Adolescent reproductive health services (ARHS) in Gauteng Province are not meeting the reproductive health needs of adolescents. There is also no formalised adolescent/youth policy laid down to assess the quality of care given to adolescents attending these clinics although the policy is currently in the process of being finalised. The purpose of the study therefore was to critically analyse the ARHS in Gauteng Province to determine which adolescents attended the clinics, whether the clinics were accessible and available and whether they provided comprehensive care, gave information and counselling to the adolescent and whether the clinics \\·ere adolescent-friendly. Using the quality care model as the conceptual framework for the study, the following research questions were asked to determine the quality of care in terms of the adolescent's needs at these clinics: Who is the adolescent using ARHS in Gauteng Province') Are the ARHS in Gauteng Province accessible and available to adolescents? Do the ARHS in Gauteng Province provide comprehensive care to adolescents? Are adolescents receiving information and counselling from the ARHS in Gauteng Province? Are the ARHS in Gauteng Province adolescent-friendly? A quantitative cross-sectional exploratory, descriptive research design using a self-administered, researcher­ designed questionnaire was used to collect data from a 203 nonprobability convenient sample, at selected ARHS in Gauteng Province. The analysed data indicated that females in the older age group. ie 18-19 years used the ARHS more than the female adolescents in the younger age group and males. Findings also indicated that the ARHS in Gauteng Province are geographically accessible and available to adolescents. However, there appeared to be a need to extend the days and hours of functioning of the ARHS so as to make them more accessible and available to adolescents. Comprehensive care is not given to adolescents attending ARHS. Adolescent gave contradictory mformation especially with regard to the attitudes of service providers. Recommendations made include management strategies that will attract the adolescent in the younger age group and in particular the male adolescent. This necessitated that service providers at ARHS be equipped with the appropriate information given in an outcome-based format in adolescent care. / Health Studies / D. Litt. et Phil. (Advanced Nursing Science)

The study has two separate but related aims, which are to explore the social and health experiences of men who are in polygynous relationships and to develop holistic health and social strategies to support men who are in polygynous relationships. Objectives of the study were to identify the different permutations of polygynous relationships that related to health and social issues; to clarify the social status of men who are in polygynous relationship; to explore and describe the health experiences of men in polygynous relationship; to explore and describe the social experiences of men in polygynous relationship; to explore the spiritual experiences of men who are in a polygynous relationship; to describe and to generate holistic strategies to support men who are in a polygynous relationships. Method: In this study, the researcher used descriptive and interpretive phenomenological processes to develop a range of holistic strategies to support men who were in polygynous relationships. The researcher described the experiences and developed interpretations based on the lived experiences that the men reported. Findings: Polygyny remains the reality within the Bapedi tribe in Sekhukhune area. The practice of polygyny is not only for the affluent as indicated in most literature but is also practiced as a corrective strategy for families who are experiencing marital problems. Polygyny is not viewed as abusive to the women and children but rather beneficial to the women. It helps to reduce the risks of the development of cervical cancer that is predisposed by frequency of sexual intercourse. Polygyny promotes the morals within the communities, as children grow up within the two parents’ environment as opposed to the rising numbers of single parent families. Polygyny practice in the Sekhukhune areas is a voluntary choice and not a forced marital arrangement. Conclusions and recommendations: The researcher recommended policy guidance to support health practitioners with strategies to assist members of polygynous families in need of help. The policy also guides employers to recognise and to register the second or third wife as beneficiaries of the working husband. / Health Studies / D. Litt. et Phil . (Health Studies)

This quantitative, explorative and descriptive survey attempted to determine factors that influence the adolescent pregnancy rate in the Greater Giyani Municipality. Data were gathered from adolescent girls attending four selected high schools. Non-probability convenient sample of 147 respondents was used with 100% return rate. Data was collected using a questionnaire which had a reliability of 0.65. Data were analysed using the SAS/Basic computer program, version 9.2. Findings indicated that 56.34% of respondents reported key psychosocial variables such as peer pressure and 58.90% of them changed values as contributory to high pregnancy rates. .Health services were reported as not freely available and relationships with nurses significantly cited as poor by 72.41% respondents with regard to maintenance of confidentiality. Recommendations were made to improve school health services, reproductive education and future research / Health Studies / M.A. (Health Studies)

The study has two separate but related aims, which are to explore the social and health experiences of men who are in polygynous relationships and to develop holistic health and social strategies to support men who are in polygynous relationships. Objectives of the study were to identify the different permutations of polygynous relationships that related to health and social issues; to clarify the social status of men who are in polygynous relationship; to explore and describe the health experiences of men in polygynous relationship; to explore and describe the social experiences of men in polygynous relationship; to explore the spiritual experiences of men who are in a polygynous relationship; to describe and to generate holistic strategies to support men who are in a polygynous relationships. Method: In this study, the researcher used descriptive and interpretive phenomenological processes to develop a range of holistic strategies to support men who were in polygynous relationships. The researcher described the experiences and developed interpretations based on the lived experiences that the men reported. Findings: Polygyny remains the reality within the Bapedi tribe in Sekhukhune area. The practice of polygyny is not only for the affluent as indicated in most literature but is also practiced as a corrective strategy for families who are experiencing marital problems. Polygyny is not viewed as abusive to the women and children but rather beneficial to the women. It helps to reduce the risks of the development of cervical cancer that is predisposed by frequency of sexual intercourse. Polygyny promotes the morals within the communities, as children grow up within the two parents’ environment as opposed to the rising numbers of single parent families. Polygyny practice in the Sekhukhune areas is a voluntary choice and not a forced marital arrangement. Conclusions and recommendations: The researcher recommended policy guidance to support health practitioners with strategies to assist members of polygynous families in need of help. The policy also guides employers to recognise and to register the second or third wife as beneficiaries of the working husband. / Health Studies / D. Litt. et Phil. (Health Studies)

This quantitative, explorative and descriptive survey attempted to determine factors that influence the adolescent pregnancy rate in the Greater Giyani Municipality. Data were gathered from adolescent girls attending four selected high schools. Non-probability convenient sample of 147 respondents was used with 100% return rate. Data was collected using a questionnaire which had a reliability of 0.65. Data were analysed using the SAS/Basic computer program, version 9.2. Findings indicated that 56.34% of respondents reported key psychosocial variables such as peer pressure and 58.90% of them changed values as contributory to high pregnancy rates. .Health services were reported as not freely available and relationships with nurses significantly cited as poor by 72.41% respondents with regard to maintenance of confidentiality. Recommendations were made to improve school health services, reproductive education and future research / Health Studies / M.A. (Health Studies)

Unintended and unwanted pregnancies are major reproductive health problems impacting negatively on women’s health globally. When faced with these pregnancies, many women choose termination of pregnancy (TOP) as their recourse. The purpose of the study was to explore and describe physical, psychological and social implications of TOP on the woman’s health. A qualitative and descriptive research design was used. The population comprised women who had TOP three months to one year before the study and were willing to participate in the study. A non-probability purposive sampling was used to select participants for the study. In-depth phenomenological interviews were used for data collection until data saturation was reached with 20 participants. The findings reveal that women had psychological, physical and social implications after TOP which impacted negatively on their health. Recommendations were made to improve the services of women choosing to terminate a pregnancy to lessen negative implications. / Health Studies / M.A. (Health Studies)

Adolescent sexual health has been identified as a significant health and development problem facing South Africa. Limited amounts of research on sexual interactions have been undertaken, with information on adolescents’ romantic relationships being particularly scarce. Qualitative research needs to foster an understanding of the dynamics of sexual interactions in specific settings, and with emphasis in the past on cognitive health psychology models, very little is thus known about how adolescents negotiate and make sense of their sexual experiences. This highlights the need to investigate the complexities of human sexuality in a contextual manner. In response, this study explores the lived experiences of four young black women as they negotiate their agency and sexuality in a local context. By way of in-depth qualitative interviews, which were analysed for recurrent themes using interpretative phenomenological analysis, this project examines the participants’ experiences regarding sex, relationships, communication, sexual health care, as well as HIV and pregnancy prevention. The results reveal that communication about sexuality in the participants’ homes was limited if not absent altogether. When seeking sexual health care, they found clinic nurses to be judgemental and rude. Regarding sexuality and HIV education, the participants stressed the need for outside educators to teach in more practical ways to increase efficacy. In their dating relationships, most participants revealed their boyfriends had a great deal of influence over their sexual initiation. Unwanted pregnancy surfaced as a greater fear than HIV in their accounts due to pressure to finish their education and attain well-paying jobs in the future. The participants felt unable to stop their boyfriends’ infidelity and had limited agency when facing sexual demands. Their accounts revealed that they negotiate their agency in an atmosphere of coercion and the threat of rape. However, areas of agency included their consistent condom use even when facing pressure to have unprotected sex, and their active accessing of sexual health services for hormonal contraception. These insights serve to better inform sexual and reproductive health education and intervention programmes for young women. Moreover, educators, researchers and programme developers alike may gain useful insights from the personalised accounts derived from this study.

The purpose of this research study is to determine the factors influencing reproductive health choices of women living with HIV attending primary health care services. The need for this research study is evident in that most women attending health care services at primary health care clinics, and who are HIV positive report unintended pregnancy. The study sought to provide answers to factors influencing their reproductive choices. A quantitative, descriptive and cross-sectional research study was used in this study. The sample consisted of 83 females between the ages of 18 and 40. The findings of the research study provided the researcher with adequate evidence on the factors influencing reproductive health choices of women living with HIV attending primary health care services. The approach to reproductive health services was still acceptable but needs to be improved. Moreover, the identified factors therefore influenced one’s perceptions on reproductive health decisions among HIV-infected women. / Health Studies / M.A. (Public Health)

Text in English / The purpose of the study was to investigate the experience explore the experience of virginity testing of female adolescents in the uThungulu district of KwaZulu-Natal. A qualitative research was conducted to explore and describe the experiences of female adolescents on virginity testing. In-depth phenomenological interviews were conducted on 18 participants during data collection. Proponents of virginity testing believe that virginity testing is a traditional practice that can assist in reducing HIV infection and teenage pregnancy amongst the youth. On the other hand, opponents of virginity testing strongly believe that the practice of virginity testing interferes with human rights and Constitutional prescripts that protect the rights to equity, privacy, bodily integrity and sexual autonomy of young women. The study found that participants had only positive experiences of the practice of virginity testing and none expressed having any negative experiences. The findings also confirmed that virginity testing is being done irrespective of different opinions from different scholars and experts on the subject. Little knowledge about the Children’s Act and the Commission for Rights of Cultural and Linguistic communities was observed. / Health Studies / M.P.H.

Unwanted and unintended pregnancies pose major reproductive health challenges to women throughout the world. Despite the availability of modern contraceptives, many women and men fail to use contraceptives effectively. This research focussed on reasons for not using contraceptives effectively in the Northern Tshwane area of the Gauteng Province of the Republic of South Africa (RSA). Structured interviews were conducted with 83 women and 71 men about their contraceptive practices. Age, religion, educational level and residential areas influenced clients' contraceptive practices. These results were categorised for adult males and females as well as for adolescent males and females. Adolescents encountered problems in accessing contraceptive services. Adult females knew most about traditional contraceptives, although men knew about some of these methods, and adolescents used some of them. All respondents could gain additional knowledge about modern contraceptives. The respondents' knowledge about · emergency contraceptives was extremely limited. Although most respondents knew about legalised choice on.termination of pregnancy (CTOP) services in the RSA, they did not know when nor how to access these services. Nurses working in contraceptive health services, revealed during a focus group discussion that a lack of resources (including shortages of malcondoms, contraceptive injections and oral contraceptives) hampered the quality of services that could be rendered. Of particular concern was the nonavailability of Norplant implants and female condoms. Nurses expressed a need for pecific national policy guidelines about supplying contraception to adolescents. Although most nurses knew about emergency contraceptives, they did not promote its use because they assumed that clients would misuse emergency contraceptives.instead of using contraceptives regularly. The nurses indicated that very few facilities offered CTOP services. The nurses regarded women who obtained repeated CTOPs to be misusing these services and suggested that limitations should be placed on the number-of times any woman could obtain such services. The negative attitudes of community members and of colleagues towards persons working in CTOP services caused hardships for them. Recommendations address ways in which contraceptive services could be improved. / Health Studies / D. Litt. et Phil. (Advanced Nursing Sciences)