The Kingdom of Swaziland is a small African nation with an HIV prevalence rate of 27.4% in adults and up to 39% in pregnant women (Global Health Observatory, 2014). In 2012, life expectancy for a woman in Swaziland was 55-years (World Health Organization, 2014). Health entails more than the absence of disease. Although considered a lower middle-income country, 69% of Swazi citizens live in poverty and nearly one-third live in extremely poor circumstances. The degree to which upstream factors such as social conditions and the cultural environment impact individuals tends to be minimized in Westernized models of health behavior. The purpose of this study was to examine the sociocultural factors that impact self-care and health maintenance of women in Swaziland. The goals related to this were to uncover the salient cultural values, beliefs and attitudes that affect the health of Swazi women, and to develop a deeper understanding of how strongly embedded cultural values are a determinant of health outcomes. Using Carspecken’s methodology of critical ethnography, which incorporates both observational and narrative methods, this study focused intensively on the life stories of four rural African women. The findings richly illustrate how social issues such as poverty and food insecurity impact the health of women and their children; and how traditional customs and practices both support and threaten the health of women and families. Women in this study experienced a loss of husband or extended family due to death or abandonment that resulted in losses in supports and resources. Additionally, they worried about the health and education of their children before personal health needs. They also reported chronic employment problems and mistrust in existing governmental agencies including the healthcare system. Application of the culturally sensitive Person-Environment-Neighborhood (PEN-3) model highlights areas of resilience, strengths, and resource targets and identifies the community as an appropriate entry level for health interventions.
|Advisor:||Gilbert, Kathleen, Dennis, Barbara|
|Commitee:||Guerra-Reyes, Lucia, Murray, Maresa|
|Department:||School of Public Health|
|School Location:||United States -- Indiana|
|Source:||DAI-A 76/11(E), Dissertation Abstracts International|
|Subjects:||African Studies, Gender studies, Health care management|
|Keywords:||Culture, Education, Employment, Health, Violence, Women|
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