Community bylaws concerning sexual and reproductive health and rights in Machinga District, Malawi: to what extent are they responsive to young people's needs?


Journal

International journal for equity in health
ISSN: 1475-9276
Titre abrégé: Int J Equity Health
Pays: England
ID NLM: 101147692

Informations de publication

Date de publication:
14 Nov 2023
Historique:
received: 12 09 2023
accepted: 06 11 2023
medline: 16 11 2023
pubmed: 15 11 2023
entrez: 14 11 2023
Statut: epublish

Résumé

Community bylaws are commonly accepted mechanisms to influence behaviour change to achieve better health and development outcomes in sub-Saharan Africa. However, the uses, benefits, and potential downsides of community bylaws are largely unclear, especially regarding sexual and reproductive health and rights (SRHR) of young people. The objective of this study was to determine the extent to which community bylaws in Machinga District in southern Malawi are responsive to young people's realities and SRHR needs. In Phase 1 of this qualitative study, 35 community members were interviewed, including 14 young people (15-24 years), five parents, five traditional leaders, and eleven key informants. Based on findings from Phase 1, eleven members from local youth groups co-created a drama performance that covered issues concerning bylaws and young people's SRHR (Phase 2). The drama was performed in the community, after which young women (18-24 years), young men (17-24 years), female and male parents discussed on what they saw in the drama, focusing on young people's SRHR, in four focus group discussions (Phase 3). All transcripts were coded and thematically analysed and narratives were written on main themes. Three community SRHR bylaws, related to teenage pregnancy, child marriage, and sexual harassment and rape were identified and commonly accepted in the community. While these bylaws intend to reduce SRHR-related issues among young people, they are often not involved in bylaw formulation. The bylaws were associated with protection of girls, and a good reputation for boys, young men and traditional leaders. Bylaw enforcement faced problems, as fines were not in line with national laws, and wealthy offenders could avoid them through bribes. Effects of bylaws on teenage pregnancy rates seemed limited, while some positive effects on school readmission, prevention of child marriage, and reporting sexual harassment were reported. The study revealed that community bylaws were accepted but not owned by young people, and had different effects on the rich versus the poor, and girls versus young men. Bylaws were associated with punishment in terms of money, which seemed to overpower their potential to promote rights and address social norms underlying SRHR issues of the youth.

Sections du résumé

BACKGROUND BACKGROUND
Community bylaws are commonly accepted mechanisms to influence behaviour change to achieve better health and development outcomes in sub-Saharan Africa. However, the uses, benefits, and potential downsides of community bylaws are largely unclear, especially regarding sexual and reproductive health and rights (SRHR) of young people. The objective of this study was to determine the extent to which community bylaws in Machinga District in southern Malawi are responsive to young people's realities and SRHR needs.
METHODS METHODS
In Phase 1 of this qualitative study, 35 community members were interviewed, including 14 young people (15-24 years), five parents, five traditional leaders, and eleven key informants. Based on findings from Phase 1, eleven members from local youth groups co-created a drama performance that covered issues concerning bylaws and young people's SRHR (Phase 2). The drama was performed in the community, after which young women (18-24 years), young men (17-24 years), female and male parents discussed on what they saw in the drama, focusing on young people's SRHR, in four focus group discussions (Phase 3). All transcripts were coded and thematically analysed and narratives were written on main themes.
RESULTS RESULTS
Three community SRHR bylaws, related to teenage pregnancy, child marriage, and sexual harassment and rape were identified and commonly accepted in the community. While these bylaws intend to reduce SRHR-related issues among young people, they are often not involved in bylaw formulation. The bylaws were associated with protection of girls, and a good reputation for boys, young men and traditional leaders. Bylaw enforcement faced problems, as fines were not in line with national laws, and wealthy offenders could avoid them through bribes. Effects of bylaws on teenage pregnancy rates seemed limited, while some positive effects on school readmission, prevention of child marriage, and reporting sexual harassment were reported.
CONCLUSIONS CONCLUSIONS
The study revealed that community bylaws were accepted but not owned by young people, and had different effects on the rich versus the poor, and girls versus young men. Bylaws were associated with punishment in terms of money, which seemed to overpower their potential to promote rights and address social norms underlying SRHR issues of the youth.

Identifiants

pubmed: 37964291
doi: 10.1186/s12939-023-02054-7
pii: 10.1186/s12939-023-02054-7
pmc: PMC10647080
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

237

Informations de copyright

© 2023. The Author(s).

Références

BMC Pregnancy Childbirth. 2017 Sep 25;17(1):321
pubmed: 28946847
J Adolesc Health. 2022 Mar;70(3S):S36-S42
pubmed: 35184828
Int J Equity Health. 2018 Sep 24;17(1):131
pubmed: 30244672
Reprod Health. 2018 Sep 21;15(1):158
pubmed: 30241542
Int J Public Health. 2020 May;65(4):379-389
pubmed: 32270235
Reprod Health. 2020 May 14;17(1):66
pubmed: 32408906
J Public Econ. 2020 May;185:104047
pubmed: 32435073
BMC Pregnancy Childbirth. 2017 Dec 29;17(1):444
pubmed: 29284439
Reprod Health Matters. 2013 May;21(41):225-33
pubmed: 23684205
Health Policy Plan. 2018 Oct 1;33(8):879-887
pubmed: 30084938

Auteurs

Maryse Kok (M)

Department of Global Health, KIT Royal Tropical Institute, Amsterdam, the Netherlands. Maryse.kok@kit.nl.

Alister Munthali (A)

PALM Consulting Limited, Zomba, Malawi.

Peter Mvula (P)

PALM Consulting Limited, Zomba, Malawi.

Zindaba Chisiza (Z)

Department of Drama and Theatre Studies, University of Malawi, Zomba, Malawi.

Marielle Le Mat (ML)

Department of Global Health, KIT Royal Tropical Institute, Amsterdam, the Netherlands.

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