Representations of reproductive health : a study about a Mayan community in the western highlands of Guatemala
This thesis investigates representations of reproductive health amongst the Mayan communities in the Western highlands of Guatemala. Representations are explored as local systems of knowledge, viewed as expressive of the community's lay knowledge, identity and cultural practices. By looking at the conditions of production and transmission of Mayan's representations and their expression in daily practices, two aspects of local knowledge are explored. First, the relevance of local knowledge in shaping practices towards reproductive health and official reproductive health programmes, and second, how local knowledge relates to other systems of knowledge coming from health institutions, the State and the Church. The theoretical framework that I have developed through this research is grounded in the theory of social representations (Moscovici, 1984), and draws on the ideas of liberation psychology (Martin-Baro, 1996), education for critical consciousness (Freire, 1972), and the analysis of positioning and identities (Hall, 1990; Moore, 1994). This conceptual framework guided the empirical component of the study, which was qualitative in nature and combined ongoing participant observation, 15 open-ended interviews with lay people and health experts, and 6 focus groups with 36 men and women in different reproductive ages. The analysis of textual data was supported by ATLAS. ti. Diverse source of data are woven together to explore how local knowledge and cultural practices mediate in the participation of the community in reproductive health services. The study shows that Mayan's representations of reproductive health are grounded on their productive activities and is shaped by their concrete conditions of living. This social knowledge is objectified through key symbolic practices, which are the expression of their cultural identity and of the Mayan cosmology. Mayan's representations of reproductive health are deeply related to the survival of the community as an ethnic group and express the crucial link between representations and identity. The data illustrate the different ways in which Mayan people construct their conceptions of femininity and virility through the value of motherhood and responsible fatherhood. I examine how these representations undermine or empower community's participation in health interventions by exploring the link between participation and resistance. The study suggests the implications of these findings for the construction of locally sensitive health programmes.