LOGIN TO YOUR ACCOUNT

Username
Password
Remember Me
Or use your Academic/Social account:

CREATE AN ACCOUNT

Or use your Academic/Social account:

Congratulations!

You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.

Important!

Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message

CREATE AN ACCOUNT

Name:
Username:
Password:
Verify Password:
E-mail:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Chikovore, Jeremiah; Hart, Graham; Kumwenda, Moses; Chipungu, Geoffrey A.; Corbett, Liz (2015)
Publisher: Co-Action Publishing
Journal: Global Health Action
Languages: English
Types: Article
Subjects: Public aspects of medicine, Malawi; masculinity; tuberculosis; healthcare seeking; gender; provider; qualitative; low income, Public Health; Sociology; Community Health; Gender Studies
Background: Delay by men in seeking healthcare results in their higher mortality while on HIV or tuberculosis (TB) treatment and contributes to ongoing community-level disease transmission before going on treatment.Objective: To understand masculinity’s role in delay in healthcare seeking for men, with a focus on TB-suggestive symptoms.Design: Data were collected between March 2011 and March 2012 in low-income suburbs in urban Blantyre using focus group discussions with community members (n=8) and health workers (n=2), in-depth interviews with 20 TB patients (female=14) and 20 uninvestigated chronic coughers (female=8), and a 3-day participatory workshop with 27 health stakeholder representatives. The research process drew to a large extent on grounded theory principles in the manner of Strauss and Corbin (1998) and also Charmaz (1995).Results: Role descriptions by both men and women in the study universally assigned men as primary material providers for their immediate family, that is, the ones earning and bringing livelihood and additional material needs. In a context where collectivism was valued, men were also expected to lead the provision of support to wider kin. Successful role enactment was considered key to achieving recognition as an adequate man; at the same time, job scarcity and insecurity, and low earnings gravely impeded men. Pressures to generate continuing income then meant constantly looking for jobs, or working continuously to retain insecure jobs or to raise money through self-employment. All this led men to relegate their health considerations.Conclusions: Early engagement with formal healthcare is critical to dealing with TB and HIV. However, role constructions as portrayed for men in this study, along with the opportunity costs of acknowledging illness seem, in conditions of vulnerability, important barriers to care-seeking. There is a need to address hidden care-seeking costs and to consider more complex interventions, including reducing precarity, in efforts to improve men’s engagement with their health.Keywords: Malawi; masculinity; tuberculosis; healthcare seeking; gender; provider; qualitative; low income(Published: 31 March 2015)Citation: Glob Health Action 2015, 8: 26292 - http://dx.doi.org/10.3402/gha.v8.26292
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. WHO (2013). Global tuberculosis report 2013. Geneva: World Health Organization.
    • 2. Lo¨ nnroth K, Jaramillo E, Williams BG, Dye C, Raviglione M. Drivers of tuberculosis epidemics: the role of risk factors and social determinants. Soc Sci Med 2009; 68: 2240 6.
    • 3. Padian NS, McCoy SI, Karim SSA, Hasen N, Kim J, Bartos M, et al. HIV prevention transformed: the new prevention research agenda. Lancet 2011; 378: 269 78.
    • 4. UNAIDS. The gap report. UNAIDS; 2014. Available from: http://www.unaids.org/en/media/unaids/contentassets/documents/ unaidspublication/2014/UNAIDS_Gap_report_en.pdf [cited 23 January 2015].
    • 5. Jahn A, Floyd S, Crampin AC, Mwaungulu F, Mvula H, Munthali F, et al. Population-level effect of HIV on adult mortality and early evidence of reversal after introduction of antiretroviral therapy in Malawi. Lancet 2008; 371: 1603 11.
    • 6. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 2011; 365: 493 505.
    • 7. Tanser F, Ba¨rnighausen T, Grapsa E, Zaidi J, Newell M-L. High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa. Science 2013; 339: 966 71.
    • 8. Johnson LF, Mossong J, Dorrington RE, Schomaker M, Hoffmann CJ, Keiser O, et al. Life expectancies of South African adults starting antiretroviral treatment: collaborative analysis of cohort studies. PLoS Med 2013; 10: e1001418.
    • 9. Mills EJ, Bakanda C, Birungi J, Chan K, Ford N, Cooper CL, et al. Life expectancy of persons receiving combination antiretroviral therapy in low-income countries: a cohort analysis from Uganda. Ann Intern Med 2011; 155: 209 16.
    • 10. WHO. Tuberculosis. WHO; 2014 [updated March 2014]. Available from: http://www.who.int/mediacentre/factsheets/fs104/en/ [cited 23 January 2015].
    • 11. White A, Cash K. A report on the state of men's health across 17 European countries. Brussels: European Men's Health Forum; 2003.
    • 12. Ayles H, Schaap A, Nota A, Sismanidis C, Tembwe R, De Haas P, et al. Prevalence of tuberculosis, HIV and respiratory symptoms in two Zambian communities: implications for tuberculosis control in the era of HIV. PLoS One 2009; 4: e5602.
    • 13. Corbett EL, Charalambous S, Moloi VM, Fielding K, Grant AD, Dye C, et al. Human immunodeficiency virus and the prevalence of undiagnosed tuberculosis in African gold miners. Am J Respir Crit Care Med 2004; 170: 673 9.
    • 14. Johansson E, Long N, Diwan V, Winkvist A. Gender and tuberculosis control: perspectives on health seeking behaviour among men and women in Vietnam. Health Policy 2000; 52: 33 51.
    • 15. Long NH, Johansson E, Diwan VK, Winkvist A. Fear and social isolation as consequences of tuberculosis in VietNam: a gender analysis. Health Policy 2001; 58: 69 81.
    • 16. Thorson A, Diwan VK. Gender inequalities in tuberculosis: aspects of infection, notification rates, and compliance. Curr Opin Pulm Med 2001; 7: 165 9.
    • 17. Yamasaki-Nakagawa M, Ozasa K, Yamada N, Osuga K, Shimouchi A, Ishikawa N, et al. Gender difference in delays to diagnosis and health care seeking behaviour in a rural area of Nepal. Int J Tuberc Lung Dis 2001; 5: 24 31.
    • 18. Cambanis A, Yassin MA, Ramsay A, Bertel Squire S, Arbide I, Cuevas LE. Rural poverty and delayed presentation to tuberculosis services in Ethiopia. Trop Med Int Health 2005; 10: 330 5.
    • 19. Chiuri W. Men's role in persistent rural poverty: lessons from Kenya. In: Uchendu E, ed. Masculinities in contemporary Africa. Dakar: Council for the Development of Social Science Research in Africa (CODESRIA); 2008, pp. 163 76.
    • 20. Silberschmidt M. Masculinities, sexuality and socio-economic change in rural and urban East Africa. In: Signe A, ed. Rethinking sexualities in Africa. Uppsala: Nordiska Afrikainstitutet; 2004, pp. 233 48.
    • 21. Courtenay WH. Constructions of masculinity and their influence on men's well-being: a theory of gender and health. Soc Sci Med 2000; 50: 1385 401.
    • 22. Connell R. Southern theory: the global dynamics of knowledge in social science. Cambridge: Polity Press; 2007.
    • 23. Connell R. Gender, health and theory: conceptualizing the issue, in local and world perspective. Soc Sci Med 2012; 74: 1675 83.
    • 24. Connell R. Masculinities. Cambridge: Polity Press; 1995.
    • 25. Morrell R. Of boys and men: masculinity and gender in Southern African studies. J S Afr Stud 1998; 24: 605 30.
    • 26. Ahlberg BM. Women, sexuality, and the changing social order: the impact of government policies on reproductive behavior in Kenya. Philadelphia: Gordon & Breach; 1991.
    • 27. Berry S. Access, control and use of resources in African agriculture: an introduction. Africa 1989; 59: 1 5.
    • 28. Coovadia H, Jewkes R, Barron P, Sanders D, McIntyre D. The health and health system of South Africa: historical roots of current public health challenges. Lancet 2009; 374: 817 34.
    • 29. Packard RM. White plague, black labor: tuberculosis and the political economy of health and disease in South Africa. Berkely: University of California Press; 1989.
    • 30. Chikovore J, Makusha T, Richter L. Father involvement in young children's care and education in southern Africa. In: Pattnaik J, ed. Father involvement in young children's lives. New York: Springer; 2013, pp. 261 78.
    • 31. Fielder A. The politics of reading the 'postnational': hybridity and neocolonial critique in Djibril Diop Mambety's Hyenes. 1999. Available from: http://english.chass.ncsu.edu/jouvert/v3i3/ fielde.htm [cited 22 January 2015].
    • 32. Malik K. Human development report 2013. The rise of the South: human progress in a diverse world. New York: United Nations Development Programme; 2013.
    • 33. Aggarwal A, Hofmann C, Phiri A. A study on informal apprenticeship in Malawi. Employment Report No. 9. Geneva: International Labour Organization; 2010.
    • 34. Habitat (2010). Malawi: urban housing sector profile. Nairobi: Habitat.
    • 35. Habitat (2012). Blantyre urban sector profile. Nairobi: Habitat.
    • 36. WHO. Global observatory data repository. Geneva: WHO. Available from: http://apps.who.int/gho/data/?theme country &vid 12800 [cited 5 September 2014].
    • 37. Sandelowski M. Triangles and crystals: on the geometry of qualitative research. Res Nurs Health 1995; 18: 569 74.
    • 38. Marshall MN. Sampling for qualitative research. Fam Pract 1996; 13: 522 6.
    • 39. Chikovore J, Hart G, Kumwenda M, Chipungu GA, Desmond N, Corbett L. Control, struggle, and emergent masculinities: a qualitative study of men's care-seeking determinants for chronic cough and tuberculosis symptoms in Blantyre, Malawi. BMC Public Health 2014; 14: 1053.
    • 40. Strauss A, Corbin J. Basics of qualitative research: techniques and procedures for developing grounded theory. Thousand Oaks, CA: Sage; 1998.
    • 41. Charmaz K. The search for meaning grounded theory. In: Smith JA, Harre´ R, van Langenhove L, eds. Rethinking methods in psychology. London: Sage; 1995, pp. 27 65.
    • 42. Farquhar C, Das R. Are focus groups suitable for 'sensitive' topics. In: Barbour RS, Kitzinger J, eds. Developing focus group research: politics, theory and practice. London: Sage; 1999, pp. 47 63.
    • 43. Morgan DL, Krueger RA, King J. The focus group kit. Vol. 1 6. Thousand Oaks, CA: Sage; 1998.
    • 44. Morse JM, Barrett M, Mayan M, Olson K, Spiers J. Verification strategies for establishing reliability and validity in qualitative research. Int J Qual Methods 2008; 1: 13 22.
    • 45. World-Bank (2011). World development report 2012: gender equality and development. Washington, DC: World Bank.
    • 46. Mavungu EM. Provider expectations and father involvement: learning from experiences of poor 'absent fathers' in Gauteng, South Africa. Afr Sociol Rev 2014; 17: 65 78.
    • 47. Morrell R. Fathers, fatherhood and masculinity in South Africa. In: Richter L, Morrell R, eds. BABA: men and fatherhood in South Africa. Cape Town: HSRC Press; 2006, pp. 13 25.
    • 48. Kamwangamalu NM. Ubuntu in South Africa: a sociolinguistic perspective to a pan-African concept. Crit Arts 1999; 13: 24 41.
    • 49. Jacobs JA, Gerson K. Overworked individuals or overworked families? Explaining trends in work, leisure, and family time. Work Occup 2001; 28: 40 63.
    • 50. Silberschmidt M. Disempowerment of men in rural and urban East Africa: implications for male identity and sexual behavior. World Dev 2001; 29: 657 71.
    • 51. Chant S. Households, gender and rural-urban migration: reflections on linkages and considerations for policy. Environ Urban 1998; 10: 5 22.
    • 52. Mokomane Z, Chikovore J, Makiwane M, Makoae M, Molotja N, Roberts B, et al. Independent assessment of the implementation of the programme of action (POA) of the international conference on population and development (ICPD). Pretoria: Human Sciences Research Council; 2010.
    • 53. Sonke-Gender-Justice-Network (2014). Engaging men in HIV and GBV prevention, SRH promotion, parenting and LGBTI issues: Malawi. Johannesburg: Sonke Gender Justice Network.
    • 54. Kaufman M. Men, feminism, and men's contradictory experiences of power. In: Brod H, Kaufman M, eds. Research on men and masculinities: theorizing masculinities. Thousand Oaks, CA: Sage; 1994, pp. 142 63.
    • 55. Kimmel MS. Masculinity as homophobia: fear, shame, and silence in the construction of gender identity. In: Brod H, Kaufman M, eds. Research on men and masculinities: theorizing masculinities. Thousand Oaks, CA: Sage; 2004, pp. 119 41.
    • 56. Galdas PM, Johnson JL, Percy ME, Ratner PA. Help seeking for cardiac symptoms: beyond the masculine feminine binary. Soc Sci Med 2010; 71: 18 24.
    • 57. Beall J, Kanji N. Households, livelihoods and urban poverty 1999. Available from: http://web.iaincirebon.ac.id/ebook/moon/ UrbanMatters/3_households_livelihoods.pdf [cited 11 October 2014].
    • 58. Mavhu W, Dauya E, Bandason T, Munyati S, Cowan FM, Hart G, et al. Chronic cough and its association with TB HIV coinfection: factors affecting help-seeking behaviour in Harare, Zimbabwe. Trop Med Int Health 2010; 15: 574 9.
    • 59. Addis ME, Mahalik JR. Men, masculinity, and the contexts of help seeking. Am Psychol 2003; 58: 5.
    • 60. Mills EJ, Beyrer C, Birungi J, Dybul MR. Engaging men in prevention and care for HIV/AIDS in Africa. PLoS Med 2012; 9: e1001167.
  • Inferred research data

    The results below are discovered through our pilot algorithms. Let us know how we are doing!

    Title Trust
    67
    67%
  • No similar publications.

Share - Bookmark

Funded by projects

Cite this article

Collected from