A formative evaluation and critical analysis of an alcohol and pregnancy intervention in the Eastern Cape of South Africa

Graham, Nicola Susan Jearey

Title: A formative evaluation and critical analysis of an alcohol and pregnancy intervention in the Eastern Cape of South Africa
Creator: Graham, Nicola Susan Jearey
Subject: Fetal alcohol spectrum disorders South Africa Eastern Cape
Subject: Foucauldian discourse analysis
Subject: Conversation analysis
Subject: Women Social conditions South Africa Eastern Cape
Subject: Sex role South Africa Eastern Cape
Subject: Cultural hegemony
Date Issued: 2023-10-13
Date: 2023-10-13
Type: Academic theses
Type: Doctoral theses
Type: text
Identifier: http://hdl.handle.net/10962/432541
Identifier: vital:72879
Identifier: DOI 10.21504/10962/432541
Description: Some communities in South Africa have the highest documented rates of Foetal Alcohol Spectrum Disorders (FASD) in the world. Interventions to reduce alcohol consumption during pregnancy are crucial, but evaluations of such interventions are sparse. Formative evaluations are indicated to assist in the development of interventions. Harmful alcohol consumption during pregnancy is undergirded by a range of social injustices, including those imposed by colonisation and patriarchy; a feminist, decolonial approach to evaluations is, therefore, important. A research project, consisting of three arms, examined alcohol use during pregnancy in an under-resourced urban area of the Eastern Cape, and this research was one of those arms. An intervention was being rolled out in this area and I gathered a range of data from it. I engaged in a formative evaluation of it, and I reflect on the difficulties that I encountered in this endeavour. In the bulk of this thesis, I examine the power apparatuses and technologies that were used during the intervention to discursively position pregnant women. My analysis was guided by Foucauldian and post-Foucauldian theories, using Foucauldian Discourse Analysis and simplified Conversation Analysis (CA). Power apparatuses of coloniality, patriarchy, and pastoral power were used in the intervention to construct positions for pregnant women who drink alcohol as ignorant children, sinners, criminals, or “Mommies”. The foetus was constructed as a precious, vulnerable baby, while the person with FASD was constructed as the defiled Other, responsible for societal dissolution. The intervention used various disciplinary techniques to exhort women to follow their dictates. Women were generally compliant with being positioned as ignorant children, which absolved them from any blame for pre-natal drinking. However, some resistance was evident. I then introduce an ethics of care and justice, and I argue that pregnant/newly parenting women need to be positioned within such an ethics, which acknowledges both the universal resources that they require for reproductive freedoms, as well as their particular care needs. I highlight the few times when women were positioned in this way in the data, and I look at how the common positions could be altered or expanded to promote such an ethics. I conclude by arguing that alcohol use during pregnancy cannot be separated from the larger context of the cultural hegemony of alcohol use in some communities, and the social injustices that potentiate this use. I provide suggestions for country-wide policies and interventions, as well as specific FASD prevention programmes, and I argue that a feminist decolonising approach, within an ethics of care and justice, should guide interventions at all levels.
Description: Thesis (PhD) -- Faculty of Humanities, Psychology, 2023
Format: computer
Format: online resource
Format: application/pdf
Format: 1 online resource (374 pages)
Format: pdf
Publisher: Rhodes University
Publisher: Faculty of Humanities, Psychology
Language: English
Rights: Graham, Nicola Susan Jearey
Rights: Use of this resource is governed by the terms and conditions of the Creative Commons "Attribution-NonCommercial-ShareAlike" License (http://creativecommons.org/licenses/by-nc-sa/2.0/)

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