‘Narratives of blame’ HIV/AIDS and harmful cultural practices in Malawi
: implications for policies and programmes

  • Samantha Page

Student thesis: Doctoral Thesis


The aim of this research is to examine the fisi practice and HIV/AIDS in a high HIV prevalence country and to highlight implications for HIV/AIDS policies and programmes. Five objectives were identified to meet this aim. First, it assesses the extent to which the Malawian elites (educated Malawians working on HIV/AIDS) are reframing the AIDS epidemic to further their goals and self interests. Second, it investigates whether the debates on HIV prevention in Malawi are facilitated or constrained by international donors (bi and multilateral agencies). Third, it explores whether or not HIV/AIDS is being represented as an exceptional circumstance, justifying policies that would not normally be applied to other public health crises, for example to other Sexually Transmitted Infections. Fourth, it ascertains and examines the extent to which international frameworks, agendas and paradigms are influencing and impacting on traditional cultural practices, resulting in changes to legislation to ban such practices. And finally, it assesses the implications of the findings for the conceptualisation and provision of current and future HIV/AIDS policies and programmes in Malawi.

In-depth interviews (n=60) were carried out to foreground stakeholders’ own views and to understand how constructions of narratives linking HIV/AIDS and harmful cultural practices came about. These data are also supported with interview data (n=28) I collected during a consultancy for the Joint United Nations Programme on HIV/AIDS, interviews I conducted in a village in Lunzu (n=45), newspaper articles, policy documents and field notes.

Findings demonstrate that due to the epidemiology of HIV the fisi practice does not contribute significantly to the spread of HIV/AIDS in Malawi. Instead, I argue that the way that harmful cultural practices have been linked to the spread of HIV/AIDS is a distortion of the reality and what becomes lost is a critical understanding of how harmful cultural practices impact negatively on women’s lives and feed into patriarchal values.
Date of AwardOct 2014
Original languageEnglish
Awarding Institution
  • University of Portsmouth
SupervisorTamsin Bradley (Supervisor), Sasee Pallikadavath (Supervisor) & Tony Chafer (Supervisor)

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