Couples' Agreement on Gender Norms and Modern Contraceptive Use in Urban Nigeria

Around the world, socially defined responsibilities, decision making ability, and control over resources vary for men and women; with men usually having more power than women in social situations. In Nigeria, gender inequity is high and use of family planning (FP) methods is low. However, few studies have examined couples’ agreement on gender norms and how (and if) this relates to modern contraceptive use in urban areas. This dissertation uses a two-paper format to analyze data collected from men and women in four Nigerian cities (Abuja, Ibadan, Ilorin and Kaduna) as part of the Measurement, Learning & Evaluation Project. I retrospectively matched data on 2,184 married couples to investigate couples’ agreement on gender norms (attitudes towards wife beating, household decision making, and restrictions on wife’s activities) and modern contraceptive use between 2010-2014. In the first paper, I present evidence of high inequity among couples on specific gender norms: namely, restrictions on contraceptive use, beating if unfaithful, and husband deciding large household purchases. Adjusted multivariate analysis found couples where both partners favored restricting wife’s activities had 0.31 times lower odds (95% CI: 0.21, 0.45) of using modern contraception as compared to couples who both disapproved of restrictions on wife’s activities. Couples that disagreed about restrictions on wife’s activities had 0.57 times lower odds of using modern contraception as compared to couples that both disapproved of restrictions in multivariate analysis. The wife beating and household decision making measures had more mixed associations with modern contraceptive use. In the second paper, using reproductive calendar data, I find that 37.5% of women adopted modern contraception within the extended postpartum period (i.e.18 months after a birth event). Couples’ agreement on gender norms was not associated with modern contraceptive adoption in this period. However, other variables such as women’s education status and work status were significantly associated with contraceptive adoption, supporting existing evidence on the importance of gender equity. These analyses suggest that even if an individual endorses an equitable viewpoint, their partner’s disagreement could prevent or discourage modern contraceptive use. Understanding of gender norms may promote healthy reproductive lives for married couples in urban Nigeria.Doctor of Philosoph

Deconstructing Urbanicity in Nigeria: Applying an Intersectional Lens to a Secondary Data Analysis of Family Planning usage

An intersectional research paradigm acknowledges the multifaceted, dynamic and relational role of social status on an individual’s daily life. However, traditionally public health research has focused on population level data and aggregate laws of averages. In light of growing health disparities between rich and poor around the world, disaggregate and more intersectional approaches are increasingly needed to increase the use of family planning. In Nigeria, the largest urban population in Africa, the family planning needs of subpopulations of urban women are largely ignored by global donors. This paper attempts to deconstruct the face of urbanicity in Nigeria using an intersectional lens using secondary data from the Measurement Learning and Evaluation program. I review empirical strategies from McCall, Hankivsky and Harnois among others. For example, I examine my analysis from “intracategorical” and “intercategorical” perspectives in the Nigerian context. I aim to identify “structural blindspots” in the measurement and analysis of gender norms and family planning measures. In particular, I examine how different cities, marital types and religions combine to influence women’s social and gender norms. In addition, I explore practical challenges associated with applying an intersectional lens to a large secondary data analysis. In my analysis, I consider the strengths and limitations of using an intersectional approach

Race, Politics, and Health

“Remapping the Margins: The Necessity for an Intersectional Approach in Investigating Black Lesbians in the American South” Jayme N. Canty, Clark Atlanta University “Activist Bodies, Jewish Identities: Profiles of Jewish American Feminists in the Women’s Health Movement, 1968-Present” Jillian M. Hinderliter, University of South Carolina - Columbia “Revisiting Intersectionality: A Framework for Addressing Health Disparities among African American Women” Marcia Davis Taylor, University of South Carolina – Columbia “Deconstructing Urbanicity in Nigeria: Applying an Intersectional Lens to a Secondary Data Analysis of Family Planning Usage” Kashika Sahay, University of North Carolina at Chapel Hil

Struggling Together: the Benefits of Interdisciplinary Classes for Learning Intersectional Approaches

This round table talk will bring together a diverse group of graduate students from the University of North Carolina at Chapel Hill who have recently completed a course on Intersectionality. Discussants come from the School of Public Health, the School of Social Work, Art History, English and Comparative Literature, Communication, and Mathematics. Together we will discuss how we have come to think about intersectionality as a research framework, a method, and as praxis including social justice work and institutional transformation. We will attend to the ways our thinking is shaped by our disciplinary locations and potential barriers to performing intersectional work as graduate students. Most importantly, we will talk about what we perceive as the benefits of learning about and studying intersectionality in an interdisciplinary environment both pedagogically and as a platform for building community across campus

Labor Market Participation and Productivity Costs for Female Caregivers of Minor Male Children With Duchenne and Becker Muscular Dystrophies

Introduction/Aims Duchenne and Becker muscular dystrophies (DBMD) are X-linked neuromuscular disorders characterized by progressive muscle weakness, leading to decreased mobility and multisystem complications. We estimate productivity costs attributable to time spent by a parent caring for a male child under the age of 18 y with DBMD, with particular focus on female caregivers of boys with Duchenne muscular dystrophy (DMD) who have already lost ambulation. Methods Primary caregivers of males with DBMD in the Muscular Dystrophy Surveillance and Research Tracking Network (MD STARnet) were surveyed during 2011–2012 on family quality of life measures, including labor market outcomes. Of 211 respondents, 96 female caregivers of boys with DBMD were matched on state, year of survey, respondent\u27s age, child\u27s age, and number of minor children with controls constructed from Current Population Survey extracts. Regression analysis was used to estimate labor market outcomes and productivity costs. Results Caregivers of boys with DBMD worked 296 h less per year on average than caregivers of unaffected children, translating to a $8816 earnings loss in 2020 U.S. dollars. Caregivers of boys with DMD with ≥4 y of ambulation loss had a predicted loss in annualized earnings of$23,995, whereas caregivers of boys with DBMD of the same ages who remained ambulatory had no loss of earnings. Discussion Female caregivers of non-ambulatory boys with DMD face additional household budget constraints through income loss. Failure to include informal care costs in economic studies could understate the societal cost-effectiveness of strategies for managing DMD that might prolong ambulation