Psychological And Socio-Cultural Effects Of Forced And Coerced Sterilisation On Women Living With Hiv (Wlhiv) In Namibia: Implications For Intervention

ABSTRACT 

The forced and coerced sterilisation of women living with HIV (WLHIV) is one of the serious forms of fundamental human rights violations, which has occurred, the world over. In Namibia, cases of forced and coerced sterilisation were first reported in 2007 to 2008. With the support of civil society organisations; these cases have gone through litigation. The litigation of Namibia?s forced and coerced sterilisation cases has been successful and considered a best practice, with the courts ordering financial compensation for the victims. Yet, aspects of the well-being of the victims have not been fully addressed. This research aimed to explore and obtain an in-depth understanding of the psychological and socio-cultural effects of forced and coerced sterilisation on WLHIV in Namibia, in order to ascertain the implications for further intervention. A qualitative approach was applied, using semi-structured interview schedules to acquire comprehensive information on the experiences of seven research participants residing in the Khomas region of Namibia. Content analysis was carried out, and results indicated negative psychological and socio-cultural effects on the lives of research participants following forced sterilisation. The themes that emerged from the findings include psychological symptoms that are usually associated with anxiety and depression. Symptoms of depression comprised: withdrawal, overthinking or ruminating, feelings of helplessness, feelings of hopelessness, feelings of worthlessness, feelings of sadness, anger, sleep disturbance, change in weight, loss of interest, self-blame and shame. Symptoms of anxiety included fear and uneasiness, sleep disturbance, persistent anxious and stressful feelings. Additionally, the themes of negative health effects and poor state health care services, gender-based violence, discrimination, victimisation and unemployment emerged. It was noted that cultural principles and values regarding reproduction, marriage and decision-making also contribute to negative socio-cultural and psychological effects. While victims have received emotional, legal and material support from support groups and from civil society, coping has been difficult, with some psychological and socio-cultural challenges still significantly affecting the women?s lives. It is recommended that in addition to the legal assistance, stakeholders should also target responses at aspects of the well-being of the victims, principally, the psychological and physical well-being of the victims