Gender, power, and communicative action:

Qualitative findings from selected Nepali communities

Carol Underwood, Zoé Hendrickson, and Ron HessNepal HC3 Project

February 2016

Presentation Outline

• Background and context• Integrating communication and gender

theory• The Nepal HC3 Project• Methods• Findings• Significance and implications

Background and context: Nepal• International and domestic

attention to contraceptive availability, accessibility, and utilization in Nepal1,2

• Contraceptive use remains lower among the young married cohort, migrants, rural populations, and couples from marginalized and disadvantaged groups3,4

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Background and context: Family planning decisions in Nepal

• Role of communication: Greater partner communication and joint decision-making associated with greater contraceptive use3,5-8

• Gender norms, gender preferences, and expectations of women’s roles also influence reproductive decision-making9-12

Habermas and communication

• Strategic communication vs. communicative action12,13

• Communicative action as the pursuit of consensus

Image from: Habermas, 1974; Jacobson & Storey, 2004

Connell and the theory of gender and power• Three organizing dimensions of gender

relations in the family/household14

– Labor: “Allocation of particular types of work to particular categories of people” (p. 99)

– Power: “Relations of power that act as a pattern of constraint on social practice” (p. 107)

– Cathexis: Structure organizing emotional attachments to people, particularly relations between men and women and masculinity/femininity

Integrating communication and gender theory • Communicative action provides a lens

that moves beyond labor, power, and cathexis to examine how mutual understanding and consensus construct and/or reconstruct gender relations in a family or household

The Nepal HC3 Project

• Multi-component, four-year project (2013-2017)

• Intervention includes integrated media, social media, community events

Dolpa

Humla

Mugu

Dang

Kailali

Doti

Gorkha

Jumla

Bajhang

Mustang

Rukum

Ilam

Kaski

Taplejung

Bajura

Rolpa

Surkhet Myagdi

Sindhuli

Banke

Jajarkot

Manang

Salyan

Solukhumbu

Bara

Bardiya

Dolakha

Darchula

Jhapa

Palpa

Kalikot

Chitawan

Morang

Parsa

Dhading

Baglung

Baitadi

Tanahu

Udayapur

Sankhuwasabha

Achham

Makwanpur

Dailekh

Bhojpur

Lamjung

Saptari

Khotang

Gulmi

Siraha

Rasuwa

Sarlahi

Nawalparasi

Sindhupalchok

Kapilbastu

Sunsari

Pyuthan

Kanchanpur

Nuwakot

Dhanusa

Syangja

Dadeldhura

Rupandehi

Panchthar

Ramechhap

Rautahat Dhankuta

Kavrepalanchok

Okhaldhunga

Arghakhanchi

Terhathum

Lalitpur

Mahottari

Parbat

KathmanduBhaktapur

Formative research districts

Map of districts in Nepal

9

Formative research methods

• Sixty in-depth interviews on attitudes, norms, experiences, and processes that influence contraceptive use

• Participants: – Unmarried women and men, – Married women and men– Mothers-in-law– Migrants– Health workers and FCHVs– Influential community members

Analysis methods

• Multi-national research team (US- and Nepal-based individuals) worked to develop coding framework using a priori and inductive coding

• Thematic analysis of English transcripts performed in ATLAS.ti

Findings: Sexual division of labor“Wife makes the decision related to raising the children . . . She takes decision right from their care to every other thing. I only bring the materials to the house.” (Married man, Banke)

“My wife does household work. . . . I take such decisions [on expenditures for children] according to my judgment, not spending extravagantly.” (Man from disadvantaged group, Siraha)“The female is similar to that of the male. She can engage in a job and make her career. She has the right; and she is not here just to have babies and cook and take care of the family.” (Migrant man, Banke)

Findings: Power inequitiesA: “In my experience, it is the husband who decides. It is the husband who gives either trouble or happiness. . . . “If [women] worked according to their own interest, husband comes with the stick and punishes them.” (Male health worker, Banke)

“Whatever husband says, wife does accordingly [regarding contraception].” (Unmarried woman, Siraha)“In my home I have a job so I have more rights. But in some houses there are women working more than men. In some houses the women will have more rights.” (Married man, Banke)

Findings: Power equity“In our Muslim community . . . if the matter between them comes to a conclusion and they both are positive for the conclusion, then they can do that thing, otherwise they can’t do it… We have that rule in our religion.” (Migrant man 1, Banke)

“[Decisions are] not only taken by husband now. Now most of the wives are understanding, and it happens through agreement. In the past men used to tell their wives to do. Males did not [use contraception]. But now if the woman is weak [so cannot use contraception], she tells her husband to do. Everything is based on agreement.” (Influential man, Syangja)

Cathexis“What kind of [husband]? (Laughing). One who fulfills my needs and wants, understands me, cooperates, and makes decision together.” (Unmarried woman, Syangja)

“If both husband and wife suggest to each other, they can live with happiness and love throughout the life.” (Influential man, Banke)

“There should be trust between husband and wife. If we lose that trust, we lose our wealth, we lose our home, and we lose everything.” (Migrant man, Syangja)

Findings: Communicative Action“If I do so on my own [make a decision] it would hurt my wife. It would be a forceful and one-sided decision. That’s why we decide collectively in everything not only in the matter of children.” (Migrant man, Siraha)

“There is good understanding. If he finds anything good, he shares with me, and vice-versa. . . There is good agreement with my husband. We work in coordination. What else?” (Woman from disadvantaged group, Banke)

“Taking the decision together helps to keep the couples happy and see other options of the subject as well.” (Man from disadvantaged group, Syangja)

Summary of Findings

• Mutual trust, understanding, and empathy• Accounts of decision-making often varied• Gendered divisions of labor and power were

reported, but participants’ emphasized that joint decisions and communication about family planning and other topics with partners was increasingly important

Significance and implications

• We often assume that household gender dynamics are characterized by strategic action and driven by power imbalances and unequal divisions of labor that perpetuate inequities between men and women

• Our findings from select communities in Nepal suggest that although gendered divisions of power/labor exist, partners are motivated to achieve mutual understanding and agreement regarding family planning and reproductive decisions

Namaste!

References1. Shrestha, D. R., Shrestha, A., & Ghimire, J. (2012). Emerging challenges in family planning programme

in Nepal. Journal of Nepal Health Research Council.2. FP2020. (2015 March 16). Nepal: Commitments, Progress & Transparency. Retrieved from

http://www.familyplanning2020.org/entities/129. 3. Ministry of Health and Population (MOHP) [Nepal], New Era, and ICF International Inc. (2012). Nepal

Demographic and Health Survey 2011. Kathmandu, Nepal: Ministry of Health and Population, New ERA, and ICF International, Calverton, Maryland.

4. Khanal M.N., Shrestha D.R., Panta P.D., and Mehata S. (2013). Impact of male migration on contraceptive use, unmet need and fertility in Nepal. Further analysis of the 2011 Nepal Demographic and Health Survey. Calverton, Maryland, USA: Nepal Ministry of Health and Population, New ERA, and ICF International.

5. Link, C. F. (2011). Spousal communication and contraceptive use in rural Nepal: an event history analysis. Stud Fam Plann, 42(2), 83-92

6. Yue, K., O'Donnell, C., & Sparks, P. L. (2010). The effect of spousal communication on contraceptive use in Central Terai, Nepal. Patient Educ Couns, 81(3), 402-408. doi: 10.1016/j.pec.2010.07.01

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8. Acharya, D. R., Bell, J. S., Simkhada, P., van Teijlingen, E. R., & Regmi, P. R. (2010). Women's autonomy in household decision-making: a demographic study in Nepal. Reproductive Health, 7, 15.

References, continued9. Asian Development Bank (ADB). (2010). Overview of Gender Equality and Social Inclusion in Nepal.

Mandaluyong City, Philippines: Asian Development Bank. 10. Rai, P., Paudel, I. S., Ghimire, A., Pokharel, P. K., Rijal, R., & Niraula, S. R. (2014). Effect of gender

preference on fertility: cross-sectional study among women of Tharu community from rural area of eastern region of Nepal. Reprod Health, 11(1), 15.

11. Uprety, S., Jha, N., Poudel, I. S., Pokharel, P. K., Poudel, M., & Niraula, S. R. (2011). Impact and determinants of gender preference in Duhavi VDC of eastern Nepal. JNMA J Nepal Med Assoc, 51(181), 28-33.

12. Basnyat, Iccha, & Dutta, Mohan J. (2011). Family planning (re)defined: how young Nepalese women understand and negotiate contraceptive choices. Asian Journal of Communication, 21(4), 338-354. doi: 10.1080/01292986.2011.574711

13. Habermas, J. (1984). The theory of communicative action, Vol. 1: Reason and the rationalization of society. Boston: Beacon Press.

14. Jacobson, T. L., & Storey, J. D. (2004). Development communication and participation: Applying Habermas to a case study of population programs in Nepal. Communication Theory, 14(2), 99-121.

15. Connell, Raewyn. (1987). Gender and power : society, the person, and sexual politics. Stanford, Calif. : Stanford University Press.