Coping, Resilience, & Women's Health: A 6-Year Ethnography in the Philippines

Background and Purpose: This paper explores women’s coping and resilience related to health and reproductive health, economic survival, and domestic violence in a rural community in the Philippines. The community is a municipality in the Mindanao region, with 20 barangays and a population of 18,000 residents. Filipino women are commonly elected to political office and may play important roles in a community, yet some do so in a hierarchal and patriarchal society that ignores their health needs and common experiences of domestic violence. It is also often left up to women in the community to develop economic strategies for their families. The specific focus of this study grew out of an earlier needs assessment that found that women’s concerns were often overlooked by the local and state governments. Women included in this current study ranged in age from 18 to 68 who lived in one of the 20 barangays. The research team had direct contact with 500 women, with indirect contact with more than approximately 2,000 others over the six-year period of this study.

 Methods: This research is a six-year, qualitative longitudinal study (QLS) study that employed ethnographic methodology and community-based participatory action research approaches. The methods included, focus groups, one-on-one interviews with residents, healthcare providers, elected officials, educators, and key informants. The research teams engaged in participant observation, community participation in typical activities, including meals, sporting events, interaction with children, home visits, celebrations, and attending local events. The research teams, which included local residents completed field notes and journals, videotaped and tape recorded interviews, and engaged in analyses with community members. The teams directly interacted with approximately 20% of the population, not including attendance at public events and festivals. Analysis included a range of established criteria to enhance credibility and dependability of the data such as repeated coding techniques, member checks, and triangulation through multiple sources and methods of data collection.

 

Results: For the women in this community, health and reproductive health, domestic violence, and economic survival were usually interrelated. One did not exist without at least one of the others. Religious and cultural beliefs were both barriers and paths to coping and resilience. The women often engaged in problem- and emotion-focused coping in order to manage conflicts, especially related to domestic violence and economic issues. Problem-focused coping was evident in health-related issues, where women were likely to consciously and intentionally self-manage any concerns, including those related to reproductive health. While true resilience was less common, the ability to cope provided multiple indicators of resilience: social capital, faith, determination, and cultural identity, especially related to health and financial concerns.

 Implications: This study reflects related conditions in several areas of the Philippines and other developing countries. While some attention is paid to women in global communities, often their concerns and modes of survival are overlooked. As social work becomes more global, greater attention should be on how to reach these women and work with them within their cultural context, looking at the barriers and pathways to positive coping and resilience.