M.Med. (Obstetrics and Gynaecology), Faculty of Health Sciences, University of the Witwatersrand,2008 / The aim of this study was to assess the demographic characteristics and contraceptive practices of women requesting termination of pregnancy (TOP) at Chris Hani Baragwanath Hospital (CHBH). The study will provide insight into the reasons for contraceptive „failure‟ or non-use. Methods This is a cross sectional questionnaire survey. Subjects for the study were recruited from clients requesting TOP at the Gynaecology clinic (ward 54), CHBH. They included women between 13 to 49 years, who were referred from their local clinic or General practitioner with a positive pregnancy test or a pregnancy confirmed on sonar, and were less than 20 weeks pregnant. Consenting women completed a self-administered questionnaire which assessed their demographic details, current contraceptive use, past contraceptive experience, future contraceptive plans, knowledge of emergency contraceptive pill, and the current status of the relationship, initial intention with regard to the pregnancy, and the number of sexual partners they had in the last year. The data was analysed using the Epi Info 6 software programme. Results There were 780 requests for TOP during the study period. Two hundred and twenty nine women were approached to participate in the study and 203 questionnaires were analysed, i.e. an 89% analysable response rate. The mean age of the respondents was 25 years (range 13 - 42 years), the mean parity was 1.3 (range 0 to 9), 35% were still in school, 28% were unemployed and 70% were financially dependent on their parents, partners, or other relatives. A total of 56% of the respondents reported that they were using contraception when they conceived. Only 11% of the respondents knew of the emergency contraception pill. Eighty two percent of the respondents knew where to obtain contraceptives and only 7% had experienced actual difficulty in obtaining contraception. However, 46% thought they received „too little‟ information about contraception at their local clinic and 26% said that the contraceptive method they received was the healthcare provider‟s choice. Up to 47% of the respondents were either unsure of the contraceptive method they would use or would not use any contraception following the TOP. However, 43% would use a highly reliable contraceptive method (the oral contraceptive pill, injectable contraceptive, or sterilisation). Regarding the status of the relationship which resulted in the pregnancy, 44% were no longer in a permanent relationship (41% were and 11% never were). Twenty two percent of the respondents initially wanted the pregnancy. Conclusions Twenty two percent of the respondents initially wanted the pregnancy and would not have been helped by better provision of contraception. A large number of respondents reported contraceptive failure. Knowledge of emergency contraception was poor, and its use should be better promoted for cases of contraceptive failure. It is alarming that up to 47% of the clients could not use contraception in the future. Perhaps more time should be spent on contraceptive counselling and initiation of a method on site, with referral and follow-up at primary health clinics to improve uptake of contraception. Only 2.5% of the respondents were having a repeat TOP.

A RESEARCH REPORT SUBMITTED TO THE UNIVERSITY OF THE WITWATERSRAND IN FULFILLMENT OF THE MASTER OF MEDICINE DEGREE / Introduction South Africa has a high prevalence of unintended pregnancies and HIV. Sixty eight thousand women die due to unsafe abortion annually worldwide, making it a leading cause of maternal mortality. In SA the maternal mortality has decreased from TOP. Maternal mortality from HIV is the leading cause of maternal mortality in South Africa. Unintended pregnancies are mainly a consequence of inconsistent and incorrect contraceptive use. The condom is the only contraceptive method which has the dual ability of preventing HIV and unintended pregnancies. We postulate that the failure of barrier contraception is a risk for both HIV and unwanted pregnancy. This study describes the contraceptive methods used by women at a TOP clinic and evaluates the use of barrier contraceptives amongst women requesting TOP, and the prevalence of HIV. Methods CHBAH is tertiary hospital in Southern Gauteng. Women with medical or surgical comorbidities that request a TOP are referred to the hospital. A prospective study using a cross sectional study design was performed at the Chris Hani Baragwanath Academic Hospital TOP clinic between February and October 2011. Data was collected using interviews and medical files. Results One hundred and nineteen women were interviewed. Most women 56 (47.06%) did not use any contraception at the time of conception. The most common reason for TOP was financial constraints, followed by relationship conflict. Pregnancy despite condom use was 34.45% (n=41). The percentage of women with condom failure, who were HIV positive was 34.14% (n=14). True condom failure was experienced by 12 women (pregnancy due to breakage/slippage of the condom. Conclusion Unintended pregnancy is mainly associated with not using contraceptives. The male condom was the most widely used contraceptive. The HIV prevalence in the group with condom failure was higher than the general antenatal population. There is a need for education regarding correct and consistent use of contraception.

Title: Knowledge and willingness of nurses in the public primary health care setting of sub-district “F” in the Johannesburg metro district to promote the use of the female condom. Methods: A quantitative cross sectional descriptive survey was conducted in the public primary health care setting of sub-district “F” in the Johannesburg metro district, which included 16 primary health care clinics. Three hundred and ninety eight nurses participated in the study. Association between knowledge and willingness to promote use of female condom was investigated using Chi-Square test. Result: Seventy nine per cent of the participants had more knowledge on female condom use than the rest of the nurses. Fifty nine per cent of the participants were more willing to promote the use of the female condom. There was no statistically significant relationship between willingness to promote the use of female condom and knowledge on female condom use. (Chi-square with one degree of freedom =2.7243, p =0.099). However, those nurses who are more knowledgeable on the use of female condom are noted to be more willing to promote female condom use (though this may not have been statistically significant. Conclusion: The more knowledgeable group of participants in this study was determined to be high (80%). Fifty nine per cent of the participants were more willing to promote female condom use than the others. Being more knowledgable in the use of female condom did not positively predict willingness to promote female condom use.

Thesis (M Med (Family Medicine)) -- University of Limpopo, 2011. / Aim and objectives Challenged by the high incidence of teenage pregnancy and sexually transmitted infections observed among high school students who were attending antenatal care at the clinics in Tswaing Sub-district. The researcher conducted this study to determine the knowledge, attitudes and practices of contraception among high school learners and establish whether the demographic characteristics of the students influenced their knowledge, attitudes and practices towards contraception. Design This study was a cross-sectional descriptive quantitative study. It was conducted among 231 learners who were aged 16 years and above, male and female, between grades 10 and 12. Systematic sampling was employed to select 33 students from 7 high schools selected by random probability sampling technique in Tswaing Sub-district who completed confidential, anonymous self-administrated questionnaires. The questionnaires were in English, Afrikaans and Setswana, so as to ensure clarity and accurate understanding of the content and hence the questionnaire was self-administered in the language of preference for each learner. Data were entered and analyzed using SPSS for windows version 17. A chi-square test was performed to determine the association between predictor's variables and knowledge. A p-value ofless than 0.05 at 95% CI was taken for statistical significance. Results More males 70 % and 60 % of the females indicated that they had a boyfriend or girlfriend. More males (50.3%) than females (49.7%) indicated that they had engaged in sexual intercourse. The average age of first sexual intercourse was 14.9 years for the males and 15.4 years for the females. The modal age for first intercourse for male was below 13 years and 15.4 years for the females. The most common contraceptive used among the males was a condom (89.8%) and among females, it was the combined injectable contraceptives (49.4%). Males (63.6%) and females (68.8%) thought it easy to access contraception. There was a high rate of unprotected sexual activity among the learners, with 34.1 % of the males and 42.1 % of the females' indicated that they had had sex without contraception. Most of the learners obtained contraceptive information from their parents 98 [33%] male, 70 [53.8%] female). The preferred source of information for the male learners was a doctor 59 [59%], and the preferred source of con1raceptive information for the female learners was their parents 57 [43%]. 54 (57.4%) of the males and 75.4% of the 84 female learners indicated that their parents had discussed contraception with them. 64.2% of the males and 68.5% of the females claimed that they were satisfied with the information they received about contraception from their parents. All the learners had the knowledge that condoms can prevent sexually 1ransmitted infections and that a condom cannot be used more than once, with a p< 0.05 and their response according to gender and age, all schools had more than 60% participants. Forty-three percent of the learners in all schools who lived with both parents had the knowledge that condoms can prevent sexually transmitted infections and condom cannot be used more than once, p< 0.05. Among the female learners, only 79 [60.8%] knew that conception could take place if they missed taking their con1raceptive pill once. 51 [39.2%] said that conception could not take place if they had missed taking the pill once. More than 90% learners wanted information on contraception from their primary health care providers. Conclusion This study showed that senior learners had a good knowledge about basic contraception. The high level of sexual activity, early sexual initiation and low contraceptive use put these adolescents at risk of pregnancy and sexually transmitted infections. They indicated that they needed more information on sexuality and contraception from their primary health care providers especially from their doctors. Adolescents should be encouraged to ask about contraception and sexual health at the clinics, and all health workers; nurses and doctors, who consult must see every encounter as an opportunity for health education and counseling in reproductive health

Proefschrift--Universiteit Leiden, 2003. / Notes bibliogr. en fin de chap.

Proefschrift--Universiteit Leiden, 2003. / Notes bibliogr. en fin de chap.

Thèse d'exercice : Médecine. Médecine générale : Université de Nantes : 2003. / Bibliogr. f. 86-89 [53 réf.].

Thèse d'exercice : Médecine. Médecine générale : Université de Nantes : 2004. / Bibliogr. f. 121-129 [80 réf.].

Thèse de doctorat : Sciences de la vie et de la santé : Lille 1 : 2000. / Bibliogr. f. 137-168.

Thèse d'exercice : Médecine. Médecine générale : Université de Nantes : 2005. / Bibliogr. f. 89-93 [75 réf.].