香草饼干和罗洛聘礼：赞比亚农村地区早孕和上学问题的平行论述。
Vanilla bisquits and lobola bridewealth: parallel discourses on early pregnancy and schooling in rural Zambia.
机构信息
CISMAC (Centre for Intervention Science in Maternal and Child Health), Bergen, Norway.
Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
出版信息
BMC Public Health. 2020 Oct 1;20(1):1485. doi: 10.1186/s12889-020-09555-y.
BACKGROUND
Adolescent pregnancy is a complex socio-economic phenomenon ranking high on the global health policy agenda. Early childbearing is associated with early marriage and school drop-out, and is defined as a problem to the health and development of girls. This paper reports from formative research. The formative research aimed to explore socio-cultural and structural dynamics at work behind early pregnancy and school drop out in rural Zambia. The study findings have been used to inform a school based intervention to reduce early pregnancy (RISE: 'Research Initiative to Support the Empowerment of Girls'). Theoretically the study is informed by social constructionism.
METHODS
A qualitative approach was employed. Semi-structured qualitative interviews (61) and focus group discussions (7) were carried out with girls (in and out of school), boys, parents, teachers, health workers and community- and district leaders in 2014-15. Systematic text condensation was drawn upon in the analysis of the material.
RESULTS
The study findings indicate that the official Zambian discourse that presents early pregnancy as a serious challenge and schooling as the prime way to confront the problem enjoy substantial support at community levels. However, a parallel discourse on fertility, early marriage and childbearing as social and economic security surfaced and was articulated by the same study participants. The latter contrasting discourse questioned schooling as the only solution to secure a girl's future arguing that there are many reasons why early pregnancy may emerge as rational.
CONCLUSIONS
Grasping the complexity of local discourse is vital in planning health interventions. The present study revealed that although delayed child bearing and schooling among girls enjoyed high status and legitimacy in the study area, the social and economic context worked to reward early marriage. Interventions to reduce early pregnancies in rural Zambian communities need to fundamentally address the material constraints that condition and reinforce a culture of early childbearing.
背景
青少年怀孕是一个复杂的社会经济现象，在全球卫生政策议程中占据重要地位。早育与早婚和辍学有关，被定义为女孩健康和发展的问题。本文报告了一项形成性研究。这项形成性研究旨在探讨赞比亚农村地区导致早孕和辍学的社会文化和结构动态。研究结果已被用于为一项基于学校的干预措施提供信息，以减少早孕（RISE：“支持女孩赋权研究倡议”）。从理论上讲，这项研究受到社会建构主义的启发。
方法
采用定性方法。2014-15 年，对在校和不在校的女孩、男孩、父母、教师、卫生工作者以及社区和地区领导人进行了 61 次半结构式定性访谈和 7 次焦点小组讨论。在分析材料时，采用了系统文本浓缩法。
结果
研究结果表明，赞比亚官方提出的将早孕视为严重挑战、将学校视为解决问题的主要途径的言论，在社区层面得到了广泛支持。然而，关于生育、早婚和生育作为社会和经济保障的平行言论也出现了，并得到了同一批研究参与者的阐述。后一种相反的言论质疑学校是确保女孩未来的唯一途径，认为早孕可能是合理的原因有很多。
结论
理解当地话语的复杂性对于规划卫生干预措施至关重要。本研究表明，尽管在研究地区，推迟女孩的生育和上学时间享有很高的地位和合法性，但社会和经济背景促使早婚成为一种奖励。要减少赞比亚农村社区的早孕，干预措施需要从根本上解决影响和强化早育文化的物质限制。
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