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"People Insult Her as Sexy Woman:" Sexuality, Stigma and Reproductive Health among Widowed and Divorced Women‐‐Documenting Social Change in Oromiya, Ethiopia

Newton-Levinson, Anna Marit (2012)
Master's Thesis (136 pages)
Committee Chair / Thesis Adviser: Stephenson, Robert
Committee Members: Girard, Amy Webb
Research Fields: Health Sciences, Public Health
Partnering Agencies: Emory University schools, faculty or affiliated programs ; International Non-governmental organization (e.g., CARE, Inc.)
Keywords: Sexuality; Reproductive Health; Family Planning; Ethiopia; Widows; Divorced; Women; Social Change; Status
Program: Rollins School of Public Health, Hubert Department of Global Health
Permanent url: http://pid.emory.edu/ark:/25593/brhd2

Abstract

"People Insult Her as Sexy Woman:" Sexuality, Stigma and Reproductive Health among
Widowed and Divorced Women--Documenting Social Change in Oromiya, Ethiopia


By: Anna Newton-Levinson

Background:

Women in Ethiopia have far less power over their lives and health than their male
counterparts. This is especially true of women living in rural communities and of those who are
widowed or divorced. The latter, in particular, according to some reports from the field, lack
resources and social capital and have poor access to health services. CARE's Results Initiative
(RI), a large scale intervention based in Hararghe, set out to change gender and other social
norms in ways that would affect family planning use. Anecdotal reports from the field had
indicated that the RI program had transformed the lives of many women who were widowed or
divorced. None of these reported changes had as yet been documented or measured.

Objective:
The purpose of this study is to examine the lives and reproductive health needs of
WDW in rural Ethiopia, and to document if and how they were influenced.

Methods:
In an effort to understand the challenges and reproductive health needs of widowed
and divorced women (WDW) and the life changes that they have experienced, we conducted
twenty-three focus group discussions, in-depth interviews, and interactive activities with WDW
and with other community members.


Results: Prior to the R.I. Program WDW experienced stigma relating to their sexuality, a stigma
that had negative impact on their economic, social, and health support systems. After
participating in the CARE RI program, WDW experienced positive changes in the way their
sexuality was perceived by the community and by themselves. These changes, in combination
with other factors, had positive effect on their economic and social support systems and on
their access to health services and family planning.


Discussion: Although positive changes are taking place, further programmatic work is needed to
address the lingering stigma attached to WDW's sexuality and their vulnerability to rape. The
findings of this study indicate that while WDW have been heretofore addressed primarily as
economic beings future interventions need to consider them as sexual beings as well and to take
into account the impact of sexual stigma on WDW's overall well-being.

Table of Contents

TABLE OF CONTENTS
Introduction............................................................................................................................. 1

Problem statement ...................................................................................................................... 1
Background ................................................................................................................................ 2
Objectives and Aims ..................................................................................................................... 3
Definition of Terms.........................................................................................................................4
Contribution to Literature and Programmatic Efforts ................................................................ ...........4
Literature Review .......................................................................................................................6
Introduction.................................................................................................................................6
Women's Status in Ethiopia ......................................................................................................... ..6
Harmful Traditional Practices ................................................................................................... .....8
Education .................................................................................................................................. 9
Marriage & Sexuality ................................................................................................................ ....9
Bargaining Power in Marriage......................................................................................................... 12

Health .......................................................................................................................................13
Reproductive Health................................................................................................................... ..13
Abortion .................................................................................................................................. 18
Widowed and Divorced Women: An overlooked population .................................................... .............19
Economic Situation of WDW ......................................................................................................... 20
Social Status of WDW ................................................................................................................. 23
Divorce Practices ..................................................................................................................... 25
The Practices of Widowhood .................................................................................................. ....27
Mental Health of WDW .............................................................................................................. 28
Sexual and Reproductive Health Needs of WDW ............................................................................. 29

Methods ............................................................................................................................... 31
Study Setting ......................................................................................................................... 31
Ethiopian Administration ........................................................................................................... 31
Hararghe Zone & Oromiya Region ............................................................................................... 31
Health System and the Health Extension Program (HEP) ....................................................... ..........34

PROGRAM BACKGROUND .............................................................................................................35
Research Design .......................................................................................................................38
Tool Development ................................................................................................................... 40
IMPLEMENTATION .....................................................................................................................50
DATA MANAGEMENT AND TRANSCRIPTION ..................................................................................... 66
ANALYSIS ............................................................................................................................... 67
Results .................................................................................................................................. 69
Challenges in the Past ............................................................................................................. 69
WDW's Sexuality ..................................................................................................................... ...69
Community Stigma .................................................................................................................... 70
Pregnancy ............................................................................................................................... 71
Fear ....................................................................................................................................... 72

Past Support Systems ................................................................................................................ 75
Changes in the Present ............................................................................................................ 84

Community Perceptions of WDW's Sexuality .................................................................................... 85
Family Planning (The less shameful option) ..................................................................................... 86
Pregnancy ............................................................................................................................... 87

WDW'S PERCEPTIONS .................................................................................................................88
Sexuality ..................................................................................................................................88
Family Planning ...................................................................................................................... ..89
Rape .......................................................................................................................................90
Unwanted Pregnancy ................................................................................................................ 92
Abortion .................................................................................................................................. 93

WDW'S SUPPORT SYSTEMS IN THE PRESENT ................................................................................. 94
HOW WDW CONCEPTUALIZE CHANGE ........................................................................................... 99
HOW THE COMMUNITY CONCEPTUALIZES CHANGE .......................................................................... 102
Discussion .......................................................................................................................... ...105
Summary of Results .................................................................................................................. 105
Larger Theory of Change .......................................................................................................... .106
RELATION TO LITERATURE ..........................................................................................................108
LIMITATIONS ........................................................................................................................... 109
PROGRAM CONSIDERATIONS ........................................................................................................ 111
IMPLICATIONS FOR PUBLIC HEALTH ............................................................................................... 113
Conclusion ............................................................................................................... ..............115
References ............................................................................................................................. 116
Appendices ........................................................................................................................ .....120
Appendix A: Interviewing Do's and Don'ts ............................................................................... .........120
Appendix B: IDI Interview Guide .............................................................................................. ......121
Appendix C:SM Interview Guide .............................................................................................. .......124
Appendix D : FGD Interview Guide .................................................................................................. 126
Appendix E: IRB Approval ......................................................................................................... .....128

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application/pdf Master's Thesis 136 pages (1.2 MB) [Access copy of Master's Thesis]
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