Sexual and reproductive health and rights through the lens of belonging : Intersectional perspectives on disability, gender, and adolescence in Tanzania

Abstract

This dissertation uses sexual and reproductive health and rights (SRHR) as a lens through which contextualized understandings of the intersection of disability, gender, and adolescence can be advanced, and discusses the current theoretical constructs of disability and development. The dissertation study counteracted the coloniality of knowledge production by exploring the perspectives of 199 Tanzanian adolescent females with disabilities. The theoretical inspirations of this qualitative abductive research were the social and human rights models of disability and the concept of intersectionality. I investigated cross-disability perceptions by using the participatory disability research approach and the method of empathy-based stories. The findings, reported in three original research articles, show that reali-zation of SRHR is based on a sense of humanness and belongingness. The no-tion of belonging was crucial for explaining the perspectives of the studied ado-lescents in the sense that sexual and reproductive health (SRH) entitlements are activated and sometimes constrained by belonging to familial and community networks. The notion of becoming in turn illustrated the potentiality of social personhood, which mediates inclusion and exclusion related to SRH, well-being, and entitlements. Additionally, singular understanding of adolescent SRHR was considered a disruption of the social norms of becoming, as were negative sexual and reproductive health outcomes. Together, these created a detrimental cycle that compromised the studied adolescents’ belonging to the social networks that sustain their SRH. The study suggests that African com-munitarianism has the potential to reaffirm the worth of the studied adoles-cents while compelling moral obligations towards their SRH. The theoretical and methodological contributions of this dissertation are based on empirical research. The existing models of disability are enriched by the thesis of belonging. Relational epistemic safe spaces are also proposed as a methodological approach for centering marginalized voices and revealing in-dividualist, colonial, ableist, ageist, and gendered assumptions of voice in re-search and in international development practices. This contribution is timely, as disability inclusion is gaining momentum as a globalized development agenda and adolescent SRH face multiple challenges in Tanzania and beyond.

Tasnifu hii inatumia Haki ya Afya ya Uzazi (SRHR) kama mrengo ambao kwao uelewa wa muktadha wa muingiliano baina ya ulemavu, jinsia, pamoja na ujana wa rika la balehe vinaweza kutazamwa kwa pamoja, na kujadili mitazamo ya sasa ya kinadharia juu ya ulemavu na maendeleo. Utafiti wa tasnifu umeenda kinyume na dhana ya ukandamizaji unaozuia ugunduzi wa maarifa mapya kwa kutafiti mitazamo ya vijana 199 wa Kitanzania wa kike wenye ulemavu. Msukumo wa kinadharia nyuma ya utafiti huu ambao haukuwa na taarifa za awali juu ya uhalisia ulikuwa ni kutazama mkabala wa kijamii na wa haki za binadam katika ulemavu na dhana nzima ya muingiliano baina ya mikabla hii. Nilichunguza mitazamo juu ya ulemavu mtambuka kwa kutumia mbinu shirikishi ya utafiti wa ulemavu na mbinu ya simulizi toka kwa walengwa wenyewe. Matokeo yaliyoripotiwa katika makala tatu za awali za utafiti, yanaonyesha kuwa SRHR inapata msingi wake katika utu. Dhana ya kukubalika katika kundi (belonging) lilikuwa muhimu kwa kueleza mitazamo ya vijana waliofanyiwa utafiti kwa maana kwamba stahiki zao juu ya Afya ya Uzazi (SRH) zinahuishwa ambazo wakati mwingine zimekuwa zikiminywa kwa wao tu kuwa sehemu ya familia na jamii kwa ujumla. Dhana ya kutakiwa kufikia viwango (becoming) kwa upande mwingine lilifafanua uwepo wa kutambuliwa kwao katika jamii, ambao huamua kipi kipewe nafasi kati ya dhana mbili za ujumuishwaji na utengwaji kuhusiana na SRH, hali bora, na stahiki. Zaidi ya hayo, uelewa haba wa SRHR kwa kijana wa rika la balehe ulionekana kuvuruga kawaida za uelewa wa jamii wa kufikia viwango, kwa kuleta matokeo mabaya juu ya afya ya uzazi. Kwa pamoja, matokeo haya yalileta uharibifu wa uelewa kwa vijana hawa waliofanyiwa utafiti, ambao wako kwenye mitandao ya kijamii inayowasaidia kuendeleza na kudumisha uelewa wao juu ya SRH. Utafiti unapendekeza kwamba falsafa ya kiafrika ya utu ina uwezo wa kuthibitisha tena thamani ya vijana hawa waliofanyiwa utafiti huku ikilazimisha wajibu wao wa kimaadili ili kulinda afya zao za uzazi. Michango ya kinadharia na kimbinu ya tasnifu hii imejikita katika utafiti juu ya vitu halisi vilivyowahi kufanyika. Mikabala iliyopo ya ulemavu imeboreshwa na nadharia yenye msingi wake katika ukubalikaji. Kuhusisha falsafa za maarifa ambapo watu wanakuwa huru kujadili masuala mbalimbali kunapendekezwa kama mbinu ya kuingiza sauti zilizotengwa na kufichua ubinafsi, kujitukuza, kujivuna, kujikweza, na dhana ya nani mwenye sauti kijinsia katika tafiti na katika shughuli za maendeleo ya kimataifa. Mchango huu umekuja kwa wakati muafaka, ambapo ushirikishwaji wa watu wenye ulemavu unazidi kushika kasi kama ajenda ya dunia ya maendeleo, vilevile afya ya uzazi kwa vijana wa rika la balehe inakabiliwa na changamoto nyingi nchini Tanzania na kwingineko.