Off-campus UMass Amherst users: To download campus access dissertations, please use the following link to log into our proxy server with your UMass Amherst user name and password.

Non-UMass Amherst users: Please talk to your librarian about requesting this dissertation through interlibrary loan.

Dissertations that have an embargo placed on them will not be available to anyone until the embargo expires.

Author ORCID Identifier



Open Access Dissertation

Document Type


Degree Name

Doctor of Education (EdD)

Degree Program


Year Degree Awarded


Month Degree Awarded


First Advisor

Cristine Smith

Second Advisor

Sharon F. Rallis

Third Advisor

Aline Gubrium

Subject Categories

Asian Studies | Community-Based Research | Education Policy | Family, Life Course, and Society | Gender and Sexuality | Health Policy | Health Services Research | International and Comparative Education | International Public Health | Other International and Area Studies | Public Health Education and Promotion | Quantitative, Qualitative, Comparative, and Historical Methodologies | Rural Sociology | Social and Cultural Anthropology | Social Policy | Women's Health


The purpose of this study is to develop a deeper understanding of the health issues facing adolescent females (ages 18-21) in rural, northeastern Afghanistan. Incorporating participant observations, in-depth interviews, and narrative inquiries, this study seeks to illustrate adolescent females’ perspectives on health issues. To achieve this goal, ten adolescent females were interviewed in rural, northeastern Afghanistan during 2010. The participants were between 18- and 21-years old. The one-on-one interviews were conducted in a multiple-response format and were structured around three research questions:

  • How does a young female’s understanding of health issues shape her identity in northeastern Afghanistan?
  • In what ways do the narrative stories of Afghan females link to issues such as education, health, and family dynamics?
  • In what ways are the narrative stories of Afghan females linked to their cultural beliefs about health?
The participants were asked to discuss their perceptions of life, health, body image, illness, and related topics. The participants struggled to articulate answers to these questions, but their personal narratives and body language vividly illustrated the issues they struggled to express. Their narrative responses are reduced in this study to produce a dynamic perspective on adolescent females’ perceptions of health issues in northeastern Afghanistan. During the course of this study, it became apparent that:
  1. Family influences shaped the participants’ social world. They relied upon their families for daily communication, information, and moral and emotional support.
  2. Despite this social dependence, the participants demonstrated a marked reluctance to discuss health issues with their mothers or with other older females in their households.
  3. The participants rarely connected health with its traditional meaning (i.e. physical or mental well-being). For them, health was related to a good life—free from stress and care—and education.
There is still much more to learn about adolescent health in rural Afghanistan; yet an understanding of these cultural constructs of family, health, and education is necessary to pursue further inquiries. This study’s findings provide the groundwork for future research and discussion—and, ultimately, a deeper understanding of adolescent females’ perceptions of health in rural Afghanistan.