Browsing by Author "Braathen, Stine Hellum"

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    Beyond the checklist : understanding rural health vulnerability in a South African context
    (Taylor & Francis Open, 2016) Vergunst, Richard; Swartz, Leslie; Mji, Gubela; Kritzinge, Janis; Braathen, Stine Hellum
    Background: Vulnerability in the past has sometimes been measured and understood in terms of checklists or common understanding. It is argued here that vulnerability is a more complex issue than this. Although checklists of vulnerable groups are important, they do not capture the essence and dynamics of vulnerability. Objective : The case of rural health vulnerability in South Africa is discussed to show that classifying people into vulnerable groups does not portray the complexity and intricacies of what it means to have vulnerability. We also wish to show that there are different kinds of vulnerabilities, and the difference between access vulnerability and illness vulnerability is highlighted. Methods : As part of a larger study, this case study is presented to show how vulnerability in a poor rural community in South Africa has to be understood in a contextual and dynamic manner as opposed to a static manner. Results : Family and social dynamics can influence health. For example, fractured families were seen as a vulnerable issue within the community, while being a person with a disability can lead to isolation and callous attitudes towards them. It is these family and social dynamics that lead proximally to vulnerability to ill health. Conclusions : A contextual approach can assist in giving a more layered understanding of vulnerability than a checklist approach can do. Interventions to change health cannot be addressed simply by medical means. Social conditions need to be changed, and part of changing social conditions is the process of assisting those who are isolated or experience themselves as vulnerable to reconnect with others in the community. Poverty leads to social exclusion; social and family inclusion may be key to well-being.
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    A household perspective on access to health care in the context of HIV and disability : a qualitative case study from Malawi
    (BioMed Central, 2016-04) Braathen, Stine Hellum; Sanudi, Lifah; Swartz, Leslie; Jurgens, Thomas; Banda, Hastings T.; Eide, Arne Henning
    Background: Equitable access to health care is a challenge in many low-income countries. The most vulnerable segments of any population face increased challenges, as their vulnerability amplifies problems of the general population. This implies a heavy burden on informal care-givers in their immediate and extended households. However, research falls short of explaining the particular challenges experienced by these individuals and households. To build an evidence base from the ground, we present a single case study to explore and understand the individual experience, to honour what is distinctive about the story, but also to use the individual story to raise questions about the larger context. Methods: We use a single qualitative case study approach to provide an in-depth, contextual and household perspective on barriers, facilitators, and consequences of care provided to persons with disability and HIV. Results: The results from this study emphasise the burden that caring for an HIV positive and disabled family member places on an already impoverished household, and the need for support, not just for the HIV positive and disabled person, but for the entire household. Conclusions: Disability and HIV do not only affect the individual, but the whole household, immediate and extended. It is crucial to consider the interconnectedness of the challenges faced by an individual and a household. Issues of health (physical and mental), disability, employment, education, infrastructure (transport/terrain) and poverty are all related and interconnected, and should be addressed as a whole in order to secure equity in health.
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    The meaning of participation : reflections on our study
    (Palgrave Macmillan, Cham, 2021) Hunt, Xanthe; Swartz, Leslie, 1955-; Braathen, Stine Hellum; Carew, Mark T.; Chiwaula, Mussa; Rohleder, Poul
    In Chapter 1 we provided a discussion of participatory research as a method for doing research, and provided an outline of what we did in the research project upon which this book is based. In this final chapter, we reflect back on our experiences of doing a participatory research project of this kind.
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    'No one bothers about the confused people': Care for people with psychosocial disabilities in rural South Africa
    (Stellenbosch : Stellenbosch University, 2016-12) Braathen, Stine Hellum; Swartz, Leslie; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
    ENGLISH ABSTRACT: This dissertation explores care for people with psychosocial disabilities in a rural area in the Eastern Cape province of South Africa. In Low and middle-income countries, including South Africa, the gap between the need for mental health services and available services is critical. Reasons for this have been said to be lack of priority at policy level, lack of equipment, personnel, and medication, and low mental health literacy. As a result, the majority of people with psychosocial disabilities are not diagnosed or treated. In order to close the gap between need and provision, there is a call for more community based mental health services, for task-shifting and a move towards recognising medical pluralism. There is lack of evidence on family and community care, traditional systems of healing and medical pluralism. Care is often reduced to health care, but arguably also includes assistance with daily tasks, companionship, conversation and intimacy. Explanatory models for psychosocial disability are crucial in care seeking, diagnosis, treatment and cure. As such, the theoretical points of departure for this dissertation are the concepts of psychosocial disability and care. The aim of this study was to explore practices, views, knowledge and experiences related to care for people with psychosocial disabilities living in a rural, South African context. To do this, a qualitative methodology was deemed suitable. The study is divided into two linked, but methodologically different parts, namely a contextual part and a case study part. The overarching methodological principles are the same; they are both anchored within a qualitative, explorative research design. The dissertation has found that in the context of psychosocial disability in Madwaleni, care is much broader than health care, and about much more than curing illness or looking after someone who is ill or dependent. In an attempt to improve mental health, and prevent, treat and cure mental disorder, it is essential to apply a broad definition of care. We need to rethink how we deliver mental health services, moving away from care as pacifying, to care as activating. Care must be integrated into real-world settings. The global mental health literature emphasises shifting the focus of mental health care from cure to promotion and prevention. It also stresses the value of using an interdisciplinary team of lay and trained health workers from the professional, folk and popular sectors. This strategy needs to be complemented by other strategies, for example, integrating mental health into other projects focussing on sustainable livelihoods and development of infrastructure. The challenges are complex, as this small study shows, but it is only by looking closely at local conditions that it is possible to develop culturally and contextually appropriate interventions and make optimal use of local resources.
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    Physical disability and femininity : an intersection of identities
    (Palgrave Macmillan, Cham, 2021) Hunt, Xanthe; Braathen, Stine Hellum; Rohleder, Poul
    ENGLISH ABSTRACT: In this chapter, we will explore the intersections of physical disability and femininity. We look at how societies’ ideas about disability influence the way women with physical disabilities are viewed and view themselves as sexual beings. Using a combination of background literature and qualitative data from our photovoice study, we explore how social representations of femininity and expectations for women may negatively affect women with physical disabilities’ sense of themselves. We include pictures, written texts, and stories produced by some of the female participants from the project.
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    Predictors of negative beliefs toward the sexual rights and perceived sexual healthcare needs of people with physical disabilities in South Africa
    (Taylor and Francis, 2019-05) Carew, Mark T.; Braathen, Stine Hellum; Hunt, Xanthe; Swartz, Leslie; Rohleder, Poul
    Background: Although sexuality is a ubiquitous human need, recent empirical research has shown that people without disabilities attribute fewer sexual rights and perceive sexual healthcare to benefit fewer people with disabilities, compared to non-disabled people. Within a global context, such misperceptions have tangible, deleterious consequences for people with disabilities (e.g., exclusion from sexual healthcare), creating an urgent need for effective strategies to change misperceptions. Methods: To lay the groundwork for developing such strategies, we examined predictors of the recognition of sexual rights of people with physical disabilities within the South African context, derived from three key social psychological literatures (prejudice, social dominance orientation and intergroup contact), as well as the relationship between sexual rights and beliefs about sexual healthcare. Data were obtained through a cross-sectional survey, given to non-disabled South Africans (N = 1989). Results: Findings indicated that lack of recognition of the sexual rights for physically disabled people predicted less positive beliefs about the benefits of sexual healthcare. In turn, high levels of prejudice (both cognitive and affective) toward disabled sexuality predicted less recognition of their sexual rights, while prejudice (both forms) was predicted by prior contact with disabled people and possessing a social dominance orientation (cognitive prejudice only). Evidence was also obtained for an indirect relationship of contact and social dominance orientation on sexual healthcare beliefs through prejudice, although these effects were extremely small. Conclusion: Results are discussed in terms of their implications for rehabilitation, as well as national-level strategies to tackle negative perceptions of disabled sexuality, particularly in contexts affected by HIV.
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    (Re)presenting the self : questions raised by a photovoice project with people with physical disabilities in South Africa
    (Routledge, 2019-08-29) Hunt, Xanthe; Swartz, Leslie; Braathen, Stine Hellum; Jordan, Cleone; Rohleder, Poul
    Photovoice is presented here as an emancipatory, participatory research method with the potential to put minority subjects in charge of their own representation. Drawing on research with disabled people conducted in South Africa, we argue that the meaning of images is often hostage to interpretations which reify untruths about the subject. We consider how photovoice projects may give rise to images that perpetuate the subjugation of their subjects, but could also facilitate an emancipatory politics of self-representation through photography, constituting a challenge and not only the discursive regimes and ideologies which underlie dominant aesthetics.
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    Sexual and reproductive health : layers of (in)access
    (Palgrave Macmillan, Cham, 2021) Hunt, Xanthe; Swartz, Leslie; Braathen, Stine Hellum; Rohleder, Poul
    ENGLISH ABSTRACT: In this chapter, we investigate some of the social (e.g. negative attitudes about sexuality and parenthood) and structural (e.g. inaccessible health care facilities) barriers that people with physical disabilities face when trying to lead a pleasurable, safe, and healthy sexual life. We do this by presenting an accessible review of the existing research literature, a summary of relevant survey evidence, and use of the personal stories of the participants.
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    The sexual lives of people with disabilities within low- and middle-income countries : a scoping study of studies published in English
    (Taylor & Francis Open, 2017-07-05) Carew, Mark T.; Braathen, Stine Hellum; Swartz, Leslie; Hunt, Xanthe; Rohleder, Poul
    Background: Although approximately 80% of the global population of people with disabilities reside in low- and middle-income countries (LMICs), very little is known about their sexual lives due to a lack of empirical data. We aimed to provide a scoping review of English- language research conducted on disability and sexuality in LMICs. Objective: Our research questions concerned what topics in disability and sexuality have (and have not) been investigated, where this research has been carried out, and how this research has been conducted. Methods: A scoping review was conducted to examine the published English-language research literature on disability and sexuality within LMICs. We searched three electronic databases (PsycINFO, Web of Science, and PsycARTICLES) for research meeting these criteria published between 2000 and 2016 (inclusive). Through this search, we identified 103 articles. Results: It is concluded that: (a) disability and sexuality research in African countries has focused predominantly on sexual abuse and violence or HIV, (b) the sexuality of people with disabilities within many LMICs has received little or no empirical investigation, and (c) there have been very few experimental studies on disability and sexuality conducted in LMICs in general. Conclusions: Much remains unknown about the sexual health and sexual lives of the majority of people with disabilities, globally. Moreover, what has been done in certain contexts has tended to focus predominantly on vulnerabilities rather than emancipatory practices. Thus, urgent action is needed within LMICs on is
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    Some background, and a South African study on sexuality
    (Palgrave Macmillan, Cham, 2021) Hunt, Xanthe; Swartz, Leslie; Braathen, Stine Hellum; Carew, Mark T.; Chiwaula, Mussa; Rohleder, Poul
    ENGLISH ABSTRACT: In this chapter, we introduce central concepts and theories relevant to thinking about disability and sexuality in the global South. We discuss what we mean by physical disability, sexuality, gender, and embodiment, and provide a brief description of the research study on which this book is based. Here, too, we provide a rationale and outline for the book.