The study explored cultural perspectives of the Zimbabwean Ndebele on alternative modes of childbirth. A qualitative generic, exploratory and descriptive design guided the study. The problem is that alternative modes of birthing are not acceptable to the Zimbabwean Ndebele. Women who give birth through alternative modes of birthing, which include caesarean section (CS) instrumental deliveries (ID) and any other unnatural modes are stigmatised. Data were collected from purposively selected samples of women who had given birth through alternative modes of birthing, spouses, mothers-in-law, community elders, sangomas (traditional healers) and traditional birth attendants (TBAs) using individual unstructured in-depth interviews, structured interviews and focus group interviews (FGIs). Data were analysed through use of qualitative content analysis which involved verbatim transcripts. Interpretations of narrations of data and script reviewing were done while simultaneously listening to audio-tapes which were transcribed in the IsiNdebele the language that was used to collect data. Data were then translated into English to accommodate all readers. Accounts of all the informants that were interviewed point to effects of supernatural ancestral powers, infidelity and use of traditional and herbal medicines as cause for “tiedness” (labour complications), a concept that showed a strong thread throughout the study. Study findings illuminated that traditional practices are culture-bound and the desire is to perpetuate the valued culture. Recommendations made from the study are; cultural orientation of local and foreign health workers, cultural consultation and collaboration with sangomas (traditional healers) and particular recognition of the significance of the study as a cultural heritage of the Zimbabwean Ndebele society. Further research on how women and their spouses cope with the grieving process after experiencing the crisis and grief following CS is recommended. With all the recommended areas addressed, Zimbabwean Ndebele would find alternative modes of birthing acceptable. / Health Studies / D. Lit. et Phil. (Health Studies)

The study attempted to identify factors influencing women’s preference for home births in the Mutare District, Zimbabwe. A quantitative, descriptive, exploratory, cross sectional survey, gathering data by conducting structured interviews with 150 women, was used. All 150 women attended antenatal clinics but did not deliver their babies at health care facilities. The research results indicated that home deliveries might decline if: • the hospital/clinic fees were reduced or removed • transport would be available for women in labour to reach hospitals/clinics • shelters were built for pregnant women at hospitals/clinics • clinics were well equipped and had sufficient numbers of midwives • women had received more effective health education on the advantages of institutional deliveries and on the danger signs of pregnancy/labour complications • nurses/midwives would treat patients respectfully. Unless these factors are addressed, the number of home deliveries might not decline, and the high maternal/infant mortality and morbidity rates in this district will persist. / Health Studies / M. Public Health

The study attempted to identify factors influencing women’s preference for home births in the Mutare District, Zimbabwe. A quantitative, descriptive, exploratory, cross sectional survey, gathering data by conducting structured interviews with 150 women, was used. All 150 women attended antenatal clinics but did not deliver their babies at health care facilities. The research results indicated that home deliveries might decline if: • the hospital/clinic fees were reduced or removed • transport would be available for women in labour to reach hospitals/clinics • shelters were built for pregnant women at hospitals/clinics • clinics were well equipped and had sufficient numbers of midwives • women had received more effective health education on the advantages of institutional deliveries and on the danger signs of pregnancy/labour complications • nurses/midwives would treat patients respectfully. Unless these factors are addressed, the number of home deliveries might not decline, and the high maternal/infant mortality and morbidity rates in this district will persist. / Health Studies / M. Public Health

The study explored cultural perspectives of the Zimbabwean Ndebele on alternative modes of childbirth. A qualitative generic, exploratory and descriptive design guided the study. The problem is that alternative modes of birthing are not acceptable to the Zimbabwean Ndebele. Women who give birth through alternative modes of birthing, which include caesarean section (CS) instrumental deliveries (ID) and any other unnatural modes are stigmatised. Data were collected from purposively selected samples of women who had given birth through alternative modes of birthing, spouses, mothers-in-law, community elders, sangomas (traditional healers) and traditional birth attendants (TBAs) using individual unstructured in-depth interviews, structured interviews and focus group interviews (FGIs). Data were analysed through use of qualitative content analysis which involved verbatim transcripts. Interpretations of narrations of data and script reviewing were done while simultaneously listening to audio-tapes which were transcribed in the IsiNdebele the language that was used to collect data. Data were then translated into English to accommodate all readers. Accounts of all the informants that were interviewed point to effects of supernatural ancestral powers, infidelity and use of traditional and herbal medicines as cause for “tiedness” (labour complications), a concept that showed a strong thread throughout the study. Study findings illuminated that traditional practices are culture-bound and the desire is to perpetuate the valued culture. Recommendations made from the study are; cultural orientation of local and foreign health workers, cultural consultation and collaboration with sangomas (traditional healers) and particular recognition of the significance of the study as a cultural heritage of the Zimbabwean Ndebele society. Further research on how women and their spouses cope with the grieving process after experiencing the crisis and grief following CS is recommended. With all the recommended areas addressed, Zimbabwean Ndebele would find alternative modes of birthing acceptable. / Health Studies / D. Lit. et Phil. (Health Studies)

Community participation has been hailed as the panacea for most community programmes. Community participation at high levels empowers communities, increases self-reliance, selfawareness and confidence in self-examination of problems and seeking solutions for them Behavioural changes are promoted and utilisation and support of services is facilitated, which is of great importance in antenatal care and generally in this present day of HIV/AIDS. The purpose of this study was to determine the extent to which women were participating in the provision of antenatal care. Secondly, the study sought the pregnant women's perceptions and expectations regarding their participation in the provision of antenatal care and to find out at what level if any, the women wanted to be involved in the provision of antenatal care. The theoretical model guiding this study was Rifkin' s model for evaluating community participation. A guided interview was conducted with 30 conveniently selected pregnant mothers residing in the area of the Chinamhora clinic. The results indicated limited participation in the five process indicators of community participation. However, all the women regarded community participation as being important. The majority of the women wished to be involved at high levels of participation. The results of this study should be valuable to health care professionais in formulating strategies and modifying existing programmes to enhance community participation, with the decentralisation of health services in Zimbabwe. / Health Studies / M.A. (Advanced Nursing Sciences)

Community participation has been hailed as the panacea for most community programmes. Community participation at high levels empowers communities, increases self-reliance, selfawareness and confidence in self-examination of problems and seeking solutions for them Behavioural changes are promoted and utilisation and support of services is facilitated, which is of great importance in antenatal care and generally in this present day of HIV/AIDS. The purpose of this study was to determine the extent to which women were participating in the provision of antenatal care. Secondly, the study sought the pregnant women's perceptions and expectations regarding their participation in the provision of antenatal care and to find out at what level if any, the women wanted to be involved in the provision of antenatal care. The theoretical model guiding this study was Rifkin' s model for evaluating community participation. A guided interview was conducted with 30 conveniently selected pregnant mothers residing in the area of the Chinamhora clinic. The results indicated limited participation in the five process indicators of community participation. However, all the women regarded community participation as being important. The majority of the women wished to be involved at high levels of participation. The results of this study should be valuable to health care professionais in formulating strategies and modifying existing programmes to enhance community participation, with the decentralisation of health services in Zimbabwe. / Health Studies / M.A. (Advanced Nursing Sciences)