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Theory and social practice of agency in combining breastfeeding and employment: A qualitative study among health workers in New Delhi,India
Authors:Amal Omer-Salim  Shobha Suri  Jai Prakash Dadhich  Mohammad Moonis Akbar Faridi  Pia Olsson
Institution:1. Department of Women''s and Children''s Health, International Maternal and Child Health (IMCH), Uppsala University, Uppsala, Sweden;2. Breastfeeding Promotion Network of India (BPNI), New Delhi, India;3. Department of Paediatrics, University College of Medical Sciences & Guru Tegh Bahadur (GTB) Hospital, New Delhi, India;1. Jhpiego, House #107, Street 3, Ansari Watt, Shar-e-Naw, District 4, Kabul, Afghanistan;2. UNICEF, Jalalabad Road, Paktiakot, UN Compound, Kabul, Afghanistan;3. MSH, House @ 24, Ayubkhan Mena, Darulaman Road, Kabul, Afghanistan;4. International Confederation of Midwives, GK2 E Block 62, New Delhi, India;5. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA;6. Jhpiego, 1615 Thames Street, Baltimore, MD 21231, USA;1. Department of Community Paediatrics, South Western Sydney and Sydney Local Health Districts, Liverpool Hospital, Liverpool, NSW 2170, Australia;2. St John''s Research Institute, Department of Psychiatry, St John''s Medical College, Sarjapur Road, Bangalore 560034, India;3. Department of Physiology, St John''s Research Institute, St John''s Medical College, Sarjapur Road, Bangalore 560034, India;4. School of Public Health & Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia;1. Johns Hopkins University Center for Communication Programs (JHUCCP), New Delhi, India;2. Kalyani Media Group, Mumbai, India;1. 380 Ashley Gorge Rd, R.D.1, Oxford 7495, New Zealand;2. School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Wagga Wagga, NSW, Australia;1. Faculty of Nursing, Chiang Mai University, 110 Intrawaroros Road, Sri-phum Sub-district, Muang District, Chiang Mai 50200, Thailand;2. Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, 110 Intrawaroros Road, Sri-phum Sub-district, Muang District, Chiang Mai 50200, Thailand
Abstract:BackgroundWomen's agency, or intentional actions, in combining breastfeeding and employment is significant for health and labour productivity. Previous research in India showed that mothers use various collaborative strategies to ensure a “good enough” combination of breastfeeding and employment. Bandura's theoretical agency constructs previously applied in various realms could facilitate the exploration of agency in an Indian context.AimTo explore manifestations of agency in combining breastfeeding and employment amongst Indian health workers using Bandura's theoretical constructs of agency and women's experiences.MethodsQualitative semi-structured interviews were conducted with ten women employees within the governmental health sector in New Delhi, India. Both deductive and inductive qualitative content analyses were used.FindingsBandura's features and modes of agency revealed that intentionality is underpinned by knowledge, forethought means being prepared, self-reactiveness includes collaboration and that self-reflectiveness gives perspective. Women's interviews revealed four approaches to agency entitled: ‘All within my stride or the knowledgeable navigator’; ‘Much harder than expected, but ok overall’; This is a very lonely job’; and ‘Out of my control’.ConclusionsAgency features and their elements are complex, dynamic and involve family members. Bandura's theoretical agency constructs are partially useful in this context, but additional social practice constructs of family structure and relationship quality are needed for better correspondence with women's experiences of agency. The variation in individual approaches to agency has implications for supportive health and workplace services.
Keywords:Women's agency  Breastfeeding  Employment  Qualitative interviews  India
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