Exploring the factors influencing the health seeking behaviours of wo

133 Pages·2017·1.34 MB·English

“The (human) body is like a car – it needs service”: Exploring the factors influencing the
health seeking behaviours of working class men in Modimolle Town, Limpopo Province.

Edmond Madhuha
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Supervisor: Associate Professor Lorena Nunez Carrasco

A research report submitted in partial fulfillment of the requirements for the degree
Master of Arts in Health Sociology in the Faculty of Humanities, University of the
Witwatersrand, Johannesburg.
Declaration
I declare that this research report is my original, unaided work and that, to the best of
my knowledge, it has neither been previously submitted nor currently being submitted to
any other University for a degree or an award. Where someone else’s work has been
used, due acknowledgment has been given and reference made accordingly.

________________________
Edmond Madhuha
Date: 15 March 2017

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Dedication
To my sons Caleb and Casper be inspired to follow your dreams.

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Acknowledgments
To God my Father, thank you for giving me this opportunity, your love has carried me
throughout this work.
A great thank you to, Associate Professor Lorena Nunez Carrasco, my supervisor for
bringing that aha moment in me throughout our numerous discussions. Your invaluable
insights and support spurred me to critically think through this work, your guidance was
spot on.
To my wife, Emildah Madhuha, thank you for holding on when the going was tough.
Your support, understanding and encouragement are immense. To my boys Caleb and
Casper Madhuha, we did it; we are going to do it again!
Special thanks to you dad and mum, I know you always believed in my education. To
Dr. Kezia Batisai, your advice was God given; a big thanks to you. To my siblings
Sthembile, Luckson, Knowledge and Ruth, thank you guys for the financial support. I
know that it was not easy for you, but thank you for being part of this work. Thank you to
my colleague Elias Maronganye for the lighter moments we shared when the going was
tough; thank you to a friend, Marifa Muchemwa for the encouragement to keep focusing
on the greater goal.
Thank you to the University of the Witwatersrand for providing me with financial support
through the Postgraduate Merit Award and a Tutoring position.
To all my participants, thank you for the time you gave me and in sharing your frank
opinions throughout the interviews.

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Abstract
This study is founded on the argument that the health of a population is dependent on
both structural factors and human agency. Literature shows that men are generally poor
at attending to their health needs as compared to women, with statistics confirming
higher mortality rates and lower life expectancy among them. This research study aimed
to explore the factors influencing the health seeking behaviours of black South African
working class men in Modimolle Township, Limpopo Province (South Africa). The study
followed a qualitative approach where semi-structured face-to-face interviews were
used for data gathering. A snowball non-probability sampling technique was used to
select 15 black working class men between the ages of 29 and 50 years. All the
interviews were conducted and audio recorded in Modimolle Township between two
residential locations. The interviews were transcribed verbatim. Thematic content
analysis was employed for data analysis in which emerging themes bordered around
the identities of men, their relationship to their bodies and their perceptions of health
care systems. The construction of masculinities among men created multiple and varied
ways to their health seeking behaviours. Men engaged in multiple practices ranging
from preventive medical check-ups, the use of various types of enemas as well as the
use of traditional medicines for the maintenance of their health. These practices were
associated with the construction of a responsible masculinity among the participants
which challenges the notion that masculinity is associated with negative health seeking
behaviours among men.

Key words: Responsible masculinity, maikarabelo, working class, health-seeking
behaviours, men, Modimolle

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Table of Contents
List of figures ............................................................................................................................................ viii
List of tables ............................................................................................................................................... ix
Chapter 1: Introduction .............................................................................................................................. 1
Introduction .............................................................................................................................................. 1
Rationale .................................................................................................................................................. 2
Background of the study ....................................................................................................................... 3
Aim and objectives of the study ........................................................................................................... 6
Research questions ................................................................................................................................... 6
Outline of the research report ............................................................................................................... 7
Chapter 2: Literature review ..................................................................................................................... 8
Introduction .............................................................................................................................................. 8
A brief review of the interplay between structural factors and health ............................................. 8
The plurality of the South African health care system ...................................................................... 9
Gender and health ............................................................................................................................... 10
A background review of men’s health ................................................................................................... 13
Masculinities and health ...................................................................................................................... 16
The dynamics of embodiment and health ........................................................................................ 20
The health seeking behaviours of men ............................................................................................. 23
The interplay of social class and health seeking behaviours ........................................................ 24
How race ties in with health ................................................................................................................ 27
Theoretical framework ............................................................................................................................. 29
Conclusion ................................................................................................................................................. 30
Chapter 3: Research methodology ........................................................................................................ 32
Introduction ............................................................................................................................................ 32
Research design................................................................................................................................... 32
Research setting and target population ............................................................................................ 34
The sampling technique .......................................................................................................................... 37
Participants ............................................................................................................................................ 38
Data collection method ............................................................................................................................ 40
Data analysis............................................................................................................................................. 41
Ethical considerations .............................................................................................................................. 43
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Reflexivity .................................................................................................................................................. 44
Strengths and limitations ......................................................................................................................... 46
A brief summary of the chapter .............................................................................................................. 46
Chapter 4: Findings and discussion ...................................................................................................... 47
Introduction ................................................................................................................................................ 47
General structural factors defining participants ................................................................................... 48
Working conditions and men’s health ............................................................................................... 48
General living conditions of participants ........................................................................................... 51
The meaning of good health for men ................................................................................................ 55
Men’s representations of what ill health is........................................................................................ 57
Masculinity means maikarabelo ............................................................................................................. 59
Masculinity as provider ........................................................................................................................ 60
Preventive medical health checkup - a sign of responsibility ........................................................ 62
Lived experiences of men on multiple sexual partners ...................................................................... 64
Men’s perceptions and lived experiences of multiple sexual relations ........................................ 65
How men keep themselves healthy ....................................................................................................... 69
The male body and food ..................................................................................................................... 76
Risk factors associated with men’s health ........................................................................................ 80
Men’s perceptions of health care services ........................................................................................... 83
Men’s perceptions about western medicines ................................................................................... 84
Complementary health systems: a man’s perspective ................................................................... 90
A synoptic intersectionality analysis ...................................................................................................... 94
Conclusion ................................................................................................................................................. 95
Central findings ......................................................................................................................................... 97
Recommendations ................................................................................................................................... 102
Reference list .......................................................................................................................................... 104
APPENDIX A: INTERVIEW GUIDE .................................................................................................... 119
APPENDIX B: PARTICIPANT INFORMATION SHEET ................................................................... 121
APPENDIX C: CONSENT FORM INTERVIEW ................................................................................. 123
APPENDIX D: CONSENT FORM RECORDING .............................................................................. 124

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List of figures

Figure 3.1: Image of a RDP house 35
Figure 3.2: An example of a RDP house in Ext 10 35
Figure 3.3: Shack dwelling in informal settlement 36
Figure 3.4: Image of a shack in informal settlement 36
Figure 4.1: Well from where household draws water 52

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List of tables
Table 3.1: Participants' demographics ........................................................................ 388

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Chapter 1: Introduction
Introduction
This study is founded on the argument that the health of a population is dependent on
the structural factors within which people exist. Notwithstanding the above assertion,
individual agency is also significant to how people maintain their health. Underlying
people’s health or lack thereof lie their health seeking behaviours, and these form the
cornerstone on which this research report is situated. The study sets out to explore the
factors that influence the health-seeking behaviours of working class men in Modimolle
Township, Limpopo Province of South Africa. This study was crafted against the overly
stated observations in men’s health literature that there is something about men that
makes them poor to take care of their health. Men, for example, are said to view health
seeking behaviours as a sign of weakness (Peacock, Redpath, Weston, Evans, Daub
and Greig 2008:3). Chief among this deficiency on men’s part towards their health is the
notion of masculinities (Connell, 1995). In contrast, men are clearly not homogenous but
are diversely affected by multiple factors in their health seeking behaviours, thus, the
need to be specific about the kind of men being talked of. Not only is there a problem of
generalising about men in relation to health, but what men do to keep themselves
healthy does not receive enough attention. In this study, I therefore explore the health-
seeking behaviours of black working class men in Limpopo. To achieve its aims, this
research used a qualitative methodology with face-to-face semi-structured interviews as
the data collection method.
The social sciences have posed a critique to the dominant perspective of biomedicine in
explaining health and illness. Schuster, Dobson, Jauregui and Blanks (2004:350) argue
that the sociology of health and medicine is concerned with understanding the
perceptual and social processes by which individuals and groups understand and
experience health in a holistic manner. In relation to the sociology of health and illness,
socio-cultural factors determine people’s perceptions and experiences of health and
illness (Nettleton, 2008). Due to social stratification, the state of being healthy and the
resulting access to health services is inevitably gendered, classed as well as racialised.
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