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"He will ask why the child gets sick so often": The gendered dynamics of intra-household bargaining over healthcare for children with fever in the Volta Region of Ghana

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  • Tolhurst, Rachel
  • Amekudzi, Yaa Peprah
  • Nyonator, Frank K.
  • Bertel Squire, S.
  • Theobald, Sally

Abstract

This paper explores the gendered dynamics of intra-household bargaining around treatment seeking for children with fever revealed through two qualitative research studies in the Volta Region of Ghana, and discusses the influence of different gender and health discourses on the likely policy implications drawn from such findings. Methods used included focus group discussions, in-depth and critical incidence interviews, and Participatory Learning and Action methods. We found that treatment seeking behaviour for children was influenced by norms of decision-making power and 'ownership' of children, access to and control over resources to pay for treatment, norms of responsibility for payment, marital status, household living arrangements, and the quality of relationships between mothers, fathers and elders. However, the implications of these findings may be interpreted from different perspectives. Most studies that have considered gender in relation to malaria have done so within a narrow biomedical approach to health that focuses only on the outcomes of gender relations in terms of the (non-)utilisation of allopathic healthcare. However, we argue that a 'gender transformatory' approach, which aims to promote women's empowerment, needs to include but go beyond this model, to consider broader potential outcomes of intra-household bargaining for women's and men's interests, including their livelihoods and 'bargaining positions'.

Suggested Citation

  • Tolhurst, Rachel & Amekudzi, Yaa Peprah & Nyonator, Frank K. & Bertel Squire, S. & Theobald, Sally, 2008. ""He will ask why the child gets sick so often": The gendered dynamics of intra-household bargaining over healthcare for children with fever in the Volta Region of Ghana," Social Science & Medicine, Elsevier, vol. 66(5), pages 1106-1117, March.
    • Handle: RePEc:eee:socmed:v:66:y:2008:i:5:p:1106-1117
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    Cited by:

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    2. Klein, Matthew J. & Barham, Bradford L. & Wu, Yuexuan, 2019. "Gender Equality in the Family Can Reduce the Malaria Burden in Malawi," Staff Paper Series 594, University of Wisconsin, Agricultural and Applied Economics.
    3. Bright Opoku Ahinkorah & John Elvis Hagan Jr. & Abdul-Aziz Seidu & Francis Sambah & Faustina Adoboi & Thomas Schack & Eugene Budu, 2020. "Female adolescents’ reproductive health decision-making capacity and contraceptive use in sub-Saharan Africa: What does the future hold?," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-20, July.
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    5. Colvin, Christopher J. & Smith, Helen J. & Swartz, Alison & Ahs, Jill W. & de Heer, Jodie & Opiyo, Newton & Kim, Julia C. & Marraccini, Toni & George, Asha, 2013. "Understanding careseeking for child illness in sub-Saharan Africa: A systematic review and conceptual framework based on qualitative research of household recognition and response to child diarrhoea, ," Social Science & Medicine, Elsevier, vol. 86(C), pages 66-78.
    6. Jenna Dixon & Eric Y Tenkorang & Isaac Luginaah, 2011. "Ghana's National Health Insurance Scheme: Helping the Poor or Leaving Them Behind?," Environment and Planning C, , vol. 29(6), pages 1102-1115, December.
    7. Sikstrom, Laura, 2014. "“Without the grandparents, life is difficult”: Social hierarchy and therapeutic trajectories for children living with HIV in rural Northern Malawi," Children and Youth Services Review, Elsevier, vol. 45(C), pages 47-54.
    8. Onah, Michael Nnachebe & Horton, Susan, 2018. "Male-female differences in households' resource allocation and decision to seek healthcare in south-eastern Nigeria: Results from a mixed methods study," Social Science & Medicine, Elsevier, vol. 204(C), pages 84-91.
    9. Sonja Merten & Adriane Martin Hilber & Christina Biaggi & Florence Secula & Xavier Bosch-Capblanch & Pem Namgyal & Joachim Hombach, 2015. "Gender Determinants of Vaccination Status in Children: Evidence from a Meta-Ethnographic Systematic Review," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-19, August.
    10. Akpalu, Wisdom & Dasmani, Isaac & Normanyo, Ametefee K., 2013. "Optimum Fisheries Management Under Climate Variability: Evidence from Artisanal Marine Fishing in Ghana," WIDER Working Paper Series 052, World Institute for Development Economic Research (UNU-WIDER).
    11. Kristine Husøy Onarheim & Karen Marie Moland & Mitike Molla & Ingrid Miljeteig, 2020. "‘I wanted to go, but they said wait’: Mothers’ bargaining power and strategies in care-seeking for ill newborns in Ethiopia," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-15, June.
    12. Kweun, Jeong Yun & Wheeler, Porter K. & Gifford, Jonathan L., 2018. "Evaluating highway public-private partnerships: Evidence from U.S. value for money studies," Transport Policy, Elsevier, vol. 62(C), pages 12-20.
    13. Richards, Esther & Theobald, Sally & George, Asha & Kim, Julia C. & Rudert, Christiane & Jehan, Kate & Tolhurst, Rachel, 2013. "Going beyond the surface: Gendered intra-household bargaining as a social determinant of child health and nutrition in low and middle income countries," Social Science & Medicine, Elsevier, vol. 95(C), pages 24-33.
    14. Kerry MacQuarrie & Jeffrey Edmeades, 2015. "Whose Fertility Preferences Matter? Women, Husbands, In-laws, and Abortion in Madhya Pradesh, India," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 34(4), pages 615-639, August.
    15. Emmanuel Quansah & Lilian Akorfa Ohene & Linda Norman & Michael Osei Mireku & Thomas K Karikari, 2016. "Social Factors Influencing Child Health in Ghana," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-20, January.

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