Dissertations / Theses on the topic 'Pregnant women – South Africa – Limpopo'

Thesis (PhD)--University of Stellenbosch, 2011.
ENGLISH ABSTRACT: Pregnancy is a vulnerable time in settings such as sub-Saharan Africa, and is associated with exposure to a multitude of physiological, social and psychological risks. High HIV prevalence, and the fact that many women will test for HIV for the first time during their pregnancy, has raised concern about women‘s psychological health during pregnancy. Depression during the antenatal period is of public health concern as it has been shown to be associated with poorer foetal and delivery outcomes, risky behaviours, and poorer uptake of antenatal care. Antenatal depression is a predictor of postnatal depression, and postnatal depression has been associated with poor maternal sensitivity and attachment in mothers which is known to result in increased behavioural and developmental difficulties in children. The aim of this research was to provide a clear, in depth and culturally sensitive understanding of the manifestation of depression in pregnant women in a rural area with high HIV prevalence in South Africa. The research method included a diagnostic assessment of depression in 109 women in their third trimester of pregnancy, and an in-depth qualitative examination of the contextual framework within which HIV testing and depression are experienced with a sub-sample of 56 women. The quantitative results demonstrated that the prevalence of antenatal depression was high (46.7%), with close to half of the women being diagnosed with depression. Presentations of depression most frequently included disturbances in mood, loss of interest and suicide ideation. Symptoms which overlap with common side effects of pregnancy such as loss of energy and weight change did not result in an overestimation of depression. Likewise, very little evidence of the somatisation of depression, or particular cultural barriers to the diagnosis of depression based on DSM-IV criteria was found. Rates of suicide ideation were high and equally common among HIV positive as HIV negative women. Factors significantly associated with depression included living within a family homestead, access to a regular source of income and practical support from a partner. Both income and partner support had a negative association with depression. Living away from a family or parental home had a positive association with depression. The results showed that the Edinburgh Postnatal Depression Scale (EPDS) was effective in identifying depression and that a shorter three item version was as effective as longer versions. A positive score for depressed mood on the EPDS was significantly associated with HIV, suggesting that the EPDS is a good screening tool for elevated psychological risks among HIV positive women post HIV testing. Qualitative results showed that having an unsupportive partner and the occurrence of relationship or familial conflict played an important role in the development of emotional distress during pregnancy and resulted in a high number of unwanted pregnancies. Partner and familial conflict was intertwined with cultural practices which govern the acceptability of childbearing among unmarried women and the social recognition of partnerships and paternal responsibilities. Testing for HIV was considered a stressful life event for all women regardless of their HIV status and was a particularly negative life event for women who tested HIV positive or for women who had concerns over partner infidelity. Disclosure among HIV positive women frequently lead to increased partnership conflict. Qualitative findings suggested that depression and emotional distress after HIV testing did interfere with women‘s ability to engage with prevention messages. Women who were coping well with learning their HIV positive status had high levels of family disclosure and subsequent family support in common. The implication of this research is that it is important that public health programmes screen for depression among childbearing women. These data suggests that a shorter three item version of the EPDS along with screening for partner and family support or conflict would effectively detect most women at high risk for depression. Likewise, public health interventions for women with depression which are implemented in primary health care facilities and in isolation of the partnership and familial context within which depression occurs are not likely to be effective. Further research is needed to establish the precise prevalence of antenatal and postnatal depression in women at high risk for HIV; to validate the effectiveness of a shorter screening tool in resource limited settings; and to establish risk and protective factors, and trimester specific risks which could inform the design of cost effective interventions in poorly resourced settings.
AFRIKAANSE OPSOMMING: Swangerskap in Afrika, suid van die Sahara, is ʼn kwesbare tydperk met blootstelling aan ʼn menigte fisiologiese, sosiale en sielkundige risiko‘s. Die hoë voorkoms van HIV en die feit dat baie vrouens gedurende swangerskap vir die eerste keer vir HIV wil toets, het ‗n besorgdheid oor vrouens se sielkundige gesondheid gedurende swangerskap laat ontstaan. Depressie gedurende die voorgeboortelike periode is van belang vir publieke gesondheid, want daar is bewyse wat dui op ‗n verband tussen depressie en swakker fetale en geboorte resultate, riskante gedrag en verminderde gebruik van voorgeboortelike sorg . Voorgeboortelike depressie is ʼn indikasie van moontlike nageboortelike depressie en nageboortelike depressie word geassosieer met swak moederlike sensitiwiteit en die gebrekkige vorming van ‗n band tussen moeder en kind; wat reeds bewys is om te lei tot verhoogde gedrags- en ontwikkelingsprobleme in kinders. Die doel van hierdie navorsing was om ʼn duidelike, indiepte en kulturele-sensitiewe begrip van die manifestasie van depressie in swanger vroue in ʼn landelike omgewing met hoë HIV voorkoms in Suid Afrika te verkry. Die navorsingsmetode sluit in ʼn simptomatiese beraming van depressie by 109 vroue in hul derde trimester van swangerskap en ʼn indiepte kwalitatiewe ondersoek na die kontekstuele raamwerk waarbinne HIV toetse en depressie ondervind word met ʼn sub-steekproef van 56 vrouens. Die bevinding was dat die voorkoms van voorgeboortelike depressie hoog was, 46.7 %, met feitlik die helfte van die vrouens wat met depressie gediagnoseer is. In die meeste gevalle het die voorkoms van depressie gepaard gegaan met ʼn verandering in gemoedstoestand, ʼn verlies aan belangstelling en selfmoordgedagtes. Simptome wat ooreenstem met algemene newe-effekte van swangerskap, soos verlies aan energie en verandering in gewig, het nie bygedra tot ʼn oorberekening van depressie nie. Soortgelyk is baie min bewyse gevind dat somatosasie van depressie, of spesifieke kulturele grense, tot die diagnose van depressie gebaseer op DSM-IVkriteria bydra. Die oorweging van selfmoord was hoog en algemeen tussen beide HIV-positiewe en HIV-negatiewe vouens. Faktore wat aansienlik met depressie geassosieer word, sluit in om in ʼn familiegroep te bly, toegang tot ʼn vaste bron van inkomste en die praktiese ondersteuning van ʼn lewensmaat. Beide inkomste en die ondersteuning van ʼn lewensmaat het ʼn negatiewe verbintenis met depressive. Om nie by familie of in ʼn ouerhuis te bly nie het ʼn positiewe assosiasie met depressive. Alhoewel HIV-status verband hou met depressie, was dit nie uitermate die geval nie, alhoewel daar ʼn gebrek aan statistiese kragdoeltreffendheid was om die effek van HIV vas te stel, gegee die beperkte grootte van die steekproef. Die resultate het getoon dat die EPDS graderingsinstrument effektief was om depressie te identifiseer en dat ʼn korter driepunt weergawe daarvan net so effektief was soos die langer weergawe. ʼn Positiewe telling vir ʼn depressiewe gemoedstoestand op die EPDS het ʼn betekenisvolle assosiasie met HIV en dui daarop dat die EPDS ʼn goeie graderingsinstrument is vir verhoogde sielkundige risiko by HIV-positiewe vrouens, selfs al is HIV-positiewe vrouens in dié steekproef statistieksgewys nie meer geneig tot depressie as HIV-negatiewe vrouens nie. Kwalitatiewe resultate toon dat ʼn lewensmaat wat nie ondersteunend is nie en die voorkoms van verhoudings- of familiekonflik ʼn belangrike rol speel in die ontwikkeling van emosionele angs gedurende swangerskap en dit het gelei tot ʼn groot aantal ongewenste swangerskappe. Konflik met ʼn lewensmaat en met familie was verweefd met kulturele gebruike wat die aanvaarbaarheid van geboortes onder ongetroude vrouens beheer en die sosiale erkenning van verhoudings en die vader se verantwoordelikhede. ʼn HIV-toets is as ʼn stresvolle lewensgebeurtenis beskou deur alle vroue, ongeag van hulle HIV-status en was ʼn besondere negatiewe lewensgebeurtenis vir vroue wat HIV-positief getoets het of vir vroue wat bekommerd was oor hulle lewensmaats se getrouheid. Onthulling van die HIV-status van positiewe vrouens het gereeld tot verhoogde konflik in verhoudings gelei. Kwalitatiewe bevindings dui daarop dat depressie en emosionele angs na ʼn HIV-toets inmeng met ʼn vrou se vermoë om ag te slaan op voorkomingsboodskappe. Vroue wat die kennis van hulle HIV-positiewe status goed hanteer het, het hoë vlakke van bekendmaking van hulle status en die ondersteuning van hulle familie in gemeen. Die implikasie van die navorsing is dat dit belangrik is vir publieke gesondheidsorgprogramme om te toets vir depressie onder swanger vroue. Die resultate dui daarop dat ʼn korter driepunt weergawe van die EPDS, saam met ʼn ondersoek na die ondersteuning van of konflik met ʼn lewensmaat en familie, effektief kan wees om vroue met ʼn hoë risiko vir depressie te identifiseer. Soortgelyk, publieke gesondheidsingryping in primêre gesondheidsorg fasiliteite vir vroue met depressie wat in isolasie van die lewensmaat en familie konteks, waar depressie voorkom geadministreer word, is onwaarskynlik om te slaag. Bevindings onderskryf die belangrikheid van ondersteuning vir die familie om effektief te kan reageer en herstel van stresvolle faktore soos onbeplande swangerskappe en HIV-diagnose, in ʼn konteks wat swaar deur HIV geaffekteer word, aangesien dit ʼn voorkomende effek op depressie kan hê. Verdere navorsing is nodig om die presiese voorkoms van voorgeboortelike en nageboortelike depressie in vrouens met ʼn hoë blootstelling aan HIV vas te stel; om die sukses van ʼn korter graderingsinstrument in arm omgewings te staaf; en om die risiko en beskermende faktore vas te stel en trimester spesifieke risiko‘s wat die ontwerp van ʼn koste-effektiewe ingryping in gebiede met ontoereikende hulpbronne kan beïnvloed.

Vythilingum, B. et.al. 2012. Risk factors for substance use in pregnant women in South Africa. South African medical journal, 102(11):851-854
ENGLISH ABSTRACT: Objectives. To study the prevalence of alcohol and substance use in a South African antenatal population and its correlates with sociodemographic factors, depression and perceived stress. Methods. A prospective self-report study on all women presenting for their first antenatal visit who consented to the study at a midwife obstetric unit (MOU) in the East Metropole district, Cape Town, using the Alcohol Use Disorders Identification Test (AUDIT), Drug Use Disorders Identification Test (DUDIT), Edinburgh Depression Scale (EDS) and Perceived Stress Scale (PSS). Statistical analyses using the chi-square test, separate one-way analyses of variance (ANOVA) and logistic regression analyses were performed as appropriate. Outcome measures were depression, alcohol use and substance use. Results. The questionnaire was completed by 323 women. During pregnancy 36.8% of women smoked, 20.2% used alcohol and 4% used substances. Using EDS cut-off scores of 12 and 15, respectively, 48.9% and 33.6% of the sample had scores consistent with major depression. An EDS cut-off score of 12 was significantly associated with both alcohol use (25.9% v. 15.2%, p=0.019) and risky drinking (76.9% v. 36.8%, p=0.04), while an EDS cut-off score of 15 was significantly associated with substance use (8.2% v. 1.4%, p=0.004) as well as alcohol dependence (23.1% v. 3.1%). Conclusions. We found high rates of both alcohol abuse and antenatal depression, and a significant association between depression, substance use and alcohol abuse; EDS scores greater than 12 could be used to identify women at risk of alcohol dependence and/or substance abuse.
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Thesis (MPH)--University of Limpopo (Medunsa Campus), 2011.
Background: South Africa hosts the largest number of pregnant HIV-positive women, accounting for almost 15% of the global total. Many amongst these HIV-positive pregnancies are unplanned and may be related to reproductive unmet needs, sexual risky behaviours, and/or community, contextual and individual factors that may determine and/or make these HIV-infected women to fall pregnant. The occurrence of an HIV-positive pregnancy in our region implies however the practice of unprotected sex, and is associated with the risk of reinfection with a different strain of HIV as well as with the risk of HIV transmission to an uninfected male partner and to the offspring. Knowing the demographic profile of HIV-infected women who become pregnant and experience parenthood as well as the circumstances of occurrence of their pregnancies is necessary for developing policies and interventions aimed at addressing the reproductive needs of this subpopulation, thus preventing HIV-positive unintended pregnancies as well as the horizontal and vertical transmission of HIV. Objectives: This study had three objectives. The first objective was to describe the demographic profile of pregnant HIV-positive women attending antenatal care (ANC) in public sector clinics in Postmasburg, South Africa. The second study objective was to determine the proportion of these pregnant HIV-infected women who were aware of their HIV-positive status prior to the occurrence of their current pregnancy. Lastly, the third objective sought to describe the circumstances of occurrence of their current pregnancy. Methodology: We used a quantitative descriptive design to collect data on 41 consecutive pregnant HIV-positive women who attended ANC at three public sector clinics in Postmasburg, from September to December 2010. Participants were administered a structured pre-tested questionnaire in their home language by trained interviewers. The study instrument was designed to collect data related to participants‘ socio-demographic characteristics, the time-period of HIV- v positive diagnosis relative to their current pregnancy, and the circumstances of occurrence of their current pregnancy. Results: The analyses of the study results showed that pregnant HIV-positive women attending ANC in Postmasburg were likely to be young (mean age, 27.71 ± 5.72 years), never married (56.10%), Afrikans (65.9%) and Setswana speakers (58.52%) of low socioeconomic status, with no or one child (65.85%). The majority of participants (63.4%) were from a predominantly informal settlement; 78% were unemployed while 61% were either devoid of any income or were living with Rands 500 or less. Sex mixing was common in the 15-19 years-old, involving 80% of respondents of this age category. Most of respondents (78.05%) became aware of their HIV-positive diagnosis during their current pregnancy that was unplanned in 73.17%. The study findings also revealed low levels of pregnancy intendedness (31.71%), hormonal contraceptives use (24.9%) and condoms uptake (34.15%), with high rates of condoms failure among users (87.12%). Respondents also reported other circumstances of occurrence of their current pregnancy, including, irregular condoms use (14.29% of condom users), partner refusal to use condom (10%), stopping contraceptives use because of side effects (50% of users), partner‘s pressure (12% of participants), coerced sex (2.4%) and having had sex under the influence of alcohol (2.4%). Conclusion: These results highlight the need for improving the reproductive health services that are offered to HIV-positive individuals. Integrating PMTCT and Family planning services, training health workers in issues related to the reproductive rights and reproductive health of HIV-infected individuals, systematically offering HIV counseling and testing to women of childbearing age who come into contact with health facilities for any reason and adequately informing HIV-positive women of childbearing age about available reproductive options, planned conception and safer motherhood, are necessary for preventing unintended HIV-positive pregnancies as well as the horizontal and vertical transmission of HIV.

The rural women in EMLM hew the wood, carry water, satisfy the men, produce and take care of the children to continue the family tree, and manage all the household chores. Their contribution is central to the effective functioning of families and communities. Yet, in terms of decision-making and local governance structures, they are absent. Indeed, there is truly a large constituency of women out there who are largely unrepresented; and therefore, they have no idea how governance is conducted – even around them. This is unfair, especially in jurisdictions where women are clearly in the majority. It is inconceivable that local governance structures have over a decade recorded only a single elected female member. With this in mind, this study seeks to explore the extent of rural women’s participation in local governance in Elias Motsoaledi Local Municipality. It is a comparison of traditional and democratic local governance structures; and the methods the researcher has used are qualitative and quantitative data on women councillors from 2013, in order to assess the factors that may be accountable for their small numbers, as compared to their male counterparts. The conclusion drawn was that the social structure, its traditions and cultural was identified in the study as the main obstacle to the advancement of women in the political arena. This study has not exhausted all the facets of the challenges; but it has brought a few to the fore, in an attempt to help stimulate debate, and inform policy and practice in the future.

Background: Intimate Partner Violence (IPV) is recognized globally as a major public health concern linked to numerous adverse physical, mental, sexual and reproductive health outcomes. IPV is associated with both pregnancy and HIV-infection independently, but there are few data on IPV in populations of HIV-infected pregnant women. We examined the prevalence and predicators of IPV among pregnant women initiating lifelong antiretroviral therapy (ART) in a large primary care clinic in Cape Town, South Africa. Methods: Consecutive pregnant women seeking antenatal care in Gugulethu, Cape Town were recruited into the MCH-ART study examining service models for postpartum ART care. IPV, depression, alcohol and drug use, and emotional distress were assessed using the 13-item WHO Violence Against Women questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), alcohol and drug use disorders identification test (AUDIT/DUDIT) and the Kessler-10 (K-10) scale, respectively. Questionnaires were administered privately by trained interviewers. Women identified with specific IPV or mental health concerns were referred to appropriate services. Logistic regression was used to examine factors independently associated with experiences of IPV after adjusting for age and socioeconomic status. Results: From April 2013-May 2014, 623 women were enrolled (median age, 28 years):97% reported being in a relationship, 38% were married and/or cohabiting and 70% reported not having discussed or agreed on pregnancy intentions prior to conception . Overall, 21%(n=132) reported experiencing ≥ 1 act of IPV in the past 12 months, including emotional violence(15%), physical violence(15%) and sexual violence(2%). Of those reporting any IPV, 48% reported experiencing multiple types. Emotional and physical violence were most prevalent among women 18-24 years old, while sexual violence was most commonly reported among women 25-29 years old. Women who reported not discussing or disagreeing on pregnancy intentions with their partners prior to conception were significantly more likely to experience violence(p=0.030), and women who experienced IPV reported higher levels of substance abuse, depression and emotional distress(p<0.001 for all associations). Discussion: These data demonstrate high levels of IPV in this population. While the potential impact of HIV-infection, pregnancy and pregnancy intention on the risk of IPV and related factors require further research, IPV-related screening and support services should be considered as part of the package of care for ART in pregnancy.

Birthweight is powerful predictor of infant growth and survival. Premature birth and intrauterine growth retardation of birthweight. Maternal environment is important underlying determinant of birthweight. Common lifestyle risk factors include maternal under-nutrition, smoking, alcohol and social factors and stress. The Winelands/West Coast region has high rates of low birthweight. In addition, alcohol abuse and smoking are major problems in this area. The aim of this quantitative case-control study was to determine the epidemiology of low birthweight, related to lifestyle behaviours in pregnant women, with particular attention to lifestyle factors such as alcohol, smoking, and stress-related factors.

Thesis (MBA)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: Scientific research that focuses on South African females’ success in engineering is limited. The South African engineering workforce and universities have been encountering challenges in attracting and retaining as many females as possible in these fields. This research assignment seeks to advance the understanding of challenges and reasons that contribute to most female learners shying away from engineering studies at tertiary level. To achieve this, Grade 11 and Grade 12 Mathematics and Physical Science female learners from six different schools, which are in a single educational circuit, were observed and interviewed. Mathematics and Physical Science are the two subjects which are prerequisites for engineering studies at any South African higher education institution. For this reason the research focused on female learners who were studying both these subjects. This study also includes a literature review of factors affecting South African women engineers in the labour market. This includes the factors that females around the world consider before choosing a career and the reasons why females stay in their chosen careers. The findings highlight a number of variables that contribute to females’ underrepresentation in engineering. These variables include societal expectations, perceptions of females in careers that are historically male dominated, the quality of education that female learners receive at school, female learners’ performance in Mathematics and Physical Science, guardians’ support of careers chosen by female learners, learners’ knowledge of the various career streams, the use of home language in teaching subjects assessed in English, family responsibilities, and university admission requirements for engineering. Suggestions on how some of these challenges can be mitigated have been highlighted in this research assignment. The main points are:  The need for career guidance workshops and companies’ exhibitions to be taken to the students’ schools where attention can be given to the students of one school at a time and companies can facilitate discussions with learners about the types of work that their companies offer.  Encouraging and advocating for greater parental involvement in the students’ studies as this can reduce the number of students who do not study on a regular basis.  Offering of teaching employment to candidates who fully meet the requirements for the positions they are applying for especially for core subjects like English, Maths, and Science.  Adding engineering faculties to the two universities in the Limpopo Province and giving bursaries or financial aid to help school girls who want to study engineering at university  Teaching school girls time management skills from an early age so as to help them know how to balance the time they spend on each subject. Further details on how some of these suggestions can be achieved are discussed in the last chapter of this research report.

Thesis (M.A.(Media studies ))--University of Limpopo, 2007
There is gross uneven access and utilization of Information and Communication Technology (ICT) between developed and underdeveloped communities in South Africa. As a result the majority of the underdeveloped communities which are mainly found in rural areas fail to participate in the global ICT arena. Rural communities’ especially rural women are subjected to deprivation, poverty and isolation. Government sought to reverse the situation through the provision of Telecentres and Multi-purpose Community Centres (MPCCs). To understand the plight of the rural women, different theories ranging from capitalism to socialism were reviewed in an attempt to trace the mode of South African production which caused the problem and some understanding of the solution possible. The theory of oppression by Paul Freire (1970) serves as the main point of focus on how rural women fail to utilize Telecentres and MPCCs. Qualitative and quantitative approaches were adopted in order to present the perceptual views of these women. Various methods of collecting data were used in order to have a wider perspective of how Telecentres and MPCCs are utilized by rural women. This includes a profound investigation through which a pilot study, participant observation, focus group, interviews and questionnaires became instrumental to the whole research. The findings of the pilot study conducted in Mogalakwena Hewlett Packard inclusive of community (HPi-community) reflected that there are discrepancies and deficiencies which exit between Mogalakwena HPi-community and the three Telecentres Botlokwa, Mankweng and Mohodi. The tripartite marriage between Government Hewlett Packard and the municipality enable the Mogalakwena HPi-community to provide better ICT facilities. The other three Telecentres fail to meet the standard of the Mogalakwena HPi- community due to the fact that they lack financial support. Participant observation assisted in discovering that ICT access created a good relationship between Botlokwa Telecentre and its neighbouring institutions. It was also discovered that most youths come for computer-skill acquisition. Focus groups interviews were conducted using English and the local language (Sepedi) in order to meet the rural women’s level of understanding. Through in depth analysis, the study indicates that poverty, unemployment, limited funding, illiteracy, and unavailability of ICT facilities for the disabled are the main issues that contribute to the low impact of Telecentre and MPCC utilization. Apart from this analysis, ICT access has a significant impact on the lives of rural communities especially women. However, there is still a need for an accelerated growth in ICT utilization. It is recommended that effective mechanisms be put in place to assist improve the situation in ICT provision. This must involve the people themselves taking initiatives, of course with the active support of government.

Thesis (M.Dev.) --University of Limpopo, 2015
The purpose of this study is to investigate the effects of gender discrimination in water services provision on women empowerment in GaPila Village, located in Limpopo Province. Gender discrimination remains a major challenge both in the labour market and within households. The allocation of resources within households is still much gendered due to unequal gender relations in most rural areas. Men are allocated most resources within households and have many benefits than women. Such also manifest to children. Despite, women being major beneficiaries of the delivery of water services, they are discriminated against as they are not involved with the processes that precede the provision of such services. The study used both quantitative and qualitative research approach to establish the effects of gender discrimination in the provision of water services on women empowerment. The findings of the study illustrated that culture and tradition are the key to the inadequacy of women’s access to and control over management of water services. Cultural practices within communities either ignore female participation in water services management. Their participation is obstructed by lack of time, level of education, low self-esteem and flexibility due to substantial workload and numerous household responsibilities. The study also showed that according to local cultural beliefs, the status of women whether high or low, does not determine the amount of work that must be done by her at home, because irrespective of her status or career placement, her primary assignment is to care for the family/home. The study further revealed that women in the GaPila Village are allowed access to economic opportunities and participation roles during community meetings. Also, women are allowed to occupy positions such as chairperson, secretary and treasurer; however, due to culture and tradition, low self-esteem and lack of support from men, women do not take advantage of such opportunities to occupy these positions of authority in water services. Therefore, the study concluded that, as woman’s contributions regarding water services provision remains inconsequential because they are excluded from decision making processes that affect their level of living and prospects of empowerment. From a water services provision perspective, this study affirms the theoretical principle that discrimination against women disempowers them. Women are the beneficiaries of water services because most of their duties require water. As such, it is important for women to actively participate and to be involved in the management committee relating to water services and provision.

Studies of smoking during pregnancy in South Africa have found exceptionally high smoking rates among disadvantaged women of mixed ethnic descent (46%) (Steyn et al., 1997; Petersen et al., 2009a). As a consequence, these women are at high risk of smoking-related pregnancy complications and poor birth outcomes. It has long been recommended that a smoking cessation intervention be developed specifically for this high risk group. There is strong evidence that best practice smoking cessation interventions for pregnant women can be effective in increasing quit rates, as well as in reducing the incidence of premature birth and low birth weight (Lumley et al., 2009). However, these interventions have only been studied in developed countries and it was unknown whether such programmes could be successfully applied to a South African setting. From 2002, the Medical Research Council of SA undertook a programme of research for the purposes of developing and evaluating a smoking cessation intervention, specifically for disadvantaged pregnant women attending public-sector, antenatal clinics in Cape Town. This thesis reports on several aspects of this research.

Background: With 2.7 million women living with HIV, the burden of HIV remains high in South Africa but adherence to antiretroviral therapy remains a concern among pregnant and postpartum women. Disclosure, or the process of gradually revealing one’s HIV status to individuals in one’s social network, is regarded as an important factor in HIV care, with potential benefits that include improved psychological well-being and adherence to antiretroviral therapy. This thesis sought to provide insights into the patterns, predictors and impact of HIV-status disclosure among pregnant and postpartum women in the context of lifelong antiretroviral therapy in South Africa, including considerations of stigma, social support, depression and unintended pregnancy. Methods: This research included women living with HIV in Gugulethu, Cape Town. A total of 1554 pregnant women were enrolled; those who were initiating antiretroviral therapy were followed up to 18 months postpartum, with one further visit at 36-60 months postpartum. Data were collected using questionnaires and blood specimens for HIV viral load testing. Findings: Across analyses, women’s social and economic circumstances emerged as central to understandings of disclosure, mental health and viral load. At entry into antenatal care, 95% of women who were diagnosed HIV-positive before the pregnancy had disclosed to at least one person but disclosure events formed two separate dimensions: disclosure to (i) a male partner and (ii) family/community members. Among women diagnosed during the pregnancy and initiating antiretroviral therapy, 61% disclosed to a male partner and 71% to a family/community member by 12 months after diagnosis; relationship status modified the impact of each of pregnancy intentions and poverty on disclosure to a male partner. During pregnancy, 1 in 10 women reported elevated depressive symptoms and 60% of women who were subsequently followed during the postpartum period reported that their pregnancy was unintended. Stigma modified the association between social support and depression: when levels of stigma were high, higher levels of social support were not associated with decreased depressive symptoms. Pregnancy intention modified the impact of disclosure to a male partner on depression during pregnancy: disclosure was associated with higher depression scores among women who reported that their current pregnancy was unintended but was associated with lower depression scores among women who reported that the pregnancy was intended. Further, unintended pregnancy was a persistent predictor of elevated viral load up to 60 months postpartum. Finally, the effect of disclosure on elevated viral load at entry into antenatal care, delivery and 12 months postpartum was complex and modified by three factors: (i) timing of HIV diagnosis (before versus during the pregnancy); (ii) relationship to the person(s) to whom women disclose; and (iii) in the case of disclosure to a male partner, relationship status. Conclusions: These findings suggest that despite the widely-held view that disclosure has beneficial impacts on psychological well-being and adherence, the individual is central to our understanding of disclosure. In particular, both the prevalence of disclosure and its impact on depression and viral load are modified by women’s circumstances. Unintended pregnancy emerged as a critical factor that heightens women’s vulnerability. In this setting, HIV-status disclosure does not appear to be universally beneficial and counselling about disclosure may be most effective if tailored to individual women’s circumstances.

Thesis (M.Dev.) --University of Limpopo, 2011
The introduction and establishment of co-operatives by the State was for purposes of fighting and alleviating poverty through creating jobs, particularly in the rural areas,which were mostly neglected by the previous apartheid State. In order to deal with these social ills and malady, the new democratic government introduced cooperatives to mitigate these challenges. These good intensions are often countered by lack of commitment by State officials and reluctance from other institutions to assist co-operatives to be catalysts in fighting poverty and unemployment in South Africa, despite their noble intentions. In other developed countries, co-operatives are given serious attention, not only because they are catalysts in poverty alleviation, but because they can make huge economic interventions with regard to economic growth and economic development. The intention of this study was to make an assessment of whether or not agricultural co-operatives have any economic impact on women in the rural areas of Polokwane Municipality, since their inception as entities for local economic development. The study also assesses whether or not the State supports these entities in a variety of forms. For this purpose, four co-operatives have been used as a Case Study,namely, Mashashane Agricultural Co-operative at Ga-Mashashane; Phegelelo Agricultural Co-operative at Ga-Thaba village; Mothiba Agricultural Co-operative at Ga-Mothiba; and Itireleng Agricultural Co-operative at Matamanyane village in Moletjie

Background: The prevalence of cases of HIV among children below the ages of 15 years continues to increase and majority of these children acquired the infection through mother-to-child transmission. Methodology: The main objectives of the study were to explore the perceptions of local women regarding the PMTCT program, to evaluate the strength of these perceptions and to make recommendations. A qualitative method was used involving a number of focus group discussions among antenatal clinic attendees in the 27 primary health care clinics in Qwa-Qwa, Free State province of South Africa. Findings: The findings were organised under eight major themes: (1) Knowledge of the program -where the participants expressed high knowledge about the PMTCT program as they knew how MTCT of HIV occurs and how it can be prevented, (2) Perceived concerns about the program- which were mainly fear of resistance to ARVs, fear of stopping the treatment after delivery, potential for high numbers of orphans, depression and suicide when HIV result is positive, the fear of the family neglecting the baby if the mothers dies, the perception that the program cares for only the babies and not their mother, (3)Readiness to do HIV test- where majority of the participants said it was difficult doing the HIV test due to fear of positive result, (4) Ease of taking ARVs- Difficulty in taking the ARVs due to fear of resistance and harmful side effects, (5) Relationship with clinic staff- a majority of the participants were happy with their relationship with the clinic staff, (6) Reactions expected from family members when program advice is followed- more than half of the participants expected negative reactions from family members if the program advice is followed because of the negative attitudes of their male partners and the elders’ of the resistance to change from their cultural beliefs, (7) Advantages of the program- according to the focus group participants, the advantages of the program include the knowledge gained about HIV, modes of MTCT of HIV and how to prevent MTCT of HIV. Other advantages mentioned were prevention of MTCT of HIV, pre-test counselling reducing the fear of doing HIV test, knowing one’s HIV status as well as the potential of the program to have positive change on the cultural beliefs of the people, and lastly (8)How they felt being part of the program- where all the participants said they were excited . Conclusions: The findings were similar to those of other studies in many respects. Recommendations: The recommendations were community and family HIV/AIDS education and their involvement in the PMTCT program in other to reduce misconceptions about the disease, and stigmatization against the women in the program. Other recommendations include: the concept of PMTCT-plus which provides ongoing support and treatment for the mothers, babies and infected family members; integration of innovative health education and culturally appropriate interventions into the program; provision of adequate maternity leaves to women in the PMTCT program as well as full integration of the PMTCT program into the District Health System (DHS) as part of the “horizontal” delivered package.

Introduction: Early Childhood Caries (ECC) is a serious public health concern globally especially in developing countries like South Africa. The main source from which infants acquire the causative bacteria - Mutans Streptococci (MS) is their mothers. The mothers with high levels of MS have a greater chance of transmitting the bacteria, particularly if they are involved in practices such as tasting the infant’s food and/or sharing eating utensils. Current research indicates that dental public health programmes fail to prevent ECC because of late intervention. Objective: This study sought to determine the existing knowledge, attitudes and perceptions (KAP) of pregnant women about ECC in a population in Tshwane district, Gauteng province, South Africa and to compare these KAP across socio-economic groups (SES). Methodology: A cross-sectional analytical study involving consenting pregnant women recruited from selected private and public antenatal healthcare facilities in the Tshwane District area was conducted. This study involved the use of a validated self-administered structured questionnaire and an oral epidemiological clinical examination (modified by WHO Oral Health Assessment 1997 Guidelines). One calibrated examiner using a dental explorer and a mouth mirror under natural light carried out the oral examination. Data analysis included descriptive statistics, principal component analysis to obtain a composite score for participant’s attitude towards ECC; and chi-square and independent student’s T-test to compare different groups. Significance level was set at p<0.05. Results: Response rate was 88.9% (n=353). Respondents’ age ranged from 18-44years (Mean age=31years). Only 18.7% of the respondents had complete knowledge of the cause of dental caries i.e. both sugar (diet) and biologic agent (bacterial plaque) whilst over half of the respondents (55.5%) mentioned only one factor. The participants’ knowledge of the cause of ECC was significantly associated with SES. A few mothers-to-be (13.9%) believed in the caries transmission from mother to child. Reported mean age for the child’s first dental visit was 2 years and 8 months. Only a quarter of respondents received oral health education for their unborn child during the antenatal visits. The majority of the pregnant women (93.8%) expressed the desire to receive information during the antenatal visit. The participants’ attitudes towards ECC was significantly associated with SES. The caries prevalence of the pregnant women was high at 64.3%, with mean DMFT of 2.97(SD 3.20). High participant DMFT was significantly associated with reports of ‘rotten teeth’ in their other children. Only 19.3% mothers-to-be had visited a dental care provider in the last 6-months. Conclusion: The knowledge of the pregnant women studied on ECC is incomplete and limited, while their attitudes and perceptions towards ECC was satisfactory. Therefore there is a need for the integration of oral health education with maternal and child health activities in both antenatal and post-natal clinics. There is a need for the oral health professionals to collaborate with other health works to reduce the prevalence of ECC.
Dissertation (MSc Dent)--University of Pretoria, 2019.
Community Dentistry
MSc Dent
Unrestricted

There is a perception that some of the pregnant women referred from district to regional hospitals should have been managed at the former hospitals. To establish the truth of this perception, a quantitative, exploratory, descriptive and contextual study was undertaken to determine to what extent pregnant women admitted to a regional hospital are appropriately referred from district hospitals according to criteria described in the Guidelines for Maternity Care in South Africa and in the Primary Health Care Package for South Africa. Maternity case records of two hundred and eighty pregnant women admitted to a regional hospital in the Eastern Cape Province following referral from district hospitals between 1 July 2005 and 31 December 2005 were reviewed and analysed. The majority of these women were referred for medical complications, previous caesarean section, failure to progress in labour, obstructed labour, preterm baby and eclampsia. The commonest reasons cited for the transfer of these patients were shortage of maternity care providers in maternity units and lack of expertise at district hospital level. A lack of drugs and equipment were less commonly cited as the reason. Criteria for referral from district to regional hospitals were fulfilled in only 78 (34.2%) of the referrals. This low level of fulfillment of the criteria is attributed to the apparent lack of feedback processes between district and regional hospitals. This in turn limits the opportunity to develop competencies and skills of staff at these maternity units. To address this issue a referral strategy for implementation in the Eastern Cape Province was developed and presented in this study.

Background: Antenatal care is essential care that assists in maintaining a state of good health for the woman and her unborn baby. Globally the use of antenatal care services remains a challenge and this tendency is closely associated with maternal and neonatal mortalities and morbidities. South Africa has adopted a free service policy for pregnant women, their infants and for children up to the age of six. Despite this policy, the problem of limited utilisation of antenatal care services by pregnant women is still observed in this country and is associated with increased maternal and neonatal mortalities and morbidities.The purpose of the current proposed study was to explore and describe the reasons for limited utilisation of antenatal care services in the Mnquma sub-district, and to develop guidelines to assist the midwives to encourage the use of antenatal care services. Objectives:To explore and describe the reasons for the limited utilisation of antenatal care services by pregnant women at Mnquma sub-district.To explore and describe the knowledge of antenatal care services by the pregnant women.To develop guidelines to facilitate empowerment of midwives to enhance utilisation of antenatal care services by pregnant women in the Mnquma sub-district in Eastern Cape Province. The study was conducted in Mnquma sub-district during the months of July to January in 2016 using a qualitative, exploratory, descriptive and contextual research design. The research population were post-delivery women and the purposive sampling was used to identify women who met the stated criteria. One-on-one audio-taped semi-structured interviews were conducted and field notes were kept to justify some of the themes identified. Thirteen interviews were conducted and transcribed verbatim. Collected data was analysed using Tesch’s data analysis method. Trustworthiness was maintained through the standards of truth value, credibility, transferability, dependability and conformability. The ethical considerations of beneficence, justice, autonomy, non-maleficence and veracity were maintained. From the findings it emerged that the participants raised various concerns with regard to barriers influencing limited utilization of antenatal care services. The participants had limited knowledge of antenatal care services. Furthermore, participants recommended some solutions to enhance utilization of antenatal care services. Recommendations were made with regard to clinical practice, nursing education and nursing research. Guidelines were formulated to assist midwives to enhance the utilization of antenatal care services by pregnant women in the Mnquma sub-district in the Eastern Cape.

Many of the known risk factors associated with low birth weight, such as socio-economic status, ethnicity, genetic makeup, and obstetric history, are not within a women's immediate control. However, there are many things that a woman can do to improve her chances of having a normal healthy child. Lifestyle behaviours, such as cigarette smoking, nutrition and the use of alcohol, play an important role in determining the growth of the fetus. The aim of this study was to establish the knowledge, attitudes and practices related to lifestyle factors such as alcohol use, smoking and nutrition among childbearing women and health care workers on the farms in Stellenbosch and Vredendal.

Thesis (MPA (Public Management and Planning))--University of Stellenbosch, 2010.
ENGLISH ABSTRACT: Since the democratic dispensation in South Africa, attempts were made in earlier studies to make recommendations for the implementation of gender equity in the labour markets. Until now companies and public service departments have done little to ensure gender equity. Most efforts made were merely window-dressing given that previous studies provide evidence of fewer female employments in Senior Management Service (SMS) positions across the public service. South Africa has introduced a legal framework to support the Employment Equity Act, 1998 (RSA, Act 55 of 1998). The study sets out to evaluate the extent of gender equity implementation in Limpopo Provincial Department of Sport, Arts and Culture. The EEA, 1998 (RSA, Act 55 of 1998) aims to redress employment inequalities previously experienced by racially, culturally and sexually marginalized South Africans. Departmental human resource processes are evaluated to establish equity measures necessary to achieve the purpose of the EEA, 1998 (RSA, Act 55 of 1998). This study reviews employment equity practices from various countries to establish best practice. Issues and proposed strategies for improvements surrounding employment equity legislation in South Africa are also highlighted. The study is extended to other departments to establish accountability standards as well as actions and penalties available for noncompliance. The findings from the study indicate that women are mostly employed in middle management while male employees continue to dominate the top management in spite of the Department of Public Service and Administration’s (DPSA) strategic goal to reach a 50% equal employment at SMS by 31 March 2009. Suggestions are provided to accelerate implementation of gender equity in Limpopo Provincial Department of Sport, Arts and Culture. Given that the study was based on a representative sample of a single public service department, the findings may as a result not be generalized to the entire South African public service.
AFRIKAANSE OPSOMMING: Sedert die demokratiese bedeling in Suid-Afrika was pogings in vroeë studies aangewend om aanbevelings te maak vir die implementering van geslagsgelykheid in die arbeidsmark. Tot dus- ver het maatskappye en staatsdiens departemente min gedoen om geslagsgelykheid te bevorder. Talle pogings wat aangewend was, is niks meer nie as uiterlike vertoon, gegee die feit dat vorige studies bewysstukke lewer van minder vroulike indiensneming in Senior Bestuursdiens (SBD) posisies deur die staatsdiens. Suid -Afrika het `n wetgewende raamwerk ingestel om die Gelyke Indiensnemingswet, 1998 (RSA, Wet 55 van1998) te ondersteun. Die studie het ten doel om die implementering van geslagsgelykheid in die Limpopo Provinsiale Departement van Sport, Kuns en Kultuur te evalueer. Die GIW, 1998 (RSA, Wet 55 van 1998) beoog om die indiensnemings ongelykhede te herstel, wat voorheen ondervind was deur rasse, kulturele en geslagtelik gemarginaliseerde Suid-Afrikaners. Departementele menslike hulpbron prosesse word beoordeel ten einde die billikheidsmaatreëls te bepaal wat nodig is om die doelwitte van die GIW, 1998 (RSA, Wet 55 van 1998) te bereik. Hierdie studie raadpleeg gelyke indiensnemings praktyke van verskillende lande ten einde die beste praktyk te stig. Aangeleenthede en voorgestelde strategieë vir die bevordering van wetgewing oor gelyke indiensneming in Suid-Afrika word ook beklemtoon. Die studie word uitgebrei na ander departemente om standaarde oor aanspreeklikheid te bepaal, asook optrede en strafmaatreëls vir nie-voldoening daaraan. Die bevinding van die studie dui daarop dat vrouens meestal op middel bestuursvlak in diens geneem word, terwyl manlike werknemers aanhou om die top bestuursvlak te domineer, ten spyte van die Departement van Staatsdiens en Administrasie (DSDA) se strategiese doelwit om 50% gelyke indiensneming op SBD- vlak teen 31 Maart 2009 te bereik. Aanbevelings word gemaak om die implementering van geslagsgelykheid te versnel in die Limpopo Provinsiale Departement van Sport, Kuns en Kultuur. Gegee die feit dat die studie gebaseer was op `n verteenwoordigende monster van `n enkele staatsdiens departement, mag die bevindinge gevolglik nie veralgemeen word met die totale Suid-Afrikaanse staatsdiens nie.

Thesis (M. Cur.) --University of Limpopo, 2015
The purpose of this study was to determine the factors that were contributing to selfreferrals of antenatal women at the Dilokong Hospital in the Tubatse Local Municipality. By employing a quantitative, non-experimental research method, 360 women completed and submitted a structured questionnaire. Validity and reliability were insured by pre-testing the data collection instrument on respondents who were not part of the main study. Data was analysed by using the SPSS and Excel computer programs with the assistance of a statistician. The age group between 21 and 30 years 197 (54.7%) was larger than the other age groups. Primigravida women represented less than half 147 (40.3%) of the respondents. These women were also supposed to be referred to the hospital for delivery; however, only 23.3% of the women were referred to the hospital for delivery. The choice of the delivery site was influenced by a lack of women’s knowledge about the referral system and of services offered at the clinics, as well as the unavailability of doctors, midwives, food, equipment, enough space for delivery at the clinics, and the perceptions that nurses and midwives were rude. The government should ensure that the clinics are provided with adequate human resources and other resources that are needed for providing these health services. Pregnant women should be given referral letters and information with regard to where they are supposed to deliver. Key concepts: Antenatal women, self-referral, referral system, and Primary Health Care (PHC).

Disclosure of a Human Immunodeficiency Virus (HIV) positive status is vital for prevention and promotion of the couple‟s health. The study aimed to investigate the perceived barriers of pregnant women diagnosed as HIV positive towards disclosure of their HIV status to their partners in the Capricorn District, Limpopo Province. Recommendations were formulated to enhance the self-efficacy. A quantitative, explorative, descriptive cross-sectional design and the Health Belief Model theory was used. Non-probability, convenience sampling utilised and 170 respondents aged 18-40 years participated in the study. A questionnaire was used to collect data and the SSPS version 24.0 was utilised to analyse data. Overall, 87.64% respondents received disclosure education and 80% disclosed their status to their partners. Reasons for non-disclosure included fear of rejection, violent behaviour, blame and stigmatisation by partners. Health care workers should provide pregnant women with information on preventive strategies to enhance disclosure of HIV status.
Health Studies
M.A. (Nursing Science)

Thesis (M. A. (Clinical Psychology)) University of Limpopo, 2017
The study investigated the prevalence of Obsessive-Compulsive Disorder (OCD) symptoms and their relationship with pregnancy-related anxiety, prenatal depression and clinical anger among African pregnant women. The sample consisted of 206 pregnant women attending their antenatal check-ups at the Mankweng, Nobody and Rethabile clinics, and Mankweng hospital in the Capricorn District, Limpopo Province. When correlational analysis was conducted, the patient characteristics of age, having undergone a medical check-up, and having previously delivered a live baby generally did not correlate with any of the main scales measuring OCD, namely, perinatal depression, pregnancy-related anxiety and clinical anger (p > 0.05). Findings from the study indicated that almost 81% of the pregnant women could be classified as obsessive-compulsive disordered, when using the Foa et al. (2002) cut-off score of 21. Furthermore, findings from the regression analyses indicated that higher age, the number of gestation weeks, having previously experienced pregnancy-related complications, perinatal depression, pregnancy-related anxiety and clinical anger were variably positive predictors of OCI-R measured OCD symptoms. The predictors are specific to each of the symptoms. It can be concluded from the study that there is a relationship between OCD symptoms and all the independent variables used.
National Research Foundation

MCur
Department of Advanced Nursing Science
● BACKGROUND Maternal Mortality rate is defined as the death of a woman while pregnant within 42 days of termination of pregnancy irrespective of the duration/site of the pregnancy. South Africa like any other country, has high maternal mortality rate. Most deaths are caused by factors attributed to pregnancy and childbirth in health facilities. It is the practice in all public hospitals and clinics that women are discharged ±6 hours after delivery hence most problems are not detected thus the complications they may be having such as thromboembolism or sepsis that may arise during the post-partum period. ● AIM OF THE STUDY The purpose of the study was to determine perceived factors contributing to maternal mortality among women in rural areas of Musina Municipality within Limpopo Province. ● METHODS A quantitative, descriptive, exploratory, cross- sectional research was used to conduct the study. The target population consisted of all pregnant and lactating women who attended the sampled clinics (ANC) in Musina Municipality. Self- Administered questionnaire was used to collect data from the women who met the criteria for inclusion. A total of 342 women were recruited to participate in this research from all five (5) health iv facilities. Collected data was analysed using SPSS Version 23.0 computer software with the assistance of a Statistician. ● FINDINGS Findings of this study revealed that majority of the respondents 215 (53.0%) reported late booking for Ante-Natal Care (ANC), among the late booking 120 (25.0%) commenced ANC attendance at second trimester, while 95 (12%) commenced ANC at last trimester and only attended once only. Minority of the respondents 127 (24.2%) reported that they never attended ANC because of various reasons cited such as not accessing clinic because of distance and not having transport. Majority 232 (83.5%) of the respondents revealed that professional nurses ‘attitudes and unwelcoming postures make them to report during labour than attending ANC. Of the respondents, 49 (17.6%) reported lack of knowledge on engorged breast and mastitis. Various socioeconomic and knowledge factors influenced women, (28.5%) women indicated long distance to health facility, while (12.5%) arrived in labour ward with head on perineum because labour started suddenly, lack of money and transport by (48.4%). ● RECOMMENDATION Recommendation was made on the importance of in-service training of professional midwives on interpersonal relation, proper assessment of women to detect any complications. Recommended workshops for training and different courses in order to broaden their knowledge relating to pregnancy and childbirth and management of pre and post-partum. Also awareness sessions for women about dangers signs during puerperium were recommended. ● CONCLUSION This study has identified several factors that have an important influence on maternal mortality in the study area. Among these are variables such as place of consultation/diagnosis, the person who pays the treatment costs, awareness of pregnancy complications and knowledge of the place of ANC treatment, among others.
NRF

The purpose of this research study is to determine the factors influencing reproductive health choices of women living with HIV attending primary health care services. The need for this research study is evident in that most women attending health care services at primary health care clinics, and who are HIV positive report unintended pregnancy. The study sought to provide answers to factors influencing their reproductive choices. A quantitative, descriptive and cross-sectional research study was used in this study. The sample consisted of 83 females between the ages of 18 and 40. The findings of the research study provided the researcher with adequate evidence on the factors influencing reproductive health choices of women living with HIV attending primary health care services. The approach to reproductive health services was still acceptable but needs to be improved. Moreover, the identified factors therefore influenced one’s perceptions on reproductive health decisions among HIV-infected women.
Health Studies
M.A. (Public Health)

Late booking is associated with high perinatal and maternal morbidity and mortality. The World Health Organization (WHO, 2016) recommends that pregnant women should book for ANC full first before 12 weeks of gestation. The aim of the study was to explore and describe factors contributing to late antenatal care booking at public health facilities of Mopani District. A qualitative approach was used. In-depth interviews were conducted with twenty one pregnant women who booked after twelve weeks of gestation and agreed to participate in the study. The study was conducted at four selected public health care facilities rendering maternal health services in Mopani district. Data was collected through in-depth interview with the aid of an interview guide. The analysis of data was done manually using a coding system to develop themes. The results revealed that there are personal and provider factors contributing to late antenatal care booking in Mopani district. Personal factors contributing to late antenatal care booking were unplanned and unaccepted pregnancy, lack of support, late recognition of pregnancy, cultural and religious beliefs, ignorance of the importance of antenatal care and fear. System or provider factors contributing to late booking were long waiting time, midwives’ attitude and lack of resources.
Health Studies
M.A. (Public Health)

Thesis (MPH.) -- University of Limpopo, 2014
Background The use of contraceptives among sexually-active teenagers in South Africa is known to be very poor and is currently estimated to be at a rate of 25% (DoH 2002). Teenagers who have unprotected sex are at a high risk of reproductive Health problems, such as Sexually Transmitted Infections (STIs) and HIV/AIDS, and unsafe abortion, amongst others (DoH 2002). Contraceptive use progressively declined between 2002 and 2004 among girls under 18 years in the Kwa-Zulu Natal Province as a whole (Health Statistical Bulletin, 2004). Aim The aim was to determine knowledge, attitudes and perceptions of pregnant teenagers with regard to usage of contraceptives at the Pietersburg Hospital, Limpopo Province, South Africa. Method of data collection and analysis A cross-sectional descriptive survey was used in this study. A self-administered questionnaire was used to collect data from pregnant clients aged 13-19 years of age. Data analysis was carried out by using the computer software called Statistical Program for Social Sciences (SPSS). The findings revealed that lack of knowledge, attitudes and perceptions of pregnant teenagers was a problem. Findings The findings of this study indicated that culture and attitude of nursing personnel were not the barriers. Barriers were “not having enough time to choose the method and just not being serious about contraception”. Thirty-six ix per cent (36%) of the participants said they had enough time to choose the method, but they did not choose. Sixty per cent (60%) said they were not serious about contraception, 40% said they were serious but did not use contraception. Married participants who did not hear about emergency contraception, the percentage was small, 6%, while the percentage of single women was higher (94%). Conclusion The study revealed that the participants had knowledge of contraceptives, both single and married; however, married women seemed to have negative attitudes towards contraceptives, based on the culture and the believe that, once married, the usage of contraception was not necessary. Based on the findings of the study, it is recommended that there should be effective ways of information giving to the public regarding family planning.

Teenage pregnancy is a global problem and its prevalence in South Africa poses a serious concern to the government, health workers, parents, teachers, communities, and social workers in particular. As such, social work services are crucial in assisting pregnant teenagers to be self-reliant. Social workers employ three primary methods of social work practice when providing services to pregnant teenagers, namely casework, group work, and community work. This study sought to explore social work services for pregnant teenagers. A qualitative research method using an exploratory, descriptive, and contextual research design was employed to gather data from 12 social workers working in both rural and urban settings in the Capricorn District, Limpopo Province. A non-probability, purposive sampling method was used to select a sample. Data was collected by means of semi-structured interviews, consisting of a list of open-ended questions included in an interview guide. Data was also analysed following Tesch eight steps while Lincoln and Guba’s model was used for data verification. There are several stumbling blocks to effective service delivery, such as complex social problems experienced by pregnant teenagers, lack of formal and informal support, high caseloads, lack of resources, and little cooperation from other disciplines and agencies. Based on these findings, recommendations are made for education, practice, policy, and further research in an attempt to provide solutions to these challenges.
Social Work
M.A. (Social Science)

DEd (Educational Management)
Department of Educational Management
This study sought to establish the impact of interventions employed by schools to support the teaching and learning of pregnant and parenting learners (PPLs) in the Mopani district of Limpopo province, South Africa. The study employed qualitative research methodology to gather narrative data from 68 key school-based education stakeholders who were purposively sampled and interviewed on what their schools were doing to support the teaching and learning of PPLs they enrolled. Data were collected through face-to-face and focus group interviews, as well as document analysis. The study revealed that although all the four schools provided basic access to education for PPLs, their inclusive support systems and strategies to assist PPLs to cope with and benefit from the school curriculum activities were largely superficial due to the following challenges: educators, as the primary duty bearers to PPLs were not trained to identify the educational needs of PPLs and to implement relevant strategies for teaching and learning of PPLs; there was inadequate political-will to support PPLs by educators; there was inadequate collegial relationship between mainstream learners and PPLs, there was no synergy between national and school policies on management of schoolgirl pregnancy and there was non-involvement of other professionals to provide psycho-social support at the four schools. The study revealed that cultural and traditional practices of the community contributed to the negative attitudes to teenage motherhood that resulted in inadequate support service provision and structures for teaching and learning of PPLs. The study recommends that the Department of Education (DoE) must put in place formal training on policy and practice for all the key school-based education stakeholders and employ a multi-sectoral counselling system to support enrolled pregnant and parenting schoolgirls to cope with schooling.
NRF

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Medicine in Obstetrics and Gynaecology. MMed (O&G) Johannesburg, July 2016
Background Tobacco secondhand smoke (SHS) has long being known for all its negative health effects. This work aimed to determine the SHS exposure rate in the pregnant population of Soweto and to determine their demographic characteristics. We also aimed to explore Soweto pregnant women’s knowledge, attitude and practice towards SHS exposure. Methods This was a prospective, cross sectional study undertaken at Chris Hani Baragwanath Academic Hospital, a tertiary hospital situated in Soweto. Soweto serves in excess of two million people, with more than 23 000 delivers annually in the hospital. This study used a questionnaire to survey a sample of pregnant women who were post caesarean section. Results A total of 100 women were interviewed. Twenty one percent reported to be exposed to SHS at home and 18% of the employed participants reported to be exposed at work. Forty three percent of the participants lived with a regular smoker and 73% had banned smoking in their house. However, even though the bans had been put in place, smoking still occurred in some of their homes. The demographic characteristics of the SHS-exposed participants compared to the non-exposed participants were similar. There was a statistically significant difference in the number of regular smokers that the participant lived with, with SHS-exposed participants being more likely to live with a regular smoker than with no regular smokers in the house. Ninety two percent of the participants reported they did not think it was appropriate that women smoke, even though some of them had previously been smokers themselves. Ninety one percent of participants were aware that SHS could have a negative effect on their babies while pregnant, and knew about health risks with SHS. Conclusion This study showed that in spite of strict anti-tobacco laws, a high percentage of pregnant women reported to be exposed to SHS at home and at work. Most were aware of the health risks of SHS, and tried to ban smoking in their homes.
MT2017

Text in English
Learner pregnancy in secondary schools of South Africa is a public health problem that requires the involvement of parents, teachers and health workers in order to promote maternal and child health and retain learners in school. The aim of this study was to explore and describe the experiences of teachers, parents and pregnant learners regarding facilitation of health for pregnant learners and then develop a model to facilitate social support for pregnant learners attending secondary schools in order to attain and maintain health for the mother and her newborn baby and prevent school dropout. A qualitative, exploratory, descriptive and contextual theory generating study was conducted using semi-structured interviews to collect data from ten pregnant learners, ten teachers and five parents who were purposely selected and voluntarily participated. Data was analysed using Tesch’s open coding method where six themes emerged. The themes were then discussed with literature control. The findings revealed that pregnancy amongst secondary school learners in Limpopo Province is a challenge to teachers, parents and pregnant learners regarding social support for pregnant learners to continue attending school and remaining healthy. A concept analysis was performed and revealed facilitation of social support as the main concept, and then other concepts related to it were identified and classified. The model was developed through the steps of theory generation and was then submitted to a panel of experts for evaluation who found it useful to nursing practice and society in general. The model promotes interaction between the role players in education to address learner pregnancy and can also be useful in addressing other challenges in the schools. It is facilitated by a school health nurse but can also be facilitated by a teacher or a social worker in cases where a school health nurse is not available. The guidelines for the implementation of the model were formulated and described. Pregnant learners, as recipient of social support, should submit themselves to the support offered by the social network and communicate their needs openly to the professional nurse, their parents and teachers, so that they can receive adequate social support.
Health Studies
D. Litt. et Phil. (Health Studies)
1 online resource (xv, 206 pages) : illustrations (some color), maps (some color)

PhD (African Studies)
Department of African Studies
This study sought to investigate self-efficacy in vocational development of women in low socio-economic communities. The main aim of the study was to investigate the sociocontextual factors influencing self-efficacy of women. The objectives were fourfold: to examine the levels of self-efficacy of these women; to ascertain the extent to which selfefficacy influences vocational development of women and to propose a pragmatic women developmental model for acceleration of access to vocational development. The study utilised Self-Efficacy Theory (SET) as its theoretical frame-work which originated from Bandura’s (1986) Social Cognitive Theory (SCT). The study employed the qualitative phenomenological approach which is concerned about the everyday experiences of individuals and how human beings experienced a certain phenomenon. The population of the study comprised of women in low socio-economic communities, traditional leaders; Community leaders; health workers and religious leaders. The sample for this study was 60 participants. Data were collected through interviews; participant observation; and focus group discussions. The study recommended the pragmatic Partnership of the Family, Church and the Society (F.C.S) Women Developmental Mode. The model emphasizes the importance of teamwork between all the community structures to help in building up the confidence of women in low socio-economic communities.
NRF

MSCPNT
Department of Nutrition
Introduction: In the year 2012, South Africa had a prevalence rate of stunting in children aged 1- 3, 4 - 6 and 7 – 9 years at 26.5%, 11.9% and 9.4%, respectively (Shisana et al. (2013). The Greater Sekhukhune District Municipality (GSDM) also showed a high rate of stunting (36%) in children aged 13 to 215 months of age (FIVIMS, 2006). The GSDM had a high unemployment rate of 69% to 82.4% (Statistics SA, 2006; Department of Social Development, 2008).). South Africa has adequate food supplies to feed the entire population at the national level (Labadarios et al., 2011; du Toit et al., 2011); however, there is evidence of under-nutrition caused by lack of purchasing power, and not a shortage of food (Rose and Charlton, 2001). Aim: The aim of the study was to determine the relationship between the employment status of the mother, household hunger and the nutritional status of children aged one to twelve years (1-12 years) in households of Sekhukhune District in Limpopo Province. Objectives : The objectives of the study were to determine the socio-economic status of the household; to assess the nutritional status of children using anthropometric measurements; to assess dietary patterns of children in households; to determine household food security using food inventories; to determine the prevalence of household hunger using the standardized hunger scale; to determine the coping strategies to food deprivation used in each household and to determine the association between employment status of the mother, nutritional status of children and household hunger. Methodology: The study design was a cross sectional, exploratory and correlational study. The study used both quantitative and qualitative methods of data collection. A simple random sampling method was used to select nine villages from Makhuduthamaga local municipality and twenty households per village were selected using the systematic random sampling. Data was collected in households and a sample size of 180 children was selected based on the availability of a child within the selected age group. If there were more than one child within the 1-12 years, each child was then allocated a number and the one with the least number was selected. Biological mothers were the preferred participants, however if the mother was unavailable, the primary caregiver was selected and180 mothers or caregivers Results: The majority (92.2%) of mothers were unemployed and 91% of them had an income of less than R500.00 per month, whereas 33.9% of households had total income of less than R1000.00 About 64.4% and 28.4% borrowed food from neighbours/family/friends and bought food on credit from the local shop. The anthropometric status of children indicated a high prevalence of stunting, a medium prevalence of underweight and a low prevalence of wasting. Most caregivers were overweight or obese. About 66% of children ate three meals per day. Almost 44% of households were food insecure, whereas 33.9% were at risk of hunger and only 21.7% were food secure. There was no association between employment status of the mother, household hunger and anthropometric status indicators. Conclusion: Greater Sekhukhune District Municipality has a high rate of unemployment, poor household income and purchasing power and high level of food insecurity. The employment status of the mother was not associated with the level of wasting, stunting and underweight. Furthermore, employment status was also not associated with the level of hunger. Caregivers employed various strategies to cope with periods of food deprivation

MGS
Institute for Gender and Youth Studies
Institutions of higher learning are still masculine-orientated; this creates a barrier for women in terms of career advancement. To this effect women are under-represented in top academic positions. The study employed qualitative research methods to explore factors that contribute to the under-representation of women in senior positions at the University of Venda. A combination of purposive and convenience sampling was used to select twenty five female academics (25). Data was collected through primary and secondary data, semi-structured interviews were used to elicit and illuminate women’s voices on issues that affect them and a thematic analysis was used to analyse the collected data. The research findings demonstrate that the University’s environment continues to be masculine-oriented within most of employment categories as well as in academia where women struggle to thrive. Women face multiple challenges in ascending the academic ladder which results in the under-representation of women in management and academic levels. These challenges included: the stringent criteria for promotion which do not seem to accommodate women, especially mothers, lack of female role-models, mentors and networks. The second major barrier is the teaching work-load which poses difficulties for women, preparations for teaching took long hours leaving them with no time for family, research, publication, as well as to further their studies, which are necessary requirements for promotion. The third major barrier women are faced with is the challenge of balancing multiple roles - as students, workers and mothers. Balancing these multiple roles makes it difficult for women to meet the highly stringent promotion criteria in the University

MPM
OR Tambo Institute of Governance and Policy Studies
There is a problem with the involvement of women on governance within traditional communities in South Africa. Consequently, the socio-political and cultural constraints narrow the potential of women and the otherwise untapped women contribution to the growing economy. This study investigates the involvement of women in governance within traditional communities in South Africa using the Ga- Machaka Village in Molemole Local Municipality as a case in point. Using the mixed method research approach, the study indicates that women in traditional communities are looked down upon and are disadvantaged from being part of governance and public administration based on gender terms. The study indicates that traditional communities in South Africa implicate negatively on women’s independent rights such as direct and equal opportunity to job offers. This is exacerbated by the customary inclination of women as house wives. The involvement of women in governance and public administration is somehow stifled within traditional communities as discussed in this study.
NRF

MCom (Business Management)
Department of Business Management
South African economic policies (for example, the National Development Plan [NDP] and Broad-Based Black Economic Empowerment Act [BBBEE]) place high emphasis on promoting entrepreneurial activities. In particular, these policies seek to provide for interventions that minimise challenges faced by entrepreneurs. In spite of this there is a segment of entrepreneurs that continues to experience numerous challenges – women entrepreneurs. The purpose of this study was to analyse the challenges faced by rural-women entrepreneurs. Rural women entrepreneurs in particular face challenges or barriers, which can be categorised under entrepreneurial, socio-cultural, personal, and technical barriers. The notion of gender socialisation can be used as one of several explanations as to why males and females behave differently. This kind of socialisation is also thought to be at the root of gender stereotyping, including chauvinism. This kind of socialisation has been said to influence the degree to which women face entrepreneurial challenges in rural areas. To address this research problem, which focuses on social perceptions, the critical realism paradigm was used. The research methodology used was a quantitative one, with the sample size 151 participants. Snowballing was utilised to locate participants with the desired characteristics. Self-completing questionnaires adapted from previous studies were utilised to gather data. The collected data was analysed using IBM-SPSS. Various descriptive and multivariate statistical tests, including ANOVA, cluster analysis, and factor analysis were used to analyse the data. The data collected indicated that women entrepreneurs with higher levels of gender socialisation (‘strongly believe’) are affected by entrepreneurial challenges more than those with low levels of gender socialisation. The results also indicated that education plays a key role in changing women’s’ attitudes towards their gendered roles and how they are socialised from a young age through to adult status. The researcher recommended equal opportunities for both males and females with regard to access to state resources such as education and finance, and access to information about businesses.
NRF