'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
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2015
TITLE AUTHOR(S): J.Chikovore, G.Hart, M.Kumwenda, G.A.Chipungu, L.Corbett
KEYWORDS: HEALTH, LOW INCOME POPULATION, MALAWI, MASCULINITY, TUBERCULOSIS
DEPARTMENT: Public Health, Societies and Belonging (HSC)
Print: HSRC Library: shelf number 8733
HANDLE: 20.500.11910/1864
URI: http://hdl.handle.net/20.500.11910/1864
If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at researchoutputs@hsrc.ac.za.
Abstract
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. The objective is to understand masculinity's role in delay in healthcare seeking for men, with a focus on TB-suggestive symptoms. 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). 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. 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.-
Related Research Outputs:
- Control, struggle, and emergent masculinities: a qualitative study of men's care-seeking determinants for chronic cough and tuberculosis symptoms in Blantyre, Malawi
- Addressing research gaps around masculinity and stigma: implications for TB health-care seeking
- Healthcare providers' challenges in providing health services to men: a masculinities-framed study of TB-related care-seeking in Blantyre, Malawi
- Factors that contribute to tuberculosis control in primary health care services at Mutale primary health care sub-district of the Limpopo Province, South Africa
- HealthKick: a nutrition and physical activity intervention for primary schools in low-income settings*
- Measuring service delivery in southern Africa project: country statistical bulletin: Malawi: progress to human development
- Measuring service delivery in southern Africa project: statistical bulletin: Malawi: health
- Food on the table and disease at the door: insights from low-income countries and regions for measuring innovation
- Health behaviour interventions in low/middle income countries
- Health behaviour intervention priorities in low and middle income countries, with a focus on diet related disorders and physical inactivity
- Strengthening TB infection prevention and control (IPC) in health care facilities in the Western Cape, South Africa
- Perceptions of and knowledge about tuberculosis (TB): findings from the South African National Health & Nutrition Examination Survey I (SANHANES I)
- The neglected triple disease burden and interaction of helminths, HIV and tuberculosis: an opportunity for integrated action in South Africa
- A multi-faceted innovative intervention to improve adherence to TB treatment at primary health care level in an urban setting: developing a photo story novella
- Mapping TB campaigns for local politicians in high burden settings
- Treatment-seeking for tuberculosis-suggestive symptoms: a reflection on the role of Human Agency in the context of universal health coverage in Malawi
- Sun protection use behaviour among university students from 25 low, middle income and emerging economy countries
- 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
- Youth health and well-being: why it matters?
- The influence of masculinity on HIVST community intervention: a qualitative evaluation of empirical evidence from Blantyre, Malawi