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Torill bull NHPRC  2013.2
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Torill bull NHPRC 2013.2



Salutogenic processes among women in poor rural areas

Salutogenic processes among women in poor rural areas



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  • What might be worse than poverty are cultural factors which aggravate the situation for poor women: the culture is strongly patriarchal. A woman, if widowed, does not inherit her husband’s property. It goes to her husband’s family on the parental side, as does most often all male children. The woman will have to move to her native village with her daughters and try to etch out a living for herself. A man can divorce a wife very easily, leaving the woman in a similar vulnerable situation. Decision power remains largely with men as well. Men can marry up to four women.
  • A typical day for a Ghanaian woman from a northern rural village begins in the early hours of the day, before sunrise. She sweeps the compound and fetches firewood and water to boil for the day’s household chores (cooking, washing dishes, clothes and bathing). After feeding and sending her children off to school in the morning, she tends to her farm. The commonly used tool is a short hoe, therefore she must hunch over and forcefully claw at the earth to soften the dirt. During this work she may well have a baby wrapped in cloth tied to her back, while being pregnant with a new child.
  • Farm work lasts for hours under the scorching sun. Late in the afternoon, she returns home to prepare dinner for her family. Here you see women pounding cassava to make food, this is a heavy task.
  • She may have to fetch more firewood and water, depending on how much was used earlier in the day. She feeds her family, bathes the children, and might even prepare the bath for her husband. During night, sleep is likely to be interrupted by breast feeding, sick children, and body aches. Night leads on to a new day, and this is the circle of life.
  • A woman in average gives birth to 7 children, and many children die young. In the group we talked to, child mortality was 25 %. Health facilities were far away, and if a complications arose during delivery, the only solution was to transport the woman in labour on the back of a bicycle for 4 kilometers. So this is the context, this is the typical situation of the women we talked to. In this context, the word ‘life course’ takes on a different shade of meaning – given the child mortality rate, the ‘life course’ might be shorter than you hope for.
  • However, a third theme gave more hope: Considerate husband behavior. This had to elements, one emotional and one practical, but both involved the husband showing care and consideration.

Torill bull NHPRC  2013.2 Torill bull NHPRC 2013.2 Presentation Transcript

  • Women and family in a salutogenic perspective Torill Bull, Maurice Mittelmark, & Ngasuma Kanyeka
  • • Production • Reproduction • Combination of production and reproduction • Relationships • Culture
  • The Bole district of Northern Region Poverty Patriarchy
  • Wellswept ground
  • Workload of women
  • Workload of women - firewood
  • Poor – but playing
  • LIFE STRESSORS 1.Nature as a Threat 2.Lack of Infrastructure 3.Food insecurity 4.Illness and death 5.Work overload 6.Culture and religion as a threat GRRs 1.Health 2.Key item ownership 3.Skills 4.Wisdom 5.Being married 6.Marital relationship quality 7.Motherhood 8.Supportive neighbours 9.Empowering group memberships 10.Culture and religion as meaning /joy 11.Political agency 12.Women-friendly local leaders MOVEMENT TOWARDS WELL-BEING SENSE OF COHERENCE 1. COMPREHENSIBILITY 2. MANAGEABILITY 3. MEANINGFULNESS Bull, T., Mittelmark, MB, and Kanyeka, N. (2012). ‘Assets for health and well-being of women in impoverished rural areas of the Global South.’ Research paper commissioned for special issue of Critical Public Health as a follow-up from the conference Assets for health and wellbeing across the life course. Accepted pending minor revisions. LIFE EXPERIENCES 1. DEGREES OF CONSISTENCY 2. UNDERLOAD- OVERLOAD BALANCE 3. PARTICIPATION LIFE SITUATION Wider determinants of health including genetic, social, cultural and contextual factors (eg. geography, climate)
  • • Practical aspects • Emotional aspects 3. Considerate husband behaviour
  • Considerate husband behaviour: Practical aspects “Some men are helpful. He can come up with some work and say let us both join hands in this work for our common good. Sometimes he helps you in bathing the children or in some house work. Then together you converse on the way to the farm. It is simply nice so.” “If he talks to you in a loving way, that alone makes you happy. If you have two children, on the way to the farm, he can carry one child and you carry the other.”
  • Considerate husband behaviour: Emotional aspects “Sometimes when you are ill and the man does not have money to take you to hospital, what he will tell you will make you happy. “ “When you are tired or ill and he shows signs of care and love and even uses warm water to massage your body in place of medicine. In doing this, if he talks gently and lovingly to you, you will be happy. You may in return prepare such a nice meal for him as you have never done. “
  • “Child death is painful. (…) Any day you count your children their number is always short by one. Anytime you are lying in bed it is like the child is still lying in front of you.” Survival of children