TY - JOUR
T1 - The role of gender in Zika prevention behaviors in the Dominican Republic
T2 - Findings and programmatic implications from a qualitative study
AU - Gurman, Tilly
AU - Sara, Anne Ballard
AU - Lorenzo, Florentina Villanueva
AU - Luis, Desirée
AU - Hunter, Gabrielle
AU - Maloney, Sean
AU - Fujita-Conrads, Ryanne
AU - Leontsini, Elli
N1 - Funding Information:
This research was made possible by the support of the American people through the United States Agency for International Development (USAID) under the Breakthrough ACTION Cooperative Agreement #AIDOAA-A-17-00017. Breakthrough ACTION is based at Johns Hopkins Center for Communication Programs (CCP). The contents of this manuscript are the sole responsibility of Breakthrough ACTION and do not necessarily reflect the views of USAID, the United States Government, or Johns Hopkins University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.We would like to acknowledge the local researchers who participated in data collection and analysis including Laura Guzman, Alberto Jiménez, Robert Adames, Milka Cuello, Eliza Cuello, and Gaspar Sanchez. We are also grateful to Elizabeth Conklin and Arianna Serino at the United States Agency for International Development as well as Elkys Santana with Save the Children for their feedback. Finally, we would like to thank Elvis Echavarria, Félix Pérez, and Daniel Morillo who facilitated the recruitment process of participants. Finally, we would like to acknowledge our colleague Hannah Cranford who provided invaluable assistance.
Publisher Copyright:
Copyright: © 2020 Gurman et al.
PY - 2020/3
Y1 - 2020/3
N2 - Background Zika remains an epidemiological threat in Latin America, including the Dominican Republic. Although transmitted by the same mosquito as Dengue and Chikungunya, Zika is unique in the potentially harmful consequences for babies born to women infected during pregnancy. Experts highlight the feminization of Zika, in terms of burden of disease and women’s care-giving responsibilities. Understanding gender’s role in Zika prevention, therefore, is key to strengthening current and future programs. Methodology/Principal findings This qualitative study, comprised of 12 focus group discussions and eight in-depth inter-views, explored gender’s role in Zika among pregnant and non-pregnant women as well as male partners of pregnant women in the Dominican Republic. Topics included perceptions about Zika and perceived feasibility and effectiveness of prevention behaviors (e.g. cleaning water storage containers, using condoms during pregnancy). Researchers applied grounded theory through a process of deductive coding—classifying data around predeter-mined categories—followed by inductive coding—identifying themes that emerged from coded data. Study findings uncovered three ways in which gender may influence Zika pre-vention. First, women are largely responsible for household chores—including cleaning water storage containers—with men as assistants. Second, men described their role in the family as the protector. Finally, men and women believed that partners would perceive suggesting condom use or abstinence during pregnancy as a sign of infidelity. Conclusions Current/future Zika programs should address knowledge gaps, especially around water storage cleaning techniques and sexual transmission. Programs should also integrate gender into programming in culturally-relevant ways that avoid reinforcing stereotypes. Fur-thermore, programs should tailor activities for men, women, as well as the couple. In the end, integrating gender in a way that is mindful of the local context while not exploiting exist-ing gender roles is critical for preventing Zika and similar mosquito-borne diseases, both in the Dominican Republic and throughout the region.
AB - Background Zika remains an epidemiological threat in Latin America, including the Dominican Republic. Although transmitted by the same mosquito as Dengue and Chikungunya, Zika is unique in the potentially harmful consequences for babies born to women infected during pregnancy. Experts highlight the feminization of Zika, in terms of burden of disease and women’s care-giving responsibilities. Understanding gender’s role in Zika prevention, therefore, is key to strengthening current and future programs. Methodology/Principal findings This qualitative study, comprised of 12 focus group discussions and eight in-depth inter-views, explored gender’s role in Zika among pregnant and non-pregnant women as well as male partners of pregnant women in the Dominican Republic. Topics included perceptions about Zika and perceived feasibility and effectiveness of prevention behaviors (e.g. cleaning water storage containers, using condoms during pregnancy). Researchers applied grounded theory through a process of deductive coding—classifying data around predeter-mined categories—followed by inductive coding—identifying themes that emerged from coded data. Study findings uncovered three ways in which gender may influence Zika pre-vention. First, women are largely responsible for household chores—including cleaning water storage containers—with men as assistants. Second, men described their role in the family as the protector. Finally, men and women believed that partners would perceive suggesting condom use or abstinence during pregnancy as a sign of infidelity. Conclusions Current/future Zika programs should address knowledge gaps, especially around water storage cleaning techniques and sexual transmission. Programs should also integrate gender into programming in culturally-relevant ways that avoid reinforcing stereotypes. Fur-thermore, programs should tailor activities for men, women, as well as the couple. In the end, integrating gender in a way that is mindful of the local context while not exploiting exist-ing gender roles is critical for preventing Zika and similar mosquito-borne diseases, both in the Dominican Republic and throughout the region.
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U2 - 10.1371/journal.pntd.0007994
DO - 10.1371/journal.pntd.0007994
M3 - Article
C2 - 32142512
AN - SCOPUS:85082780282
SN - 1935-2727
VL - 14
JO - PLoS neglected tropical diseases
JF - PLoS neglected tropical diseases
IS - 3
M1 - e0007994
ER -