1
|
Ouahid H, Mansouri A, Sebbani M, Nouari N, Khachay FE, Cherkaoui M, Amine M, Adarmouch L. Gender norms and access to sexual and reproductive health services among women in the Marrakech-Safi region of Morocco: a qualitative study. BMC Pregnancy Childbirth 2023; 23:407. [PMID: 37268874 DOI: 10.1186/s12884-023-05724-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/20/2023] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION Improving access to sexual and reproductive health remains a public health challenge, especially for women, whose access is affected by several determinants, such as gender inequality, which is the underlying barrier to all other determinants. Many actions have been carried out, but much remains to be done before all women and girls can exercise their rights. This study aimed to explore how gender norms influence access to sexual and reproductive health services. METHOD A qualitative study was conducted from November 2021 to July 2022. The inclusion criteria were women and men aged over 18 years old, living in the urban and rural areas of the Marrakech-Safi region in Morocco. A purposive sampling method was used to select participants. Data were obtained through semi-structured interviews and focus groups with selected participants. The data were coded and classified using thematic content analysis. RESULTS The study highlighted inequitable, restrictive gender norms that lead to stigmatization and affect the sexual and reproductive healthcare-seeking behavior and access of girls and women in the Marrakech-Safi region. These most common gender norms for women include parental refusal, stigmatization, and social exclusion of girls from sexual and reproductive health education services; strong decision-making power of family members over contraceptive use and women's adherence to pregnancy monitoring and access to supervised delivery; and culturally constructed role allocation, assigning a reproductive role to women and making them responsible for the health of new-borns. CONCLUSION Sexual and reproductive health projects must strive to be gender sensitive. Gender-blind projects are missed opportunities to improve health outcomes and advance gender equality.
Collapse
Affiliation(s)
- Hajar Ouahid
- Bioscience and Health Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco.
| | - Adil Mansouri
- Clinical Research Department, Mohammed VI University Hospital, Marrakech, Morocco
| | - Majda Sebbani
- Bioscience and Health Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
- Clinical Research Department, Mohammed VI University Hospital, Marrakech, Morocco
- Department of Public Health, Community Medicine and Epidemiology, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - Nadia Nouari
- Bioscience and Health Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - Fatima Ezzahra Khachay
- Bioscience and Health Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - Mohamed Cherkaoui
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, and Environment, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco
| | - Mohamed Amine
- Bioscience and Health Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
- Clinical Research Department, Mohammed VI University Hospital, Marrakech, Morocco
- Department of Public Health, Community Medicine and Epidemiology, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - Latifa Adarmouch
- Bioscience and Health Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
- Clinical Research Department, Mohammed VI University Hospital, Marrakech, Morocco
- Department of Public Health, Community Medicine and Epidemiology, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| |
Collapse
|
2
|
Kane H. [Newborn care: International recommendations confronted with the social challenges surrounding birth]. SANTE PUBLIQUE 2020; 1:17-27. [PMID: 32374091 DOI: 10.3917/spub.200.0017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Driven by international programs specifically targeting neonatal survival, a set of recommended care practices is being promoted in West Africa. Using data from a multi-centered anthropological study, we enquire as to how local practices integrate the recommendations disseminated by these programs. METHOD The surveys were conducted in rural localities in five countries : Benin, Burkina Faso, Mali, Mauritania, and Togo. In every site, the investigations combined ethnography of newborn care and in-depth interviews in maternity homes and homes. RESULTS The care of newborns is based on a set of local social representations and logics, where medical recommendations are integrated heterogeneously. In maternity wards, health professionals face difficulties in implementing recommended practices, and make various conciliations when faced with local material and social constraints. In private homes, the "messages" promoting life-saving care for newborns punctuate conversations, but lead to various interpretations and variations in care. DISCUSSION The irregular integration of medical recommendations in neonatal care is analyzed around three areas: the divergence of intentions around the birth, the dissonances between the recommended care and the local conceptions of the newborn, the influence of intra-family power relations. Considering the complexity of the changes in neonatal care, we argue for the implementation of programs that respect local cultures, and for health professionals to skillfully accommodate conflicting constraints.
Collapse
|