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Theory and social practice of agency in combining breastfeeding and employment: A qualitative study among health workers in New Delhi, India
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). (Internationell barnhälsa och nutrition/Persson)
Breastfeeding Promotion Network of India (BPNI), New Delhi, India.
Breastfeeding Promotion Network of India (BPNI), New Delhi, India.
Department of Paediatrics, University College of Medical Sciences & Guru Tegh Bahadur (GTB) Hospital, New Delhi, India.
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2014 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 27, no 4, 298-306 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Women's agency, or intentional actions, in combining breastfeeding and employment is significant for health and labour productivity. Previous research in India showed that mothers use various collaborative strategies to ensure a "good enough" combination of breastfeeding and employment. Bandura's theoretical agency constructs previously applied in various realms could facilitate the exploration of agency in an Indian context.

AIM:

To explore manifestations of agency in combining breastfeeding and employment amongst Indian health workers using Bandura's theoretical constructs of agency and women's experiences.

METHODS:

Qualitative semi-structured interviews were conducted with ten women employees within the governmental health sector in New Delhi, India. Both deductive and inductive qualitative content analyses were used.

FINDINGS:

Bandura's features and modes of agency revealed that intentionality is underpinned by knowledge, forethought means being prepared, self-reactiveness includes collaboration and that self-reflectiveness gives perspective. Women's interviews revealed four approaches to agency entitled: 'All within my stride or the knowledgeable navigator'; 'Much harder than expected, but ok overall'; This is a very lonely job'; and 'Out of my control'.

CONCLUSIONS:

Agency features and their elements are complex, dynamic and involve family members. Bandura's theoretical agency constructs are partially useful in this context, but additional social practice constructs of family structure and relationship quality are needed for better correspondence with women's experiences of agency. The variation in individual approaches to agency has implications for supportive health and workplace services.

Place, publisher, year, edition, pages
2014. Vol. 27, no 4, 298-306 p.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-232781DOI: 10.1016/j.wombi.2014.07.002ISI: 000346617900022PubMedID: 25108676OAI: oai:DiVA.org:uu-232781DiVA: diva2:749727
Available from: 2014-09-25 Created: 2014-09-25 Last updated: 2017-12-05Bibliographically approved
In thesis
1. Mothers’ Agency in Managing Breastfeeding and Other Work in Dar es Salaam, Tanzania and New Delhi, India
Open this publication in new window or tab >>Mothers’ Agency in Managing Breastfeeding and Other Work in Dar es Salaam, Tanzania and New Delhi, India
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Combining breastfeeding and other forms of work is desirable from both public health and labour productivity perspectives. This is often challenging, especially in low- or middle-income fast-growing urban settings. The aim of this thesis was to gain a deeper understanding of mothers’ perspectives on combining breastfeeding and other work in the urban contexts of Dar es Salaam, Tanzania, and New Delhi, India. Individual semi-structured interviews were conducted with community mothers (n=8) and health worker mothers (n=12) in Dar es Salaam, and mothers working in the health (n=10) and education sectors (n=10) in New Delhi. The methods of analysis were:  qualitative content analysis, grounded theory approach, and directed and general inductive content analyses. Mothers’ agency manifested in several ways. Striving to integrate or segment the competing domains of home and work was a goal of these mothers to reduce conflicts in managing breastfeeding and other work. Spatial and time constraints led mothers to engage in an array of carefully planned actions and troubleshooting tactics that included ways of ensuring proximity between them and their baby and efficient time managing. The timing of these strategic actions spanned from pregnancy, over maternity leave, to the return to employment. Managing breastfeeding and work triggered emotions such as stress, frustration and guilt, but also satisfaction and joy. Mothers negotiated with family, employers, colleagues and informal networks to gain support for their strategies, displaying both individual, collective and proxy agency. Changing family structures and roles highlight the potentially greater supportive role of the partner/husband. Work/Family Border Theory and Bandura’s agency constructs provided frameworks for a deeper understanding of mothers’ perspectives, but using existing family relationship constructs would better diffentiate between various modes of agency. Workplaces and maternity protection conditions were generally inadequate. Interventions are required: to strengthen the breastfeeding mother’s own agential capacity using an individual approach; to provide information to families and communities; to improve regulatory, structural and attitudinal conditions at workplaces, and to strengthen health and social services to adequately support mothers in managing breastfeeding and other work.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 68 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1086
Keyword
Breastfeeding, Women, Mothers, Work, Employment, Agency, Tanzania, India
National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:uu:diva-247759 (URN)978-91-554-9208-3 (ISBN)
Public defence
2015-05-26, Room IX, Universitetshuset, Biskopsgatan 3, Uppsala, 13:00 (English)
Opponent
Supervisors
Available from: 2015-05-04 Created: 2015-03-23 Last updated: 2015-07-07

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Omer-Salim, AmalOlsson, Pia

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