Date of Award

5-2019

Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Global Governance and Human Security

First Advisor

Courtenay Sprague

Second Advisor

Jane Parpart

Third Advisor

Eileen Stuart-Shor

Abstract

Ensuring human security post-war is essential for effective reconstruction efforts and attaining a sustainable peace. This involves establishing people’s access to basic needs, including healthcare, and addressing their health security. Sri Lanka is hailed for its impressive health indicators and public health services. However, its national indicators do not accurately reflect the health context in the Northern and Eastern Provinces. Additionally, research on post-war access to healthcare for resettled, formerly displaced communities, particularly women, is sparse. Given this gap, this study investigated barriers to resettled women’s efforts in post-war Jaffna, Sri Lanka to access healthcare.

This qualitative study utilized the methodology of phenomenology with the methods of interviews (35 with resettled women; 32 with key informants) and focus groups (four with 19 resettled women) to explore the lived experiences of resettled women of reproductive age (18 to 49) in two villages in the district of Jaffna in northern Sri Lanka. Participants, who all gave informed consent, were recruited through purposive and snowball sampling. Women were recruited from two contrasting villages – a more rural, predominantly Tamil village, and a predominantly Muslim village closer to the urban center. The conceptual framework used was the socio-ecological model through a gender and intersectionality lens.

Two main themes emerged that influence the women’s ability to access healthcare: (1) their perceptions of and experiences with public health staff/providers and resources, and (2) their perceptions of and behaviors within their village and home contexts. Various factors within society also affect the women’s human security and thus their ability to access healthcare. The main finding from this study indicates that the intersectionality of the women’s household income and gender (specifically gender hierarchies, norms, relations, and roles) in the home impacts their ability to access health services in post-war Jaffna, more so than ethnicity. This illustrates the importance of looking beyond solely the influence of ethnicity on people’s access to basic needs post-war. This study also demonstrates the key effect of gender dynamics on women’s access to and experience of health services in post-war Jaffna, including implications for Sri Lanka’s greater reconstruction and sustainable peace efforts.

Comments

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