Fulane Gefra, Major Maria, Lorenzoni Cesaltina, Munguambe Khatia
Nova School of Business and Economics, Universidade Nova de Lisboa, Lisbon, Portugal.
International Federation of the Red Cross and Red Crescent Societies, Geneva, Switzerland.
Health Serv Insights. 2024 Aug 27;17:11786329231224619. doi: 10.1177/11786329231224619. eCollection 2024.
This study investigates the role of emotional attachment to competing institutional logics on women's uptake of cervical cancer screening in Mozambique. Through a qualitative study conducted in Xai-Xai, Southern Mozambique, we identify 2 concurrent logics in the context of screening: preservation logic, influenced by social-cultural norms, and the prevention logic, centered around screening. Women, affected by emotions such as shame, fear, and marital subordination, often become attached to the preservation logic, which influences their values and contradicts acceptance of screening. However, some women with marital autonomy may reflect on both logics and gradually detach themselves from the preservation norms and show their intention to adopt life-saving behavior by accepting screening. It is through their emotions that women show their attachment to and detachment from competing logics, reinforcing traditional norms on the one hand, or giving them the means to adopt preventive measures on the other. The study indicates that cultural expectations, shame and the desire to preserve intimacy tie women to the logic of preservation and have a negative impact on participation in cervical cancer screening. Consequently, to improve screening uptake in Mozambique, the authorities need to adapt screening to socio-cultural and emotional factors, empower women, and effectively engage communities.
本研究调查了对相互竞争的制度逻辑的情感依恋在莫桑比克女性接受宫颈癌筛查方面所起的作用。通过在莫桑比克南部的赛赛进行的一项定性研究，我们在筛查背景下识别出两种并行的逻辑：受社会文化规范影响的保护逻辑，以及围绕筛查的预防逻辑。受羞耻、恐惧和婚姻从属等情绪影响的女性，往往会依恋保护逻辑，这会影响她们的价值观，并与接受筛查相矛盾。然而，一些拥有婚姻自主权的女性可能会对两种逻辑进行反思，并逐渐摆脱保护规范，通过接受筛查表现出采取挽救生命行为的意愿。正是通过她们的情感，女性表现出对相互竞争的逻辑的依恋和脱离，一方面强化了传统规范，另一方面为她们提供了采取预防措施的途径。该研究表明，文化期望、羞耻感以及维护亲密关系的愿望将女性与保护逻辑联系在一起，并对参与宫颈癌筛查产生负面影响。因此，为提高莫桑比克的筛查接受率，当局需要使筛查适应社会文化和情感因素，赋予女性权力，并有效地让社区参与进来。
