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 OUTPUT TYPE
: Journal Article PUBLICATION YEAR
, G.Hart, M.Kumwenda, G.A.Chipungu, N.Desmond, L.CorbettKEYWORDS
, GENDER EQUALITY
, HEALTH SERVICES
: Public Health, Societies and Belonging (HSC)
: HSRC Library: shelf number 8386
Download this report
If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at email@example.com.
Men's healthcare-seeking delay results in higher mortality while on HIV or tuberculosis (TB) treatment, and implies contribution to ongoing community-level TB transmission before initiating treatment. We investigated masculinity's role in healthcare-seeking delay for men with TB-suggestive symptoms, with a view to developing potential interventions for men.
Data were collected during March 2011- March 2012 in three high-density suburbs in urban Blantyre. Ten focus group discussions were carried out of which eight (mixed sex = two; female only = three; male only = three) were with 74 ordinary community members, and two (both mixed sex) were with 20 health workers. Individual interviews were done with 20 TB patients (female =14) and 20 un-investigated chronic coughers (female = eight), and a three-day workshop was held with 27 health stakeholder representatives.
An expectation to provide for and lead their families, and to control various aspects of their lives while facing limited employment opportunities and small incomes leaves men feeling inadequate, devoid of control, and anxious about being marginalised as men. Men were fearful about being looked at as less than men, and about their wives engaging in extramarital sex without ability to detect or monitor them. Control was a key defining feature of adequate manhood, and efforts to achieve it also led men into side-lining their health. Articulate and consistent concepts of men's bodily strength or appropriate illness responses were absent from the accounts.
Facilitating men to seek care early is an urgent public health imperative, given the contexts of high HIV/AIDS prevalence but increasingly available treatment, and the role of care-seeking delay in TB transmission. Men's struggles trying to achieve ideal images seem to influence their engagement with their health. Ambiguous views regarding some key masculinity representations and the embrace of less harmful masculinities raise questions about some common assumptions that guide work with men. Apparent 'emergent masculinities' might be a useful platform from which to support the transformation of harmful masculinity. Finally, the complex manifestations of masculinity indicate the need for interventions targeting men in health and TB control to assume supportive, multidimensional and long-term outlooks.
Related Research Outputs:
- Education and health services (including HIV/AIDS and gender)
- Performing heteromasculinities in South African men's magazines
- The invention of "moffie" life in Cape Town South Africa
- Treatment-seeking for tuberculosis-suggestive symptoms: a reflection on the role of Human Agency in the context of universal health coverage in Malawi
- 'For a mere cough, men must just chew Conjex, gain strength, and continue working': the provider construction and tuberculosis care-seeking implications in Blantyre, Malawi
- Conceptions of chronic cough as serious illness in a high HIV prevalence context, and implications for tuberculosis control through men: a study in Blantyre, Malawi
- The influence of masculinity on HIVST community intervention: a qualitative evaluation of empirical evidence from Blantyre, Malawi
- The influence of masculinity on care seeking for TB
- TB and HIV stigma compounded by threatened masculinity: implications for TB health-care seeking in Malawi
- Masculine bodies, feminine symbols: challenging gendered identities or compulsory femininity?
- Performative queer identities: masculinities and public bathroom usage
- Gender, power and resistance to change among two communities in the Western Cape, South Africa
- Constructions of masculine sexuality, high risk sex and HIV/AIDS amongst young Xhosa men in South Africa
- Intervening to reduce gender-based violence does not enhance HIV risk reduction outcomes for South African men: results of a quasi-experimental field trial
- Gender attitudes, sexual power, HIV risk: a model for understanding HIV risk behavior of South African men
- "If you talk about a window period of two weeks, it is worse": HIV testing among men who have sex with men (MSM) in Johannesburg and Durban, South Africa
- "You become afraid to tell them that you are gay": availability and utilisation of health services by men who have sex with men (MSM) in the Johannesburg/eThekwini men's study
- Male soldiers' constructions of masculinity, sexuality and sexual violence
- Race and masculinities in the South African military
- Masculinity, the body & power relations