The Influence of Institutional Logics and Emotions on the Uptake of Cervical Cancer Screening: A Case Study from Xai-Xai, Mozambique

Gefra Fulane, Maria Major,Cesaltina Lorenzoni,Khatia Munguambe

Health services insights(2024)

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Abstract
This study investigates the role of emotional attachment to competing institutional logics on women’s uptake of cervical cancer screening in Mozambique. Through a qualitative study conducted in Xai-Xai, Southern Mozambique, we identify 2 concurrent logics in the context of screening: preservation logic, influenced by social-cultural norms, and the prevention logic, centered around screening. Women, affected by emotions such as shame, fear, and marital subordination, often become attached to the preservation logic, which influences their values and contradicts acceptance of screening. However, some women with marital autonomy may reflect on both logics and gradually detach themselves from the preservation norms and show their intention to adopt life-saving behavior by accepting screening. It is through their emotions that women show their attachment to and detachment from competing logics, reinforcing traditional norms on the one hand, or giving them the means to adopt preventive measures on the other. The study indicates that cultural expectations, shame and the desire to preserve intimacy tie women to the logic of preservation and have a negative impact on participation in cervical cancer screening. Consequently, to improve screening uptake in Mozambique, the authorities need to adapt screening to socio-cultural and emotional factors, empower women, and effectively engage communities.
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