Infertility in women’s life courses in northern Malawi

Joanne M. Hemmings, London School of Hygiene and Tropical Medicine
Doris Banda, Karonga Prevention Study
Amelia Crampin, Karonga Prevention Study
Andreas Jahn, Karonga Prevention Study
Lydia Ngwira, Karonga Prevention Study

Infertility, and risks to fertility, are significant factors throughout women’s lives in Malawi: they are vulnerable to reproductive health hazards within a patriarchal society in which women’s status is ascribed by fertility. Fear of infertility or desire to demonstrate fertility may contribute to low contraceptive rates and ‘risky’ sexual partnerships. Infertility may precipitate disruption in women’s marital, residential, and socioeconomic experiences, resulting in vulnerability to ill health and poverty. Employing qualitative methodology, in-depth life histories are obtained from infertile and fertile women in Karonga district, northern Malawi. We investigate associations between infertility and household structure, socioeconomic status, and biomedical indicators including HIV status, using data from parallel quantitative studies. Preliminary results show women using traditional infertility treatments are five times more likely to be HIV-positive than other women. The low priority accorded to these fertility-related behaviours in current models of the behavioural dimension of the HIV epidemic is critically discussed.