Thesis (Mnutr)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: Pregnancy and growth have been found to have a detrimental effect on the micronutrient status of adolescent girls. Dietary studies in adolescents have shown serious shortfalls in their dietary iron and folate intake. The competition for nutrients between the fetus and a pregnant adolescent may carry the risk of complications such as intrauterine growth retardation, pre-eclampsia, both maternal and fetal intrapartum mortality, the increased risk of birth injuries and low birth weight. The aim of the study was to assess the nutritional status of rural black, pregnant teenagers attending the antenatal clinic at Siloam Hospital in the Limpopo Province, with special emphasis on iron and folic acid intake, and evaluation of the newborn babies in terms of weight status and neural tube defects. The nutritional status was determined in 40 pregnant and 40 non-pregnant adolescent girls. The pregnant girls were selected during their first visit to the antenatal clinic, and the non-pregnant girls were selected from nearby schools. The demographic and dietary history questionnaires were used to collect information from the subjects. The dietary intake of the subjects was collected by the completion of a pre-tested quantified food frequency questionnaire. The anthropometric questionnaire was used to get information from the pregnant adolescents and the control group. The infant anthropometric measurements questionnaire provided information on the infant and the outcome of birth. Blood was collected from the pregnant adolescent girls and the control subjects. Anaemia was observed in 57.5% of the pregnant and 27.5% of the non-pregnant adolescents (haemoglobin <Il g/dl and <12 g/dl, respectively). The prevalence of low serum ferritin « 12 ug/L) and low transferrin saturation « 16%) was high in both the pregnant (30% and 60% respectively) and the non-pregnant adolescents (17% and 72.5% respectively). Iron deficiency was observed in 45% of the pregnant girls and 35% of the control subjects. The prevalence of iron deficiency anaemia in the pregnant girls (30%) and the control subjects (22.5%) was high. Low red blood cell folate in pregnant and non-pregnant girls was uncommon. Low serum vitamin BI2 was common in most of the pregnant girls. Analysis of the quantitative food frequency questionnaire (QFFQ) that was completed for 80 of the pregnant and non-pregnant girls showed that 55% had low dietary iron intakes «67% of the RDA) (p = 0.7307). Forty-five percent of the pregnant girls reported taking iron supplements. The QFFQ showed 20% of pregnant girls with low intake of folate (p = 0.0577). Forty-five percent of pregnant girls also reported taking folate supplements. Anthropometric measurements of pregnant girls and their dietary intake could not be correlated to the birth outcome. The social profile of the subjects did not seem to influence their iron and folate status and the outcome of pregnancy. The findings in this study showed that pregnant adolescents appeared to be similar to the non-pregnant adolescent girls socio-economically, anthropometric and nutritionally. We recommend that educational programmes targeted at adolescents and teenagers in the Siloam area should reach girls that could potentially fall pregnant. An educational programme must include: reproductive needs (avoidance of sex or safe sex); nutritional needs, especially targeted at improving nutritional status to meet future reproductive needs; early booking at the antenatal clinic and effective supplementation during pregnancy. The need to improve the dietary and nutrient intake of the adolescent girls should be addressed within the current framework of the Integrated Nutrition Programme (!NP). A food fortification programme with essential micronutrients such as iron, folic acid, zinc and Vitamin A to improve the micronutrient status should be promoted among the adolescent girls. / AFRIKAANSE OPSOMMING: Daar is bevind dat swangerskap en groei 'n nadelige effek het op die mikronutriëntstatus van vroulike adolessente. Dieetstudies in adolessente het ernstige tekortkominge in dieetyster- en folaatinnames getoon. Die kompetisie vir nutriente tussen die fetus en die swanger adolessent kan verantwoordelik wees vir komplikasies soos intra-uterine groeivertraging, preeklampsie, verhoogde mortaliteit van beide moeder en baba tydens kraam, 'n verhoogde risiko vir geboortebeserings en lae geboortegewig. Die doel van die studie was om die effek van voedingstatus by swart, swanger tieners by die voorgeboortekliniek in Siloam Hospital in die Limpopo-provinsie te bepaal, met spesifieke verwysing na die yster- en foliensuurinname, asook die evaluering van die pasgebore babas in terme van gewig en neurale buis defekte. Die voedingstatus van 40 swanger en 40 nie-swanger adolessente meisies IS bepaal. Die swanger meisies is ewekansig geselekteer gedurende die eerste besoek aan die voorgeboortekliniek , en die nie-swanger meisies is geselekteer by nabygeleë skole. Die demografiese en dieetgeskiedenisvraelyste is gebruik om inligting van die proefpersone in te samel. Voorafgetoetste gekwantifiseerde voedselfrekwensie vraelyste is gebruik om die voedselinname van proefpersone te bepaal. Antropometriese vraelyste is gebruik om antropometriese inligting van die swanger adolessente en die kontrole groep. Die antropometriese vraelys vir babas is gebruik om inligting ten opsigte van die baba aan te teken asook die verloop van die swangerskap. Bloedmonsters is van die swanger tieners en die kontrole groep ingesamel. Anemie is waargeneem by 57.5% van die swanger en 27.5% van die nie-swanger adolessente (hemoglobien <Il g/dl en <12 g/dl onderskeidelik). Die voorkoms van lae serum ferritien « 12 ugIL) en lae transferrienversadiging « 16%) was hoog by beide die swanger (30% en 60%) en die nie-swanger adolessente (17.5% en 72.5% onderskeidelik). Ystergebrek is in 45% van die swanger meisies en in 35% van die kontrole groep waargeneem. Die voorkoms van ystergebrekanemie in die swanger meisies (30%) en die kontrole groep (22.5%) was hoog. Lae rooibloedselfolaat by swanger en nie-swanger meisies is nie algemeen waargeneem nie. Lae serum vitamien B12 was algemeen by die meeste swanger meisies. Ontleding van die gekwantifiseerde voedselfrekwensievraelys (KVFV) wat vir 80 van die swanger en nie-swanger meisies voltooi is, het getoon dat 55% 'n lae dieetysterinname gehad het «67% van die ADT) (p=0.7307). Vyf-en- veertig persent van die swanger meisies het bevestig dat hulle ystersupplemente gebruik het. Die gekwantifiseerde voedselfrekwensievraelys (KVFV) het getoon dat 20% van die swanger meisies 'n lae folaatinname het (0.0577). Vyf-en-veertig persent van die swanger meisies het ook genoem dat hulle folaatsupplemente gebruik het. Die antropometriese metings van swanger meisies en dieetinname kon nie gekorreleer word met die verloop van die geboorte nie. Dit blyk dat die sosiale profiel van die meisies nie 'n effek op die yster- en folaatstatus en op die verloop van swangerskap gehad het nie. Die bevindinge van hierdie studie toon dat swanger en nie-swanger adolessente meisies sosio-ekonomies, antropometries en nutrisioneel dieselfde voorkom. Dit word aanbeveel dat voorligtingsprogramme vir adolessente en tieners in die Siloam-area meisies moet bereik wat moontlik swanger sal word. 'n Voorligtingprogram moet die volgende insluit: reproduktiewe behoeftes (vermyding van seks of veilige seks); voedingbehoeftes, veral geteiken om voedingstatus te verbeter om ten einde toekomstige voorplantingsbehoeftes te vervul; vroeë besoeke aan die voorgeboortekliniek en effektiewe supplementering gedurende swangerskap. Die behoefte om die dieet en nutriëntinname van adolessente meisies te verbeter moet binne die huidige raamwerk van die Geintegreerde Voedingsprogram aangespreek word. 'n Voedselfortfiseringsprogram met essensiële mikronutriënte soos yster, foliensuur, sink en vitamien A om die mikronutriëntstatus van adolessente meisies te verbeter, moet bevorder word.

MA (Psychology) / Department of Psychology / In South Africa, today, teenage pregnancy is on the increase, resulting in social and public health problems. The Department of Health (2002) indicates that, nationally 16.4% of the teenagers become pregnant every month. The Department also states that 26.4% of Grade 8 learners, 13.4% Grade 9 learners, 12.6% Grade 12 and 13.3% Grade 11 learners, fall pregnant every month. Many of these teenage mothers are confronted with various health problem, for example, HIV/AIDS, psychological (for example, high stress) and social problems (for example, lack of parenting skills, neglect, poverty, and low educational attainment). These problems have far-reaching consequences on the mothers. For example, many teenage mothers drop-out of school, attempt to commit suicide, as well as take part in prostitution and robbery. Many are unemployed and this puts the welfare of their children at risk. This research study was qualitative in nature. The exploratory phenomenological design was used in this study to explore the experiences or challenges of teenage mothers on social support as pregnancy interferes with all aspects of their lives. For example, it jeopardises teenage mothers’ relationships with their parents who are the main source of support for the young mothers. If this relationship is broken, it reduces the chances of the young mother’s success. These factors contribute to an inadequate parent-child interaction and diminish the infant’s development. Support during pregnancy and after birth is vital for a teenage mother. If her future and mental health are to be bright, then she needs to have strong social support. Non- probability sampling methods were used, namely purposive and snowball sampling. Pre-testing was done with four teenage mothers who had the same background as those in the main study. Data were collected from six teenage mothers through semistructured face to face interviews which required teenage mothers to answer a set of predetermined questions. The question asked allowed probing and clarification of answers. A tape recorder was used and the language used was Tshivenda. All ethical issues were adhered to throughout the study. Interpretative Phenomenological Analysis (IPA) was used to analyse the collected data. The findings from the interviews were integrated to avoid repetition. From the analysed v data, the following themes emerged: Challenges experienced by teenage mothers; Support system for teenage mothers; and Coping strategies for teenage mothers. Analysis of data revealed that lack of social support for teenage mothers was a major problem and this was collaborated by literature. These findings revealed that teenage mothers experience many challenges compared to the support they get from significant others. In this study, the researcher found that doing field work with teenage mothers with low educational backgrounds is very challenging because they do not understand what research is all about. The researcher realised that there is more that South African needs to do to encourage people to support teenage mothers. Whilst the work done at Tshikuwi is appreciated, the researcher feels it is too little too late considering the number of teenage mothers who continue to lack support. The researcher recommends that teenage mothers who experience challenges should take the initiatives to start projects that will boost their confidence. Teachers who teach life science orientations should, in the meantime, focus on teaching learners about the consequences of not having support either from family or partners and communities.

PhDPH / Department of Public Health / There is a growing concern over the rising cases of adolescent pregnancy, drug and substance abuse, poor academic performance, violence, high school dropout rate and HIV/AIDS prevalence among secondary school students. The grounds of these problems are considered to be related to inadequate Life Orientation Education which should equip the learners with psychosocial competencies, but the ability to make informed decision, solve problems, think creatively and critically, communicate effectively, build healthy interpersonal relationships is lacking among the youths (Dash, 2018). The purpose of the study was to develop strategies to facilitate the implementation of existing Life orientation curriculum in secondary schools of Limpopo province, South Africa. An exploratory sequential design was used in this study. This research design had three stages. In the first stage (1a) the researcher collected and analysed quantitative data. Based on the quantitative results, the researcher will then engage a second stage (1b), the qualitative phase, to test and make the general view of the initial findings. This was followed by phase 3, which was the development of the coping strategies and validation of the strategies as outlined. Purposive sampling was employed to select two districts and then four circuits. Phase 1a identified factors influencing implementation of existing Life Orientation curriculum. Eight schools were selected using stratified random sampling. Simple random sampling was used to select 521 grade 10, 11 and 12 adolescent girls. Data was collected through a self-designed and self-administered questionnaire. Data was analysed descriptively using statistical software Stata/IC version 15.0. of the computer program. Validity and reliability were ensured. Phase 1b identified the predisposing, enabling, and reinforcing factors that can affect the behaviours, attitudes, and environmental factors contributing to the implementation of Life skills programmes in schools. A qualitative approach, and explorative, descriptive and contextual designs were applied. The population were all guardians and school teachers. Purposive sampling was used to select guardians for the focus groups discussions and teachers for in-depth interviews. Data analysis employed Tesch open coding method. Phase 2 was the development strategies to facilitate the implementation of existing LO programme in Limpopo province. Results from Structured Interviews, Focused group, Questionnaires were fused together with the use of the Precede Proceed Model. Phase 3 was to validate the developed strategies. The aim of validation was to collect and evaluate data, from the process design stage, the consistency and quality of the product or outcome of the strategies. The objectives to validate the strategies were to: determine the credibility of the strategies. The researcher used the non–experimental, intervention validation design to validated the credibility of the developed strategies. The developed strategies were given to the learners, guardians and Life Orientation teachers Vhembe and Mopani district. To collect data, the researcher used a checklist with 6 questions as outlined by Chin and Kramer (refer to table 6.4). Simple descriptive statistics was use where the data was summarized using the frequency distribution. / NRF

This study explored knowledge, perceptions and attitudes regarding contraception and contraceptive practices among secondary school learners in the Limpopo Province. Self-administered questionnaires were completed by 612 Grade 8 and 332 Grade 12 learners from 24 randomly selected secondary schools. The study found that permissive attitudes prevailed towards sex, characterised by casual sexual activities commencing at 12 years of age. The availability of contraceptive and termination of pregnancy (TOP) services did not enable learners to utilise them, because of social, cultural, financial and service barriers. Most learners were sexually active without being knowledgeable about contraceptives, emergency contraceptives and TOP services. Two workshops conducted with learners produced similar results to those obtained from the completed questionnaires. Semi-structured interviews conducted with nurses, providing contraceptive and TOP services in the Limpopo Province, also substantiated the findings from the questionnaires. Secondary school learners in the Limpopo Province require more knowledge about and ready access to contraceptives to enable them to delay child bearing until they are emotionally, financially and physically ready for these responsibilities. Nurses and teachers in this province can enhance the learners' contraceptive knowledge and utilisation to help learners make better informed decisions about their own and their future children's lives. / Health Studies / D. Litt. et Phil. (Health Studies)

This study explored knowledge, perceptions and attitudes regarding contraception and contraceptive practices among secondary school learners in the Limpopo Province. Self-administered questionnaires were completed by 612 Grade 8 and 332 Grade 12 learners from 24 randomly selected secondary schools. The study found that permissive attitudes prevailed towards sex, characterised by casual sexual activities commencing at 12 years of age. The availability of contraceptive and termination of pregnancy (TOP) services did not enable learners to utilise them, because of social, cultural, financial and service barriers. Most learners were sexually active without being knowledgeable about contraceptives, emergency contraceptives and TOP services. Two workshops conducted with learners produced similar results to those obtained from the completed questionnaires. Semi-structured interviews conducted with nurses, providing contraceptive and TOP services in the Limpopo Province, also substantiated the findings from the questionnaires. Secondary school learners in the Limpopo Province require more knowledge about and ready access to contraceptives to enable them to delay child bearing until they are emotionally, financially and physically ready for these responsibilities. Nurses and teachers in this province can enhance the learners' contraceptive knowledge and utilisation to help learners make better informed decisions about their own and their future children's lives. / Health Studies / D. Litt. et Phil. (Health Studies)

MPM / Oliver Tambo Institute of Governance and Policy Studies

MPH / Department of Public Health / See the attached abstract below

MPH / Department of Public Health / Unplanned pregnancy is a major medical, social and public health problem worldwide. This problem affects learners’ performance and leads to a high learner drop-out rate at schools. The purpose of this study was to investigate the factors influencing unplanned pregnancy among high school learners in the Collins Chabane Municipality, Limpopo Province, South Africa. A quantitative study using survey methods was used. A structured questionnaire was used to collect data. The total sample size was 362 female learners ranged between learners whose ages ranged between 16 and 24. Only female learners in the school were recruited to participate in the study. Validity and Reliability were ensured. Data were analyzed using SPSS version 25.0 program. Descriptive and inferential statistics were used to summarize and present the data. Permission to conduct the study was obtained from the Department of Education, Limpopo Province, the Malamulele Circuit and the Principal of the school. Informed consent was obtained from parents on behalf of female learners under 18 years of age. Confidentiality and anonymity was ensured. The study found that about 58.2% of adolescents had used contraceptives, while 64.1% indicated that they needed more information on contraceptive methods and their use. The study also found that about 71.8% of the respondents had abstained from sexual activities in order to avoid unplanned pregnancy. Unplanned pregnancies were found to be associated with ignorance of the consequences of sexual activities, information about sex from their peers and the power imbalance in sexual relationships between male and female adolescents. It is recommended that adolescents be given adequate information about contraceptives, addressing the advantages, disadvantages, side effects and how to manage their side effects. This would help mitigate against the negative attitudes that the adolescents have toward contraceptives owing to misinformation and misconceptions. In addition, school health nurses should use Information Education Communication (IEC) materials on family planning to increase awareness about family planning and to prevent unplanned pregnancies. The IEC materials should be in the most common languages of Limpopo Province, i.e. Sepedi, Xitsonga and Tshivenda for clear understanding of the content. / NRF

DEd (Educational Management) / Department of Educational Management / This study sought to establish the impact of interventions employed by schools to support the teaching and learning of pregnant and parenting learners (PPLs) in the Mopani district of Limpopo province, South Africa. The study employed qualitative research methodology to gather narrative data from 68 key school-based education stakeholders who were purposively sampled and interviewed on what their schools were doing to support the teaching and learning of PPLs they enrolled. Data were collected through face-to-face and focus group interviews, as well as document analysis. The study revealed that although all the four schools provided basic access to education for PPLs, their inclusive support systems and strategies to assist PPLs to cope with and benefit from the school curriculum activities were largely superficial due to the following challenges: educators, as the primary duty bearers to PPLs were not trained to identify the educational needs of PPLs and to implement relevant strategies for teaching and learning of PPLs; there was inadequate political-will to support PPLs by educators; there was inadequate collegial relationship between mainstream learners and PPLs, there was no synergy between national and school policies on management of schoolgirl pregnancy and there was non-involvement of other professionals to provide psycho-social support at the four schools. The study revealed that cultural and traditional practices of the community contributed to the negative attitudes to teenage motherhood that resulted in inadequate support service provision and structures for teaching and learning of PPLs. The study recommends that the Department of Education (DoE) must put in place formal training on policy and practice for all the key school-based education stakeholders and employ a multi-sectoral counselling system to support enrolled pregnant and parenting schoolgirls to cope with schooling. / NRF

Text in English / Learner pregnancy in secondary schools of South Africa is a public health problem that requires the involvement of parents, teachers and health workers in order to promote maternal and child health and retain learners in school. The aim of this study was to explore and describe the experiences of teachers, parents and pregnant learners regarding facilitation of health for pregnant learners and then develop a model to facilitate social support for pregnant learners attending secondary schools in order to attain and maintain health for the mother and her newborn baby and prevent school dropout. A qualitative, exploratory, descriptive and contextual theory generating study was conducted using semi-structured interviews to collect data from ten pregnant learners, ten teachers and five parents who were purposely selected and voluntarily participated. Data was analysed using Tesch’s open coding method where six themes emerged. The themes were then discussed with literature control. The findings revealed that pregnancy amongst secondary school learners in Limpopo Province is a challenge to teachers, parents and pregnant learners regarding social support for pregnant learners to continue attending school and remaining healthy. A concept analysis was performed and revealed facilitation of social support as the main concept, and then other concepts related to it were identified and classified. The model was developed through the steps of theory generation and was then submitted to a panel of experts for evaluation who found it useful to nursing practice and society in general. The model promotes interaction between the role players in education to address learner pregnancy and can also be useful in addressing other challenges in the schools. It is facilitated by a school health nurse but can also be facilitated by a teacher or a social worker in cases where a school health nurse is not available. The guidelines for the implementation of the model were formulated and described. Pregnant learners, as recipient of social support, should submit themselves to the support offered by the social network and communicate their needs openly to the professional nurse, their parents and teachers, so that they can receive adequate social support. / Health Studies / D. Litt. et Phil. (Health Studies) / 1 online resource (xv, 206 pages) : illustrations (some color), maps (some color)