title: Vaginal practices as women's agency in sub-Saharan Africa: a synthesis of meaning and motivation through meta-ethnography.
abstract: This paper reports on a systematic review of qualitative research about vaginal practices in sub-Saharan Africa, which used meta-ethnographic methods to understand their origins, their meanings for the women who use them, and how they have evolved in time and place. We included published documents which were based on qualitative methods of data collection and analysis and contained information on vaginal practices. After screening, 16 texts were included which dated from 1951 to 2008. We found that practices evolve and adapt to present circumstances and that they remain an important source of power for women to negotiate challenges that they face. Recent evidence suggests that some practices may increase a woman's susceptibility to HIV and other sexually transmitted infections. The success of new female-controlled prevention technologies, such as microbicides, might be determined by whether they can and will be used by women in the course of their daily life.
authors.affiliation: University of Bern, Institute of Social and Preventive Medicine, Finkenhubelweg 11, CH-3012 Bern, Switzerland; Swiss Tropical and Public Health Institute, Switzerland. amartinhilber@ispm.unibe.ch
authors.forename: Adriane
authors.initials: A
authors.lastname: Martin Hilber
authors.forename: Elise
authors.initials: E
authors.lastname: Kenter
authors.forename: Shelagh
authors.initials: S
authors.lastname: Redmond
authors.forename: Sonja
authors.initials: S
authors.lastname: Merten
authors.forename: Brigitte
authors.initials: B
authors.lastname: Bagnol
authors.forename: Nicola
authors.initials: N
authors.lastname: Low
authors.forename: Ruth
authors.initials: R
authors.lastname: Garside
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D000884:Anthropology, Cultural; D001828:Body Image; D002562:Ceremonial Behavior; D003466:Cultural Characteristics; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control; D015438:Health Behavior; D006801:Humans; D006920:Hygiene; D009042:Motivation; D011209:Power, Psychological; D036301:Qualitative Research; D012098:Reproduction; D012307:Risk Factors; D012746:Sexual Abstinence; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control; D014621:Vagina; D016387:Women's Health