Social and cultural aspects of infertility in Mozambique

Abstract

Findings of an anthropological study of socio-cultural aspects of infertility among members of the matrilineal ethnic group Macua in the north of Mozambique are presented. Infertile women apply various strategies to have a child. Traditional healers are visited much more often than the modern hospital, and the explanations the infertile women themselves give for their infertility more often originated from the traditional healers than from the hospital staff. Almost all of the interviewed women commit adultery in the hope to conceive. Some of them apply fostering as a partial solution for childlessness. The Macua infertile women experience various consequences due to their infertility, of which exclusion from certain social activities and traditional ceremonies is perceived as a very problematic one. The matrilineal kinship system means that the husband and his family do not mistreat and repudiate her. Infertility must be considered as a serious reproductive health problem in Mozambique. For the long term preventive measures may be more influential than curative one. The findings of this study can be used to elaborate culturally sensitive health education programmes.

PIP: The experiences, perceptions, and problems of infertile Macua women in Montepeuz, Mozambique, were investigated in an anthropological field study conducted in 1993. Respondents included 34 women considered infertile (unable to achieve a desired pregnancy, for whatever reason, including husband's biomedical condition), 6 "cured" women (have resolved a former inability to become pregnant), 10 fertile women (never had a fertility problem), a range of traditional healers, female advisors in initiation rites and pregnancy ceremonies, members of the popular tribunal, a group of elderly men, and a hospital doctor and nurse. Since the Macua have a matrilineal kinship system, having children is critical to social and economic survival. Women who have never been pregnant are excluded from cultural ceremonies and face concerns about who will care for them. At the time of interview, the infertile women had been unsuccessfully attempting pregnancy for a period of 6 months to 10 years. All women had sought help from traditional healers, primarily herbalists. About half had consulted a hospital physician, but failed to understand the medical explanations provided. Women tended to attribute their infertility to personalistic causes such as possession by spirits or witchcraft. Extramarital sexual relations and child fostering represented alternative non-medical responses to infertility. Overall, these findings confirm that the way women experience their infertility is closely related to the social and cultural context. Preventive interventions, especially those focused on sexually transmitted diseases, are likely to have more of an impact on infertility in this culture than are curative ones.