Gender equality and ensuring the equal rights of women and girls is the fifth United Nations Sustainable Development Goal set for 2030. Access to quality reproductive healthcare and information is a critical aspect of gender equality, including access to information about family planning and contraceptives. However, there are many barriers that impact a woman’s access to contraception in rural sub-Saharan Africa, such as financial constraints, supply shortages, stigma, and misconceptions. Through and African Feminist lens, this study examines how these perceived barriers intersect with each other, and how they negatively impact women’s access to family planning and their perceived value of contraceptives in Luweero, Uganda. This qualitative study analyzed data collected from healthcare workers at one private clinic and one public clinic that offer family planning services in four focus group discussions in Luweero, Central Region, Uganda. Two focus group discussions were held in each clinic. Coded transcripts were analyzed using a reflexive methodology through an African Feminist lens. Most of the responses indicated that financial constraints experienced either by the clinic or the women significantly impact access family planning. Healthcare workers and Village Health Teams (VHTs) reported that funding constraints impact their ability to reach the clients with the resources they need in the rural areas, and clients in rural areas are often not able to afford the cost of family planning methods, especially when considered with the hidden costs of contraception. Social barriers were also discussed, and the participants explained that barriers such as stigma, misconceptions, lack of knowledge, religiosity and cultural values impact women’s motivation or ability to access contraceptive methods. Side effects also have a significant role to play in women’s ability or motivation to navigate through these perceived social barriers. Participants determined that increased funding for transportation for VHTs, consistent funding for free contraception, and expanded sensitization efforts that particularly target men would be some of the most impactful methods they can adapt to address some of these barriers. This study demonstrates that increasing women’ access to contraception in rural Uganda requires increased state funding for sensitization efforts and subsidized contraceptive methods. Social barriers can be more deeply understood and addressed by the international development community through an African Feminist lens, which explores modern contraceptives in the Ugandan context in a more culturally, socially and historically conscientious way.

This research explored the reproductive needs of people of low socio-economic standing living with HIV/AIDS (PLWHA) and attending public health facilities in South Africa. A qualitative research design based on the theoretical framework of critical realism using grounded theory was employed in revealing the dominant unobserved underlying mechanisms, powers and structures that influence their reproductive decision-making. HIV-positive men, HIV positive pregnant women and HIV positive non-pregnant women were recruited by HIV counsellors from the Ante-Natal Clinic and the Voluntary Counselling and Testing Clinic at the Kalafong Hospital. Individual interviews were used to explore participants’ reproductive needs. Focus group discussions were employed to holistically explore the HIV counsellors’ attitudes and perceptions regarding their clients’ reproductive needs and future family planning. Parenthood was an important factor to all participants in establishing their gender identities. Different cultural norms existed for men and women realising their reproductive needs. Society expects of women to be mothers, yet at the same time negatively judges HIV-positive women who choose to become pregnant or refuse to abort an existing pregnancy. Consequently, most women choose not to disclose their status and continue to live as if they are not HIV-positive. Having children is so important to these reproductive-aged PLWHA that they will risk their own health, the health of their partners and their babies. Emancipatory transformation of current HIV counselling services is needed and can be established by improving counsellor knowledge through training as well as giving PLWHA access to accredited HIV risk reducing services. / Thesis (PhD)--University of Pretoria, 2013. / lk2014 / Psychology / PhD / unrestricted