Occupational segregation, gender essentialism and male primacy as major barriers to equity in HIV/AIDS caregiving: Findings from Lesotho

International Journal for Equity in Health

Research

Constance J Newman¹  Linda Fogarty²  Lucia Nthabiseng Makoae³ 

[1] IntraHealth International6340 Quadrangle Drive, Suite 200Chapel Hill, 27517, North Carolina, USA;Jhpiego, 1615 ThamesStreet, 21231-3492, BaltimoreMaryland, USA;National University of Lesotho, P.O. Roma 180, Maseru, Lesotho;

关键词: Caregiving Burden;    Status Belief;    Gender Segregation;    Male Involvement;    Occupational Segregation;   

DOI  :  10.1186/1475-9276-10-24

 received in 2010-11-29, accepted in 2011-06-08,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundGender segregation of occupations, which typically assigns caring/nurturing jobs to women and technical/managerial jobs to men, has been recognized as a major source of inequality worldwide with implications for the development of robust health workforces. In sub-Saharan Africa, gender inequalities are particularly acute in HIV/AIDS caregiving (90% of which is provided in the home), where women and girls make up the informal (and mostly unpaid) workforce. Men's and boy's entry into HIV/AIDS caregiving in greater numbers would both increase the equity and sustainability of national and community-level HIV/AIDS caregiving and mitigate health workforce shortages, but notions of gender essentialism and male primacy make this far from inevitable.In 2008 the Capacity Project partnered with the Lesotho Ministry of Health and Social Welfare in a study of the gender dynamics of HIV/AIDS caregiving in three districts of Lesotho to account for men's absence in HIV/AIDS caregiving and investigate ways in which they might be recruited into the community and home-based care (CHBC) workforce.MethodsThe study used qualitative methods, including 25 key informant interviews with village chiefs, nurse clinicians, and hospital administrators and 31 focus group discussions with community health workers, community members, ex-miners, and HIV-positive men and women.ResultsStudy participants uniformly perceived a need to increase the number of CHBC providers to deal with the heavy workload from increasing numbers of patients and insufficient new entries. HIV/AIDS caregiving is a gender-segregated job, at the core of which lie stereotypes and beliefs about the appropriate work of men and women. This results in an inequitable, unsustainable burden on women and girls. Strategies are analyzed for their potential effectiveness in increasing equity in caregiving.ConclusionsHIV/AIDS and human resources stakeholders must address occupational segregation and the underlying gender essentialism and male primacy if there is to be more equitable sharing of the HIV/AIDS caregiving burden and any long-term solution to health worker shortages. Policymakers, activists and programmers must redress the persistent disadvantages faced by the mostly female caregiving workforce and the gendered economic, psychological, and social impacts entailed in HIV/AIDS caregiving. Research on gender desegregation of HIV/AIDS caregiving is needed.

【 授权许可】

CC BY   
© Newman et al; licensee BioMed Central Ltd. 2011