Maithya, Harrison M. Kilila; (2002) Sexual and reproductive issues in the contemporary Akamba of Machakos District, Kenya: Implications for the management of childbearing and STD and HIV/AIDS. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

This thesis examines some sexual and reproductive aspects and their implication for the management of childbearing and STD/HIV. I explore these issues using anthropological data collected over a period of 10 months among the rural Akamba. The study suggests that the destabilisation of traditional institutions that provided support and maintained a balance between individuals, family and community has impacted negatively on women's reproductive health, and has also exposed individuals to dangers associated with sex, including HIV/AIDS. I explore the local perceptions and explanations of reproductive successes or failures and drawing on specific case studies, show that they are embedded in the Kamba notions of disease causation, health and wellbeing. In presenting an intricate complex of sexuality, reproduction and health, the study recognises the influence of historical processes in these domains. These changes, it is argued, have considerably diminished the social support traditionally available to women of childbearing age. The changes, it is further argued, have resulted in the expansion of the role of men in childbearing events. The problem of STD and AIDS is real in rural Kenya. Using material in part three of this thesis I show that the meaning of STD to women is different from from that of men; men and women experience STD differently and this calls for different management strategies. In examining the AIDS epidemic I contend that it cannot be explained only by cultural practices, including sexuality perceived as lacking in morality. In rural Kenya, the spread of AIDS is rooted in part in what may be termed as migratory sexuality whose main cause is poverty. The current programmes have made positive impacts in the creation of awareness, prevention, and management of AIDS. But I suggest that emphasis on AIDS much to the exclusion of STD may hamper the success of AIDS programmes. The thesis concludes with a discussion of how intervention programmes aimed at enhancing sexual and reproductive health and wellbeing can be improved.

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