Thesis (M.CUR.) -- University of Limpopo, 2014 / Indigenous practices (IPs) are experiences generated by people who are living in a specific region context and a specific cultured group. IPs are shaped by cultural traits that are passed from one generation to the next. The practices are rooted and embedded in such a society and, therefore, the practices become part of the people’s lifestyle. It is difficult to try and change these practices, since people have adhered to them throughout their entire lives. The believe system plays a major role in health care seeking behaviour of individuals because they are informed by the IPs that are observed in their environment (Shaik & Hatcher, 2005). IPs are stored in people’s memories and are expressed in songs, dances, beliefs, rituals, cultural values, myths, and healing of diseases by using herbs. During pregnancy, IPs are still applied worldwide. Ayaz and Efe (2008) indicate that it occurs mostly in Turkey and Africa where women’s reassurance is depending on the local context and meaning of pregnancy. THE PURPOSE OF THE STUDY To determine indigenous practices of pregnant women at the Dilokong Hospital in the Greater Tubatse Municipality of the Limpopo Province.This was achieved by the exploring and describing the indigenous practices of pregnant women in the antenatal (ANC) clinic of the maternity ward at the Dilokong Hospital.. DESIGN AND METHOD A qualitative, descriptive, explorative and contextual research design was used for the participants to describe the indigenous practices by pregnant women. Data was collected by means of unstructured one-on-one interviews in maternity unit of the ANC clinic at the Dilokong Hospital of the Greater Tubatse Municipality. Ethical considerations as described by Denosa (2000) were adhered to in order to ensure the v quality of the study. The criteria for trustworthiness were observed as stipulated in Babbie and Mouton (2009).Fifteen pregnant women were interviewed. FINDINGS AND RECOMMENDATIONS Four themes with sub-themes emerged from the data analysis by using Tech’ṡ open coding approach (Creswell 2006, Botma, Greef, Mulaudzi & Wright, 2010). Four themes were emerged namely; indigenous practices based on ancestral knowledge; indigenous practices based on spiritual diviners versus church principles; restricted practices versus instructions followed during pregnancy and labour and indigenous practices during labour and delivery. It is recommended that a national IP strategy needs to be developed to provide a framework and platform to support and promote grass roots IPs into mainstream development in the health care system in relation to midwifery practice. CONCLUSION The study findings indicated that IPs were regarded as an honourable health intervention by THPs, families, and pregnant women. They showed trust in methods used to preserve pregnancy, labour, and delivery, although, the indigenous practices by pregnant women still continue. Indigenous practices such as cords around their waists, are still observed during physical examinations. However, there is a reduction of prescribed potions mixed with cool drinks for use to accelerate labour and to prevent negative consequences because the potential toxicity has been explained during the provision of health education. These findings call for health care professionals to emphasise training and workshops for the THPs church diviners that are the fundamental principle of effective implementation of IPs to enhance improvement in the prevention of complications during pregnancy, labour and delivery. KEYWORDS Pregnant women Indigenous practice Indigenous knowledge Antenatal care

Overweight and obesity are a growing national concern, particularly among women and selected minority populations (Ayala, Elder, Campbell, Slymen, Roy, Engelberg, et al., 2004; NHANES, 2003). Pregnant women bear a disproportionate risk of becoming overweight or obese (Greene, Smickikias-Wright, Scholl, & Karp, 1988; Gunderson et al., 2000; Rossner, 1999). Although exercise is a key factor in preventing overweight and obesity, women often decrease their exercise levels during pregnancy (McTigue, Garrett, & Popkin, 2002; Viau, Padula, & Eddy, 2002; Zhang & Savitz, 1996). Reported percentages of regular exercise during pregnancy have been documented as low as 5% in a predominately White population (Steele, 2002). Although there is ample evidence demonstrating that Hispanic women exercise less than White women during every other stage of life, little is known about how pregnant Hispanic and White women compare in exercise behaviors (Crespo, Smit, Andersen, Carter-Pokras, & Ainsworth, 2000). The purpose of this research was to study low-income White and Hispanic pregnant women to (1) determine the nature and the extent of exercise behaviors both before pregnancy and during pregnancy (2) identify factors that influence exercise behaviors (3) determine if there are differences in factors that influence exercise between ethnicities. Data were collected via a questionnaire developed by the author. A sample of 301 White and Hispanic pregnant women were recruited through the Women, Infants, and Children [WIC] agencies in four selected counties in Oregon. Although ACOG guidelines provide clear information on the benefits of exercise, over 90% of the women surveyed did not exercise at ACOG guidelines. A majority of the women, 57.8%, actually decreased exercise during pregnancy. Although ethnic differences did not exist in the prevalence of exercise during pregnancy, differences between ethnicities were found in the variety of exercise activities performed and behavioral factors that predicted exercise behavior. Analysis of these differences and the factors contributing to the overall low levels of exercise may provide critical information for future intervention program planning. Well targeted programs will ultimately decrease the excessive weight gain and subsequent increased risk for overweight or obesity that pregnant women face. / Graduation date: 2006

published_or_final_version / Buddhist Studies / Doctoral / Doctor of Philosophy

The health of pregnant women is a major concern to health care providers. This grounded theory study of 40 women examined the health of pregnant women and the special threat that poverty and violence posed to their capacity for health. Pregnant women experienced their health as an integrated part of their daily lives; that is, they reported that their health was affected by 'everybody and everything." Women's main concern during pregnancy was to have a healthy newborn and, to this end, they engaged in the process of creating a healthy pregnancy by engaging in health-enhancing behaviours. In this process, the woman focused primarily on ensuring the birth of a healthy baby. Three conditions were essential to a woman's capacity to create a healthy pregnancy: (1) the acceptance of the pregnancy, (2) adequate financial resources, and (3) supportive relationships (especially having a supportive partner). Pregnancies invariably carried with them some uncertainty, and this caused the 40 women in this study to experience a state of vulnerability which, in turn, triggered attempts to create healthy pregnancies. This led to a cycle of improving health: the more energy women had to carry out health-enhancing behaviours the better they felt physically and mentally; the more able they were to conduct their daily activities; and, consequently, the better their health. However, living within a context of poverty and/or violence increased pregnant women's vulnerability and decreased their capacity for creating a healthy pregnancy, leading to extreme stress and the experience of threat. Male violence threatened the women's ability to be connected to those who were important sources of emotional, financial, task-oriented, and knowledge-oriented support, and, thus jeopardized their ability to meet their fundamental needs. Furthermore, the lack of sufficient financial resources limited women's abilities to leave their abusive partners. In order to survive, women in these circumstances sometimes reverted to previous, often harmful, ways of coping in an attempt to reduce their high levels of stress. These coping strategies usually took the form of behaviours that required little energy, such as smoking, not eating properly, and consuming alcohol. Having financial support and a safe place to go were crucial with regard to enabling women to decide to leave abusive partners. Regaining control of their lives in this way allowed women to refocus their energy on health-enhancing behaviours. The women in this study showed incredible strength as they met the challenges imposed by poverty and abuse. They did not remain victims but took hold of their lives with courage and conviction. In order to promote the adoption of health-enhancing behaviours by childbearing women, health care providers must recognize poverty and violence as factors that significantly threaten women's capacity for health. Further to this, special efforts must be made to render culturally sensitive care to First Nations women (i.e., recognizing their cultural identity and heritage, their connection to nature, and the importance of the elders of their community). To this end, we must recognize the connections between racism, colonization, poverty, and violence. For until we have eradicated poverty, and the cycle of violence and degradation that is its legacy, we will not have succeeded in doing all we can to ensure the health and well being of our citizens.

Studies have shown that pregnant women do understand and value information of their unborn child. However, those providing health promotion services often focus on medical procedures and health education messages, ignoring the cultural, socio-economic and psychological dimensions that impact on women's health. This research aimed to look at a specific component of health promotion, i.e. health promotion messages shared with pregnant women attending Stellenbosch and Klapmuts Community Health Centre Antenatal Health Promotion Programme and their perceptions of how they apply messages in their daily lives.

Thesis (M.S.)--University of Michigan, 1994.

Thesis (M.S.)--University of Michigan, 1994.

The health of pregnant women is a major concern to health care providers. This grounded theory study of 40 women examined the health of pregnant women and the special threat that poverty and violence posed to their capacity for health. Pregnant women experienced their health as an integrated part of their daily lives; that is, they reported that their health was affected by 'everybody and everything." Women's main concern during pregnancy was to have a healthy newborn and, to this end, they engaged in the process of creating a healthy pregnancy by engaging in health-enhancing behaviours. In this process, the woman focused primarily on ensuring the birth of a healthy baby. Three conditions were essential to a woman's capacity to create a healthy pregnancy: (1) the acceptance of the pregnancy, (2) adequate financial resources, and (3) supportive relationships (especially having a supportive partner). Pregnancies invariably carried with them some uncertainty, and this caused the 40 women in this study to experience a state of vulnerability which, in turn, triggered attempts to create healthy pregnancies. This led to a cycle of improving health: the more energy women had to carry out health-enhancing behaviours the better they felt physically and mentally; the more able they were to conduct their daily activities; and, consequently, the better their health. However, living within a context of poverty and/or violence increased pregnant women's vulnerability and decreased their capacity for creating a healthy pregnancy, leading to extreme stress and the experience of threat. Male violence threatened the women's ability to be connected to those who were important sources of emotional, financial, task-oriented, and knowledge-oriented support, and, thus jeopardized their ability to meet their fundamental needs. Furthermore, the lack of sufficient financial resources limited women's abilities to leave their abusive partners. In order to survive, women in these circumstances sometimes reverted to previous, often harmful, ways of coping in an attempt to reduce their high levels of stress. These coping strategies usually took the form of behaviours that required little energy, such as smoking, not eating properly, and consuming alcohol. Having financial support and a safe place to go were crucial with regard to enabling women to decide to leave abusive partners. Regaining control of their lives in this way allowed women to refocus their energy on health-enhancing behaviours. The women in this study showed incredible strength as they met the challenges imposed by poverty and abuse. They did not remain victims but took hold of their lives with courage and conviction. In order to promote the adoption of health-enhancing behaviours by childbearing women, health care providers must recognize poverty and violence as factors that significantly threaten women's capacity for health. Further to this, special efforts must be made to render culturally sensitive care to First Nations women (i.e., recognizing their cultural identity and heritage, their connection to nature, and the importance of the elders of their community). To this end, we must recognize the connections between racism, colonization, poverty, and violence. For until we have eradicated poverty, and the cycle of violence and degradation that is its legacy, we will not have succeeded in doing all we can to ensure the health and well being of our citizens. / Applied Science, Faculty of / Nursing, School of / Graduate

Summaries in English and Sesotho / This qualitative, exploratory, descriptive study explored culturally sensitive health information about the use of herbal medicine by pregnant women in Lesotho, in order to provide culturally sensitive health advice to pregnant women. Pregnant women used herbal medicine and remedies during pregnancy resulted in still births and complications during labour. Data on the beliefs and practices of fifteen purposively and conveniently sampled pregnant women attending a rural antenatal clinic was collected through semistructured interviews and analysed using Colaizzi’s seven-step method. Ethical principles and strategies to ensure trustworthiness were applied. One central theme emerged: ‘Women believe that the use of herbal medicine and remedies is a traditional practice that pregnant women need to follow due to culture’. The cultural beliefs and practices of the women were deeply rooted in Basotho culture, which guided the use of herbal medicine. However, some considered herbal medicines to be harmful, as the dosage and content of these medicines vary. Nurses are therefore key to providing culturally sensitive health care advise on using herbal medicine during pregnancy. / Boithuto bona ba boleng bo botle, bo hlalosang le ho fumaneng tlhaiso-leseling e mabapi le bophelo bo botle mabapi le ts’ebeliso ea meriana ea litlama ke basali ba baimana Lesotho, ele ho fana ka likeletso tsa bophelo bo botle ba setso. Lintlha tse mabapi le litumelo le litloaelo tsa basali ba baimana ba leshome le metso e mehlano ka boomo le ka mokhoa o fumanehang li ile tsa bokelloa ka lipuisano tse hlophisitsoeng le ho hlahlojoa ho sebelisoa mekhoa e supileng ea Colaizzi. Melao-motheo ea boits’oaro le maano a ho netefatsa hore a ts’epahetse a sebelisitsoe. Ho ile hoa hlaha sehlooho se le seng se bohareng: ‘Basali ba lumela hore ts’ebeliso ea litlama ke tloaelo eo basali ba baimana ba lokelang ho e latela ka lebaka la moetlo’. Litumelo le litloaelo tsa basali li ne li metse ka metso moetlong oa Basotho, o neng o tataisa ts’ebeliso ea meriana ea litlama. Leha ho le joalo, ba bang ba ne ba nka meriana ea litlama e le kotsi, hobane litekanyetso le litlhare tsa meriana ena li ea fapana. Ka hona baoki ke senotlolo sa ho fana ka thuto ea bophelo bo botle ba setso mabapi le ho sebelisa litlama nakong ea boimana. Mehopolo ea bohlokoa Meriana ea litlama, litumelo le litloaelo tsa moetlo, basali ba baimana, thuto ea bophelo bo botle / Health Studies / M.A. (Public Health)

Environmental exposure levels are often sufficiently disparate between populations such that there is little or no overlap, complicating our ability to ascertain the full dose-response curve and as such create informed regulatory policy.I reviewed the literature on methods available to address non- and partially-overlapping exposure distributions, drawing from both epidemiology as well as other relevant disciplines to describe the universe of proposed solutions. I also used the case study of maternal PCB-153 exposure and birthweight, utilizing real-world and simulated data to explore our ability to ascertain “true” dose-response curves from observational data given the limited cohort-specific exposure ranges. I investigated the importance of controlled and uncontrolled confounding as well as the impact of sample size on our ability to ascertain a “true” underlying dose-response curve. Pooling and meta-analysis were useful to increase the heterogeneity of exposure distributions despite imperfect confounding control and heterogenous confounding structures across cohorts. The analyses also serve as continued evidence of the challenges of making population-wide inferences from study samples with restricted exposure ranges as well as the danger of pooling multisite data without sufficiently accounting for heterogeneity in both exposure level and distribution of confounders. These results highlight the limitations of using both individual studies and systematic reviews of environmental chemicals, and emphasize the need for pooling and meta-analysis to widen exposure distributions that in turn permit us to accurately capture the negative effects of these environmental chemicals.