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 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)

Text in English / This qualitative descriptive phenomenological study explored the experiences of HIV positive women utilising PMTCT services at a central hospital in Zimbabwe. Data was collected using in-depth interviews of fifteen participants. The interviews were audio recorded and transcribed verbatim. Using the Interpretive Phenomenological Analysis framework for data analysis, two super-ordinate themes emerged, namely resources for provision of PMTCT services and approaches and nature of PMTCT care. The study revealed challenges experienced by HIV positive women emanating from material, financial and human resource related constraints in the PMTCT setting. The resource challenges negatively affected access and utilisation of PMTCT services. A practice model, whose purpose is to enhance the quality and utilisation of PMTCT services, was developed and described. The model was evaluated using Chin and Krammer (2011) criteria plus a modified form of the Delphi technique. These findings have implications for effective PMTCT service provision. The key lessons learnt for programmatic improvement were that in order to provide quality and accessible PMTCT services the health care system will need to be well resourced. There is need to strengthen the health care system in line with HIV related programmatic changes. / Health Studies / D. L.itt. et Phil. (Health Studies)