PMTCT, HAART, and Childbearing in Mozambique: An Institutional Perspective
PMTCT, HAART, and Childbearing in Mozambique: An Institutional Perspective
复制标题
DOI：
10.1007/s10461-009-9535-0
复制
发表时间：
2009-06-01
影响因子：
4.4
通讯作者：
Hayford, Sarah R.
中科院分区：
文献类型：
--
作者：
Agadjanian, Victor;Hayford, Sarah R.
妇幼保健单位将自愿咨询和检测/防止母婴传播/高效抗逆转录病毒疗法与传统服务相结合，在大规模高效抗逆转录病毒疗法的推广与生殖行为之间的联系方面发挥着关键作用。在这篇文章中，我们使用的数据，从半结构化的采访妇幼保健工作者和民族志观察在莫桑比克南部进行探索，从制度的角度来看，这一作用。我们发现，沿着后勤和工作量问题，“综合”妇幼保健系统内的预防母婴传播/高效抗逆转录病毒疗法客户事实上的隔离，以及不鼓励进一步生育和强调避孕套避孕的简单化和不妥协的信息，可能对血清反应阳性客户成功制定和实施生殖目标构成严重挑战。虽然最近的PMTCT/HAART服务可能部分解释这些挑战，我们认为，他们主要是由于提供者和客户之间的文化沟通不畅。我们展示了如何通过社区活动家和客户之间的同行互动来弥合两者之间的文化差距。
Maternal and Child Health (MCH) units, where VCT/PMTCT/HAART have been integrated with traditional services, play a critical role in the connection between the massive HAART rollout and reproductive behavior. In this article, we use data from semi-structured interviews with MCH workers and ethnographic observations carried out in southern Mozambique to explore this role from the institutional perspective. We find that, along with logistical and workload problems, the de facto segregation of PMTCT/HAART clients within the "integrated" MCH system and the simplistic and uncompromising message discouraging further fertility and stressing condom-based contraception may pose serious challenges to a successful formulation and implementation of reproductive goals among seropositive clients. Although the recency of PMTCT/HAART services may partly explain these challenges, we argue that they are due largely to cultural miscommunication between providers and clients. We show how the cultural gap between the two is bridged by community activists and peer interactions among clients.