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‘He will ask why the child gets sick so often’: The gendered dynamics of intra-household bargaining over healthcare for children with fever in the Volta Region of Ghana

1 Mar 2008

Chinnock

Source: Social Science & Medicine (see original article)

Citation: Tolhurst R, Amekudzi YP, Nyonator FK, Bertel Squire S, Theobald S (2008). ‘He will ask why the child gets sick so often’: the gendered dynamics of intra-household bargaining over healthcare for children with fever in the Volta Region of Ghana. Social Science & Medicine; 66 (5): 110-1117

In recent years gender issues in infectious disease control have been the subject of two reports from the Special Programme for Research and Training in Tropical Diseases (TDR): The gender agenda in the control of tropical diseases: A review of current evidence and Gender and tuberculosis: cross-site analysis and implications of a multi-country study in Bangladesh, India, Malawi, and Colombia. New qualitative research on the topic has now been published from Ghana.

Abstract

This paper explores the gendered dynamics of intra-household bargaining around treatment seeking for children with fever revealed through two qualitative research studies in the Volta Region of Ghana, and discusses the influence of different gender and health discourses on the likely policy implications drawn from such findings. Methods used included focus group discussions, indepth and critical incidence interviews, and Participatory Learning and Action methods. We found that treatment seeking behaviour for children was influenced by norms of decision-making power and ‘ownership’ of children, access to and control over resources to pay for treatment, norms of responsibility for payment, marital status, household living arrangements, and the quality of relationships between mothers, fathers and elders. However, the implications of these findings may be interpreted from different perspectives.

Most studies that have considered gender in relation to malaria have done so within a narrow biomedical approach to health that focuses only on the outcomes of gender relations in terms of the (non-)utilisation of allopathic healthcare. However, we argue that a ‘gender transformatory’ approach, which aims to promote women’s empowerment, needs to include but go beyond this model, to consider broader potential outcomes of intra-household bargaining for women’s and men’s interests, including their livelihoods and ‘bargaining positions’.

Note: This article is published in a journal which is not open access. To see the full article a subscription to Social Science & Medicine is therefore required. In some developing countries, readers who are based in institutions may be able to access it through the HINARI initiative.

Elsevier 2008

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