Gendered Patterns of Migration in Rural South Africa

Gender is increasingly recognised as fundamental to understanding migration processes, causes, and consequences. In South Africa, it is intrinsic to the social transformations fueling high levels of internal migration and complex forms of mobility. Although female migration in Africa has often been characterised as less prevalent than male migration and primarily related to marriage, in South Africa, a feminisation of internal migration is underway, fueled by women's increasing labour market participation. In this paper, we report sex differences in patterns, trends, and determinants of internal migration based on data collected in a demographic surveillance system between 2001 and 2006 in rural KwaZulu‐Natal. We show that women were somewhat more likely than men to undertake any migration, but sex differences in migration trends differed by migration flow, with women more likely to migrate into the area than men and men more likely to out‐migrate. Out‐migration was suppressed by marriage, particularly for women, but most women were not married; both men's and women's out‐migrations were undertaken mainly for purposes of employment. Over half of female out‐migrations (vs 35% of male out‐migrations) were to nearby rural areas. The findings highlight the high mobility of this population and the extent to which gender is intimately related to the processes determining migration. We consider the implications of these findings for the measurement of migration and mobility, in particular for health and social policy and research among highly mobile populations in southern Africa. © 2013 The Authors. Population, Space and Place published by John Wiley & Sons Ltd

Gender Attitudes and Fertility Aspirations among Young Men in Five High Fertility East African Countries

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97275/1/j.1728-4465.2013.00341.x.pd

The social meaning of infertility in Southwest Nigeria

There has been very little documentation of the social meaning given to infertility in many developing countries, including Nigeria, where the prevalence of infertility is known to be high. We have conducted a number of qualitative studies aimed at exploring socio-cultural issues associated with infertility in Ile-Ife, Southwestern Nigeria. Twenty-five focus-group discussions were held with knowledgeable persons in the rural and urban parts of the community to ascertain their attitudes towards infertility. The results show that community members accord great significance to child-bearing, but, they have incorrect knowledge of the causes and appropriate treatment of infertility. Focus-group participants mentioned several traditional beliefs regarding the causes of infertility from which they derived a variety of traditional and religious methods for its treatment; many affected couples use these methods of treatment, sometimes singly but most often in combination. Orthodox treatments are less often used because of perceptions of the causes of infertility and lack of confidentiality at the treatment centres. Women are more likely to suffer the social consequences of infertility; they suffer physical and mental abuse, neglect, abandonment, economic deprivation and social ostracism as a result of their infertile status. These findings have profound implications for reproductive health and reproductive rights of women in the area. Measures recommended to ameliorate the adverse consequences of infertility in the community include provision of broad reproductive health education and appropriate services; integration of infertility treatment and prevention into primary health care and the traditional system of health care delivery; and programs aimed at the empowerment of women in the area

Prevalence of the metabolic syndrome in a rural population in Ghana

Abstract Background The Metabolic syndrome (MS) which is a constellation of cardiometabolic risk factors including dyslipidaemia, hypertension, hyperglycaemia, central obesity, and endothelial dysfunction was hitherto relatively uncommon among Africans south of the Sahara. This study seeks to determine the prevalence of MS, its components and risk factors among a rural population in Ghana based on two popular international algorithms. Methods This was a cross-sectional survey of a rural population in Ghana conducted between November and December, 2007. Two hundred and twenty-eight (228) settler farmers, families and staff associated with the GOPDC Ltd, between the ages of 35 and 64 years, were randomly selected for the study; pregnant women were excluded. The prevalence of MS was estimated using the IDF and ATPIII criteria. Results The final subject pool included 102 males, and 104 females. The mean age of all subjects was 44.4 ± 6.9 years. The overall prevalence of MS by the IDF and ATPIII criteria were 35.9% and 15.0%, respectively, but there was an alarming female preponderance by both criteria {IDF: males = 15.7%, females =55.8%; ATPIII: males = 5.9%, females = 24.0%; sex differences p<0.001 for both criteria}. The most important determinants for IDF-defined MS were central obesity (55.3%), low High Density Lipoprotein (42.7%) and high Blood Pressure (39.5%). Conclusion The triad of central obesity, high blood pressure and low HDL were most responsible for the syndrome in this rural population.http://deepblue.lib.umich.edu/bitstream/2027.42/112461/1/12902_2012_Article_148.pd

Sexual and reproductive health : progress and outstanding needs

Accomplishments include a 45% decline in the maternal mortality ratio (MMR) between 1990 and 2013; 11.5% decline in global unmet need for modern contraception; 21% increase in skilled birth attendance; and declines in both the case fatality rate and rate of abortion. Yet aggregate gains mask stark inequalities, with low coverage of services for the poorest women. While there have been notable declines in HIV incidence and prevalence, women affected by HIV are too often bereft of other sexual and reproductive health (SRH) services, including family planning. The paper examines inequalities in SRH outcomes and services both between and within regions and countries

Psychosocial Challenges and Strategies for Coping with HIV Among Adolescents in Uganda: A Qualitative Study

Although more than 90% of youth perinatally infected with HIV live in sub-Saharan Africa, little is known about the psychosocial factors that impact their wellbeing, or how these youth cope with these challenges. The purpose of this study was to identify the psychosocial challenges and coping strategies among perinatal HIV-infected adolescents in Uganda. In-depth interviews were conducted with a purposive sample of 38 HIV-infected adolescents aged 12?19 years at a large HIV treatment center in Kampala. Data were analyzed thematically to identify themes and domains related to stressors and specific coping strategies. Psychosocial challenges included stigma/discrimination, relationship challenges such as HIV status disclosure, and medication difficulties. Coping strategies included medication adherence, concealment or limited disclosure of HIV status, treatment optimism, social support, rationalizing, social comparison, spirituality/religiosity, avoidance, and distraction. Age and gender differences also emerged: younger participants generally lacked specific coping strategies; compared to females, male adolescents reported greater use of avoidance/distraction techniques. Findings underscore the need to address stigma within homes and schools, and to equip adolescents with the comprehensive knowledge and skills to address their varied challenges.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140199/1/apc.2014.0222.pd

Paying to Listen: Notes from a Survey of Sexual Commerce

As the study of sexual commerce has grown dramatically in recent decades due to interest in HIV/AIDS, an expanded literature has scrutinized how research teams manage the operational challenges of accessing spaces that typically resist scrutiny. This paper ventures a combination of both scholarly reflections on the utility of ethical listening and specific methodologies for working with hard-to-reach populations, and selective use of field notes to illustrate the ethical and operational challenges of data collection with marginalized youth. The paper highlights several pivotal commitments and procedures for generating an effective community-based research project, the extent of time demanded for such research, and collective reflections on the potential for both harm and good in such projects. Efforts to understand the social context in which young adults engage in sexual exchange—both on the street and in erotic dance clubs—requires a commitment to ethical listening, and to progressive learning

For money or service? a cross-sectional survey of preference for financial versus non-financial rural practice characteristics among ghanaian medical students

Abstract Background Health worker shortage and maldistribution are among the biggest threats to health systems in Africa. New medical graduates are prime targets for recruitment to deprived rural areas. However, little research has been done to determine the influence of workers' background and future plans on their preference for rural practice incentives and characteristics. The purpose of this study was to identify determinants of preference for rural job characteristics among fourth year medical students in Ghana. Methods We asked fourth-year Ghanaian medical students to rank the importance of rural practice attributes including salary, infrastructure, management style, and contract length in considering future jobs. We used bivariate and multivariate ordinal logistic regression to estimate the association between attribute valuation and students' socio-demographic background, educational experience, and future career plans. Results Of 310 eligible fourth year medical students, complete data was available for 302 students (97%). Students considering emigration ranked salary as more important than students not considering emigration, while students with rural living experience ranked salary as less important than those with no rural experience. Students willing to work in a rural area ranked infrastructure as more important than students who were unwilling, while female students ranked infrastructure as less important than male students. Students who were willing to work in a rural area ranked management style as a more important rural practice attribute than those who were unwilling to work in a rural area. Students studying in Kumasi ranked contract length as more important than those in Accra, while international students ranked contract length as less important than Ghanaian students. Conclusions Interventions to improve rural practice conditions are likely to be more persuasive than salary incentives to Ghanaian medical students who are willing to work in rural environments a priori. Policy experiments should test the impact of these interventions on actual uptake by students upon graduation.http://deepblue.lib.umich.edu/bitstream/2027.42/112499/1/12913_2011_Article_1837.pd