University of Groningen

Aging and gender in TanzaniaRutagumirwa, Sylivia Karen

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Aging and Gender in Tanzania:

Uncovering the cultural schemas, nexus of identities

and the Aging Body

Sylivia Karen Rutagumirwa

ISBN number: 978-94-6295-994-1Lay-out and print by: ProefschriftMaken // www.proefschriftmaken.nl

Aging and gender in Tanzania

Uncovering the cultural schemas, nexus of identities and the Aging Body

PhD thesis

to obtain the degree of PhD at the University of Groningen on the authority of the

Rector Magnificus Prof. E. Sterken and in accordance with

the decision by the College of Deans.

This thesis will be defended in public on

Thursday 5 July 2018 at 11.00 hours

by

Sylivia Karen Rutagumirwa

born on 3 November 1975 in Lushoto, Tanzania

SupervisorProf. I. Hutter 

Co-supervisorDr. A. Bailey 

Assessment CommitteeProf. J.J.M. Zeelen Prof. C.M. Fokkema Prof. W. Harcourt

DEDICATIONI dedicate my thesis to my family. Dad, thank you for being such a great father. Mom, you have inspired me through my entire life. Thank you! To my husband Dunstan thank you for being the best husband and a best friend. To my children, Rodney, Precious and Abigail, I hope to inspire you to aim higher and not let anything stop your dreams. With determination and resilience you can become anyone.

ACKNOWLEDGEMENT

I begin by thanking the Almighty GOD for providing me the strength, health and ability to finish my doctoral work. His mercy was with me throughout my life and ever more in this study.

I am especially indebted to my supervisor Prof. Inge Hutter and co-supervisor, Dr. Ajay Bailey. You constituted the perfect supervision team, I feel very lucky to have you as my supervisors. Nothing I write here can sufficiently express my gratitude to you; it’s your trust in me, your continuous support, patience, motivation and your insightful comments that lead to completion of this doctorial Journey. To Prof. Inge, I am immensely grateful for your endless patience especially at the beginning of my PhD trajectory (where I had three proposals), you patiently listened to my scattered ideas, guided me to think critically and encouraged me to constantly improve and extend my work. Thank you for mentoring me throughout my doctoral journey. To Dr. Ajay, I am really grateful to you, for your patience, your continuous support and for your door always open for me. Thank you for your sharp intellectual and academic insight, you always pointed out things I had overlooked. Thank for your presence as mentor and friend. You two have made my PhD thesis go farther than I ever imagined possible. My sincerest gratitude also goes to Prof. Hinke Haisma who was my initial supervisor, thank you for all that you have done and for all that goes unsaid.

I would like to thank the members of the Reading Committee, Prof. J.J.M. Zeelen, Prof. C.M. Fokkema and Prof. W. Harcourt. Thank you for the time and efforts spent reviewing this thesis and more so, for approving it.

To my paranymphs: Dr. Billies de Haas and Fieke Visser thank you very much. You accepted to be my paranymphs despite your busy schedules and with great pleasure. I will forever cherish your kind hearts and support. My sincere thanks also go to Prof. Clara Mulder, for all the lovely chats during coffee breaks, and tips you gave me dur-ing our morning conversations. To the faculty members of spatial sciences, demog-raphy department and many colleagues outside the faculty I have had throughout my doctorial journey, know that each of you has left a lasting impression on me, and thanks for the conducive environment you allowed me by extension and for always making me feel welcome. I would especially like to thank Dr. Louise, Dr. Sepideh, Stiny, Liesbeth, and Kanika. Thank you for your time, for opening your homes to me. To other faculty members, I wish I could mention all your names! I would like to thank particularly Prof. Fanny, Dr. Eva, Allen, Nikhil, Ziad, Lybrich, Linden, Vera,

Dr. Marieke, Dr. Shirish, Titissari, Dr. Sanne, Dr. Debbie, Arun, Dr. Anu, Elda, Jakko, Sergi, Dr. Acul, Ruben, Antje, Roselinde, Dr. Emmy and my other PhD colleagues and students of Population master’s course intake of 2011/2012.

I would also like to thank Alida from Graduate school and Feara who took over after her for helping me with all the procedures of the PhD. I would also like to thank the secretaries at demography department: Stiny, Mirjam, Eliza and others for always being very helpful.

In my academic life, I have met many other scholars who have helped to shape my academic worldview. I would particularly like to mention Prof. Liz from Karolinska Institutet, Dr. Tom Strong from the National university of Ireland, Maynooth and Prof. Kamuzora and the late Prof. Chachage from the University of Dar es Salaam and Prof. Henk Sol from Groningen University.

I must also extend my deepest gratitude to Laura who is like a rare book of which but only one copy was made. We met through our children, Abigail and Lotte, at the day care, our friendship has since blossomed. Your support to me and Abigail has meant more to me than words on this page can ever convey. You and Hilbert are friends I hope to keep forever!! You will always be remembered. I also want to extend my gratitude to the Kinderdagverblijf—KITS daycare, Siska Kanninga and all members of staff at KITS, Abigail was well cared for. You have all been wonderful.

I would like to thank the Netherlands Organization for International Cooperation in Higher Education and Research (NUFFIC)—(NICHE Project) for the financial support throughout my doctorate. I would like to express my gratitude for the finan-cial support I received from Erasmus + ICM scholarship during mobility exchange program. My special appreciation goes to the International Office of the University of Groningen and the staff who played a central role in supporting and facilitating my visit and stay in the Netherlands; Drs. Wiebe Zijlstra, Gonny Lakerveld, drs. Esme Bakker, Ivita Kops and Hendrik Jan thank you very much for your kind support. I am thankful to the institute of Finance Management (IFM), my employer, for granting me a study leave to pursue this program. I am also grateful for the assistance with proofreading provided by Miriam and Ms Annrita.

In addition, I wanted to express my deep appreciation to all older women and men who participated in this study. I am humbled by their warmth, openness, patience, humor and trust and count which have enabled this rich and enjoyable study. I would also like to express my gratitude to Village executive officers (VEO) in Pwani, Ward

executive officers (WEO) in Pwani, organizations for older people and Help age Tanzania and many other gatekeepers, for enabling an easy access to participants. I am also indebted to my fellow Tanzanians in Groningen: Zaina, Igulu, Zahor, Zubeda, Agustus, Jerome, Frank, Daniel, Anne, Mohamed, Zainab, Nyausi, Jokha, Karin, Kafwenji, Fabian,Noel, Deborah, Dr. Mackfallen and Dr. Idda and many others col-leagues from Tanzania, Uganda, Kenya, Rwanda, Ghana and Nigeria .

Last but certainly not least, I am grateful to my family in Tanzania. Dunstan, my Husband, you supported me wholeheartedly and cared for our children so lovingly while I was preoccupied with this project: thanks for your relentless encouragement, patience, understanding and love. To my children Rodney, Precious and Abagail: You have helped me to celebrate every step and accomplishment along the way. Thank you for your constant, devoted and now answered prayers for my success! This achievement is yours as much as is mine. I would also like to say massive heartfelt thanks to my Dad and Mom and my sisters and Brothers: Pendo, Joe Doreen, Rutta and Benjamin and all my in-laws, thank you for your kind support. My friends Joan, Advera, Koku, Candida and Elvira and to all those who supported my family in one way or the other during my absence, ASANTENI SANA! Mom, you have inspired me through my entire life. I have always looked up to you and admired you for who you are and for what you have achieved as a woman (of your generation). Thank you for your support, prayers and for always being my friend. Where I grew frustrated, your counselling skills worked—I always I recall you saying that “It gets darker before dawn”, thank you mom for being a pillar to me.

Sylivia Karen Rutagumirwa

Dar es salaam, Tanzania April 2018

Table of Contents

Chapter 1 Introduction 151.1 Situating the study 171.2 Background of the study 201.3 Gender and aging in the cultural context of Tanzania 211.4 Family, intergenerational support, and policy responses to

population aging in Tanzania22

1.5 Research objective and thesis outline 231.6 Theoretical framework 251.7 Organization of thesis 28

Chapter 2 Study Population and Methodology and Methods 372.1 Introduction 392.2 Study Setting and population 392.3 Study design 412.4 Recruitment strategy and reflection 452.5 Data collection methods 482.6 Ethical Considerations 512.7 Data quality 522.8 Data analysis 532.9 Motivation for the current study and positionality 57

Chapter 3 “We Never Graduate from Caregiving Roles”: Cultural Schemas for Intergenerational Care among Older women and men in Tanzania*

67

Abstract 683.1 Introduction 693.2 Intergenerational caregiving in Tanzania 703.3 Research goal 703.4 Caregiving and Cultural schema theory 713.5 Methods 733.6 Analyses 753.7 Results 763.8 Discussion 913.9 Conclusion 943.10 Limitations and future directions 95

Chapter 4 ‘I have to listen to this old body’: Femininity and the aging body*

101

Abstract 1024.1 Background 1034.2 The Theoretical Framework 1034.3 Methods 1064.4 Analysis 1074.5 Results 1074.6 Discussion 1124.7 Limitations and Future Directions 1174.8 Conclusion 117

Chapter 5 “It’s all about being a woman”: Intersections of multiple (dis)advantages experienced by older women*

123

Abstract 1245.1 Introduction 1255.2 Agency 1265.3 Methods 1285.4 Results 1295.5 Discussion 1385.6 Conclusion 1425.7 Limitations and Future Directions 146

Chapter 6 “The Heart Desires but the Body Refuses”: Sexual Scripts, Older Men’s Perceptions of Sexuality, and Implications for Their Mental and Sexual Health*

151

Abstract 1526.1 Introduction 1536.2 Method 1576.3 Methods and Procedure 1586.4 Research Positionality and Reflexivity 1616.5 Validity 1626.6 Analysis 1636.7 Results 1646.8 Discussion 1746.9 Limitations, and Future Research 1776.10 Practice Implications 1776.11 Conclusion 179

Chapter 7 “I am just a man by name …” The Intersectionality of Age, Gender and Socio-Economic Status*

185

Abstract 1867.1 Introduction 1877.2 Theoretical framework 1887.3 Methodology 1917.4 Findings 1947.5 Discussion 2017.6 Conclusion 2047.7 Limitation and future research 205

Chapter 8 Conclusion and Discussion 2118.1 Introduction 2138.2 Summary of main findings 2138.3 Theoretical reflections 2168.4 Reflections on methodology 2198.5 Concluding remarks 2208.6 Implications of the findings, recommendations for future

research221

Appendices 231Appendix 1: Interview guides for older men 233Appendix 2: Focus group discussion guides for older men 238Appendix 3: Interview guides for older women 241Appendix 4: Focus group discussion guides for older women 246

Summary / Samenvatting 249Summary 251Samenvatting 258

LIST OF FIGURES

Figure 2.1 Location of Pwani (Coastal Region) on Tanzania Mainland 40Figure 2.2 procedures used in collecting and analyzing data 54

Figure 3.1 Internalization of cultural schemas 79Figure 3.2 Motivation force for intergenerational caregiving 82Figure 3.3 Care needed by older adults 85

Figure 4.1 Doing femininity with an old body (capital) 110

Figure 5.1 Older women’s structural dis(advantages and intersecting identities across the life course

139

Figure 8.1 Cultural schemas, scripts and gender habitus that shape older adults’ perceptions, experiences and meaning of old age

223

LIST OF TABLES

Table 2.1 Pwani Region: Total Population of older people by Age in Single Years, Five Year Age Groups, Sex and Rural-Urban

42

Table 2.2 Profile of focus group participants—20 FGDs (n=120) 49Table 2.3 Profile of participants interviewed (N=30) 50Table 2.4 Themes and sub themes 56

Table 3.1 Profile of participant interviewed (N=30) 74Table 3.2 Profile of focus group participants—20 FGDs (n=120) 75

Table 4.1 Feminine Habitus and Lived Experience of Femininity in Later Life 109

Table 5.1 Demographic characteristics of women selected for the case study 129Table 5.2 The intersecting sources of (dis) advantages over life course 145

Table 6.1 Characteristics of participants who were interviewed 159Table 6.2 Themes, descriptions, coding, and examples 166

Table 7.1 Characteristics of participants who were interviewed 192

Chapters included in this thesis are reprinted from the following publications and manuscriptChapter 3“We Never Graduate from Caregiving Roles”: Cultural Schemas for Intergenerational Care among Older women and men in Tanzania, (forthcoming) Journal of Cross-Cultural Gerontology, Springer, publishers:

Chapter 4“I Have to Listen to This Old Body”: Femininity and the Aging Body, The Gerontolo-gist, 1, 10, doi.org/10.1093/geront/gnx161

Chapter 5“Intersections of multiple (dis)advantages experienced by Tanzanian women’s across the life course (revised and submitted), Gender, Place & Culture ; A Journal of Feminist Geography

Chapter 6“The Heart Desires but the Body Refuses”: Sexual Scripts, Older Men’s Perceptions of Sexuality, and Implications for Their Mental and Sexual Health. Sex Roles, 1-16. DOI: 10.1007/s11199-017-0822-3

Chapter 7“I am just a man by name …” The intersectionality of age, gender and socio-economic status (Submitted), a journal of men and masculinities