https://doi.org/10.1177/1049732317750382
Qualitative Health Research
1–14
© The Author(s) 2018
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DOI: 10.1177/1049732317750382
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Research Article
International reproductive and sexual health strategies such
as the Safe Motherhood Campaign and the Millennium/
Sustainable Development Goals provide frameworks on
which low-middle-income nations may focus their
resources aimed at improving maternal health (Jaffre &
Suh, 2016). The success of such strategies requires an inti-
mate understanding of context and the targeted community
(Mwaikambo, Speizer, Schurmann, Morgan, & Fikree,
2011; Say & Raine, 2007). Through probing indigenous
knowledge, researchers have identified different interpreta-
tions of physiological concepts among stakeholders
(Butcher & Kievelitz, 1997; Pelto & Pelto, 1997). The
exploration of these alternate worldviews provides insights
which may influence reproductive health decision-making,
behavior, or service provision (Ireland, Narjic, Belton,
Saggers, & McGrath, 2015; Mba, Obi, & Ozumba, 2007).
The qualitative research method of body mapping, that is,
asking people to draw and explain their anatomical and
physiological perceptions, is an effective way to gain such
insights (Cornwall, 1992; MacCormack, 1985).
Ignoring these emic ethno-anatomical and ethno-
physiological beliefs decreases the chance of success-
fully implementing new health policy, as well as risks
losing valuable indigenous knowledge. In addition,
opportunities for health promotion may be jeopardized
with the development of health messages or interven-
tions that are ignored or unsuccessful if deemed inap-
propriate or irrelevant (Butcher & Kievelitz, 1997;
Doyle & Faucher, 2002; Goodkind, Gorman, Hess,
Parker, & Hough, 2015; Jordan, 1989; Senior, Helmer,
Chenhall, & Burbank, 2014). Ethno-anatomy and ethno-
physiology are described as “the ways in which we con-
ceive of the body, its internal process, and its ideal
configuration” (Dighe, 2011, p. 238). A person’s percep-
tion of their anatomy or physiology is particular to their
worldview (Obermeyer, 2000). These beliefs stem from
750382QHR XX X 10.1177/1049732317750382Qualitative Health ResearchWallace et al.
research-article 2018
1
La Trobe University, Melbourne, Victoria, Australia
2
Charles Darwin University, Darwin, The Northern Territory,
Australia
3
Marie Stopes Timor-Leste, Dili, Timor-Leste
4
National University Timor Lorosa’e, Dili, Timor-Leste
Corresponding Author:
Heather Julie Wallace, Judith Lumley Centre, La Trobe University,
Bundoora, Victoria 3086, Australia.
Email: Wallace.hj@students.latrobe.edu.au
Body Mapping to Explore Reproductive
Ethno-Physiological Beliefs and Knowledge
of Contraception in Timor-Leste
Heather Julie Wallace
1
, Susan McDonald
1
, Suzanne Belton
2
,
Agueda Isolina Miranda
3
, Eurico da Costa
3
, Livio da Conceicao Matos
4
,
Helen Henderson
3
, and Angela Taft
1
Abstract
Maternal mortality remains a significant public health challenge for Timor-Leste. Although access to quality family
planning measures may greatly reduce such deaths, consideration of indigenous perceptions, and how they influence
reproductive health decision-making and behavior, is crucial if health services are to provide initiatives that are accepted
and helpful in improving reproductive health outcomes. We aimed to demonstrate that body mapping is an effective
method to traverse language and culture to gain emic insights and indigenous worldviews. The authors’ two qualitative
research projects (2013 and 2015) used a decolonizing methodology in four districts of Timor-Leste, body mapping
with 67 men and 40 women to illuminate ethno-physiology and indigenous beliefs about conception, reproduction,
and contraception. Body mapping provided a beneficial conduit for identifying established indigenous reproductive
perceptions, understandings, and vocabulary, plus fears surrounding contraception. This may inform health service
provision and engagement, ultimately improving the reproductive health of community members.
Keywords
body mapping; ethno-physiology; ethno-anatomy; reproductive health; contraception; qualitative; decolonizing Timor-
Leste; South East Asia