Approche ethnographique de l'utilisation des contraceptifs hormonaux en milieu rural sahélien, Burkina Faso

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Securing Tenure for Sustainable Livelihoods: A Case of Women Land Ownership in Anglophone Cameroon

The majority of women in Third World countries depend on land for their livelihood. Security of tenure is important for them to ensure sustainable development, especially in rural areas. In most parts of Africa, land ownership is affected by traditional values, inheritance rights, and government influence. These forces have provided varying types of tenure which are detrimental to the women in rural and urban areas. Land acquisition and its development has been an emotive issue due to traditional pressures and the law as regards the process of land certification. The government and traditional administrations are highly involved in the way women own land and subsequently develop it in Anglophone Cameroon. State authority over land acquisition is important, but the process for obtaining land title is herculean especially for the rural woman. This study illustrates that land acquisition and development by women constitute a problem because of traditional pressures and the law guiding the process of land certification. There is need to exhume the barriers of government’s legal instrument (The Land Consultative Board) that regulates the ownership of land and to revisit some traditional practices as regards land ownership that impact negatively on women in a changing and globalizing world. A compromise approach is advocated for land acquisition that can transcend traditional barriers as well as render the process of land registration more realistic especially for women.

Contexte de genre, autonomie des femmes et utilisation des services de santé maternelle en milieu rural africain : analyse par modèles d’équations structurelles

La vie des femmes du continent africain et de leurs enfants continue d’être mise en danger lors de chaque accouchement car les risques de décès maternels et infantiles sont encore très élevés. Il est estimé chaque année à environ le quart du million le nombre de décès maternel et de près de quatre millions celui des enfants de moins de cinq ans. La comparaison de la situation sanitaire avec d’autres contextes permet de mieux cerner l’ampleur du problème : en Afrique sub-Saharienne, le risque de décès lié à la grossesse est de l’ordre de 1 pour 31, alors qu’il n’est que de 1 pour 4300 dans les pays industrialisés. Cette situation est évitable et, le plus souvent, résulte de la sous ou non-utilisation des services de santé maternelle, du manque de structures adéquates de soins ou de personnel de santé qualifié. Notre thèse cherche à comprendre la manière dont les inégalités de genre au sein du ménage et dans la communauté renforcent les inégalités quant à l’utilisation des services de santé maternelle, ainsi qu’aux relations empiriques qui lient les différents recours aux soins. Concrètement, elle vise à 1) proposer une mesure des normes de genre favorables à la violence contre les femmes et à analyser son influence sur leur prise de décision au sein du ménage, 2) analyser simultanément l’influence de ces normes et de l’autonomie des femmes sur le recours aux soins prénatals et à l’accouchement assisté et finalement, 3) cerner l’influence des soins prénatals sur le recours à l’accouchement assisté. Chacun de ces objectifs se heurte à un problème méthodologique substantiel, soit de mesure ou de biais de sélection, auxquels l’approche par modèles d’équations structurelles que nous avons adoptée permet de remédier. Les résultats de nos analyses, présentés sous forme d’articles scientifiques, s’appuient sur les données issues des Enquêtes Démographiques et de Santé (EDS) du Ghana, du Kenya, de l’Ouganda et de la Tanzanie et concernent les femmes vivant en milieu rural. Notre premier article propose une mesure des normes de genre et, plus exactement, celles liées à la violence contre les femmes en recourant à l’approche des variables latentes. Les cinq questions des EDS relatives à l’attitude des femmes sur la légitimation de la violence ont permis de saisir cette mesure au niveau contextuel. Les résultats suggèrent d’une part que cette mesure a de bons critères de validité puisque l’Alpha de Cronbach varie de 0.85 pour le Kenya à 0.94 pour le Ghana; les chi-deux sont non significatifs partout; le RMSEA est en dessous de 0.05; le CFI supérieur à 0.96 et les saturations sont pour la plupart supérieures à 0.7 dans tous les pays. D’autre part, à l’aide du modèle d’équations structurelles multiniveaux, nous avons trouvé qu’au-delà de leur propre attitude envers la violence contre les femmes, celles qui vivent dans un milieu où les normes de genres sont plus favorables à la violence ont plus de chances d’être de faible autonomie ou sans autonomie (comparativement à forte autonomie) dans l’ensemble des pays étudiés. Le second article documente l’influence des inégalités de genre, cernées au niveau contextuel par les normes favorables à la violence contre les femmes et au niveau individuel par l’autonomie de prise de décision au sein du ménage, sur la survenue des soins prénatals au cours du premier trimestre et sur les recours à au moins 4 consultations prénatales et à l’accouchement assisté. En utilisant également les modèles d’équations structurelles multiniveaux sur les mêmes données du premier article, nous constatons que chacune de ces variables dépendantes est fortement influencée par la grappe dans laquelle la femme vit. En d’autres mots, son lieu de résidence détermine le comportement de santé maternelle que l’on adopte. De même, en contrôlant pour les autres variables explicatives, nos résultats montrent que les femmes qui vivent dans un milieu où les normes de genre liées à la violence contre les femmes sont élevées ont, en moyenne, une plus grande chance de ne pas accoucher auprès d’un personnel qualifié au Ghana et en Ouganda, de ne pas débuter leurs soins prénatals dans le premier trimestre dans les mêmes pays, et de ne pas recourir à au moins quatre consultations prénatales en Tanzanie. Par contre, cette variable contextuelle n’influence pas significativement le recours aux soins de santé maternelle au Kenya. Enfin, les résultats montrent que les normes de genre favorables à la violence contre les femmes sont plus déterminantes pour comprendre le recours aux soins de santé maternelle dans les pays étudiés que l’autonomie de prise de décision de la femme. Dans le cadre du troisième et dernier article empirique de la thèse, nous nous sommes intéressés à l’importance des soins prénatals dans le processus de recours à l’accouchement assisté et à la place du contenu des soins reçus avant l’accouchement dans cette relation. Cet article met en exergue l’existence de biais d’endogénéité au Kenya et en Tanzanie, où sans sa prise en compte, l’effet des soins prénatals sur le recours à l’accouchement auprès d’un personnel qualifié serait fortement biaisé. De plus, il ressort qu’à l’exception du Ghana et dans une moindre mesure de la Tanzanie, cet effet est totalement médiatisé par le contenu des soins prénatals que les femmes reçoivent. L’article met ainsi en relief le rôle des prestataires de soins qui pour atteindre plus efficacement les populations doivent agir en tant que leaders au sein de leur communauté.

Improvement of Food Security in Bangladesh through Socio-Economic Empowerment of Women

Empowerment is one possible approach to increase political, social and economic participation of a target group and thus decrease food insecurity among vulnerable people. The objective of this research was to evaluate a socio-economic empowerment project implemented for 8 years in rural northern Bangladesh by using secondary data from 2000 and primary data from 2009. Three hundred women were primarily selected out of all existing and active 121 women groups formed during 8 years project implementation. Standardized interviews were conducted to collect quantitative data. In addition an overall qualitative analysis included focus group discussions, the review of project summaries and discussions with implementing staff. Data was collected on socio-economic status, rice storages and food consumption. In addition knowledge was gained on current activities of the women groups. The empowerment concept implemented in this setting was successful to increase the participants’ political, social and economic engagement and visibility. Apart from that the utilization of skills for income generation led to an improvement of the socio-economic status and food insecurity became less common. Recommendations for future projects include the increase of female members among the NGO staff as well as the further follow-up and strengthening of political acceptance and visibility of the empowered participants to sustain the outcome of the project.

Sociodemographic and nutritional correlates of neurobehavioral development: a study of young children in a rural region of Ecuador

To identify and describe the sociodemographic and nutritional characteristics associated with neurobehavioral development among young children living in three communities in the northeastern Andean region of Cayambe-Tabacundo, Ecuador. Women in the study communities who had a child 3 to 61 months of age completed a questionnaire about maternal and child health and sociodemographic characteristics. The Ages and Stages Questionnaire (ASQ) was directly administered to 283 children by two trained interviewers. Growth measurements and a hemoglobin finger-prick blood test were obtained in 2003–2004. Prevalence of developmental delay was calculated, and associations between child development and maternal, child, and household characteristics were explored. High frequencies of developmental delay were observed. Children 3 to 23 months old displayed delay in gross motor skills (30.1%), and children 48 to 61 months old displayed delay in problem-solving skills (73.4%) and fine motor skills (28.1%). A high frequency of both anemia (60.4%) and stunting (53.4%) was observed for all age groups. Maternal educational level was positively associated with communication and problem-solving skills, and monthly household income was positively associated with communication, gross motor, and problem-solving skills. The results suggest a high prevalence of developmental delay and poor child health in this population. Child health status and the child’s environment may contribute to developmental delay in this region of Ecuador, but sociodemographic factors affecting opportunities for stimulation may also play a role. Research is needed to identify what is causing high percentages of neurobehavioral developmental delay in this region of Ecuador.

From ideals to reality: The women's smallholding colony at Lingfield, 1920-39

The immediate impetus for the colony at Lingfield in Surrey was the desire by the Women's Farm and Garden Association to enable women who had worked on the land during the First World War to be able to farm on their own account. However the motivation for the colony can also be traced back to late nineteenth-century ideals. The colony soon ran into problems which were exacerbated by the adverse agricultural conditions of the early 1920s. The association responded constructively but the colony was wound down from 1929. At one level the colony could be seen as a failure, yet this article argues that the 19 colony provided a rural community where single women lived in a mutually supportive environment.

Does watershed development implemented through public private partnership empower women? A case review from Rajasthan, Western India

This paper critically examines the impact of the ‘Guidelines for Hariyali’ – a rural watershed development policy launched in Rajasthan, Western India which has been implemented through a Public Private Partnership (PPP) – for local communities. In 2003, the Government of India launched the ‘Guidelines’ (a comprehensive Integrated Wastelands Development Programme and Drought Prone Areas Programme and Desert Development Programme), the purpose of which is to restore ecological balance by harnessing, conserving and developing natural resources in drought-prone and arid rural areas for the benefit of villages. In the particular case-study area, the policy has been implemented through institutional linkages between a corporation and the government with the aim of sharing responsibilities for finances, planning, implementation and monitoring, the end goal being to enhance the livelihoods of rural households. The analysis focuses specifically on how the ‘Guidelines’ have affected the livelihoods of Rajasthani women, drawing upon findings from focus groups with men and women in the project catchment area, as well as interviews with key actors at public and private sector institutions. Findings reveal that there are significant gaps between policy objectives and the realities on the ground, particularly in the context of women's accessibilities and entitlements. The paper also broadens understanding of how PPPs, if implemented properly, could empower women in the area of watershed management across rural South Asia.

Association of low adiponectin levels with the metabolic syndrome--the Chennai Urban Rural Epidemiology Study (CURES-4)

The aim of the study was to assess the relation of adiponectin levels with the metabolic syndrome in Asian Indians, a high-risk group for diabetes and premature coronary artery disease. The study was conducted on 100 (50 men and 50 women) type 2 diabetic subjects and 100 age and sex matched subjects with normal glucose tolerance selected from the Chennai Urban Rural Epidemiology Study, an ongoing population study in Chennai in southern India. Metabolic syndrome was defined using modified Adult Treatment Panel III (ATPIII) guidelines. Adiponectin values were significantly lower in diabetic subjects (men: 5.2 vs 8.3 microg/mL, P=.00l; women: 7.6 vs 11.1 microg/mL, P<.00l) and those with the metabolic syndrome (men: 5.0 vs 6.8 microg/mL, P=.01; women: 6.5 vs 9.9 microg/mL, P=.001) compared with those without. Linear regression analysis revealed adiponectin to be associated with body mass index (P<.05), waist circumference (P<.01), fasting plasma glucose (P=.001), glycated hemoglobin (P<.001), triglycerides (P<.00l), high-density lipoprotein (HDL) cholesterol (P<.001), cholesterol/HDL ratio (P<.00l), and insulin resistance measured by homeostasis assessment model (P<.00l). Factor analysis identified 2 factors: factor 1, negatively loaded with adiponectin and HDL cholesterol and positively loaded with triglycerides, waist circumference, and insulin resistance measured by homeostasis assessment model; and factor 2, with a positive loading of waist circumference and systolic and diastolic blood pressure. Logistic regression analysis revealed adiponectin to be negatively associated with metabolic syndrome (odds ratio [OR], 0.365; P<.001) even after adjusting for age (OR, 0.344; P<.00l), sex (OR, 0.293; P<.001), and body mass index (OR, 0.292; P<.00l). Lower adiponectin levels are associated with the metabolic syndrome per se and several of its components, particularly, diabetes, insulin resistance, and dyslipidemia in this urban south Indian population.

Liushou women’s happiness and its influencing factors in rural China

The economic development of urban cities in China has attracted a large number of labour from the rural countryside. The married migrant workers will usually leave their wives’ homes to look after the other family members and the farmland. A special term liushou women, has been created for this group of women. Among the 87 million rural residents, 47 million of them are liushou women according to the recent survey conducted by China Agricultural University. They play a crucial role in the development of rural economy and an essential role to the social stability of rural China. In this research, the factors that influence the happiness of liushou women were investigated in the Western part of China. Based on the population investigated, it was found that the financial situation, personality, government efficiency, conjugal relationship and relationship with in-laws are the significant factors influencing the happiness of liushou women. This finding demonstrates that the Chinese women are willing to sacrifice their personal interest for the interests of their families.

Gendered struggles over land: shifting inheritance practices among the Serer in rural Senegal

Although women's land rights are often affirmed unequivocally in constitutions and international human rights conventions in many African countries, customary practices usually prevail on the ground and often deny women's land inheritance. Yet land inheritance often goes unnoticed in wider policy and development initiatives to promote women's equal access to land. This paper draws on feminist ethnographic research among the Serer ethnic group in two contrasting rural communities in Senegal. Through analysis of land governance, power relations and 'technologies of the self', this article shows how land inheritance rights are contingent on the specific effects of intersectionality in particular places. The contradictions of legal pluralism, greater adherence to Islam and decentralisation led to greater application of patrilineal inheritance practices. Gender, religion and ethnicity intersected with individuals' marital position, status, generation and socio-ecological change to constrain land inheritance rights for women, particularly daughters, and widows who had been in polygamous unions and who remarried. Although some women were aware that they were legally entitled to inherit a share of the land, they tended not to 'demand their rights'. In participatory workshops, micro-scale shifts in women's and men's positionings reveal a recognition of the gender discriminatory nature of customary and Islamic law and a desire to 'change with the times'. While the effects of 'reverse' discourses are ambiguous and potentially reinforce prevailing patriarchal power regimes, 'counter' discourses, which emerged in participatory spaces, may challenge customary practices and move closer to a rights-based approach to gender equality and women's land inheritance.

A Community-based Survey of Human Toxoplasmosis in Rural Amazonia: Seroprevalence, Seroconversion Rate, and Associated Risk Factors

IgG antibodies to Toxoplasma gondii were detected in, March-April 2004, in 65.8% (95% confidence interval, 60.8-70.8%) of 342 systematically sampled subjects 5-90 years of age (87.5% of the eligible) living in a rural settlement in Amazonia, with a seroconversion rate of 9% over I year of follow-up of 99 seronegative subjects. Multiple logistic regression analysis identified age as the only significant independent predictor of seropositivity at the baseline. Each additional year of age increases the odds of being seropositive by 6%, and 76.8% of the subjects are expected to be seropositive at 30 years of age. A single high-prevalence spatial cluster, comprising 11.9% of the seropositive subjects, was detected in the area; households in the cluster were less likely to have dogs as pets and their heads had a lower education level, when compared with households located outside the cluster. The challenges for preventing human toxoplasmosis in tropical rural settings are discussed.

The panorama and outcomes of reported pregnancies within a well defined population in rural Vietnam 1999-2004

Background Pregnancy outcomes in the general population are important public health indicators. Purpose The overall aim of this study was to investigate the outcomes of reported pregnancies within a well-defined population, to identify risk groups for adverse pregnancy outcomes, and to suggest preventive measures. Method A prospective population-based cohort study of pregnant women in Bavi district, Vietnam between 1 January 1999 and 30 June 2004. Results Pregnancy outcome was reported for 5,259 cases; 4,152 (79%) resulted in a live birth, 67 (1.3%) in a stillbirth, 733 (14%) in an induced abortion, and 282 (5.4%) in a spontaneous abortion. There was an increased risk of home delivery for women from ethnic minorities (OR?=?1.85; 95%CI?=?1.06–3.24) or with less than 6 years of schooling (OR?=?7.36; 95%CI?=?3.54–15.30). The risk of stillbirth was increased for ethnic minorities (OR?=?6.34; 95%CI?=?1.33–30.29) and women delivering at home (OR?=?6.81; 95%CI?=?2.40–19.30). The risk of induced abortion increased with maternal age. Conclusion Our findings emphasize the public health significance of access to adequate family planning, counselling, and maternal health care for all women. Policies should specifically target women from high-risk groups.

Literacy Practices in and out of School in Karagwe : The case of primary school literacy education in rural Tanzania

This study has investigated the question of relation between literacy practices in and out of school in rural Tanzania. By using the perspective of linguistic anthropology, literacy practices in five villages in Karagwe district in the northwest of Tanzania have been analysed. The outcome may be used as a basis for educational planning and literacy programs. The analysis has revealed an intimate relation between language, literacy and power. In Karagwe, traditional élites have drawn on literacy to construct and reconstruct their authority, while new élites, such as individual women and some young people have been able to use literacy as one tool to get access to power. The study has also revealed a high level of bilingualism and a high emphasis on education in the area, which prove a potential for future education in the area. At the same time discontinuity in language use, mainly caused by stigmatisation of what is perceived as local and traditional, such as the mother-tongue of the majority of the children, and the high status accrued to all that is perceived as Western, has turned out to constitute a great obstacle for pupils’ learning. The use of ethnographic perspectives has enabled comparisons between interactional patterns in schools and outside school. This has revealed communicative patterns in school that hinder pupils’ learning, while the same patterns in other discourses reinforce learning. By using ethnography, relations between explicit and implicit language ideologies and their impact in educational contexts may be revealed. This knowledge may then be used to make educational plans and literacy programmes more relevant and efficient, not only in poor post-colonial settings such as Tanzania, but also elsewhere, such as in Western settings.

Maternal health care professionals perspective on the provision and use of antenatal and delivery care : a qualitative descriptive study in rural Vietnam

Background. High quality maternal health care is an important tool to reduce maternal and neonatal mortality. Services offered should be evidence based and adapted to the local setting. This qualitative descriptive study explored the perspectives and experiences of midwives, assistant physicians and medical doctors on the content and quality of maternal health care in rural Vietnam. Method. The study was performed in a rural district in northern Vietnam. Four focus group discussions with health care professionals at primary health care level were conducted. The data was analysed using qualitative manifest and latent content analysis. Result. Two main themes emerged: "Contextual conditions for maternal health care" and "Balancing between possibilities and constraints". Contextual conditions influenced both pregnant women's use of maternal health care and health care professionals' performance. The study participants stated that women's uses of maternal health care were influenced by economical constraints and cultural norms that impeded their autonomy in relation to childbearing. Structural constraints within the health care system included inadequate financing of the primary health care, resulting in lack of human resources, professional re-training and adequate equipment. Conclusion. Contextual conditions strongly influenced the performance and interaction between pregnant women and health care professionals within antenatal care and delivery care in a rural district of Vietnam. Although Vietnam is performing comparatively well in terms of low maternal and child mortality figures, this study revealed midwives' and other health care professionals' perceived difficulties in their daily work. It seemed maternal health care was under-resourced in terms of staff, equipment and continuing education activities. The cultural setting in Vietnam constituting a strong patriarchal society and prevailing Confucian norms limits women's autonomy and reduce their possibility to make independent decisions about their own reproductive health. This issue should be further addressed by policy-makers. Strategies to reduce inequities in maternal health care for pregnant women are needed. The quality of client-provider interaction and management of pregnancy may be strengthened by education, human resources, re-training and provision of essential equipment.

Criação de conhecimento em propriedades rurais no Rio Grande do Sul, Brasil e em Queensland, Austrália

A realidade de mudanças no agronegócios requer novas ferramentas gerenciais dos proprietários rurais e o conhecimento ganha importância como fator gerador de diferencial competitivo. O objetivo desta tese é desenvolver um método dinâmico de análise da criação de conhecimento para o elo da produção no agronegócios no Brasil e na Austrália com base no modelo de Nonaka e Takeuchi (1997). A presente pesquisa caracteriza-se por um estudo descritivo de caráter qualitativo, complementada por dados quantitativos. É realizado um estudo de dois casos, utilizando-se de documentação e observação in loco, questionário, entrevista e focus group. As realidades estudadas localizam-se no Rio Grande do Sul, Brasil, e em Queensland, na Austrália. Os dados da pesquisa possibilitaram o desenvolvimento de uma figura representativa do modo como ocorre a criação de conhecimento nas duas realidades. Da figura foi feito um desdobramento e desenvolveu-se um método dinâmico de análise da criação de conhecimento para o elo da produção no agronegócios. Os resultados demonstraram haver significativas similaridades e diferenças entre as realidades, sendo, no Brasil, os produtores rurais inseridos num contexto cooperativo (Cooperativa Tritícola Mista Alto Jacuí – Cotrijal) e, na Austrália, os negócios conduzidos individualmente. Para a ocorrência da criação de conhecimento é necessária a existência de grupos de relacionamento e de certa liderança em nível de propriedade, de comunidades de prática (CoPs) ou da cooperativa. O aspecto cultural e o estilo das relações pareceram exercer forte influência para que as trocas ocorram e para a maior ampliação da atuação das CoPs, as quais podem ser suporte para a criação de conhecimentos.As CoPs não se constituem num processo tecnológico e, sim, num processo social e cognitivo; assim, sua formação nas CoPs não parece depender somente de tecnologia, mas do estabelecimento de relações informais, nas quais as pessoas podem utilizar esses ambientes para definir suas verdades quanto às suas posturas frente aos processos de mudança. A forma de conduzir os negócios pode afetar o modo como se dá a criação de conhecimento, pois, numa propriedade onde as pessoas buscam socializar, questionar e inovar constantemente, evidencia-se haver maior espaço para transformar conhecimento tácito em explícito; assim, pessoas mais abertas ao novo e ao questionamento de suas práticas demonstram apresentar maiores possibilidades para criar um campo de interação para que o conhecimento seja criado. O estudo mostrou que há um grande percurso entre o produtor rural ter conhecimento e a capacidade de torná-lo uma atitude que possibilite trazer bons resultados nos negócios.