Chikotsa—Secrets, Silence, and Hiding: Social Risk and Reproductive Vulnerability in Central Mozambique

Abstract

In this article, I examine pregnancy narratives and patterns of reproductive health seeking among women of fertile age in central Mozambique. I map the interplay between gendered economic marginalization, maternal risk perceptions, and pregnancy management strategies. By interpreting my data in light of Shona illness theories, I illuminate the ways that embodied experiences of reproductive vulnerability, risk perceptions, and social inequalities are linked: women attribute the most serious maternal complications to human- or spirit-induced reproductive threats of witchcraft and sorcery. This construction of reproductive vulnerability as social threats related to material and social competition significantly influences prenatal health seeking. Data reveal the structural and cognitive gap between biomedical constructions of risk and lay social threat perceptions. Plural health care systems are strategically utilized by women seeking to minimize both social and biological harm. On-the-ground ethnography shows that maternal health initiatives must take this plurality into full and accommodative account to achieve viable improvements in reproductive care and outcomes.

Loss to Follow-Up Among HIV-Exposed Children in an HIV Clinic in Beira, Mozambique

“…The small sample size and purposeful sampling methodology may also limit our ability to generalize to the HIV population in Mozambique. Nonetheless, the voices and life circumstances of those who participated in our study were consistent with the findings of other studies, and provide valuable insights that allow us to better understand reasons for poor follow-up that may apply to women and children in similar contexts (Chapman, 2003(Chapman, , 2006Farmer, Leandre, et al, 2001;Jones et al, 2005;Painter et al, 2004;Painter et al, 2005).…”

“…The small sample size and purposeful sampling methodology may also limit our ability to generalize to the HIV population in Mozambique. Nonetheless, the voices and life circumstances of those who participated in our study were consistent with the findings of other studies, and provide valuable insights that allow us to better understand reasons for poor follow-up that may apply to women and children in similar contexts (Chapman, 2003(Chapman, , 2006Farmer, Leandre, et al, 2001;Jones et al, 2005;Painter et al, 2004;Painter et al, 2005).In conclusion, our study's findings suggest that the mere provision of clinical HIV care services will not necessarily engage HIV/AIDS-affected women and children into medical care. Our observed LTFU of more than 50% of infants (Blankenship et al, 2000) appeared to be associated with mothers' daily struggles related to poverty and food insecurity, which prevented their use of available services.…”

Traditional healers and laypeople: A qualitative and quantitative approach to local knowledge on medicinal plants in Muda (Mozambique)

“…Previous studies carried out in the same province (Pfeiffer, 2005;Chapman, 2006;Pfeiffer et al, 2007) report that even in urban areas sick people turn to curandeiros or prophets to resolve spiritual or magical causes believed to underlay specific health problems and misfortune, while for "natural" diseases they normally address to the hospitals and other health centers.…”

“…Beside common laypeople, two key informant groups (curandeiros and profetas) were selected, in order to investigate whether and how different cultural and religious systems bear on knowledge about plant resources and their use. As reported above, some studies have already approached the anthropological and socioeconomic context within which these models of healing processes evolve in modern Mozambique society (Pfeiffer, 2005;Chapman, 2006;Pfeiffer et al, 2007). However, no study has been carried out so far about the distribution of ethnobotanical knowledge among the different figures of traditional healers.…”

The costs of ‘free’: Experiences of facility-based childbirth after Benin's caesarean section exemption policy

“…Gaps in effective solutions to improve 11 maternal health outcomes have been linked to a lack of political will and gender inequality (Grepin 12 2013). In research that speaks to circumstances beyond her study site, Chapman (2006) impacted in low-resource settings when care giving is in part undertaken on the basis of "social 4 recognition" and status of patients (Jaffré & Suh 2016), due to scarcity of staff, energy and morale. 5…”