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Health research must be of high ethical and scientific quality and consider the needs and experiences of women, men, and nonbinary individuals. National Research Ethics Committees (RECs) are in a strategic position to impede sex- and gender-blind research. In 2020 and 2021, training programs on gender mainstreaming and sex and gender approaches in research evaluation were launched in Senegal. They were evaluated through a mixture of qualitative and quantitative methods. Knowledge acquisition was 16.67%, 8.54%, and 28.42% for the trainees of 2021, 2020, and those who attended the training in both years, respectively. Gender mainstreaming was reported as pertinent in research ethics by 74% of participants. This training is expected to catalyze gender-transformative research ethics in West Africa.
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Comitês de Ética em Pesquisa , Ética em Pesquisa , Humanos , Senegal , Feminino , Masculino , Ética em Pesquisa/educação , Pesquisa Biomédica/ética , Sexismo , Avaliação de Programas e Projetos de Saúde , Adulto , Identidade de GêneroRESUMO
Livestock diseases are a major barrier to productivity for both male and female livestock keepers in Africa. In Kenya, two of the most devastating livestock diseases are Newcastle Disease (ND) in poultry and Contagious Caprine Pleuropneumonia (CCPP) in goats. Female livestock keepers tend to own more small ruminants (goats, sheep, etc.) and poultry and their livelihoods are adversely affected if their herds are not vaccinated against these diseases. Livestock farming has gender specific challenges and opportunities, with implications for the empowerment of women smallholder farmers, their household well-being, food security, and livelihoods. There is a need to estimate the level to which women benefit personally, socially, and economically from keeping livestock, yet there are very few studies that can measure if livestock production does in fact empower women smallholder livestock farmers. This study was done to examine linkages between women's empowerment and access and control over livestock products and vaccines. The Women Empowerment in Livestock Index (WELI) tool, which was customized to include questions on livestock vaccine access, was used to capture baseline data on empowerment scores for women in Machakos county, Kenya, prior to implementation of animal health and vaccine test models. In total, 400 participants were surveyed in two wards of Machakos County, Kola and Kalama, which were purposively selected. Women's empowerment was mapped to three domains (3DE): intrinsic agency (power within), instrumental agency (power to), and collective agency (power with) measured against adequacy in 13 indicators. Our results indicate that the household structure (female headed or dual headed household), age of respondents and number of members in a household influence the adequacy score. Work balance was the most significant negative contributor to women's disempowerment. Women contributed the most to livestock productive activities and attained adequacy in this area compared to men, directly impacting the WELI score. Women smallholder livestock farmers report low CCPP and ND vaccination rates, minimal knowledge on livestock diseases, a lack of access to cold chain storage and rarely visited veterinarians. The WELI score was 0.81 indicating a high level of empowerment for women in this community compared to men leading us to conclude that the overall WELI score was not an accurate indicator of women's empowerment in Machakos County. However, the decomposability of the index allows us to disaggregate the drivers of change and to examine how individual indicators contribute to disempowerment.
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Most rural women smallholder farmers in Kenya generate income from the sale of small ruminant animals. However, diseases such as Contagious Caprine Pleuropneumonia (CCPP) prevent them from optimizing earnings. A crucial aspect for the control of CCPP is vaccination. In Kenya, CCPP vaccines are distributed through a government delivery mechanism. This study examines gaps and barriers that prevent women smallholder farmers from accessing CCPP vaccines. Qualitative data collection tools used were focus groups discussions, focus meals, jar voices and key informant interviews. Using outcome mapping (OM) methodology, critical partners and stakeholders in the CCPP vaccine value chain (CCPP-VVC) were identified to be the manufacturers, importers, distributors, agrovets, public and private veterinarians, local leaders, and farmers. Respondents highlighted the barriers to be limited access to vaccines due to cold chain problems, inadequate and late delivery of services, lack of information and training on vaccines, and financial constraints. Identified opportunities that can support women's engagement in the CCPP-VVC are the Kenya Governments two-third gender rule, which requires that not more than two thirds of the members of elective or appointive bodies shall be of the same gender, and positive community perception of female veterinarians. We conclude that more resources and training should be made available to women farmers, and that gender perspectives on policy development related to livestock production and disease prevention are urgently needed to improve livestock productivity and increase agency for women.
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Participatory epidemiology (PE) evolved as a branch of veterinary epidemiology and has been largely employed for the control and early warning of infectious diseases within resource-limited settings. It was originally based on combining practitioner communication skills with participatory methods to facilitate the involvement of animal caretakers and owners (embracing their knowledge, experience, and motivations) in the identification and assessment of animal disease problems, including in the design, implementation, monitoring and evaluation of disease control programs, policies, and strategies. With the importance of understanding social perceptions and drivers receiving increasing recognition by epidemiologists, PE tools are being adapted for an increasingly wide range of settings and endeavors. More recently, PE tools have been adapted for use in food and nutrition security programs, One Health activities, wildlife disease surveillance and as part of mixed-methods research across a range of socio-economic settings. This review describes the evolution of PE (in relation to veterinary epidemiology and briefly in relation to public health epidemiology), the underpinning philosophy and principles essential to its effective application and the importance of gender-sensitive approaches and data triangulation, including conventional confirmatory testing. The article also provides illustrative examples highlighting the diversity of approaches and applications of PE, hallmarks of successful PE initiatives and the lessons we can learn when these are missing. Finally, we look forward, describing the particular utility of PE for dealing with emerging infectious diseases, gaining attention of field-level cross-sector officials who can escalate concerns to a higher level and for continuing to raise the voices of those less-heard (such as women, minority groups, and remote communities with limited exposure to formal education) in defining the problems and planning activities that will likely impact directly on their well-being and livelihoods.
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The health of our planet and humanity is threatened by biodiversity loss, disease and climate crises that are unprecedented in human history, driven by our insatiable consumption and unsustainable production patterns, particularly food systems. The One Health approach is a pathway to synergistically addressing outcomes in term of health and sustainability, but gender issues at the One Health and biodiversity nexus are largely ignored. By examining the roles and responsibilities of Indigenous and Local People, and especially women, in conserving natural resources, and the social costs of living at the Human-Animal-Environment interface under current conservation strategies, we show that women bear a disproportionate health, poverty and climate burden, despite having pivotal roles in conserving biodiversity. To mitigate risks of emerging infectious diseases, food insecurity and climate change impacts, a gender perspective has previously been proposed, but implementation lags behind. Endemic zoonotic diseases, human-wildlife conflict and environmental pollution lack gender-sensitive frameworks. We demonstrate that women can be powerful agents for change at all levels of society, from communities to businesses, and policy-making institutions, but gender inequalities still persist. We develop a framework for mainstreaming a gender-responsive and rights-based One Health approach, in order to heal ourselves and nature. Using a leverage-points perspective, we suggest a change of paradigm, from the pursuit of GDP and over-consumption, to a focus on human well-being and their reconnection with healthy environments, using a One Health understanding of nature and health. We recommend learning from Indigenous People to re-position ourselves within nature and to better conserve biodiversity. We also propose integration of gender equity in leadership, the respect of human rights, women's rights (access to health care, healthy food, land tenure, natural resources, education, and economic opportunities), and the rights of nature, through the implementation of gender-responsive and rights-based One Health Action Plans, at policy-making level, in the private sector and the civil society. As the COVID-19 pandemic continues to unveil deep socio-economic inequities in the wealthiest economies and the vital role of nature in supporting our health, we argue to seize this opportunity to build back better and improve resilience and sustainability by using a gender-responsive and rights-based One Health approach.
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Gender sensitivity in health promotion has been widely recommended, yet attention to gender roles and gender-disaggregated studies is often lacking in disease research and public health intervention planning. In the rural Mnisi community of Mpumalanga, South Africa, where zoonotic pathogens are known to contribute to acute febrile illness, community and household tasks may increase an individual's risk of exposure, and these tasks are likely to be influenced by gender. This study described the roles and responsibilities of community residents, specifically those that have been identified as critical control points for infectious pathogen exposure, by gender. Male gender-typed tasks included those associated with livestock and poultry husbandry, hunting and slaughtering wildlife, and rodent control. Female gender-typed tasks included animal-sourced food preparation, domestic cleaning and maintenance, and caregiving to children and ill family members. Given the gender-specific nature of these tasks, potential pathogen exposure and transmission patterns of infectious diseases may be also gender specific. These data can inform the development and revision of health promotion strategies, such as the community-based One Health Training and Leadership program, prioritizing outcomes for male and female participants alike. Gender-disaggregated analysis is recommended for effective risk mitigation and community-wide health promotion using a One Health approach.
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Saúde Única , Zoonoses/transmissão , Criação de Animais Domésticos , Animais , Feminino , Papel de Gênero , Humanos , Gado , Masculino , Fatores de Risco , África do Sul/epidemiologiaRESUMO
Poultry are important for many poor households in developing countries, but there are many constraints to poultry production, including disease. One of the most important diseases of chickens is Newcastle disease (ND). Even though there are effective vaccines against this disease available in most countries, uptake by small-scale poultry keepers is often low. In this study, two areas in Kenya and Tanzania were studied, where some villages had received additional support to get vaccination and other villages had not. In Kenya, 320 households from 10 villages were interviewed, of which half of the villages had active promotion of vaccination through village-based advisors. In Tanzania, 457 households were interviewed, of which 241 came from villages that have had active support through either a project or government extension services. Knowledge about vaccines and the attitudes towards vaccinating against ND was evaluated using mixed multivariable logistic models. Results indicate that in Kenya, the most important determinants for understanding the function of a vaccine were having had support in the village and to have knowledge about ND signs, while in Tanzania gender and previous vaccine use were important in addition to having had support. Attitudes towards vaccination were mainly determined by knowledge, where more knowledge about how vaccines work in general or about ND contributed to more positive attitudes. Among Kenyan farmers that had never used the vaccine before, the amount of birds they lost to disease and predators also influenced attitudes. In conclusion, this study supports the notion that knowledge is a very important component of extension support and that simply making vaccines available may not be sufficient for high levels of uptake.
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Galinhas , Fazendeiros/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Doença de Newcastle/prevenção & controle , Doenças das Aves Domésticas/prevenção & controle , Vacinação/veterinária , Animais , Humanos , Quênia , População Rural/estatística & dados numéricos , Tanzânia , Vacinação/psicologiaRESUMO
There is substantial current interest in linkages between livestock-keeping and human nutrition in resource-poor settings. These may include benefits of improved diet quality, through animal-source food consumption and nutritious food purchases using livestock-derived income, and hazards of infectious disease or environmental enteric dysfunction associated with exposure to livestock feces. Particular concerns center on free-roaming chickens, given their proximity to children in rural settings, but findings to date have been inconclusive. This longitudinal study of 503 households with a child under 24 months at enrolment was conducted in villages of Manyoni District, Tanzania between May 2014, and May 2016. Questionnaires encompassed demographic characteristics, assets, livestock ownership, chicken housing practices, maternal education, water and sanitation, and dietary diversity. Twice-monthly household visits provided information on chicken numbers, breastfeeding and child diarrhea, and anthropometry was collected six-monthly. Multivariable mixed model analyses evaluated associations between demographic, socioeconomic and livestock-associated variables and (a) maternal and child diets, (b) children's height-for-age and (c) children's diarrhea frequency. Alongside modest contributions of chicken-keeping to some improved dietary outcomes, this study importantly (and of substantial practical significance if confirmed) found no indication of a heightened risk of stunting or greater frequency of diarrhea being associated with chicken-keeping or the practice of keeping chickens within human dwellings overnight.
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Galinhas , Diarreia/epidemiologia , Dieta , Transtornos do Crescimento/epidemiologia , Adolescente , Adulto , Animais , Antropometria , Pré-Escolar , Diarreia/diagnóstico , Características da Família , Feminino , Transtornos do Crescimento/diagnóstico , Humanos , Lactente , Gado , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Estado Nutricional , Aves Domésticas , Prevalência , População Rural , Fatores Socioeconômicos , Inquéritos e Questionários , Tanzânia , Adulto JovemRESUMO
Suboptimal breastfeeding practices, early initiation of complementary feeding, and monotonous cereal-based diets have been implicated as contributors to continuing high rates of child undernutrition in sub-Saharan Africa. Nutrition-sensitive interventions, including agricultural programs that increase access to nutrient-rich vegetables, legumes, and animal-source foods, have the potential to achieve sustainable improvements in children's diets. In the quest to evaluate the efficacy of such programs in improving growth and development in the first 2 years of life, there is a role for mixed methods research to better understand existing infant and young child feeding practices. This analysis forms part of a longitudinal study assessing the impact of improvements to poultry health and crop production on diets and growth of 503 randomly selected children from eight rural communities in Manyoni District in central Tanzania. Using an explanatory sequential design, the quantitative phase of data collection was conducted between May 2014 and May 2016, comprising six monthly structured questionnaires, four monthly household-level documentation of chicken and egg consumption, and fortnightly records of children's breastfeeding status. The subsequent qualitative phase involved in-depth interviews with a subset of 39 mothers in October 2016. Breastfeeding was almost universal (96.8%) and of long duration (mean = 21.7 months, SD = 3.6), but early initiation of complementary feeding was also common (74.4%; mean = 4.0 months, SD = 1.8), overwhelmingly driven by maternal perceptions of insufficient milk supply (95.0%). Chicken and eggs were infrequently eaten, but close associations between maternal and child consumption patterns (p < .001) suggest the potential for strategies that increase household-level consumption to bring nutritional benefits to young children.
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Fenômenos Fisiológicos da Nutrição Infantil/fisiologia , Dieta/métodos , Alimentos Infantis/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia , Produtos Avícolas/estatística & dados numéricos , População Rural/estatística & dados numéricos , Pré-Escolar , Humanos , Lactente , Estudos Longitudinais , Masculino , TanzâniaRESUMO
Newcastle disease (ND) is a viral disease of poultry with global importance, responsible for the loss of a potential source of household nutrition and economic livelihood in many low-income food-deficit countries. Periodic outbreaks of this endemic disease result in high mortality amongst free-ranging chicken flocks and may serve as a disincentive for rural households to invest time or resources in poultry-keeping. Sustainable ND control can be achieved through vaccination using a thermotolerant vaccine administered via eyedrop by trained "community vaccinators". This article evaluates the uptake and outcomes of fee-for-service ND vaccination programs in eight rural villages in the semi-arid central zone of Tanzania. It represents part of an interdisciplinary program seeking to address chronic undernutrition in children through improvements to existing poultry and crop systems. Newcastle disease vaccination uptake was found to vary substantially across communities and seasons, with a significantly higher level of vaccination amongst households participating in a longitudinal study of children's growth compared with non-participating households (p = 0.009). Two multivariable model analyses were used to explore associations between vaccination and chicken numbers, allowing for clustered data and socioeconomic and cultural variation amongst the population. Results demonstrated that both (a) households that undertook ND vaccination had a significantly larger chicken flock size in the period between that vaccination campaign and the next compared with those that did not vaccinate (p = 0.018); and (b) households with larger chicken flocks at the time of vaccination were significantly more likely to participate in vaccination programs (p < 0.001). Additionally, households vaccinating in all three vaccination campaigns held over 12 months were identified to have significantly larger chicken flocks at the end of this period (p < 0.001). Opportunities to understand causality and complexity through quantitative analyses are limited, and there is a role for qualitative approaches to explore decisions made by poultry-keeping households and the motivations, challenges and priorities of community vaccinators. Evidence of a bi-directional relationship, however, whereby vaccination leads to greater chicken numbers, and larger flocks are more likely to be vaccinated, offers useful insights into the efficacy of fee-for-service animal health programs. This article concludes that attention should be focused on ways of supporting the participation of vulnerable households in ND vaccination campaigns, and encouraging regular vaccination throughout the year, as a pathway to strengthen food security, promote resilience and contribute to improved human nutrition.
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Doença de Newcastle/prevenção & controle , Vírus da Doença de Newcastle/imunologia , População Rural , Vacinas Virais/administração & dosagem , Animais , Galinhas , Estudos Longitudinais , Análise Multivariada , TanzâniaRESUMO
The project "Strengthening food and nutrition security through family poultry and crop integration in Tanzania and Zambia" brings together animal, crop, and human health specialists, economists, ecologists, social scientists, and practitioners to work with participating communities. It aims to increase poultry value chain, crop farming systems efficiency, and household food and nutrition security and thus requires understanding of, and ability to work effectively within, complex systems. In this context, communication knowledge sharing and synthesis between stakeholders from diverse backgrounds and a range of experiences, perspectives, agendas, and knowledge is a challenge. To address this situation, communication is conceived as a dialog and a participatory process bringing together all stakeholders. This process results in unanticipated and unexpected results that require a high degree of flexibility and adaptability from team members. The paper analyses the approach and aim of the communication strategy developed for the project and the challenges faced.
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A WHO-supported provincial-level population-based survey was conducted in 2007 to understand the determinants and implications for health of vaginal practices. A total of 919 women aged 18-60 were selected randomly for enrolment. This is the first population-based study of females in Tete Province, Mozambique. At some time over their lives, 98.8% of women had practiced elongation of their labia minora and a quarter (24.0%) had done so in the past month. Currently practicing women were more likely to have engaged in sex recently, and used contraceptives and condoms at last sex than women who had stopped labial elongation. Younger age, residence in rural areas and having two or more male partners were also determinants of current practice. Women commonly reported they practiced for no specific reason (62.8%). Discomforting itchiness and lower abdominal pain were more frequent in women who had stopped labial elongation than in women who were currently practicing. Although women may not report current vaginal ill health, it is possible that prospective cohort studies could uncover alterations in genital vaginal flora or other indicators of impact on women's health. The findings of this study do not suggest that labial elongation is linked with high-risk behaviors for HIV transmission.
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Labia minora elongation consists in the manual stretching of the inner lips of the external genitalia. This practice is documented in east and southern Africa. The experiences of African women in the diaspora practicing elongation are not thoroughly understood. The purpose of this qualitative study was to explore the health harms and benefits associated with this practice of Zambian women who have migrated to Cape Town, South Africa. Twenty women and seventeen men participated in this study. Between December 2013 and May 2014, in-depth interviews and natural group discussions were conducted with the participants. The focus of this article is to report on the emic of the women related to notions of health, hygiene, and well-being. Labial elongation is perceived as a practice involving minor, short-term adverse effects that can be prevented by following some basic hygiene. Overall, personal and social value is placed on this practice because of its reported benefits for the sexual health of men and women, and for women's femininity and self-image. Further research is necessary on how female genital modifications influence Zambians' sexual preferences to inform the development of culturally appropriate health promotion interventions.
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Modificação Corporal não Terapêutica/psicologia , Vulva , Adulto , Modificação Corporal não Terapêutica/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , África do Sul/etnologia , Adulto Jovem , Zâmbia/etnologiaRESUMO
Labia minora elongation has been documented as being practiced by 98.6% of the women in Tete province, Mozambique. Women engage in this procedure before the first menstruation. In this article we report on the findings from the male respondents from Tete province that participated in the qualitative component of the World Health Organization-supported multicountry Gender, Sexuality, and Vaginal Practices study. The men reported that the main motivation behind labia minora elongation is to enhance the sexual pleasure for both female and male partners. Researching what men know and perceive of labia minora elongation is crucial to understanding the contribution of this practice for sexual health. This knowledge is helpful to inform the development of new human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention technologies and culturally appropriate information, education, and communication interventions.
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Modificação Corporal não Terapêutica , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Comportamento Sexual/etnologia , Vulva , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Moçambique/etnologia , Adulto JovemRESUMO
Village poultry and their owners were frequently implicated in disease transmission in the early days of the highly pathogenic avian influenza (HPAI) H5N1 pandemic. With improved understanding of the epidemiology of the disease, it was recognized that village poultry raised under extensive conditions pose less of a threat than intensively raised poultry of homogeneous genetic stock with poor biosecurity. This paper provides an overview of village poultry production and the multiple ways that the HPAI H5N1 pandemic has impacted on village poultry, their owners, and the traders whose livelihoods are intimately linked to these birds. It reviews impact in terms of gender and cultural issues; food security; village poultry value chains; approaches to biosecurity; marketing; poultry disease prevention and control; compensation; genetic diversity; poultry as part of livelihood strategies; and effective communication. It concludes on a positive note that there is growing awareness amongst animal health providers of the importance of facilitating culturally sensitive dialogue to develop HPAI prevention and control options.
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Surtos de Doenças/economia , Surtos de Doenças/veterinária , Abastecimento de Alimentos/economia , Virus da Influenza A Subtipo H5N1 , Influenza Aviária/epidemiologia , Doenças das Aves Domésticas/economia , Animais , Comércio , Países em Desenvolvimento/economia , Cadeia Alimentar , Indonésia/epidemiologia , Virus da Influenza A Subtipo H5N1/patogenicidade , Influenza Aviária/prevenção & controle , Influenza Aviária/virologia , Masculino , Aves Domésticas , Doenças das Aves Domésticas/prevenção & controle , Doenças das Aves Domésticas/virologia , Produtos Avícolas/economia , Fatores de Risco , População Rural , Fatores Sexuais , Fatores Socioeconômicos , Vietnã/epidemiologiaRESUMO
This paper reports on a systematic review of qualitative research about vaginal practices in sub-Saharan Africa, which used meta-ethnographic methods to understand their origins, their meanings for the women who use them, and how they have evolved in time and place. We included published documents which were based on qualitative methods of data collection and analysis and contained information on vaginal practices. After screening, 16 texts were included which dated from 1951 to 2008. We found that practices evolve and adapt to present circumstances and that they remain an important source of power for women to negotiate challenges that they face. Recent evidence suggests that some practices may increase a woman's susceptibility to HIV and other sexually transmitted infections. The success of new female-controlled prevention technologies, such as microbicides, might be determined by whether they can and will be used by women in the course of their daily life.
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Comportamentos Relacionados com a Saúde , Poder Psicológico , Comportamento Sexual , Vagina , Saúde da Mulher , África Subsaariana/epidemiologia , Antropologia Cultural , Imagem Corporal , Comportamento Ritualístico , Características Culturais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Higiene , Motivação , Pesquisa Qualitativa , Reprodução , Fatores de Risco , Abstinência Sexual , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/prevenção & controleRESUMO
BACKGROUND: Women worldwide use various vaginal practices to clean or modify their vulva and vagina. Additional population-level information is needed on prevalence and motivations for these practices, characteristics of users, and their adverse effects. METHODS: This was a household survey using multistage cluster sampling in Tete, Mozambique; KwaZulu-Natal, South Africa; Yogyakarta, Indonesia; and Chonburi, Thailand. In 2006-2007, vaginal practices and their motivations were examined using structured interviews with women 18-60 years of age (n=3610). RESULTS: Prevalence, frequency, and motivations varied markedly. Two thirds of women in Yogyakarta and Chonburi reported one or more practices. In Yogyakarta, nearly half ingest substances with vaginal effects, and in Chonburi, external washing and application predominate. In Tete, half reported three or four current practices, and a quarter reported five or more practices. Labial elongation was near universal, and 92% of those surveyed cleanse internally. Two third's in KwaZulu-Natal practiced internal cleansing. Insertion of traditional solid products was rare in Chonburi and Yogyakarta, but one tenth of women in KwaZulu-Natal and nearly two thirds of women in Tete do so. Multivariate analysis of the most common practice in each site showed these were more common among less educated women in Africa and young urban women in Asia. Explicit sexual motivations were frequent in KwaZulu-Natal and Tete, intended for pleasure and maintaining partner commitment. Practices in Chonburi and Yogyakarta were largely motivated by femininity and health. Genital irritation was common at African sites. CONCLUSIONS: Vaginal practices are not as rare, exotic, or benign as sometimes assumed. Limited evidence of their biomedical consequences remains a concern; further investigation of their safety and sexual health implications is warranted.
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Atitude Frente a Saúde/etnologia , Comportamento Ritualístico , Comportamento Sexual/etnologia , Ducha Vaginal/estatística & dados numéricos , Saúde da Mulher/etnologia , Administração Intravaginal , Adolescente , Adulto , Estudos Transversais , Características Culturais , Feminino , Humanos , Indonésia/epidemiologia , Moçambique/epidemiologia , Prevalência , Comportamento Sexual/psicologia , Parceiros Sexuais , África do Sul/epidemiologia , Tailândia/epidemiologia , Doenças Vaginais/etnologia , Ducha Vaginal/efeitos adversos , Adulto JovemRESUMO
Between 2005 and 2006, we investigated vaginal practices in Yogyakarta, Indonesia; Tete, Mozambique; KwaZulu-Natal, South Africa; and Bangkok and Chonburi, Thailand. We sought to understand women's practices, their motivations for use and the role vaginal practices play in women's health, sexuality and sense of wellbeing. The study was carried out among adult women and men who were identified as using, having knowledge or being involved in trade in products. Further contacts were made using snowball sampling. Across the sites, individual interviews were conducted with 229 people and 265 others participated in focus group discussions. We found that women in all four countries have a variety of reasons for carrying out vaginal practices whose aim is to not simply 'dry' the vagina but rather decrease moisture that may have other associated meanings, and that they are exclusively "intravaginal" in operation. Practices, products and frequency vary. Motivations generally relate to personal hygiene, genital health or sexuality. Hygiene practices involve external washing and intravaginal cleansing or douching and ingestion of substances. Health practices include intravaginal cleansing, traditional cutting, insertion of herbal preparations, and application of substances to soothe irritated vaginal tissue. Practices related to sexuality can involve any of these practices with specific products that warm, dry, and/or tighten the vagina to increase pleasure for the man and sometimes for the woman. Hygiene and health are expressions of femininity connected to sexuality even if not always explicitly expressed as such. We found their effects may have unexpected and even undesired consequences. This study demonstrates that women in the four countries actively use a variety of practices to achieve a desired vaginal state. The results provide the basis for a classification framework that can be used for future study of this complex topic.
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Comparação Transcultural , Conhecimentos, Atitudes e Prática em Saúde , Higiene , Sexualidade/psicologia , Doenças Vaginais/prevenção & controle , Ducha Vaginal/estatística & dados numéricos , Adolescente , Adulto , Feminino , Grupos Focais , Humanos , Indonésia , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Motivação , Moçambique , África do Sul , Tailândia , Adulto JovemRESUMO
Este artigo analisa as noções de estética e erotismo, e como estas moldam a maneira de as mulheres na província de Tete, em Moçambique, prepararem seu corpo. Grupos focais e entrevistas individuais permitiram constatar que as mulheres utilizam diferentes produtos naturais e sintéticos, tradicionais e modernos, por inserção na vagina ou por ingestão, para modificar a maneira de sentir seu corpo e se preparar para o ato sexual. Em adição, a maioria das mulheres alonga os lábia minora (pequenos lábios vaginais) desde a infância, modificando seu corpo de acordo com critérios estéticos, noções de feminilidade e de prazer sexual. Essas intervenções se inserem num processo de socialização cuja educação integra componentes de estética, sexualidade, reprodução e sobre a vida em geral. O artigo procura mostrar a importância das metáforas e das noções de fechado/aberto, seco/úmido, quente/frio, pesado/leve, vida/morte, riqueza/pobreza, doce/não-doce como simbolismo de gênero ligado ao erotismo, a reprodução e a concepções estéticas.
This paper analyzes notions of aesthetics and eroticism and the ways these mould how women in Tete Province, in Mozambique prepare their body. Focus group and individual interviews allowed to assess that women use different products both natural and synthetic by insertion in their vagina or by ingestion to modify the way they feel their body and prepare themselves for the sexual act. In addition, the majority of women elongate their labia minora (small vaginal lips) since their childhood, modifying their body accordingly to aesthetic criteria, notions of femininity and sexual pleasure. These interventions are part of a process of socialisation integrating components on aesthetic, sexuality, reproduction and life in general. This paper aims at showing the importance of metaphors and of the notions of closing up/open, dryness/ wetness, hot/cold, heavy/light, life/death, wealth/poverty, sweet/ non-sweet as gendered symbols related to eroticism and aesthetic.