Abortion remains one of the most controversial sexual health topics and yet is a common experience for women around the world. Making sure that women are practicing safe abortions is integral to women’s sexual and reproductive health as well as their sexual rights. South Africa has one of the most progressive and liberal abortion laws in the world, yet women still face major barriers in accessing these services. Introducing medical abortion as another termination of pregnancy option could potentially save women’s lives, while reducing the number of unsafe abortions in South Africa. Medical abortion also contributes to fulfilling women’s sexual and reproductive rights, providing more choices to best suit their needs. In 2001, the South African Medicines Control Council (MCC) approved the use of mifepristone in conjunction with misoprostol for termination of pregnancy. Currently there is no formal national policy that allows for the provision of medical abortion in public health facilities, and the Department of Health is considering introducing it into the public sector. In order for any public health intervention to be successful it must be acceptable to potential clients and the context in which it is being implemented must be assessed. This study first looks at women’s attitudes toward abortion; following Eaton’s model of sexual behavior it examines the personal, proximal, and distal environments that influence reproductive decision-making, specifically regarding abortion. With this background information, the study then aims to assess women’s knowledge of medical abortion and whether or not they find it to be an acceptable method for the South African public health system and South African women. The findings suggest that there is a demand for medical abortion among this sample of women. The majority of women find medical abortion to be an acceptable method, and would choose it if they were ever faced with having to terminate a pregnancy. The overwhelming majority of women felt that medical abortion should be introduced into the public sector and efforts should be made to ensure that this method is affordable, accessible, and available for women in South Africa in order to expand their sexual and reproductive health rights. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2010.

Thesis (MA)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The Population Reference Bureau (PRB) in 2011 reported a low rate of contraceptive use among Nigerian youths at 29%, despite reported high rates of sexual activity and increased awareness of the existence of contraceptive methods. This exposes the youths to the risk of contracting sexually transmitted infections and the effects associated with unwanted pregnancy. From a social constructionist standpoint, I used a mixed method research design to explore contraceptive knowledge and practices among students (18 to 25 years of age) at the Federal Polytechnic Kaduna. I see students’ attitudes towards contraception as being historically and culturally located and dependent on the prevailing cultural arrangement at that period. I thus distance myself from the position of the Health Belief Model (HBM) by recognising that individuals’ attitudes towards contraception is not only informed by the perceived benefits of contraceptive use but also by certain external social factors which could serve as barriers to the individual’s decision to use contraceptives. I collected data from 187 students out of a sample of 200 who had been systematically selected from the Departments of Mass Communication and Architecture at the polytechnic between August and September 2013. In addition, I conducted fifteen follow-up semi-structured interviews with students and three key informant interviews; two staff at the polytechnic clinic and one private pharmacist close to the polytechnic. Similar to other Nigerian studies among tertiary students, there is a relatively high level of sexual activity as well as high level awareness of contraceptive methods among students; however, they lack sufficient knowledge of how contraceptives function. Contraceptive use among sexually active students was also low either due to negative attitudes towards contraceptives resulting from inadequate or incomplete contraceptive information from friends or due to lack of easy access to contraceptive methods by students, partners’ influence or influences from cultural, including religious, beliefs and practices, thereby making students vulnerable to the risk associated with unprotected sex. There is therefore the need for interventions by relevant stakeholders that will seek to provide adequate information to students and develop in them positive attitudes towards contraceptive use. / AFRIKAANSE OPSOMMING: In 2011 het Nigerië se Bevolkingsverwysingsburo (PRB) ’n lae gebruikskoers van kontrasepsiemiddels (29%) onder Nigeriese jeugdiges gerapporteer, afgesien van die hoë koers van seksuele aktiwiteit en verhoogde bewustheid oor die bestaan van kontrasepsiemetodes. Dit stel jongmense bloot aan die risiko om seksueel-oordraagbare infeksies op te doen, sowel as aan die negatiewe gevolge wat met ongewensde swangerskap gepaard gaan. Vanuit ’n sosiaal-konstruksionistiese standpunt het ek ’n gemengdemetodenavorsingsontwerp gebruik om kennis oor voorbehoedmiddels en gebruike onder studente (18 tot 25 jaar oud) aan die Federal Polytechnic Kaduna (’n politegniese tersiêre instelling) in noordelike Nigerië te ondersoek. Ek beskou studente se ingesteldheid jeens kontrasepsie as histories- en kultuurgefundeerd en onderworpe aan die heersende kulturele reëlings van die tydperk. Ek distansieer my dus van die posisie van die gesondheidoortuigingsmodel (HBM) deur erkenning te gee aan die feit dat individue se ingesteldheid jeens kontrasepsie nie net deur die waargenome voordele van kontrasepsiegebruik ingelig word nie, maar ook deur bepaalde eksterne maatskaplike faktore wat struikelblokke kan skep by ’n individu se besluit om kontrasepsiemiddels te gebruik. Tussen Augustus en September 2013 het ek data van 187 studente uit ’n steekproef van 200, wat stelselmatig in die Departement Massakommunikasie en Argitektuur aan die Politegniese skool gedoen is, versamel. Verder het ek vyftien semigestruktureerde opvolgonderhoude met studente gevoer, asook drie sleutelinformantonderhoude, waaronder twee met personeellede by die Politegniese kliniek en een met ʼn privaat apteker in die omgewing van die Politegniese skool. Soortgelyk aan ander Nigeriese studies onder tersiêre studente het ek gevind dat ofskoon daar ’n relatief hoë seksueleaktiwiteitsvlak, asook ’n hoë bewustheidsvlak van kontrasepsiemetodes onder studente bestaan, die meeste studente onvoldoende ingelig was oor hoe kontrasepsiemiddels regtig werk. Daar is ook gevind dat kontrasepsiegebruik onder seksueel-aktiewe studente weens verskeie faktore redelik laag was, ingesluit negatiewe ingesteldhede oor kontrasepsiemetodes as gevolg van onvoldoende of onvolledige kontrasepsie-inligting (wat hoofsaaklik van vriende bekom is); ’n gebrek aan maklike toegang tot kontrasepsiemetodes; beïnvloeding deur seksmaats; asook invloede vanweë kulturele oortuigings en gebruike, met inbegrip van geloof. Die gevolg is dat studente kwesbaar is vir die risiko’s wat met onbeskermde seks gepaard gaan. Daar bestaan dus ’n behoefte aan intervensies deur die betrokke belanghebbendes wat studente van voldoende inligting sal voorsien en positiewe ingesteldhede oor die gebruik van kontrasepsiemiddels by studente sal kweek.

Any form of sexual interaction contains risk, for example the risk of pregnancy and/or STI transmission. There are a range of measures that can be used to prevent the above mentioned risks, namely contraceptive practices. However, condom use is the best method to prevent all risks related to sex. Although South Africa has the highest number of people living with HIV (Shisana et al., 2009), it has been found that the HIV prevalence is low amongst students in comparison to nationwide statistics (HEAIDS, 2010). Additionally condom use amongst students at last sex is reportedly high (HEAIDS, 2010). However there are many reasons why students in particular do not engage in protective sexual practices such as condom use. The question that guided this research study was what motivates students to engage or not engage in condom use? The study explored dynamics of condom use amongst heterosexual students at the University of KwaZulu-Natal, Pietermaritzburg. This qualitative study used Hollway (1984) and Willig’s (1995) discourses to examine the ways in which men and women relate to each other in engaging in sex, relationships and protective sexual practices. Information was gathered using two focus groups (one female and one male group) and five individual interviews. Students saw the risks related to pregnancy and HIV differently which impacted on their preferred method of contraceptive use and the ways in which they viewed condom use. Students seem to draw on Hollway’s (1984) “male sexual drive discourse” and “have/hold discourse”, and Willig’s (1995) “marital discourse”, to position themselves with regards to each other and their sexual activities. This suggests a need to redirect health promotion strategies.