Sociocultural approaches to learning and development were first systematized and applied by L. S. Vygotsky and his collaborators in Russia in the nineteen-twenties and thirties. They are based on the concept that human activities take place in cultural contexts, are mediated by language and other symbol systems, and can be best understood when investigated in their historical development. At a time when psychologists were intent on developing simple explanations of human behavior, Vygotsky developed a rich, multifaceted theory through which he examined a range of subjects including the psychology of art; language and thought; and learning and development, including a focus on the education of students with special needs. However, his work was suppressed for 20 years and did not become accessible again until the late fifties and early sixties. Since then, sociocultural approaches have gained increasing recognition and have been further developed by scholars in over a dozen countries. Contemporary interpretations and reinterpretations of Vygotsky's and his collaborators' work reflect the visibility and obscurity of this theory's sixty-year existence. The expansions and interpretations in the last 25 years have led to diverse perspectives on sociocultural theory.
Social taboos
Issues around sex and sexuality are taboo in many cultures, and perceived stigma and embarrassment can lead to a reluctance to discuss and address sexual health issues. Taboos are even more pronounced for people who do not conform to socially accepted norms of behaviour such as adolescents who have sex before marriage and men who have sex with men (MSM). Unmarried adolescent girls are routinely denied or have limited access to SRH services even though they are vulnerable to violence and sexual abuse, and the consequences of early sexual experiences including unwanted pregnancy, STIs and unsafe abortions. In West Africa, some donors are apprehensive to fund research and support the service needs of MSM for fear that these activities might fuel anger in some communities and restrict progress made on less sensitive reproductive health programmes.
Gender roles
Gender norms in many societies tend to make men macho, women passive, and marginalise transgender people - making all of them vulnerable in different ways to SRH problems, and inhibiting access to services. For example, men may associate masculinity with taking risks in their sexual relations which expose them to HIV and STIs, and may be reluctant or too embarrassed to seek out appropriate health information and care (these are often focussed on women).
Women who are financially, materially or socially dependent on men may have limited power to exercise control in relationships, such as negotiating the use of condoms during sex. Social expectations about how women should behave can place women in subordinate roles and increase their risk of being sexually assaulted, contracting STIs and having unwanted pregnancies, and also limit their access to SRH services. In Zanzibar, unmarried women are denied contraceptives from health professionals, while in Botswana and Senegal married women are restricted from using contraceptives without the permission of their husbands. In many societies, women's health concerns are often considered less important than ...