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- W1506522237 abstract "This study examines social constructions of infertility in Malawi. The literature oninfertility consists of epidemiological studies, describing patterns of infertility interms of its incidence, causes and health seeking behaviour; studies of thepsychological correlates of infertility; and ethnographic studies which describeexperiences, perceptions and management of infertility within specific socio-culturalcontexts. In addition, some studies discuss social aspects of medical practice inrelation to infertility. Overall, studies of infertility in developing countries emphasizeits many serious psychological and social consequences, usually attributed to culturalnorms mandating parenthood. There appear to be several lacunae in the literature:men with fertility problems are rarely included, an in-depth examination ofpractitioners’ views is missing, and no qualitative study has been conducted oninfertility in Malawi, which has a considerable secondary infertility rate.Furthermore, although ethnographic studies highlight the interpersonal (related toothers’ judgements), normative (related to ideas about what ‘ought’ to be) and moral(related to ideas about what is good or bad) issues involved in infertility, no studyhas investigated how these issues are managed in situ, in verbal interactions.However, it has been argued that ‘talk’ is a prime site for the management of issuessuch as blaming and deflecting responsibility. Hence, this study addresses severalgaps in the literature. It focuses on Malawi, and includes a wide range ofparticipants: women and men with a fertility problem, significant others, indigenousand (Malawian and expatriate) biomedical practitioners. Semi-structured interviewswith 63 participants were recorded and transcribed, and translations were obtained ofinterviews in which interpreters were used. For the analysis, I used discourse analysis(DA), informed by conversation analysis (CA). This analytic approach, novel ininfertility studies, examines the interpersonal functions of statements in interactions,such as blaming or justifying.Use of DA and CA has led to novel insights into how respondents constructinfertility, its causes, solutions (sought and offered), and consequences, and how theythereby manage interpersonal, normative, and moral issues, revolving aroundaccountability, blame and justification, and attribution of (problematic) identitycategories. For instance, I have shown how respondents construct childbearing as acultural, normative requirement, and how this can be used to justify practices likeextramarital affairs, or polygamy, as necessary solutions. In addition, identifyingcauses appears to be problematic for people with a fertility problem due to certaininterpersonal and interactional issues, such as the idea that they are not entitled to medical knowledge. Practitioners can be seen to work up and bolster an identity ofprofessional, competent expert in constructions of causes of infertility, and byattributing problems in helping infertility clients to external factors, includingpatients’ intelligence.This study has several theoretical, practical, and methodologicalimplications, although I discuss some thorny methodological issues,especially those concerning the use of translations and the transferability of theanalytic findings. A first contribution pertains to methodological debates anddevelopments in conversation analysis, and in studies of infertility and other healthissues which rely upon people’s self-reports. Second, my study contributes totheoretical developments in health psychology and health promotion. My analysispoints to the relevance of social and normative considerations for engagement in‘risky’ behaviours, such as extramarital affairs. This challenges cognition modelswhich treat health behaviour as the outcome of individualistic decision-makingprocesses, and see providing information as the main way of changing people’sbehaviour. Therefore, a third set of implications is of a practical nature: some of thefindings can contribute to health promotion, as well as to improvement of healthservices. For example, practitioners’ attribution of failures and (communication)problems to their patients, may prevent them from reflecting critically on, andaddressing, their own contributions to problems. Overall, this thesis shows that whenone wants to ‘give voice’ to people who are suffering from infertility, it is valuable toexamine what they say in detail, within its interactional context, and the concernsthey themselves make relevant, in their own terms." @default.
- W1506522237 created "2016-06-24" @default.
- W1506522237 creator A5063038072 @default.
- W1506522237 creator A5065011035 @default.
- W1506522237 date "2007-05-17" @default.
- W1506522237 modified "2023-09-23" @default.
- W1506522237 title "Constructing infertility in Malawi : management of interpersonal, normative and moral issues in talk" @default.
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