Abstract
Background
The mothering role of female sex workers, as the sole provider, in low- and middle-income countries (LMIC) is quite challenging and most of them turn into sex work to meet the basic needs of the family. Efforts to address their unique needs across the spectrum of matriarchy and often stigmatized occupational identity within the context of LMIC requires research-based evidence. The community-centric health and social care needs of 2657 female sex worker mothers (FSWM) in eight LMICs (Angola, Brazil, DRC, India, Indonesia, Kenya, Nigeria, and South Africa) were explored.
Methods
The data came from a community-participatory mixed method study conducted among 2657 women in 165 group discussions. The two-stage feminist ethics of care framework was applied to FSWM narratives to guide thematic analysis. In the first stage we focused on how sex work serves as means of survival and the second stage guided the duty to sacrifice for their children.
Results
Four major themes were identified using an inductive coding qualitative approach: assistance with alternative sources of income; healthcare needs; education needs for children; and equitable social respect/legal rights. Application of the feminist ethics of care framework, at the intersection of sex work and motherhood, revealed the leading priority for mothers in sex work is alternative sources of income. The findings reveled that engagement in sex work is for the survival of children and stigma and discrimination impede access to healthcare for female sex workers mothers and their children.
Conclusion
From a theoretical standpoint, our findings align with the two components of the feminist ethics of care; fulfilling self-care first and then making self-sacrifice in providing a nurturing environment for children. The most expressed need was support for alternative sources of income, to transition out of sex work, realizing the work-related threats and dangers for them and their children. This study suggests that legal and HIV protection may not be their highest priority. Local organizations should include the FSWM community as equal partners in addressing unmet health, social and economic needs to ensure that welfare program implementations are responsive to and prioritize the self-reported needs of FSWM.