“The Politics of Abortion Care in Ohio” is based on 16-months (November 2021- February 2023) of ethnographic fieldwork and 47 semi-structured interviews conducted before and after the Dobbs Supreme Court decision (2022) overturning the right to abortion in the United States (US). Currently, 14 states have banned abortion and three have bans prior to six weeks of pregnancy. I assert that the criminalization of abortion care is a form of structural violence that leads to direct harm experienced by pregnant people. My dissertation strives to make significant contributions to theories of state-based violence with particular attention to reproductive governance, the anthropology of policy, and the politics of care. First, I develop my concept of reproductive gerrymandering, which names a particular phenomenon wherein the political power of voters who support reproductive healthcare access is suppressed across political party lines. It gives the false impression that the majority of residents in states that predominately elect Republican representatives want government elimination of abortion and related services. I argue that reproductive gerrymandering is a form of bureaucratic violence used to promote anti-abortion agendas, which then causes everyday structural harm to pregnant people. Second, building upon theories of agnotology, or the study of ignorance, I argue that “heartbeat” bans—legislation that advances medical misinformation—manipulates biomedical terms to imbue a particular social meaning to embryos at a very early stage of pregnancy. I explore how biomedical practices, in this case the use of ultrasound technology to detect a “heartbeat,” furthers the cultural production of ignorance around pregnancy and sends a strategic message about the beginnings of life. Third, I demonstrate how constant fluctuations in abortion policy shape temporalities of care in clinic settings. Finally, I reveal three overlooked dimensions of reproductive governance to better understand political control of reproductive bodies: administrative and regulatory, the spread of ignorance, and the political reconfiguring of reproductive time. Ultimately, I argue for the conceptual value of attending to temporalities of structural violence, and specifically the pace with which political violence unfolds.

Community participation has been hailed as the panacea for most community programmes. Community participation at high levels empowers communities, increases self-reliance, selfawareness and confidence in self-examination of problems and seeking solutions for them Behavioural changes are promoted and utilisation and support of services is facilitated, which is of great importance in antenatal care and generally in this present day of HIV/AIDS. The purpose of this study was to determine the extent to which women were participating in the provision of antenatal care. Secondly, the study sought the pregnant women's perceptions and expectations regarding their participation in the provision of antenatal care and to find out at what level if any, the women wanted to be involved in the provision of antenatal care. The theoretical model guiding this study was Rifkin' s model for evaluating community participation. A guided interview was conducted with 30 conveniently selected pregnant mothers residing in the area of the Chinamhora clinic. The results indicated limited participation in the five process indicators of community participation. However, all the women regarded community participation as being important. The majority of the women wished to be involved at high levels of participation. The results of this study should be valuable to health care professionais in formulating strategies and modifying existing programmes to enhance community participation, with the decentralisation of health services in Zimbabwe. / Health Studies / M.A. (Advanced Nursing Sciences)

Background: Group B streptococcus (GBS) is regarded as one of the most important causes of maternal and neonatal morbidity and mortality in many parts of the world. GBS recto-vaginal colonization is important in the health of a mother and her neonate, especially in developing countries. Maternal vaginal colonization with GBS at the time of delivery can cause vertical transmission to the neonate. Multilocus sequence typing (MLST) is a technique used to characterize microbial isolates by means of sequencing internal fragments of housekeeping genes and has the advantage of reproducibility and has been shown to correlate with the other typing techniques and thus has emerged as the standard for delineating the clonal population of GBS. The study aimed to investigate the epidemiology of GBS colonization among pregnant women and their neonates, and to characterize the isolates by multilocus sequence typing technique at Dr George Mukhari Academic Hospital, Pretoria. Methodology: A total of 413 pregnant women who visited the antenatal clinic were recruited and screened. Participants were interviewed using a questionnaire to gather demographic and other relevant information such as history of current pregnancy, previous miscarriages and still births. Samples from maternal rectum and vagina as well as neonate ear and umbilical cord were taken for culture using colistin and nalidixic acid (CNA) blood agar and incubated for 24-48 hours. If negative after 48 hours, Todd-Hewitt broth was subcultured after 18-48 hours onto sheep blood agar. Multilocus sequence typing (MLST) was used to characterize seven group B streptococcus isolates collected at Dr George Mukhari academic hospital. Fragments of seven housekeeping genes were amplified by polymerase chain reaction (PCR) for each strain and sequenced. CLC bio software (Inqaba biotech, South Africa; Pretoria) was used to analyse sequenced loci and UPGMA dendrogram was constructed. Results: The colonization rate for GBS in pregnant women and their neonates was 30.9% and 0%, respectively. A higher proportion of GBS were isolated from the rectum (37.9%) as compared to the vagina (20.6%). Most socio-economic, demographic and obstetric factors analysed were not significantly associated with.GBS colonization. On 128 positive samples, the results of Todd-Hewitt enrichment broth and direct plating method using CNA were compared. A total of 45.3% of colonised were positive on direct selective agar (CNA); an additional 54.7% samples were recovered from Todd-Hewitt broth. Three genes (adhP, glnA and tkt) were sequenced successfully for six samples (1, 2. 4,6,12 and 65). The UPGMA tree with 1000 bootstrap showing the relationship between six samples was drawn.Conclusion: This study revealed that pregnant women of all ages are at risk of group B streptococcus colonization. Group B streptococcus was common among pregnant women at Dr George Mukhari Academic Hospital. No socio-economic risk factor was associated with group B streptococcus colonization. Results confirm that the combination of Todd-Hewitt broth and CNA agar plate is a time saving and sensitive method. The allelic profile, characteristics such as G+C (guanine+cytosine) content and dN/dS ratio were not analysed because of the smaller sample size used in this study, which shows that the MLST method was unsuccessful in this study. The UPGMA tree based on differences in consensus of the isolates showed that all group B streptococcus isolates are clustered and descend from a single node. / Life & Consumer Sciences / Life Sciences / M.Sc. (Life Sciences)

The proposition that inadequate health literacy on antenatal care (ANC) is exacerbating maternal mortality in sub Saharan Africa (SSA) is undisputable. Yet, little is known about ANC literacy in Lesotho, an SSA country with high maternal mortality rates. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts using a semi-structured questionnaire making recourse to statistical principles. Overall, 16.4% of the participants had grossly inadequate ANC literacy, while 79.8% had marginal levels. Geographic location and level of education were the most significant predictors of ANC literacy. Participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Furthermore, significant knowledge gaps on baby layette and mother’s essential items for delivery were found. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas is recommended. / Health Studies / M.A. (Nursing Science)

Community participation has been hailed as the panacea for most community programmes. Community participation at high levels empowers communities, increases self-reliance, selfawareness and confidence in self-examination of problems and seeking solutions for them Behavioural changes are promoted and utilisation and support of services is facilitated, which is of great importance in antenatal care and generally in this present day of HIV/AIDS. The purpose of this study was to determine the extent to which women were participating in the provision of antenatal care. Secondly, the study sought the pregnant women's perceptions and expectations regarding their participation in the provision of antenatal care and to find out at what level if any, the women wanted to be involved in the provision of antenatal care. The theoretical model guiding this study was Rifkin' s model for evaluating community participation. A guided interview was conducted with 30 conveniently selected pregnant mothers residing in the area of the Chinamhora clinic. The results indicated limited participation in the five process indicators of community participation. However, all the women regarded community participation as being important. The majority of the women wished to be involved at high levels of participation. The results of this study should be valuable to health care professionais in formulating strategies and modifying existing programmes to enhance community participation, with the decentralisation of health services in Zimbabwe. / Health Studies / M.A. (Advanced Nursing Sciences)

Text in English / Malaria is endemic throughout Uganda and the leading cause of morbidity and mortality. Malaria causes complications in 80.0% of all pregnancies in Uganda. This study attempted to identify factors that influence pregnant women’s utilisation of anti-malaria services in the Buikwe district of Uganda. These factors were contextualised within the Social Learning Theory’s major concepts. The target populations comprised pregnant women attending antenatal clinics (phase 1) and midwives providing antenatal services (phase 2) at 16 clinics in the Buikwe district of Uganda during the data collection phase of the study. Structured interviews were conducted with a sample of 400 randomly selected pregnant women and with the accessible population of 40 midwives. Pregnant women, who had progressed beyond primary school level education, were more likely to take intermittent preventive treatment (IPT) drugs and to use long lasting insecticide treated nets (LLINs) to prevent malaria. Pregnant women were more likely to implement malaria-preventive actions if they lived within five kilometres of clinics, were satisfied with available health services, were knowledgeable about the malaria preventive measures and had used IPT during previous pregnancies. Pregnant women who implemented one malaria-preventive action were likely to implement other actions as well (Pearson’s correlation coefficient was 0.65; p<0.05). Midwives’ provision of malaria-preventive services to pregnant women were influenced by the availability of IPT drugs, accessibility of safe drinking water, frequency of giving health education to pregnant women, cooperation with village health teams, malaria-related in-service training, midwives’ education level and experience. Although 97.9% of the pregnant women had taken IPT and 84.2% of those who had received LLINs, utilised these nets, malaria prevention during pregnancy could be improved. All pregnant women should attend antenatal clinics at least four times during each pregnancy, commencing during the first trimester of pregnancy to receive adequate health education and prenatal services, including IPT and LLINs. All midwives should receive malaria-related in-service training. Regular audits of midwives’ records should identify and address strengths and weaknesses related to the prevention and management of malaria during pregnancy. Such actions could enhance the prevention and management of malaria, estimated to affect 80% of pregnant women in Uganda. / Health Studies / D. Litt. et Phil. (Health Studies)

Background Plasmodium falciparum malaria during pregnancy poses a substantial risk to mother and foetus. In recent years, convincing evidence has shown that preventive methods such as the use of insecticide treated bed nets (ITNs) and intermittent preventive treatment (IPT) in pregnancy with sulphadoxine-pyrimethamine (IPTp-sp) can greatly reduce the adverse effects of malaria during pregnancy. Purpose The main purpose of the study was to assess the knowledge and use of Intermittent Preventive Treatment of Malaria among pregnant women receiving Antenatal Care at the primary health centers of the Federal Capital Territory, Abuja Nigeria. Methods A quantitative, descriptive, cross-sectional study was conducted Structured questionnaires were administered to 300 pregnant women aged between 18 and 49 years. Data was analysed using Statistical Package for Social Sciences (SPSS) 22. Results The results revealed that most of the respondents had knowledge about IPT, majority of the respondents had received IPT drugs, in the clinic, but unfortunately none of them were supervised by a health worker during taking of the drug. Few of the respondents did not take the drugs at all for fear of complication, some of them did not know exactly how many tablets were given to them and there was poor adherence to the Directly Observed Therapy (DOT) scheme. Conclusion Knowledge of malaria and IPT was good and many pregnant women received the drugs and used it, but some of them had challenges and did not use the drugs. / Health Studies / M.P.H.

Background: Group B streptococcus (GBS) is regarded as one of the most important causes of maternal and neonatal morbidity and mortality in many parts of the world. GBS recto-vaginal colonization is important in the health of a mother and her neonate, especially in developing countries. Maternal vaginal colonization with GBS at the time of delivery can cause vertical transmission to the neonate. Multilocus sequence typing (MLST) is a technique used to characterize microbial isolates by means of sequencing internal fragments of housekeeping genes and has the advantage of reproducibility and has been shown to correlate with the other typing techniques and thus has emerged as the standard for delineating the clonal population of GBS. The study aimed to investigate the epidemiology of GBS colonization among pregnant women and their neonates, and to characterize the isolates by multilocus sequence typing technique at Dr George Mukhari Academic Hospital, Pretoria. Methodology: A total of 413 pregnant women who visited the antenatal clinic were recruited and screened. Participants were interviewed using a questionnaire to gather demographic and other relevant information such as history of current pregnancy, previous miscarriages and still births. Samples from maternal rectum and vagina as well as neonate ear and umbilical cord were taken for culture using colistin and nalidixic acid (CNA) blood agar and incubated for 24-48 hours. If negative after 48 hours, Todd-Hewitt broth was subcultured after 18-48 hours onto sheep blood agar. Multilocus sequence typing (MLST) was used to characterize seven group B streptococcus isolates collected at Dr George Mukhari academic hospital. Fragments of seven housekeeping genes were amplified by polymerase chain reaction (PCR) for each strain and sequenced. CLC bio software (Inqaba biotech, South Africa; Pretoria) was used to analyse sequenced loci and UPGMA dendrogram was constructed. Results: The colonization rate for GBS in pregnant women and their neonates was 30.9% and 0%, respectively. A higher proportion of GBS were isolated from the rectum (37.9%) as compared to the vagina (20.6%). Most socio-economic, demographic and obstetric factors analysed were not significantly associated with.GBS colonization. On 128 positive samples, the results of Todd-Hewitt enrichment broth and direct plating method using CNA were compared. A total of 45.3% of colonised were positive on direct selective agar (CNA); an additional 54.7% samples were recovered from Todd-Hewitt broth. Three genes (adhP, glnA and tkt) were sequenced successfully for six samples (1, 2. 4,6,12 and 65). The UPGMA tree with 1000 bootstrap showing the relationship between six samples was drawn.Conclusion: This study revealed that pregnant women of all ages are at risk of group B streptococcus colonization. Group B streptococcus was common among pregnant women at Dr George Mukhari Academic Hospital. No socio-economic risk factor was associated with group B streptococcus colonization. Results confirm that the combination of Todd-Hewitt broth and CNA agar plate is a time saving and sensitive method. The allelic profile, characteristics such as G+C (guanine+cytosine) content and dN/dS ratio were not analysed because of the smaller sample size used in this study, which shows that the MLST method was unsuccessful in this study. The UPGMA tree based on differences in consensus of the isolates showed that all group B streptococcus isolates are clustered and descend from a single node. / Life Sciences / M.Sc. (Life Sciences)

The registered midwives are engaged in continuous health education lessons In antenatal visits, discouraging antenatal clients from using hannful traditional and cultural practices in an attempt to preserve pregnancy to tenn. Despite the registered midwives' efforts, the clients continue to use hannful cultural methods, which are life-threatening to both the mother and the foetus In utero. The prenatal clients perceive the registered midwives as not being sensitive to their culture. The results of this study revealed that health education in antenatal clinics should be collaborative: that is, the people who have influence over the clients' pregnancy, like me mother-in-law, the traditional practitioners, cUents and their family members, should be involved by the midwives during the preparation of pregnancy lessons and health education lessons on how to preserve pregnancy to term according to· scientifically proven methods. / Health Studies / M.A. (Health Studies)

Fetal Alcohol Syndrome (FAS) is a preventable cause of mental retardation and is the severest category within Fetal Alcohol Spectrum Disorder (FASD). As gestational alcohol exposure affects fetal cognitive functioning, children with FAS present with intellectual deficits. Unfortunately FASD prevalence rates are increasing amongst infants and school-going children. The main goal of this study was to compare the neurodevelopmental subscales of infants diagnosed with FAS, Partial FAS and non- FAS. Seventy-four infants with confirmed FAS, Partial FAS or Non- FAS diagnoses were assessed using the Griffiths Mental Developmental Scale. Development assessed at 7-12 and 17-29 months of age showed that, regardless of a FAS, PFAS or Non-FAS diagnosis, all infants performed weaker at their assessment at 17-29 months. The Subscales significantly affected included Personal-Social, Eye- Hand Coordination and Performance. The infants with FAS and PFAS displayed the most marked developmental delays. From this study it can be concluded that there are definite neurodevelopmental profiles for infant's diagnosed with FAS, PFAS and/or Non-FAS, highlighting the significant impact of prenatal alcohol exposure on various aspects of infant development. / Social work / M.Diac.