Read about the methods and partnerships behind Becoming Fathers (a four year public health research project) including the participants, sampling methods, the interview technique and the funders.
Becoming fathers was a four-year project (2011-2015) designed to explore Malawian men’s aspirations and experiences of having children, particularly from the vantage point of men’s involvement in their own and their partner’s reproductive health. We wanted to understand how men cope with reproductive worries and misfortune, including - but not limited to - HIV/AIDS. The overall aim of the work was to help contextualise the reproductive health issues that people experience in Karonga District, a rural area in the north of Malawi, and facilitate sharing and learning from that information.
We recorded the reproductive life stories of 55 men and their female partners over the course of 200 individual interviews. We heard about priority health concerns and reproductive decision making from a further 50 men and women during group discussions split by gender, age and education. And health care workers, herbalists and church leaders contributed their reflections on help-seeking topics raised during the study. Over 150 men and women aged eighteen to 60 took part.
Ethical approval was granted by the Malawi National Health Sciences Research Committee (NHSRC) and the London School of Hygiene & Tropical Medicine. Written informed consent was obtained from all participants, for research activities and reproduction of photographs and quotations.
Becoming fathers was carried out in partnership with the Amsterdam Institute for Social Science Research (AISSR) University of Amsterdam, the Karonga Prevention Study, Malawi and the London School of Hygiene & Tropical Medicine. The exhibition and website was produced in collaboration with On the Record Community Interest Company.
The work was supported by the Nederlandse Organisatie voor Wetenschappelijk Onderzoek [Netherlands Organisation for Scientific Research] NWO-WOTRO Innovational Research Incentives Scheme (VENI Grant C.2520.0299.01.)
All material copyright © Becoming Fathers, 2015.
making the exhibition
The exhibition is a long-considered distillation of 233 interview hours.
The ten themes – boyhood aspirations to finishing the program - reflect the concerns and events that recurred again and again in the life stories. We wanted to show the different ways men encounter reproductive milestones and problems, rather than presenting a "typical" life cycle stamped with the expected anthropological receipt. In presenting contraceptive use or HIV testing as part of men’s reproductive journeys we aimed to draw attention to the way health priorities and needs change over time. We sought to keep a sense of how men speak and show their searches for love, meaning, respect and legacy.
Meek sounding quantifiers "many farmers","some", "a few" hint at the difficulty of generalising from the richness of individual lives. Instead, we tried to show participants’ responses to emerging ideas and norms. Population-wide surveys illustrate some broad characteristics and changes to reproductive life for men and women in Karonga District today. An accompanying fact sheet is available here.
Portrait photographs overlaid with quotations highlight moments of transformation or decision in people’s reproductive journeys, as they navigate romantic relationships, bearing and planning their families. They were originally taken as a thank you to participants who chose how they wanted to be portrayed. These images draw on local aesthetics from the romantic to the formally composed and focus attention on the relationships and context of the research. Read more about the photographs here.
Peer to peer intervention is one of the most effective ways to spread public health messages, so we hope this website becomes a virtual space for men and their partners to exchange experiences. Site visitors in Malawi and elsewhere are invited to submit comments or short responses to the project via email or twitter, so we can carry on the conversation.
We thank everyone who participated, generously consented to the reproduction of their words and images, and collaborated in bringing these reflections to life.
The majority of participants were recruited through the Karonga Prevention Study health and demographic surveillance system (Read profile paper). During an earlier survey household members were asked if they would consent to being visited and informed about a study on sexual and reproductive health. We selected three localities to illustrate a range of rural settings in Karonga District, which includes villages close to the main road and trading centres, remote rural farming villages and lakeshore fishing villages. We sampled men at random, ensuring representation of the populations of interest. Only one man declined to participate in the life story interviews, which were arranged at the participant’s convenience. The group discussions were more complex to arrange. Around 80 percent of those originally recruited attended.
As a result, we heard from a wide range of men, including those least likely to be found at home. Field notes reveal how accident, sickness and sheer hard work often delayed interviews (fishermen, for instance, are dictated to by the weather and cannot wait at home even if an appointment has been booked). The team was fastidiously punctual in order to have the best chance of catching employed men in their lunchtime.
FIELDNOTES BY GREEN KAPIRA
“I arrived at the house of the participant for the second time in this day at 14:00hrs. I was welcomed by his wife who was sweeping the verandah. After greeting l was told that her husband was sleeping because he was fishing last night and again from morning up to lunch. After he woke up, we exchanged greetings. I was happy to see this participant because I missed him almost eight times after getting agreement to meet. But l couldn’t find him; his wife reported that he had gone to fish all the time. While greeting each other we were laughing about missing him. The participant was able to explain many issues from his life; could laugh at a certain point and smile. I decided to stop the interview because the participant began to doze.”
FIELDNOTES BY BLESSINGS MWANDOSYA
“When I was thinking of leaving, it started raining heavily so that forced me to stay longer with the participant. He had some clothes to sew, but because I was still around he decided not to start but I told him there is no problem. We started chatting and he had some good advice to impart about marriage while he was sewing.”
FIELDNOTES BY AARON NDOVI
“We agreed with the participant to do an interview around 11:00hrs. Since the participant doesn’t have a phone I had to set off around 10:00hrs. While on the way to the village I noticed the participant together with his wife and child carrying them on a bicycle. They told me that they are on their way to the Uliwa private hospital to get treatment for their sick child. They said that they first went to Fulirwa hospital and after realizing that there was no treatment there they decided to go to the private hospital. We agreed to reschedule the interview. A few days later I indeed went there and arrived at the participant’s house around 8:40hrs. Upon arrival it was his wife who welcomed me and gave me a chair to sit on. She told me that the participant has just gone to search for a goat rope just within the nearby bush and will be back anytime.”
In all, 55 men and their 42 female marital partners participated in life story interviews, with a further 50 men and women contributing to group discussions. All participants called the northern region home, the vast majority being Tumbuka. The youngest men were usually unmarried. The oldest men diverged dramatically in their experiences, from five times married to decades with a school sweetheart. And while some men encountered the pain of involuntary childlessness, others fathered as many as twelve children. Everyone aspired to iron sheet roofs, as they remove the laborious task of replacing the thatch each year but while some lived in relative poverty other men lived in affluence in houses constructed from brick, concrete and glass, connected to electricity and satellite TV. Half of participating men had use of a mobile phone.
Everyone had some years of primary education and a quarter completed secondary education and above. The majority of men were farmers, followed by fishermen, business and skilled occupations from teaching to carpentry and medics. After a decade of intensive HIV testing offered by clinics, community organisations and house-to-house surveys, most men knew their HIV status and - with encouragement - accessed treatment.
“The interview process is like a river. You can vary the course, but not stop the flow.”
This advice was given to the team who conducted a series of individual interviews with men and their partners, usually at their households.
We conceived of the interviews as guided life stories. Each interview opened with ‘tell me about some of the memorable events, whether positive or negative, that you’ve experienced in your life?’ and continued with open ended questions and non-directive prompts. Participants explored and recalled experiences, thoughts, feelings and aspirations relevant to reproductive life. We recorded up to three interviews with the men and up to two with their partners.
The team had guiding themes in their minds so there was some degree of consistency, though the emphasis was on what participants raised as relevant to them. A ‘time-line’ was created with participants, to help structure narratives and return to reproductive events in more detail, especially in the first interview.
We incorporated reflection on reproductive and sexual health issues towards the end of the narrative interviews. Group discussions were the major forum for exploring perspectives on reproductive health issues. However, this exhibition explicitly focuses on the life stories we collected, cross-referenced for consistency with the group discussions.
The life story interviews were supported by a series of reflections provided by health workers from the local and district hospitals, herbalists, pastors and church elders on help-seeking topics raised in the life stories.
Participants spoke lakeshore Chitumbuka, which we use throughout the Chitumbuka site. We wanted to show how language is culturally expressive and ever changing so we kept adapted English (e.g. ‘Jenda’ – Gender) or Chichewa words (e.g. kubelenge – to read) where they were used in the vernacular. It was striking that development and committee speech has been adapted to describe domestic relationships and aspirations, including fatherhood, so that a father needs to be strong to “do development” for his children and finish “the programme”. Or a household head who shows leadership while listening is a “chairman in the house”.
The following individuals carried out the research and created the exhibition:
Photographs by Green Kapira, Blessings Mwandosya, Aaron Ndovi and Fiona Parrott.
Research by Fiona Parrott, Green Kapira, Dorothy Makoka, Blessings Mwandosya, Aaron Ndovi, Paston Mkandawire, Misheck Nkhata and Mia Crampin.
Exhibition by Fiona Parrott, Green Kapira, Dorothy Makoka, Blessings Mwandosya, Aaron Ndovi, Levie Gondwe, Paston Mkandawire, Misheck Nkhata and Mia Crampin.
Design by On the Record and Fiona Parrott.
The text of the exhibition benefited from careful reading and feedback by the following external reviewers:
Alister Munthali, PhD. Director of the Centre for Social Research, Chancellor College, University of Malawi.
Lot Nyirenda, PhD. Senior Social Science Researcher at REACH (Research for Equity and Community Health) Trust, Malawi.
Laban Kashaija Musinguzi, MPhil. Makerere University, Kampala, Uganda.
Rijk van Dijk, PhD, Professor of Anthropology, University of Amsterdam, The Netherlands.
FR Parrott, G Kapira, D Makoka, A Ndovi, B Mwandosya, L Gondwe, P Mkandawire, MJ Nkhata and AC Crampin (2015) Exhibition: Becoming Fathers - reproductive journeys in Malawi/Ulendo wakufuma kuchinyamata kuya ku udada ku Malawi. https://www.reproductivejourneysinmalawi.org