Thesis (M. A. (Communication Studies)) -- University of Limpopo, 2019 / Globally, over the years, health promotion organisations have developed communication campaigns geared towards addressing most major public health issues with the intention of preventing risky sexual behaviour. Teenage pregnancy is a major health, social, systemic and economic challenge, not only for the basic education sector but also, crucially for national development in general. The use of modern contraceptives, specifically implant contraceptives, has the potential to alleviate unintended teenage pregnancies. Modern contraceptives such as implant contraceptives have proven to be highly effective from 24 hours after insertion up to three years. Theoretically, the Health Belief Model and the Theory of Planned Behaviour have been applied to guide the study. A quantitative, descriptive survey was used in this study, with data collected using questionnaires. Purposive sampling of six secondary schools under the Mankweng Circuit in the Limpopo province where 306 participants were randomly selected was employed. Data were analysed using the SPSS version 26. The study revealed that that 34% of the participants were willing to use the implant contraceptive method based on the benefits found to be associated with the method. However, 66% were not willing to use the method regardless of the benefits found in using the implant contraceptives. In addition, it was found that only 3.9% of the participants were using implant contraceptives as a tool to prevent unintended pregnancies. This study makes a contribution to existing literature on implant contraceptives uptake among young women in South Africa. It would be informative to organisations and the National Department of Health who propose the use of implant contraceptives to stem increasing teenage pregnancies.

This study examines a chosen set of prominent actors within family planning initiatives aimed toward the global South to find out if there are traces of “smart economics” within the framings of the initiatives. The smart economic framework has received critique for instrumentalising women and using gender equality as a tool rather than a goal. Researchers have found similar arguments within the family planning discourse and emphasised the potential harm these arguments lead to. By looking at the websites of six family planning actors, a content analysis is the chosen method. By examining the texts from the websites through categories invented from key elements of the smart economic framework, certain themes or the lack of these themes can be used to find traces of smart economics within the framings of family planning initiatives. The material from the chosen organisations is argued to influence the family planning discourse and is relevant to review. The results show that there are traces of a smart economic narrative within the framings of family planning initiatives. As previous research has pointed out, there is a lack of focus on men’s role in family planning. By using a smart economic narrative, the organisations working with family planning contribute to the discourse as well as the overall development discourse. By addressing the problems of using the smart economic framework, hopefully, the discourse can transform into being rights-based and not instrumental.

This study was designed to explore the hormonal regulation of CNS opioid peptide levels in female Sprague Dawley rats. Forty-eight animals were divided into 2 equal groups for acute and chronic studies. Each group was further divided into 4 subgroups, each containing 6 animals. Each rat in the control group received an inert pill (in 0.25 ml corn oil daily by gavage); the second group, 15 μg norethindrone (NE, a potent progestin present in the oral contraceptive Micronor®); the third group, 15 μg NE and 1 μg ethinyl estradiol, EE2 (present in the oral contraceptive Modicon®) and the fourth group, 10 times the dose of the third group. Rats were treated either acutely for 5 days or chronically for 7 weeks. Opioid peptides were estimated by radioimmunoassay. Acute administration of 150 μg NE + 10 μg EE2 decreased the levels of methionine-enkephalin (ME), leucine-enkephalin (LE), dynorphin (DYN) and β-endorphin like immunoreactivity (β-EI) by about 50% in the pituitary. The same dose on chronic administration also decreased DYN, but increased the levels of ME and LE in the pituitary by 331 and 69%, respectively. In the hypothalamus, chronic administration of NE + EE2 increased the level of ME (155%) and LE (87%) as well as of DYN (97%). In the striatum, the levels of LE (33%) and DYN (115%) were elevated during chronic administration. It is concluded that the acute administration of NE + EE2, in general, reduces the levels of ME, LE, DYN and β-EI. The extent of this decrease is about the same in the pituitary, hypothalamus and striatum. Chronic administration of these hormones, however, results in a reversal of this decrease (except for β-EI) and actually can increase the levels of ME, LE and DYN in all three tissues.

Patient-centered contraceptive care is key for ensuring that individuals achieve their personal reproductive goals. Despite public health efforts, preventing undesired pregnancies and improving maternal and child health outcomes remains unresolved in the United States (US). In Tennessee (TN), the rate of unintended pregnancies remains higher than the national rate (32.4% vs. 30.3%). Long-acting reversible contraceptives (LARCs) are 99% effective in preventing undesired pregnancies; however, uptake remains low in rural and underserved communities. Previous research has provided some insight into women’s perceptions of LARCs; however, those guided by conceptual frameworks to understand the multiple influences that impact perceptions towards LARCs, especially among rural regions, are scarce. This multimethod qualitative study explored multiple influences that impact northeast Tennessee women’s perceptions and attitudes toward LARCs using the Socio-ecological Model (SEM) as a guiding framework. The qualitative study comprised six focus groups and seven individual interviews of women aged 18-44, not pregnant, and current residents of five Counties in Northeast TN. Participants’ demographics were captured through an anonymous survey administered through REDCap. Qualitative data from these sessions were recorded via Zoom, an online audio/video conferencing platform. Each interview and focus group lasted 60 to 90 minutes. Focus group and interview data were combined, transcribed, and uploaded into NVivo for thematic analysis. A priori list of codes identified from the constructs of the SEM was initially used to deductively code the data. Subsequently, the data were analyzed inductively for new codes and themes that did not apply to the a priori categories. Quotations that were representative of or inconsistent with the codes of interest were identified. Fifteen themes and 20 sub-themes were identified using the SEM; On the intrapersonal level of the SEM, participants’ attitudes towards a method, perception of method features, and perceived side effects were identified as themes that delineate influences on their LARC utilization. On the interpersonal level, perception of partner support, perceived support from peer/social networks, and provider trust were themes that describe influences on participants’ LARC utilization. On the community level, the cost of the method, access to information, perceived accessibility to a method, social services, and cultural norms themes were identified as influences on participants’ use of LARCs. On the organizational level, the availability of preferred methods in a clinic, the need for multiple clinic visits to enable the use of a method, and provider counseling practices were salient themes impacting LARC utilization. On the policy level, insurance, and billing policies, sex education policies were identified as impacting LARC utilization. The study presents multi-layered influences on LARC utilization among Northeast TN women, highlighting the utility of the SEM in understanding factors that influence contraceptive use. Findings are critical for programming as they highlight the areas of influence that can be addressed to increase LARC uptake and enable women in rural and underserved regions of the US to achieve personal reproductive goals.

A prospective study of two combined oral contraceptives was conducted in the Sudan. No pregnancies occurred. Overall incidence of side effects was low. Headache was most frequently reported. Elevations were observed for weight, systolic and diastolic blood pressures, and SGOT and SGPT values while a decrease was seen for hemoglobin levels. Menstrual irregularities were not a problem for the users. Total 6-month use discontinuation rates were low for both pill groups.

This research compared contraceptive advertisements in two top-circulated publications for white and African American female subscribers, Cosmopolitan and Essence. Data consisted of a sample of 172 contraceptive advertisements from the two magazines published between 1992 and 2012. Quantitative analysis focused on the model(s)' race, age, marital status, and socioeconomic status; the type of contraceptive being advertised; and the reason stated in the ad for using the product. This analysis determined a disparity in the rate of advertisement of doctor-administered contraceptives for the publications of 25.4 percent in Essence magazine and 9.5 percent in Cosmopolitan magazine. Black women were targeted with long-term, doctor-administered birth control ads more frequently than white women over a twenty-year period, which correlates with findings of previous studies suggesting minority women receive these types of birth control more often than their white counterparts. Qualitative analysis focused on the written messages in the advertisements. This analysis identified the theme of risk as a prominent message of advertisements, appealing to concerns surrounding health, desirability, freedom and pregnancy.

Background: A significant amount of research has previously been conducted in developing countries such as India, to improve women’s sexual and reproductive health. However, women living in North Indian slums still have poor access to proper sexual and reproductive healthcare. The aim of this thesis is to investigate the published literature to create a consolidated understanding of the key barriers faced by women in slum populations when accessing sexual and reproductive health services in Northern India. Methods: A scoping review was carried out following the five stages outlined in Arksey and O’Malley’s framework. Five online databases (MEDLINE, Global Health, Ovid Emcare, Embase, and Web of Science) were searched. An interpretive thematic analysis was conducted to extract meaningful themes from the data using the Conceptual Framework for Reproductive Empowerment developed by the International Center for Research on Women Results: In total, 28 articles were identified to be incorporated into the scoping review. The results of this study were grouped according to the CFFRE to understand how they compared in regard to women’s reproductive empowerment. This scoping review found reproductive empowerment was significantly hindered by women lacking a proper education and understanding of SRH services, lack of employment and financial resources. Additionally, women’s husbands and mothers-in-laws were barriers to contraceptive use. Finally, poor interactions with healthcare providers and the healthcare system, and systemic factors such as behaviours in treatment seeking, son preference and religion were barriers to accessing SRH services. Conclusion: This scoping review investigated the barriers faced by women living in slum populations in Northern India to accessing SRH services. The results of this study contribute to the literature by identifying areas that require improvement to SRH services for women living in slums, and will be integral to implementing strategies and interventions to allow better access to SRH services in the future. / Thesis / Master of Science (MSc) / A significant amount of research has previously been conducted in India, to improve women’s sexual and reproductive health. However, women living in North Indian slums still have poor access to proper sexual and reproductive healthcare. Therefore, this study investigated the key barriers faced by women in slum populations when accessing sexual and reproductive health services in Northern India. A review of previous studies was conducted by searching five electronic databases and a total 28 articles were included into the review. This study found that women lacking a proper education and understanding of SRH services, lack of employment and financial resources, and women’s husbands and mothers-in-laws were barriers to SRH services. Finally, poor interactions with healthcare providers and the healthcare system, and systemic factors such as behaviours in treatment seeking, son preference, and religion were also barriers to accessing SRH services.

The purpose of this study was to determine if a training program consisting of 30 minutes of running on a treadmill, 3 days per week for 6 weeks, would lower serum cholesterol and/or triglyceride concentration in women using oral contraceptives. The intensity of the training was maintained at approximately 75% of the subject's pre-training maximal oxygen uptake. Comparisons were made in the variables triglyceride, cholesterol, maximum ventilation and maximum oxygen uptake, prior to and following training, between subjects who used birth control pills and those who did not. Eighteen women volunteers between the ages of 25-39 years, participated in the training program. Nine women were using oral contraceptives of the combined type. The subjects were free of metabolic diseases and were judged to be sedentary. Fasting blood samples were taken prior to and following the training program for lipid analyses. Maximum oxygen uptake and ventilation were determined by pre-training and post-training stress tests. To isolate training as the factor responsible for any changes in serum lipid concentration, the factors of body weight, skinfold thickness, fasting times and dietary patterns were held constant across the training period. Using multivariate analysis of covariance, one-way classification, to compare the group using oral contraceptives with the group not using them, no significant differences (p < 0.05) were found between the groups for either the blood lipids or the measures of functional capacity. Hotelling’s T² for comparison of pre-test to post~test differences within groups was employed using the linear combinations of the means of maximum ventilation and maximum oxygen uptake. The same analysis was used for the linear combination of the means of triglyceride and cholesterol. Only the group not using oral contraceptives showed significant difference (p < 0.05) in any of the variables. This difference was an increase after training, in maximum ventilation and maximum oxygen uptake. Other changes as a result of training were noted, although differences were not statistically significant at the 0.05 level of probability. These changes were 1) an improvement in the physical working capacity of the group using oral contraceptives, 2) a decrease in serum triglyceride and/or cholesterol levels in subjects whose initial values were in the upper ranges of clinical normality for these lipids. Exercise did not appear to affect the lipid levels of subjects who initially had low or average values. / Doctor of Education

京都大学 / 新制・課程博士 / 博士(医学) / 甲第25163号 / 医博第5049号 / 京都大学大学院医学研究科医学専攻 / (主査)教授 近藤 尚己, 教授 古川 壽亮, 教授 阪上 優 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DGAM

Contraceptives are available free of charge throughout South Africa. Nevertheless the number of requests for termination of pregnancy (TOP) services continues to increase. This research investigated challenges preventing women from using contraceptives effectively. Structured interviews were conducted with 47 women who requested TOP services. Gender and financial issues posed challenges for some women to access contraceptives as well as their reported inability to access contraceptives. Most (85,5%) of the respondents used contraceptives. They discontinued using contraceptives because they experienced side-effects, necessitating them to request TOPs. Knowledge about, access to, nor the actual use of contraceptive enabled these women to prevent unwanted pregnancies. More effective counselling about the side-effects of contraceptives and enhanced accessibility of contraceptives during weekends and lunch breaks could enable more women to prevent unwanted pregnancies and reduce the number of requests for TOPs in the Gert Sibande District (Mpumalanga). / Health Studies / M.A. (Health Studies)