This thesis investigates the issue of side effects and how they may act as a barrier to the use of modern contraceptive methods among women in Ghana. Three papers are presented each addressing the issue using different sources of data and different methodologies. The disparate nature of the data sources and techniques used provides each paper with its own perspective on the research question and each paper gives a unique insight into the topic. The aim of the first paper is to use a qualitative focus group methodology to explore in-depth the way individuals perceive information about family planning. The study seeks to better define what is meant by the term fear of side effect in this particular social context and to determine on what information and from what sources is this fear constructed. Overall the findings of this study show that fear of side effects does act as a significant barrier to the use of temporary methods and these fears result mainly from a large amount of negative information regarding side effects being passed through the social network. However the events being recounted cannot be dismissed as myth or rumour as they are most often based in real experiences. The second paper uses monthly data on contraceptive use and the experience of side effects from the calendar section of a longitudinal survey of women in Southern Ghana. Using life tables and a multi-level logistic discrete-time hazards model this study analyses contraceptive discontinuation and how it relates to the concurrent self-reported experience of side effects. The results show that experiencing side effects is associated with a higher probability of discontinuation of the method and that counselling from health workers is extremely important in minimizing discontinuation rates. The third paper uses a sub-sample of women who are not current contraceptive users from the 2003 GDHS. The study uses multiple logistic regression to determine the association between exposure to family planning information, through mass media and interpersonal channels, and the probability that a respondent will cite fear of side effects as their main reason for not intending to use a contraceptive method in the future. The results show that the only family planning communication variable which does have a significant effect is receiving a message from a health worker which increases the odds of fear of side effects being the main reason for not intending to use a method in the future. Overall the socio-economic characteristics of those not intending to use a method in the future due to a fear of side effects is more similar to current users than to those who are not intending to use in the future for other reasons.

Population ageing is a global phenomenon and occurring most rapidly in countries in Asia, which have experienced a rapid decline in fertility and mortality. Malaysia is one such country. The increase in life expectancy along with a rising cost of living has meant that many elderly women are exposed to the risk of poverty in later life. This is also due to the inability of the current pension system in Malaysia to recognise interruptions during employment. In the West, there has been extensive research highlighting how living longer combined with an early retirement age and having disruptions during employment years may lead to an inadequate retirement income and affect the quality of life during retirement. Such research is lacking in the Malaysian context. This research therefore investigated the effectiveness of Malaysia’s current pension system to deliver an adequate income in retirement, taking into account the differences in life course experienced by women, particularly interrupted work histories as a result of care-taking responsibilities as well as differences in educational level. This study used a hypothetical simulation model – MHYRISA (Malaysian Hypothetical Retirement Income Simulation Analysis) model to simulate different scenarios. The findings suggest that women with gaps and disruptions during employment will not be able to maintain their standard of living in later life under the present pension system due to the low replacement rate level generated. The findings also suggest that the current retirement age and contribution rate should be increased and also reconsidering the pre-retirement withdrawals policy in order to provide an adequate retirement income during old age. The government should also consider providing a pension credit contribution to women who are unemployed due to care-taking responsibilities, so that they are lifted out of poverty during old age.

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This dissertation will explore the lives, experiences and medical histories of diseased almshouse women living in late eighteenth and early nineteenth century Philadelphia. During this period Philadelphia matured from being a relatively small colonial city into a major manufacturing metropolis. Venereal disease was omnipresent in America’s major port city, and diseased residents were surrounded by a thriving medical marketplace. Historians have identified the “who and why” of prostitution, however the scope of the prostitute experience has yet to be fully explored. This dissertation will address a considerable and important gap in the historiography of prostitutes’ lives as it actually affected women. Venereal disease was an ever present threat for women engaging in prostitution, however casual, and historians have yet to illuminate the narrower aspects of the already shadowy lives of such women. Whether intentionally or by omission, historians have often denied agency to prostitutes and the diseased women associated with them, the effect of which has drained this group of sometimes assertive women of any individuality. While some women lived in circumstances and carried out activities that came to the attention of the courts, others lived more understated lives. A large proportion of the women in this study led the lives of “ordinary” women, and prostitution per se was not the only focal point of their existence. For many almshouse women their only unifying variables were disease, time and place. While prostitutes were often victims of economic adversity, they made a choice to engage in prostitution in the face of hardship and sickness. The overall aim is to consider the diseased female patient’s perspective, in an effort to illuminate how she confronted venereal infection within the context of the medical marketplace. This includes the actions she took, and how she negotiated with those in positions of authority, whose aim was sometimes -although not always- to curtail her activities. As many diseased women became more acquainted with the poor relief system of medical welfare, they were able to manipulate the lack of coherent strategy “from above”, which left room for assertive behaviour “from below”. Diseased women did not always use the almshouse as a last resort-institution as historians often have us believe. Many selected the infirmary wing as opposed to other outlets of healthcare in Philadelphia, a city that was often labelled the crucible of medicine. There is also an oft-believed notion that prostitutes and lower class women suffering from venereal disease were habitually saturated with mercury “punitive-style” as treatment for their condition. This argument does not hold for those women who were cared for in the venereal ward of the almshouse’s infirmary wing. Broadly speaking, almshouse doctors did not sanction drastic depletion and the use of mercury compounds unless deemed absolutely necessary. Many almshouse doctors adopted a different therapeutic approach as compared with that of Benjamin Rush and his followers who dominated therapy at the Pennsylvania Hospital, a voluntary institution mostly closed off to venereal women. Such medical differences reflected wider transformations in ideas of disease causation, therapeutic approaches, medical education as well as doctor-patient relationships.

Background: Evidence from population-level studies demonstrates that adolescent sexual health outcomes are associated with social exclusion, and that certain groups, including young people looked after by local authorities often experience poorer sexual health outcomes. The poorer sexual health outcomes observed for looked after young people has led to the Scottish Government recommending that looked after young people be prioritised for the delivery of sexual health and relationships education, and that residential carers, foster carers and social workers should play a key role in the delivery of sexual health and relationships information to looked after young people. This recommendation builds on existing policy initiatives that have emphasised that parents should be routinely talking to their children about sexual health and relationships. Despite a growing research interest in the health of looked after young people, there is currently little known about how sexual health and relationships discussions are undertaken within the care setting. This is because much of the research that has been published to date has focussed upon identifying barriers to communication rather than establishing how communications are shaped by the characteristics of carers, looked after children and the wider context of the care system. In this thesis I hope to address this research gap by exploring what factors shape communications about sexual health and relationships within the care setting, and examining the extent to which connectedness, monitoring and supervision — parenting factors identified as promoting positive sexual health outcomes for adolescents within the wider literature — mediate these discussions. Methods: 54 in-depth qualitative interviews were conducted with looked after young people (aged 14-18), care leavers (aged 16-23), residential workers, foster carers and social workers in one local authority in Scotland between August and December 2011. Data were analysed thematically, with data collected from corporate parents and looked after young people used to compare and contrast experiences of talking about sexual health within the care setting. Findings: The results presented in this study demonstrate that there has been a perceived shift in attitudes towards talking to looked after young people about their sexual health, and that residential carers, foster carers and social workers believe that talking to young people about sexual health and relationships should be a core responsibility of the corporate parent. Despite this, the results of this study demonstrate that talking to young people about sexual health and relationship is a subject that is fraught with tensions, with many of the corporate parents interviewed expressing difficulties reconciling their own views about the appropriateness of talking to young people about sexual behaviours with their professional responsibility to inform and protect looked after young people from risk. Looking specifically at how communications about sexual health and relationships were undertaken within the care setting, the results of this study show that talking to young people in care about sexual health and relationships is mediated by the impact or pre-care and care histories, in particular maltreatment and poor attachment security, upon young people’s understandings of relationships and their ability to trust other people and seek out help and support. Whilst corporate parents emphasised the need for training to help them identify strategies for talking to young people about sexual health and relationships, the results of this study show that corporate parents are already undertaking sexual health and relationships work that is tailored to the age and stage of the child, and is balanced by the provision of monitoring and supervision to minimise risk. Conclusions: The results of this thesis show that discussions about sexual health and relationships need to be underpinned by a trusting relationship between corporate parents and looked after children. As such, an emphasis needs to be placed upon improving young people’s ability to trust other people. Improving permanency for young people in the care system, in conjunction with the development of attachment based sexual health practices, may result in the promotion of positive outcomes for looked after young people. Future policies and training relating to the provision of sexual health and relationships education within the care system should reflect this fact.

Despite the vast literature surrounding tobacco use, there is little work looking at the question of smoking among women in a historical context. The work which has been done on women and smoking has largely looked at the issue from a sociological viewpoint. In addressing this gap, I have drawn from both disciplines to explore the history of smoking among women from 1890 until the end of the 20th century and to historicise existing sociological literature on women and smoking. I have aimed to integrate women into the history of tobacco more generally and to explore women’s own interpretations of smoking in the past. In doing so, I have focused on the relationship between smoking among women and the socio-cultural position of smoking in Britain from the 19th century until the end of the 20th. I have also explored the relationship between smoking and the changing social position of women. Drawing on archival material from a variety of sources and interviews with epidemiologists and health professionals, I have shown the changing, often ambiguous, public discourses surrounding smoking from the late 19th century until the end of the twentieth. I have also shown, through oral history interviews with women aged between 40 and 85, how these discourses have shaped individual women’s interpretations of smoking in their lives and the personal experiences of smoking which they recollect. What I found is that the social meaning of smoking has undergone a series of redefinitions over this period. The advent of the cigarette in the 1880s and its subsequent popularity in the decades following was crucial to this. From having been a recreational pastime, suited to certain times and occasions, in the nineteenth century, smoking permeated every aspect of public and private life for most of the twentieth. The First World War was pivotal in this expansion, as smoking, particularly cigarette smoking, was defined as a necessity to men’s lives, both at the Front and at home. Its increasing prevalence in the interwar period and the priority accorded to tobacco supplies during and immediately after the Second World War served to reinforce the idea that smoking was integral to every day life.

This study makes a contribution to the gender history of modern Scotland and addresses issues of ethnic diversity in the Scottish past. By examining the experiences of women in immigrant Jewish families and including gender analysis, it also forms an addition to British/Jewish history. The development of a Jewish community is examined in chronological format beginning with the arrival of immigrants from Eastern Europe and ending with aspects of Jewish acculturation. The thesis has three main aims: firstly it seeks to place women at the centre of the immigrant narrative; secondly it aims to explore the materiality of women’s lives as lived in the working class Jewish community of the Gorbals, and thirdly, it endeavours to analyse aspects of Jewish suburban life in Glasgow that were shaped and expressed through changes in gender relations. There is also a thematic element to the analysis that includes the following topics: Jewish settlement in Glasgow; ways of making a living; domesticity; upward mobility; women’s communal involvement, and lastly, the way that memories of Jewish life in Glasgow have been represented in different texts. The thesis makes use of multiple types of source material, including personal testimony, to argue that the identity of Glaswegian Jewry was shaped by the operation of gender as well as ethnicity and class; and in combination, these defined the social organisation of Glasgow Jewry. This approach demonstrates the intersection of culture with more customary social and economic aspects of the migration process and reveals the central roles played by women immigrants.

The transformation of traditional gender ideology has been actively promoted in Mexican society over recent decades. While adults’ renegotiations of traditional ideals and their efforts to forge modern relations have received significant ethnographic attention, little is known about how children in Mexico engage with the contradictions inherent in the coexistence of old and new expectations. This thesis, based on twelve months of ethnographic fieldwork, explores children’s readiness to resist gender divisions and embrace gender equality in the Mexican village of Metztitlán in the state of Hidalgo. The research focused on the, often contradictory, information that was made available to children at home, in the neighbourhood and in the school setting and on how children, aged between six and eleven, negotiated expectations that concerned aggressive behaviour, toy use and the division of labour. The thesis asks whether children regarded gender divisions as problematic and, if they did, whether this translated into readiness to resist traditional expectations through everyday interactions. It pays particular attention to how different kinds of audiences both influenced and were influenced by children’s resistance to gender divisions. The finding is that in domains, such as toy use or the division of labour, in which egalitarian alternatives to traditional expectations were available (e.g. through schooling), most girls and boys, in conversations with the anthropologist, expressed their allegiance to gender equality. However, children did not put these attitudes to work through interactions with peers and adults unless they found personally meaningful advantages in egalitarian arrangements. When they recognised tangible benefits of equality, they not only showed readiness to resist traditional divisions themselves but also to encourage adults to do the same.

UK Higher Education is considered to be at the forefront of equality and diversity policy and practice, yet its staff profile is characterised by persistent gender (among other types of) imbalance. This thesis investigates this paradox, focusing on the under-researched professional and support services staff, and particularly female-dominated administrative and secretarial occupations. In contrast to the few previous studies on the topic, this PhD project takes a discursive perspective to explore this paradox. In other words, it examines how university professional and support staff discursively account for the persistent gender imbalance in their sector, with a particular focus on how they talk themselves out of acting to change the status quo, i.e. on discursive barriers to change. A UK case-study university, whose staff gender-imbalanced profile is representative of the national picture, was selected as the epistemological site. Focus groups were conducted with female and male staff in administrative and secretarial occupations; interviews were carried out with managers who had progressed internally from administrative and secretarial roles, and with former employees of the case-study university. Data were analysed and interpreted from a critical realist, feminist perspective. Discourse analysis was conducted, with a specific focus on the functions, effects and implications of participants’ situated use of gendered discourses and discursive constructions, and co-production of patterned accounts. This thesis takes a much-needed step beyond deconstruction and critique of discursive barriers, towards promoting discursive reconstruction and change. It highlights participants’ potentially emancipatory uses of counter-discourses, and provides recommendations for discursive change.

This thesis explores the implementation of a rights-based policy for children in Chile by examining progress within two programs: rights protection and juvenile imprisonment. By applying a combination of organisational and institutional theories, and relying on multiple sites, case-based, qualitative method, this study explores how organizational and cultural dimensions interact to support or hinder this fundamental shift in the framework for children’s policy. Findings showed the role of power as the major device affecting the implementation process. Structural power in organisational arrangements unveiled a prevalent model of top-down implementation, marked by patronage and symbolic implementation. Institutional power exerted in the cultural and normative Chilean context showed a persistent hierarchical society infused with conservative beliefs based in dichotomous conceptions of people. This resulted in policy implementers distinguishing strongly between those they considered worthy or not worthy, good or bad, service provider or user, either or, with no room for overlap and little appreciation of difference as a positive societal feature. Interplay between organisational and cultural variables evidenced the strong legacy of deep-rooted understandings of the place of child care services in family life. Until this legacy can be effectively challenged, the implementation of a rights-based approach will remain partial and ineffective.