Abstract
BackgroundIn South Sudan, women disproportionately bear the burden of morbidity and mortality related to sexual and reproductive health, with a maternal mortality ratio of 789 deaths per 100,000 live births.DesignA qualitative study was conducted to analyze how gendered social relations among the Fertit people affect women's ability to exercise control over their reproductive lives and thereby their sexual and reproductive health. Transcripts of 5 focus group discussions and 44 semi-structured interviews conducted with purposefully selected community members and health personnel were analyzed using Connell's relational theory of gender.ResultsWomen across all age groups report that they have little choice but to meet the childbearing demands of husbands and their families. Women, both young and old, and also elders, are frustrated about how men and society are letting them down and how they are left to bear the reproductive burden. The poverty and chronic insecurity in South Sudan mean that many men have few sources of pride and achievement; conformity and complicity with the hegemonic practices accord both security and a sense of belonging and privilege to men, often at the expense of women's reproductive health.ConclusionsInequalities in the domestic, social, and economic spheres intersect to create social situations wherein Fertit women's agency in the reproductive realm is constrained. In South Sudan, as long as economic and social opportunities for women remain restricted, and as long as insecurity and uncertainty remain, many women will have little choice but to resort to having many children to safeguard their fragile present and future. Unless structural measures are taken to address these inequalities, there is a risk of both a widening of existing health inequalities and the emergence of new inequalities.
Highlights
Women bear a disproportionate burden of morbidity and mortality related to sexual and reproductive health (SRH)
Others have pointed out that the complex nature of these interactions seems to hinder the scholarship on this subject and have urged researchers to take on this challenge [1, 4]; this article attempts to do this in the context of the SRH of women in South Sudan
The third theme builds on these two themes to highlight how broader societal and political circumstances have undermined the social compact among the Fertit and how this amplifies the unequal gender order, further undermining women’s ability to exercise their reproductive agency and thereby their reproductive health
Summary
Women bear a disproportionate burden of morbidity and mortality related to sexual and reproductive health (SRH). De Francisco et al [1] argued that individuals’ SRH is shaped by the nature of intimate and family relations set within kinship structures, community institutions, and relations They added that how women experience their sexual and reproductive situation and health is embedded within a variety of gendered social relations Á relations with their intimate partners, immediate family, community, and, broader society. Results: Women across all age groups report that they have little choice but to meet the childbearing demands of husbands and their families Women, both young and old, and elders, are frustrated about how men and society are letting them down and how they are left to bear the reproductive burden.
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