Ulla Larsen

• A Community Study of Infertility in N Tanzania
  Current (2005-02-01 - 2008-08-31)
  EKS-NICHD
  Abstract

  The long-term objective of this project is to enhance the understanding of infertility in sub-Saharan Africa. Previous analyses have established that infertility in sub-Saharan Africa is determined by multiple factor, including evidence that regional and local factors are important determinants. The present proposal goes beyond these previous 'country level' analyses of infertility by studying a single local African community in depth. The proposed work will add clinical evaluation of infertile couples and the measurement of biological markers to community-based survey data obtained from both partners in a couple. By studying on community, this project will be able to integrate the biomedical, demographic, and anthropologic analyses of infertility, and to integrate knowledge of female, male, and couple factor of infertility. The quantitative analyses of survey data will include estimates of the prevalence of primary and secondary infertility by age of the woman, estimates of the risk factors of primary infertility based on a Cox model, and estimates of the risk factors of secondary infertility using a discrete logistic regression. The quantitative finding will be interpreted together with the findings of the qualitative analysis, which includes an ethnographic study and a content analysis of in depth interviews using software for qualitative analysis (QSR NUD IST). It is important to understand infertility for several reasons. Infertility is a strong indicator of poor health, and infertility can largely be prevented with appropriate public health interventions. In addition, infertility depresses population growth. Finally, infertility has serious social consequences, such as the ostracism of women which leads to strained gender relations. To address these issues the research has seven aims: 1. To estimate the prevalence of primary and secondary infertility. 2. To determine the proportions of female, male, and couple factors infertility. 3. To examine the risk factors of infertility. 4. To investigate local perceptions of the causes of infertility. 5. To describe treatment options and services that are currently in use, including traditional local healers, medical professionals, and self-treatment. A basic protocol for the recommended treatment of infertility will be developed. 6. To analyze the social implications of infertility. 7. To assess the demographic implications of infertility.

• The Cultural Context of Infertility in Southern Nigeria: Meanings, Consequences, and Coping Mechanisms
  Current (2004-07-04 - 2008-06-30)
  NSF
  Abstract

  Infertility (the inability to conceive or to carry a pregnancy to full term) is a problem of major proportions in sub-Saharan Africa, where in many societies women who are unable to bear children are stigmatized and are often unable to reach full social adulthood. The problem of infertility in Africa received relatively little attention from social scientists since it was obscured by the region's high fertility rates, which resulted in a concern over population growth. This research by a team of an anthropologist, a demographer and a sociologist involves a comparative in-depth study of infertility in the context of two southern Nigerian communities. It will investigate local meanings of infertility as these are shaped by the social and cultural context; the impact of the prevalence of infertility on these meanings; and how the community responses as well as the life experiences and treatment-seeking behaviors of infertile women and their male partners among the Ijo and Yakurr people. The two communities, Patani in the Niger Delta and Ugep in Cross River State, are primarily rural and located in the same region of the country. Descent in Patani is patrilineal whereas in Ugep it is double unilineal. In addition, high levels of infertility are historically documented for Ugep, whereas infertility levels in Patani are relatively low. The amount of stigma attached to female infertility in Patani is considerably higher than it is in Ugep. The project will study how these differential responses to infertility are related to the differences in social organization and infertility rates.

  This comparative study of these communities will examine the meaning of infertility in its local context as well as analyze the social and cultural variables that influence those meanings. The broader impact of the research lies in the value of the new information for policy makers, health care specialists and social service providers. Given that no cure exists for infertility in the context of sub-Saharan African, prevention through awareness of the causes of infertility is the only means whereby its incidence and prevalence may be lowered. A better understanding of the social consequences of infertility will help formulate strategies aimed at ameliorating the stigma associated with it and also contribute to better understanding of fertility. The research will also contribute to building a partnership with Nigerian researchers. The intellectual merit lies in a contribution to the field of demographic anthropology, specifically to the creation of "whole demographies" which take account of the interaction of individuals with their cultural contexts.

• Doctoral Dissertation Research: A Sociological Analysis of Trust, Commitment, and Health Risk among Young Adults
  Ended (2006-07-01 - 2007-06-29)
  NSF
  Abstract

  In Tanzania, seven percent of the adult population is HIV positive. Trust and commitment play a complex but critical role in AID prevention. These are likely prerequisites for long-term fidelity. Of the ABC's of AIDS prevention, abstain, be faithful, use condoms, fidelity remains relatively under-researched. For HIV prevention to better address couples, the role of trust and commitment must be better understood. Through collaboration with Population Services International (PSI), this research aims to improve the understanding of the role of trust and commitment in AIDS prevention for a key target group: individuals aged 15 to 24. Prior to PSI's annual household-based survey in Tanzania, in-depth interviews will be conducted to explore local understandings of how individuals develop trust in and commitment to their partners and how trust and commitment affect condom use and fidelity. The household-based survey will provide the empirical basis for quantifying the relationship between trust, commitment, and AIDS prevention. After the survey, a second round of in-depth interviews will clarify the relationships found in the survey data. The broader impacts of this research is that it contributes to our understanding of the role of trust and commitment in producing positive health outcomes, in particular AIDS prevention planning.