socio-cultural and political context in which the individual or couple is located. Within demography itself, institutional and political-economic analyses have argued strongly that sexual and reproductive behaviour must be understood within locally specific social, cultural, economic and political contexts. Positivist and empiricist research methods, such as the sample survey and focus groups, which continue to dominate demographic inquiry and applied research into sexual and reproductive behaviour, have been shown to be limited in their ability to inform about the process of behaviour change and contexts within which different behaviours occur. The article introduces a new methodology for researching sexual and reproductive behaviour, called the peer ethnographic approach, which the authors have developed in an attempt to address some of the limitations of the methods which currently dominate research into sexual and reproductive behaviour. The peer ethnographic methodology is discussed in detail and the results of recent field-testing are reported, which show that, although the approach has limitations, it also has the potential to make a significant contribution to our understanding of sexual and reproductive behaviour.Sexual and reproductive behaviour Qualitative research methods Peer ethnography Zambia

Rwanda (2005): Making the Transition from Good Girl to Good Wife: Young Women and Sex-workers' Narratives on Social Life, Sexuality, and Risk: Byumba, Rwanda

This report presents the findings of a qualitative study carried out among young people and commercial sex-workers in the rural province of Byumba, Rwanda. The study was conducted between January and March 2005 using the PEER (participatory ethnographic evaluation and research) method. PEER is an innovative approach to programme research, evaluation, and design. The method is based upon training members of the target group (peer researchers) to carry out in-depth qualitative interviews among their peers. Data for this study were collected over a five-week period, during which time peer researchers received regular supervision from PSI staff. Sixteen peer researchers were selected through the Byumba sex-worker association, and sixteen young people in the age range 15-24 years were recruited through the Byumba youth association. Sex-workers and youth were trained separately

Myanmar (2003): Peer Ethnographic Research with Sex-Workers and Male Students in Yangon

This report presents key findings of peer ethnographic research carried out by PSI Myanmar among female sex-workers and male students between May and August 2003. The peer ethnographic tool has been designed to enable agencies and programmes to gain an in-depth understanding of how people perceive and experience their social worlds, specifically in relation to sexual and reproductive health, through documenting their conversational interactions with peers around key issues. Fifteen sex-workers and fourteen male students were trained as peer researchers and were the key informants for this study. Each of the PERs interviewed 3-4 peers, and these interviews, together with the results of debriefing sessions and synthesis workshops, provide the raw data on which this report is based