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- All Subjects: Cultural Anthropology
- All Subjects: Kenya
Description
Investment and interest in mental health on a global scale is increasing. This interest creates a need to gain an in depth understanding about how mental illness is conceptualized and treated in different cultures. This article aims to explore the views of maternal mental health in Kenya's sub-counties. Maternal mental health has a significant impact on child development outcomes, so the topic has cross-generational importance. Ten focus group discussions with a variety of participants were conducted to understand the health care system. The participants were from four Kenya sub-counties: Rachuonyo N., Wagwe, Okiki Amayo, Nyative and they were either members of either SCHMT (Sub-county health management team), CHEW (community health extension worker), facility/staff of the county hospital, HHCDO (Homa Hills Community Development Organization), THRIVE II staff (Catholic Relief Service's early childhood development program) or mothers and fathers with children under two years of age. The qualitative data were translated and transcribed on site and then retranslated and counterchecked. A secondary data analysis using Atlas.ti was performed to identify themes and trends in factors that contribute to maternal wellbeing. Four main categories were identified as having prevalent effects on the Kenyan mothers' mental health: cultural values, broken support system, limitations of resources, and knowledge, behavior and attitudes. The participants were broken up into administrative, clinical, social, maternal and paternal categories to determine specific influence in each of these areas. Further analysis defined participants' involvement in the categories as mediating, moderating and direct effects on maternal depression. Main contributors to depression were identified as a lack of paternal support, poor cultural values, and administrative resistance. Discussion focuses on consequences for the future.
ContributorsAugur, Haley Rose (Author) / Nelson, Elizabeth (Thesis director) / Glenberg, Arthur (Committee member) / Hagaman, Ashley (Committee member) / Department of Psychology (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
Suicide is one of the fastest-growing and least-understood causes of death, particularly in low and middle income countries (LMIC). In low-income settings, where the technical capacity for death surveillance is limited, suicides may constitute a significant portion of early deaths, but disappear as they are filtered through reporting systems shaped by social, cultural, and political institutions. These deaths become unknown and unaddressed. This dissertation illuminates how suicide is perceived, contested, experienced, and interpreted in institutions ranging from the local (i.e., family, community) to the professional (i.e., medical, law enforcement) in Nepal, a country purported to have one of the highest suicide rates in the world. Drawing on a critical medical anthropology approach, I bridge public health and anthropological perspectives to better situate the problem of suicide within a greater social-political context. I argue that these complex, contestable deaths, become falsely homogenized, or lost. During 18 months of fieldwork in Nepal, qualitative, data tracing, and psychological autopsy methodologies were conducted. Findings are shared through three lenses: (1) health policy and world systems; (2) epidemiology and (3) socio-cultural. The first investigates how actors representing familial, legal, and medical institutions perceive, contest, and negotiate suicide documentation, ultimately failing to accurately capture a leading cause of death. Using epidemiologic perspectives, surveillance data from medical and legal agencies are analyzed and pragmatic approaches to better detect and prevent suicidal death in the Nepali context are recommended. The third lens provides perceived explanatory models for suicide. These narratives offer important insights into the material, social, and cultural factors that shape suicidal acts in Nepal. Findings are triangulated to inform policy, prevention, and intervention approaches to reduce suicidal behavior and improve health system capabilities to monitor violent deaths. These approaches go beyond typical psychological investigations of suicide by situating self-inflicted death within broader familial, social, and political contexts. Findings contribute to cultural anthropological theories related to suicide and knowledge production, while informing public health solutions. Looking from the margins towards centers of power, this dissertation explicates how varying institutional numbers can obfuscate and invalidate suffering experienced at local levels.
ContributorsHagaman, Ashley (Author) / Wutich, Amber (Thesis advisor) / Hruschka, Daniel (Committee member) / Kohrt, Brandon (Committee member) / Arizona State University (Publisher)
Created2017