Between compliance and resistance: exploring discourses on family planning in Community Health Committees in Mozambique
Identifieur interne : 000E75 ( Pmc/Checkpoint ); précédent : 000E74; suivant : 000E76Between compliance and resistance: exploring discourses on family planning in Community Health Committees in Mozambique
Auteurs : Rehana Dauto Capurchande [Mozambique, Belgique] ; Gily Coene [Belgique] ; Kristien Roelens [Belgique] ; Herman Meulemans [Belgique, Afrique du Sud]Source :
- BMJ Open [ 2044-6055 ] ; 2015.
Abstract
Although the Mozambican government has implemented a community-based approach to family planning (FP), little is known about the appropriateness of this process. We explore how members of Community Health Committees (CHCs) address and act regarding FP.
An in-depth qualitative study of CHCs was conducted at two sites in Maputo province—Ndlavela and Boane—using focus group discussions (n=6), informal conversations (n=4) and observation. The analysis followed a phenomenological approach.
CHCs in Ndlavela appeared to transfer more of the expected information than those in Boane. However, in the CHCs at both study sites, we found heterogeneity in CHCs’ perspectives leading to conflicting views among committee members (CMs). Arising issues included contraceptive type, target groups, the desirable number of children per family as well as the way FP was to be represented. Moreover, weak communication between CMs and health workers, and lack of payment for CMs’ activities influenced promotion of FP.
The two CHCs framed FP in different ways leading to inconsistent participation of CHC members in promoting FP. Policymakers should consider the diversity of discourses and aspirations of these committees when delivering information to them.
Url:
DOI: 10.1136/bmjopen-2014-006529
PubMed: 26009572
PubMed Central: 4452751
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type="main">Between compliance and resistance: exploring discourses on family planning in Community Health Committees in Mozambique</title><author><name sortKey="Capurchande, Rehana Dauto" sort="Capurchande, Rehana Dauto" uniqKey="Capurchande R" first="Rehana Dauto" last="Capurchande">Rehana Dauto Capurchande</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Department of Sociology</addr-line>,<institution>Eduardo Mondlane University</institution>,<addr-line>Maputo</addr-line>,<country>Mozambique</country></nlm:aff><country xml:lang="fr">Mozambique</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><institution>Vrije Universiteit Brussel (Brussels University), Centre for Research in Gender and Diversity</institution>,<addr-line>Brussels</addr-line>,<country>Belgium</country></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Coene, Gily" sort="Coene, Gily" uniqKey="Coene G" first="Gily" last="Coene">Gily Coene</name><affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Department of Philosophy and Ethics</addr-line>,<institution>Vrije Universiteit Brussel (Brussels University), Centre for Research in Gender and Diversity</institution>,<addr-line>Brussels</addr-line>,<country>Belgium</country></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Roelens, Kristien" sort="Roelens, Kristien" uniqKey="Roelens K" first="Kristien" last="Roelens">Kristien Roelens</name><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Department of Obstetrics and Gynecology</addr-line>,<institution>Universiteit Gent (Ghent University)</institution>,<addr-line>Ghent</addr-line>,<country>Belgium</country></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Meulemans, Herman" sort="Meulemans, Herman" uniqKey="Meulemans H" first="Herman" last="Meulemans">Herman Meulemans</name><affiliation wicri:level="1"><nlm:aff id="af5"><addr-line>Department of Sociology</addr-line>,<institution>Universiteit Antwerpen (Antwerp University), Centre for Longitudinal and Life Course Studies</institution>,<addr-line>Antwerpen</addr-line>,<country>Belgium</country></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af6"><institution>Centre for Health Systems Research and Development (CHSR&D), University of the Free State</institution>,<addr-line>Bloemfontein</addr-line>,<country>South Africa</country></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMJ Open</title><idno type="eISSN">2044-6055</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objectives</title><p>Although the Mozambican government has implemented a community-based approach to family planning (FP), little is known about the appropriateness of this process. We explore how members of Community Health Committees (CHCs) address and act regarding FP.</p></sec><sec><title>Methods/settings</title><p>An in-depth qualitative study of CHCs was conducted at two sites in Maputo province—Ndlavela and Boane—using focus group discussions (n=6), informal conversations (n=4) and observation. The analysis followed a phenomenological approach.</p></sec><sec><title>Results</title><p>CHCs in Ndlavela appeared to transfer more of the expected information than those in Boane. However, in the CHCs at both study sites, we found heterogeneity in CHCs’ perspectives leading to conflicting views among committee members (CMs). Arising issues included contraceptive type, target groups, the desirable number of children per family as well as the way FP was to be represented. Moreover, weak communication between CMs and health workers, and lack of payment for CMs’ activities influenced promotion of FP.</p></sec><sec><title>Conclusions</title><p>The two CHCs framed FP in different ways leading to inconsistent participation of CHC members in promoting FP. Policymakers should consider the diversity of discourses and aspirations of these committees when delivering information to them.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Agadjanian, V" uniqKey="Agadjanian V">V Agadjanian</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yao, J" uniqKey="Yao J">J Yao</name></author><author><name sortKey="Murray, At" uniqKey="Murray A">AT Murray</name></author><author><name sortKey="Agadjanian, V" uniqKey="Agadjanian V">V Agadjanian</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Prata, N" uniqKey="Prata N">N Prata</name></author><author><name sortKey="Sreenivas, A" uniqKey="Sreenivas A">A Sreenivas</name></author><author><name sortKey="Bellows, B" uniqKey="Bellows B">B Bellows</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Abbot, A" uniqKey="Abbot A">A Abbot</name></author><author><name sortKey="Luke, N" uniqKey="Luke N">N Luke</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mubyazi, Gm" uniqKey="Mubyazi G">GM Mubyazi</name></author><author><name sortKey="Hutton, G" uniqKey="Hutton G">G Hutton</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chin Quee, D" uniqKey="Chin Quee D">D Chin-Quee</name></author><author><name sortKey="Bratt, J" uniqKey="Bratt J">J Bratt</name></author><author><name sortKey="Malkin, M" uniqKey="Malkin M">M Malkin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Maes, K" uniqKey="Maes K">K Maes</name></author><author><name sortKey="Kalofonos, I" uniqKey="Kalofonos I">I Kalofonos</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wallerstein, Nb" uniqKey="Wallerstein N">NB Wallerstein</name></author><author><name sortKey="Duran, B" uniqKey="Duran B">B Duran</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chapmann, Rr" uniqKey="Chapmann R">RR Chapmann</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Alnakash, Ah" uniqKey="Alnakash A">AH Alnakash</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rifkin, S" uniqKey="Rifkin S">S Rifkin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Laverack, G" uniqKey="Laverack G">G Laverack</name></author><author><name sortKey="Wallerstein, N" uniqKey="Wallerstein N">N Wallerstein</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Takasugi, T" uniqKey="Takasugi T">T Takasugi</name></author><author><name sortKey="Lee, Ack" uniqKey="Lee A">ACK Lee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Berger, P" uniqKey="Berger P">P Berger</name></author><author><name sortKey="Luckmann, T" uniqKey="Luckmann T">T Luckmann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yin, Rk" uniqKey="Yin R">RK Yin</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Bryman, A" uniqKey="Bryman A">A Bryman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bernard, Rh" uniqKey="Bernard R">RH Bernard</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gibson, W" uniqKey="Gibson W">W Gibson</name></author><author><name sortKey="Brown, A" uniqKey="Brown A">A Brown</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hermann, K" uniqKey="Hermann K">K Hermann</name></author><author><name sortKey="Damme, Wv" uniqKey="Damme W">WV Damme</name></author><author><name sortKey="Pariyo, Gw" uniqKey="Pariyo G">GW Pariyo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Phillips, Jf" uniqKey="Phillips J">JF Phillips</name></author><author><name sortKey="Greene, Wl" uniqKey="Greene W">WL Greene</name></author><author><name sortKey="Jackson, Ef" uniqKey="Jackson E">EF Jackson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kassa, M" uniqKey="Kassa M">M Kassa</name></author><author><name sortKey="Abajobir, Aa" uniqKey="Abajobir A">AA Abajobir</name></author><author><name sortKey="Gedefaw, M" uniqKey="Gedefaw M">M Gedefaw</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wallerstein, N" uniqKey="Wallerstein N">N Wallerstein</name></author><author><name sortKey="Duran, B" uniqKey="Duran B">B Duran</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMJ Open</journal-id><journal-id journal-id-type="iso-abbrev">BMJ Open</journal-id><journal-id journal-id-type="hwp">bmjopen</journal-id><journal-id journal-id-type="publisher-id">bmjopen</journal-id><journal-title-group><journal-title>BMJ Open</journal-title></journal-title-group><issn pub-type="epub">2044-6055</issn><publisher><publisher-name>BMJ Publishing Group</publisher-name><publisher-loc>BMA House, Tavistock Square, London, WC1H 9JR</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26009572</article-id><article-id pub-id-type="pmc">4452751</article-id><article-id pub-id-type="publisher-id">bmjopen-2014-006529</article-id><article-id pub-id-type="doi">10.1136/bmjopen-2014-006529</article-id><article-categories><subj-group subj-group-type="heading"><subject>Health Policy</subject><subj-group><subject>Research</subject></subj-group></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>1506</subject><subject>1703</subject><subject>1724</subject></subj-group></article-categories><title-group><article-title>Between compliance and resistance: exploring discourses on family planning in Community Health Committees in Mozambique</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Capurchande</surname><given-names>Rehana Dauto</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Coene</surname><given-names>Gily</given-names></name><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Roelens</surname><given-names>Kristien</given-names></name><xref ref-type="aff" rid="af4">4</xref></contrib><contrib contrib-type="author"><name><surname>Meulemans</surname><given-names>Herman</given-names></name><xref ref-type="aff" rid="af5">5</xref><xref ref-type="aff" rid="af6">6</xref></contrib></contrib-group><aff id="af1"><label>1</label><addr-line>Department of Sociology</addr-line>,<institution>Eduardo Mondlane University</institution>,<addr-line>Maputo</addr-line>,<country>Mozambique</country></aff><aff id="af2"><label>2</label><institution>Vrije Universiteit Brussel (Brussels University), Centre for Research in Gender and Diversity</institution>,<addr-line>Brussels</addr-line>,<country>Belgium</country></aff><aff id="af3"><label>3</label><addr-line>Department of Philosophy and Ethics</addr-line>,<institution>Vrije Universiteit Brussel (Brussels University), Centre for Research in Gender and Diversity</institution>,<addr-line>Brussels</addr-line>,<country>Belgium</country></aff><aff id="af4"><label>4</label><addr-line>Department of Obstetrics and Gynecology</addr-line>,<institution>Universiteit Gent (Ghent University)</institution>,<addr-line>Ghent</addr-line>,<country>Belgium</country></aff><aff id="af5"><label>5</label><addr-line>Department of Sociology</addr-line>,<institution>Universiteit Antwerpen (Antwerp University), Centre for Longitudinal and Life Course Studies</institution>,<addr-line>Antwerpen</addr-line>,<country>Belgium</country></aff><aff id="af6"><label>6</label><institution>Centre for Health Systems Research and Development (CHSR&D), University of the Free State</institution>,<addr-line>Bloemfontein</addr-line>,<country>South Africa</country></aff><author-notes><corresp><label>Correspondence to</label> Dr Rehana Dauto Capurchande; <email>rehana.dc@gmail.com</email></corresp></author-notes><pub-date pub-type="collection"><year>2015</year></pub-date><pub-date pub-type="epub"><day>25</day><month>5</month><year>2015</year></pub-date><volume>5</volume><issue>5</issue><elocation-id>e006529</elocation-id><history><date date-type="received"><day>3</day><month>9</month><year>2014</year></date><date date-type="rev-recd"><day>23</day><month>4</month><year>2015</year></date><date date-type="accepted"><day>26</day><month>4</month><year>2015</year></date></history><permissions><copyright-statement>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement><copyright-year>2015</copyright-year><license license-type="open-access"><license-p>This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link></license-p></license></permissions><self-uri xlink:title="pdf" xlink:href="bmjopen-2014-006529.pdf"></self-uri><abstract><sec><title>Objectives</title><p>Although the Mozambican government has implemented a community-based approach to family planning (FP), little is known about the appropriateness of this process. We explore how members of Community Health Committees (CHCs) address and act regarding FP.</p></sec><sec><title>Methods/settings</title><p>An in-depth qualitative study of CHCs was conducted at two sites in Maputo province—Ndlavela and Boane—using focus group discussions (n=6), informal conversations (n=4) and observation. The analysis followed a phenomenological approach.</p></sec><sec><title>Results</title><p>CHCs in Ndlavela appeared to transfer more of the expected information than those in Boane. However, in the CHCs at both study sites, we found heterogeneity in CHCs’ perspectives leading to conflicting views among committee members (CMs). Arising issues included contraceptive type, target groups, the desirable number of children per family as well as the way FP was to be represented. Moreover, weak communication between CMs and health workers, and lack of payment for CMs’ activities influenced promotion of FP.</p></sec><sec><title>Conclusions</title><p>The two CHCs framed FP in different ways leading to inconsistent participation of CHC members in promoting FP. Policymakers should consider the diversity of discourses and aspirations of these committees when delivering information to them.</p></sec></abstract></article-meta></front></pmc><affiliations><list><country><li>Afrique du Sud</li><li>Belgique</li><li>Mozambique</li></country></list><tree><country name="Mozambique"><noRegion><name sortKey="Capurchande, Rehana Dauto" sort="Capurchande, Rehana Dauto" uniqKey="Capurchande R" first="Rehana Dauto" last="Capurchande">Rehana Dauto Capurchande</name></noRegion></country><country name="Belgique"><noRegion><name sortKey="Capurchande, Rehana Dauto" sort="Capurchande, Rehana Dauto" uniqKey="Capurchande R" first="Rehana Dauto" last="Capurchande">Rehana Dauto Capurchande</name></noRegion><name sortKey="Coene, Gily" sort="Coene, Gily" uniqKey="Coene G" first="Gily" last="Coene">Gily Coene</name><name sortKey="Meulemans, Herman" sort="Meulemans, Herman" uniqKey="Meulemans H" first="Herman" last="Meulemans">Herman Meulemans</name><name sortKey="Roelens, Kristien" sort="Roelens, Kristien" uniqKey="Roelens K" first="Kristien" last="Roelens">Kristien Roelens</name></country><country name="Afrique du Sud"><noRegion><name sortKey="Meulemans, Herman" sort="Meulemans, Herman" uniqKey="Meulemans H" first="Herman" last="Meulemans">Herman Meulemans</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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