Carol Underwood, Zoé Hendrickson, and Ron Hess Gender, power, and communicative action: Qualitative findings from selected Nepali communities Carol Underwood, Zoé Hendrickson, and Ron Hess Nepal HC3 Project February 2016

Presentation Outline Background and context Integrating communication and gender theory The Nepal HC3 Project Methods Findings Significance and implications

Background and context: Nepal International and domestic attention to contraceptive availability, accessibility, and utilization in Nepal1,2 Contraceptive use remains lower among the young married cohort, migrants, rural populations, and couples from marginalized and disadvantaged groups3,4 Image from: http://mesa.ucdavis.edu/files/pictures-staff-faculty-flags-maps-etc/pictures-of-the-maps/south-asia-map.gif/view The modern contraceptive prevalence rate (CPR) is lowest, and unmet need highest, among the young married cohort (14.4% CPR for CMWRA aged 15–19; 23.8% CPR for CMWRA aged 20–24; 39.8% CPR for CMWRA aged 25–29), migrants (52.9% CPR husband and wife live together; 22.5% CPR husband lives away), rural populations (42.1% vs. 49.8% in urban areas), and marginalized and disadvantaged groups (MDAGs) (22.8% CPR Muslims; 40% CPR Dalit).

Background and context: Family planning decisions in Nepal Role of communication: Greater partner communication and joint decision-making associated with greater contraceptive use3,5-8 Gender norms, gender preferences, and expectations of women’s roles also influence reproductive decision-making9-12

Habermas and communication Strategic communication vs. communicative action12,13 Communicative action as the pursuit of consensus Image from: Habermas, 1974; Jacobson & Storey, 2004

Connell and the theory of gender and power Three organizing dimensions of gender relations in the family/household14 Labor: “Allocation of particular types of work to particular categories of people” (p. 99) Power: “Relations of power that act as a pattern of constraint on social practice” (p. 107) Cathexis: Structure organizing emotional attachments to people, particularly relations between men and women and masculinity/femininity

Integrating communication and gender theory Communicative action provides a lens that moves beyond labor, power, and cathexis to examine how mutual understanding and consensus construct and/or reconstruct gender relations in a family or household

The Nepal HC3 Project Multi-component, four-year project (2013-2017) Intervention includes integrated media, social media, community events

Map of districts in Nepal Humla Darchula Bajhang Mugu Baitadi Bajura Dadeldhura Jumla Doti Achham Kalikot Dolpa Kanchanpur Mustang Dailekh Jajarkot Kailali Rukum Manang Surkhet Myagdi Bardiya Salyan Baglung Gorkha Rolpa Kaski Lamjung Parbat Rasuwa Banke Pyuthan Gulmi Syangja Dang Arghakhanchi Tanahu Nuwakot Sindhupalchok Palpa Dhading Kathmandu Dolakha Formative research districts Bhaktapur Kapilbastu Nawalparasi Solukhumbu Kavrepalanchok Sankhuwasabha Taplejung Rupandehi Chitawan Lalitpur Makwanpur Ramechhap Okhaldhunga Sindhuli Parsa Khotang Terhathum Bhojpur Panchthar Bara Sarlahi Rautahat Udayapur Mahottari Dhankuta Ilam Dhanusa Siraha Sunsari Saptari Morang Jhapa

Formative research methods Sixty in-depth interviews on attitudes, norms, experiences, and processes that influence contraceptive use Participants: Unmarried women and men, Married women and men Mothers-in-law Migrants Health workers and FCHVs Influential community members

Analysis methods Multi-national research team (US- and Nepal-based individuals) worked to develop coding framework using a priori and inductive coding Thematic analysis of English transcripts performed in ATLAS.ti

Findings: Sexual division of labor “Wife makes the decision related to raising the children . . . She takes decision right from their care to every other thing. I only bring the materials to the house.” (Married man, Banke) “My wife does household work. . . . I take such decisions [on expenditures for children] according to my judgment, not spending extravagantly.” (Man from disadvantaged group, Siraha) “The female is similar to that of the male. She can engage in a job and make her career. She has the right; and she is not here just to have babies and cook and take care of the family.” (Migrant man, Banke)

Findings: Power inequities A: “In my experience, it is the husband who decides. It is the husband who gives either trouble or happiness. . . . “If [women] worked according to their own interest, husband comes with the stick and punishes them.” (Male health worker, Banke) “Whatever husband says, wife does accordingly [regarding contraception].” (Unmarried woman, Siraha) “In my home I have a job so I have more rights. But in some houses there are women working more than men. In some houses the women will have more rights.” (Married man, Banke)

Findings: Power equity “In our Muslim community . . . if the matter between them comes to a conclusion and they both are positive for the conclusion, then they can do that thing, otherwise they can’t do it… We have that rule in our religion.” (Migrant man 1, Banke) “[Decisions are] not only taken by husband now. Now most of the wives are understanding, and it happens through agreement. In the past men used to tell their wives to do. Males did not [use contraception]. But now if the woman is weak [so cannot use contraception], she tells her husband to do. Everything is based on agreement.” (Influential man, Syangja)

Cathexis “What kind of [husband]? (Laughing). One who fulfills my needs and wants, understands me, cooperates, and makes decision together.” (Unmarried woman, Syangja) “If both husband and wife suggest to each other, they can live with happiness and love throughout the life.” (Influential man, Banke) “There should be trust between husband and wife. If we lose that trust, we lose our wealth, we lose our home, and we lose everything.” (Migrant man, Syangja)

Findings: Communicative Action “If I do so on my own [make a decision] it would hurt my wife. It would be a forceful and one-sided decision. That’s why we decide collectively in everything not only in the matter of children.” (Migrant man, Siraha) “There is good understanding. If he finds anything good, he shares with me, and vice-versa. . . There is good agreement with my husband. We work in coordination. What else?” (Woman from disadvantaged group, Banke) “Taking the decision together helps to keep the couples happy and see other options of the subject as well.” (Man from disadvantaged group, Syangja)

Summary of Findings Mutual trust, understanding, and empathy Accounts of decision-making often varied Gendered divisions of labor and power were reported, but participants’ emphasized that joint decisions and communication about family planning and other topics with partners was increasingly important

Significance and implications We often assume that household gender dynamics are characterized by strategic action and driven by power imbalances and unequal divisions of labor that perpetuate inequities between men and women Our findings from select communities in Nepal suggest that although gendered divisions of power/labor exist, partners are motivated to achieve mutual understanding and agreement regarding family planning and reproductive decisions

Namaste!

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