Critical Ethnography and the PEN-3 Model: An Analysis of Women's Health in Swaziland

By Murray, Bethany | Journal of Theory Construction and Testing, Spring/Summer 2016 | Go to article overview

Critical Ethnography and the PEN-3 Model: An Analysis of Women's Health in Swaziland


Murray, Bethany, Journal of Theory Construction and Testing


The Kingdom of Swaziland (SZ) is located in the sub-Saharan region of the continent of Africa. SZ is approximately 17,000 km2 in size with a population of over 1.2 million people (World Health Organization [WHO], 2014). Swaziland gained full independence from Great Britain in 1968 and. is relatively homogeneous as a nation with a single ethnic heritage, the Ngwane (or Swazi), comprised of many tribal affiliations and. one local language, siSwati (Matsebula, 1988).

SZ is administered as both a monarchy and a democratically elected government. King Mswati III presides over the country and. has governance of its rural regions through delegation to over 300 Chieftains; while, the Prime Minister (PM) Barnabas Sibusiso Dlamini exercises executive power over the Senate and the House of Assembly. The PM is appointed by the King, and the King must ultimately approve all acts of parliament. Swaziland's dual, political system incorporates both traditional beliefs and customs alone with westernized methods of modern governance (1 lie Government of the Kingdom of Swaziland, 2014). This duality complicates many aspects of Swazi life.

Tradition permits polygyny or the marriage of one man to multiple women, whereas parliamentary law does not. Marriage between a man and. a woman may be enacted under customary law, under the constitutional Marriage Act of 1964, or both, These practices are often in conflict with one another at a local level (Bhalla, 2000). Traditional Swazi customs are patriarchal; women have historically experienced alack of empowerment, as a result of required male guardianship. The Constitution of Swaziland, enacted, in 2005 gave women independence, but: traditions especially in regard to family life have been slow to change.

Swaziland has seen dramatic increases in negative disease outcomes and early death in the past 30-years. Men and. women currently have an average life expectancy of 52-yea.rs and 55-years respectively (WHO, 2014). SZ has the highest HIV prevalence rate of any country in the world; 27.4% of all adults aged 15-49 years and 39% of pregnant women aged. 15-24 years are currently HIV-positive (Global Health Observatory of the World Health Organization [GHO], 2014). Complications related to AIDS and opportunistic tuberculosis (TB) infections account for one-third of all hospital deaths, and. the incidence of these infections is increasing (GHO, 2014; Ministry of Health [MOH], 2010). In areas of women's health, maternal mortality is high, cervical, cancer is the 17th leading cause of death for women, and. surgery was still the only treatment option for women with breast cancer as recently as 20.13 (All Africa Global Media, 2013; GHO, 2014). Domestic and. gender-related, violence have been reported in one out of every four women (Bustos, 2011; Gardsbane &' Hlatshwayo, 2012).

PURPOSE

The purpose of this study was to examine the social and cultural factors that affect self-care and health maintenance of women in Swaziland (SZ), and to develop a deep understanding of how cultural values determine health outcomes among Swazi women.

Critical Ethnography

Critical research is grounded in an epistemology that is action-oriented; i.e., meaning is constructed through social activity (Carspecken, 1996). Communicative structures are essential components of a critical approach and are based in part on Habermas' assumption that the human species, "Maintains itself through the socially coordinated activities of its members...established through communication" (Habermas, 1981/1984, p. ix). Communication is holistic and as such it requires actors to draw upon a range of values, attitudes and beliefs to be employed in a variety of situations. Observable physical and verbal actions (i.e., signifiers) reflect underlying cultural prescriptions and provide important clues to a social system's role and power relationships. By analyzing communication, the researcher can begin to understand a social system. …

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