Sexual and reproductive health are integral parts of the health and well-being of every human being, however they remain sensitive and controversial issues, particularly when they concern persons with disabilities. Within the legal framework, sexual and reproductive health is recognized as basic human rights. They are also essential components of good health and personal development. Making sure that persons with disabilities have access to sexual and reproductive health services contributes to the fulfillment of their sexual and reproductive rights by providing them with more choices that potentially best suit their reproductive health needs. South Africa has one of the most progressive and liberal sexual and reproductive health laws and policies in the world, yet persons with disabilities still face major barriers in accessing these services. In fact, their sexuality has been largely overlooked or actively suppressed and in turn, their reproductive rights denied. With this background information, the study aims to shed more insights into the experiences and perspectives of persons with disabilities in accessing sexual and reproductive health in Durban, KwaZulu-Natal. Following the rights-based approach it assesses their awareness of sexual and reproductive health services and determines the factors that hinder their access to sexual and reproductive health services. The findings from the sample of 16 persons with different types of disabilities suggest that access to sexual and reproductive health services is complex and involve a variety of factors. The majority of respondents revealed that sexual and reproductive health services are a big part of their lives. However, there seemed to be a huge gap between their needs for services and their right to access these services. The general consensus was that persons with disabilities face challenges and multiple barriers to access services. Significantly these barriers are not raised by the disability itself but are related to specific contexts or instances of persons with disabilities trying to access services. From the discussions it was apparent that respondents‟ rights to be treated with dignity and to access sexual and reproductive health services is often overshadowed by social isolation, discrimination and other stereotypical assumptions that the society holds about the sexuality of persons with disabilities. Often, persons with disabilities are percieved as not sexually active hence information on sexual and reproductive health matters is not widely available in formats accessible to them. Health providers appeared surprised that person with disabilities will require assistant with family planning services and they are not given choices about suitable birth control methods rather often the nurses suggested that they terminate their pregnancies or to be sterilized. This reveals a need to address access to sexual and reproductive health services for persons with disabilities especially, through public health facilities in South Africa. / Thesis (M.Dev.Studies)-University of KwaZulu-Natal, Durban, 2013.

This thesis examines the lives and experiences of poor young women street sex workers in the city of Surabaya, Indonesia. This thesis focuses on sexual and reproductive health knowledge and practices; conditions of work; and experiences of discrimination, marginalization, and agency. Qualitative research methods, including participant observation techniques and multiple in-depth interviews, were used to gain a detailed understanding of these women’s lives. Results of this research indicate that these young women are severely marginalized through poverty, state ideologies, and public moralities. Their marginalized status leads them to experience poor health outcomes, physical violence, sexual violence, and police harassment. The concept of structural violence is used to describe how poverty and marginalization impact these young women’s health, everyday-lives, and life chances.

The aim of this study was to explore the knowledge of HIV transmission and prevention among adolescents aged between 14 and 16 years at the Tshwane West District. A qualitative exploratory descriptive contextual study was conducted. The World Café approach was used to obtain data from participants in this research. A questionnaire served as the data collection tool to extract data from participants. The study consisted of 37 participants and content analysis was done to analyse data gathered from participants during the World Café. Conclusions were drawn from the study and the findings revealed that the knowledge of HIV transmission and prevention among adolescents in the Tshwane West District is poor. / Health Studies / M.P.H.

The understanding of the patterns of association between positive sexual behaviours and protective factors that have greater impact helps to design appropriate strategies not only on positive sexual behaviour but also for reproductive health outcomes. The purpose of the study was to explore the protective factors and develop strategies to support positive sexual behaviours among high school adolescents. A concurrent mixed method research design was employed to explore the protective factors for positive sexual behaviours. A total of 990 adolescent students attending regular classes were selected using systematic sampling technique for the quantitative study and 33 focus group participants for qualitative study. Pre-tested, self-administered questionnaire was used for the quantitative whereas focus group discussions were employed for the qualitative phase. Protective factors were assessed at family, community/ neighbourhood, school, peer and individual levels. Quantitative data was analyzed using SPSS version 23. Descriptive statistics and binary logistic regression analysis were employed to identify protective factors. Variables with significant association in bivariate analysis were entered into logistic regression to control confounding effects. The qualitative data management, analysis and interpretation followed thematic analysis principles. Illuminating verbatim quotations used to illustrate findings. RESULTS: adolescents follow parents' rules about sexual activities [AOR=0.462, 95%CI: 0.285-0.748], authoritative [AOR=0.075, 95%CI: 0.021-0.265] and authoritarian [AOR=0.091, 95%CI:0.025-0.331] parenting styles were protective factors. Adolescents’ communication with parents was more likely to have positive association [AOR=0.56, 95%CI:0.31-0.94] than counterparts. Parental greater monitoring [AOR=0.604, 95%CI:0.38-0.959], clear rules and consequences [AOR=0.378, 95%CI: 0.233-0.613] and need for permission to go anywhere [AOR=0.387; 95%CI: 0.235-0.637] were significantly associated. School performance [AOR=0.141, 95%CI:0.055-0.362], perception that teachers are supportive [AOR=0.447, 95%CI:0.266-0.752], sex education [AOR=0.424, 95%CI: 0.243- 0.742], people approved contraceptive use [AOR=0.319, 95%CI: 0.165-0.619] and discussion with health workers on sexuality AOR=0.545, 95%CI:0.318-0.932] were strongly associated with positive sexual behaviour. Positive sexual behaviour associated with peer influence resulted in preferred later sexual debut [AOR=0.444, 95%CI: 0.248- 0.797] and bonding with peers AOR=0.531, 95%CI: 0.327-0.862]. / Health Studies / D. Lit. et Phil. (Health Studies)

The objective of the present article is to analyze the process of introducing the regulation of therapeutic abortion into the peruvian governmental agenda, identifying the factors that came together to generate such event, the period of study being between the years 2005 to 2014. The investigation corroborates that said event was possible due to the confluence of certain political and institutional factors on the national stages, the strategy of groups in favor (pro-choice) and against (pro-life) the regulation, and international influence. / El presente artículo tiene como objetivo analizar el proceso de ingreso de la reglamentación del aborto terapéutico en la agenda política gubernamental peruana, así como identificar los factores que confluyeron para generar dicho ingreso, siendo el periodo de estudio entre los años 2005 y 2014. La investigación corrobora que dicho ingreso fue posible gracias a la confluencia de ciertos factores políticos e institucionales del ámbito nacional, de las estrategias de los grupos a favor (pro-elección) y en contra (pro-vida) de la reglamentación, y de la influencia internacional.

Este trabalho se inscreve no campo dos estudos sobre sexualidade e práticas reprodutivas e contraceptivas, no contexto do Município de Porto Alegre onde muito recentemente passou a ser disponibilizado, na rede pública de saúde, um novo método contraceptivo, o implante subcutâneo Implanon. Partindo de um caso específico de implementação de uma ação governamental na área de saúde reprodutiva, este estudo tem como objetivo compreender, a partir de uma perspectiva antropológica, os significados da prática contraceptiva de implantes subcutâneos para as jovens residentes na região geográfica da cidade, a Restinga e seu entorno, que foi alvo privilegiado desta intervenção pública. Como pano de fundo descreve-se e apresenta-se o processo de idealização, implementação e debate em torno desta política de saúde, assim como o conjunto de atores e agencia que participaram do mesmo. Com a finalidade de conhecer o universo cultural das mulheres que optaram pela tecnologia contraceptiva oferecida pela política municipal, analisam-se as práticas sexuais, reprodutivas e contraceptivas das mulheres entrevistadas, evidenciando algumas categorias e valores imputados a estas práticas e experiências. Discutem-se, a partir do contexto específico pesquisado, os significados e o universo de relações onde se dá a prática contraceptiva de implantes subcutâneos. Enfatiza-se, nesta parte final, como é que tal prática contraceptiva se conecta com as relações afetivo-sexuais, contraceptivas e reprodutivas. A partir desta contextualização foi possível perceber que os eventos envolvidos no processo de gestar e evitar gravidez pode significar e gerar diferentes consequências para os sujeitos neles envolvidos. Igualmente, a abordagem centrada nas especificidades do grupo social "alvo" da ação governamental, evidenciou as diferentes perspectivas e apropriações desta política municipal. / Situated within the field of studies on sexuality and reproductive and contraceptive practices, this study takes as its context the municipality of Porto Alegre, where a new contraceptive method - the subcutaneous implant, Implanon - was recently made available through the public health system. Departing from a specific case of the implementation of a governmental action in reproductive health, the objective of this study is to understand, from an anthropological perspective, what the contraceptive implants mean for young female residents of a particular area of the city - Restinga and its surroundings - that was a target of this public intervention. As background, the process of the health policy's formulation and implementation, and the subsequent debates regarding it, is described, and the collection of participating actors and agencies is presented. With the aim of becoming familiar with the cultural universe of the women who opted for the contraceptive technology proffered by the municipal policy, the sexual, reproductive, and contraceptive practices of interviewed women are analyzed; these data bring to light some of the categories and values ascribed to aforesaid practices and experiences. The meanings and the universe of relationships in which the contraceptive practice of the implants takes place is discussed with specific reference to the research context. The last section emphasizes how such contraceptive practices connect with affective-sexual, contraceptive and reproductive relationships. Through contextualization, it is possible to perceive that the process of both becoming pregnant and avoiding becoming pregnant can mean different things and generate diverse consequences for the subjects involved. Likewise, an approach focused on the specificities of the target population of this governmental action makes plain the different perspectives on and appropriations of municipal policy.

The study explored the community role in support of adolescents’ sexual reproductive health (ASRH) in Acholi sub-region, which was affected by over two decades of LRA war. The study aimed at establishing the impact of the war on Acholi socio-cultural norms of adolescents’ socialisation on sexual matters by exploring the effects of the war, mass media and the modern education system on the socio-cultural norms of socialisation and compared with the current modes of promoting sexual education among adolescents as mandated by the national adolescent health policy; the study then assessed the community responsiveness to ASRH needs. Based on the findings, community strategy for enhancing community response to adolescent health was developed. Exploratory, descriptive and case study methodology was used to execute a three- phased concurrent study with five sub-studies. Data were collected from selected participants and respondents including teen mothers, guardians, midwives, parents, adolescents, local, cultural and religious leaders as well as policy makers, technocrats and implementers at the community and district levels. The study was implemented in Gulu, Kitgum and Pader districts of Northern UgandaThe study results found that the LRA war greatly impacted on the Acholi tradition of socialising children; the war destroyed the socio-cultural, economic and family protection structures. The teen mothers’ case study vividly documented the stories. Confounded by the influence of mass media and modern education system, the Acholi community is experiencing what the study called ‘intergenerational cultural shock’ in which the old and young generations are shocked and amazed with the cultural difference. community responsiveness to adolescent health needs, amidst the societal changing contexts and emerging new youth cultures, the study proposes a community model and a strategy to promote community participation in ASRH but with many implications to policy, programs, and further research as detailed under the recommendations.. / Health Studies / D. Litt. et Phil. (Health Studies)

Voluntary Counselling and Testing (VCT) is vital in the management of HIV/AIDS as it is the first step in treatment, care and behavioural change. Entrenched economic and gender inequities drive an increasingly feminized HIV/AIDS pandemic. This study investigated factors influencing VCT attendance by women in the Glen View high density suburb in Harare. A survey methodology was followed using a semi-structured, self-administered questionnaire that was distributed to randomly selected women of reproductive ages in the area. The analysis showed that VCT usage is low and that factors such as fear of the consequences of testing positive for HIV, such as violence and rejection by male partners are to blame. Importantly, the findings suggest that if the vulnerability of women is not addressed, then increased VCT uptake and better reproductive health outcomes for women are also unlikely. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

In 1996 the South African government legalised the termination of pregnancy (TOP) services, allowing women to choose to terminate unplanned pregnancies at designated facilities. Although TOP services are available, pregnant women continue to use illegal abortion services, with potentially life-risking consequences. The purpose of this study was to identify challenges encountered by women requesting TOP services, and to make recommendations for improved policies and practices, enabling more women in the North West Province (NWP) to access TOP services. This was a non-experimental, exploratory, descriptive and quantitative study. Structured interviews were conducted with 150 women who had used TOP services in phase 1, with 50 women who were unable to access TOP services in phase 2 and with 20 professional nurses providing TOP services in the NWP in phase 3. In phase 1, 96.0% (n=144) of the women needed transport to access TOP services, and 73.2% (n=109) indicated that nurses put women’s names on waiting lists, posing barriers to such access in the NWP. In phase 2, 92.0% (n=46) of these respondents had reportedly requested TOPs for the first time, but 89.0% (n=44) could not access TOP services. In phase 3, only 14 out of 19 designated facilities in the NWP, and only 20 nurses, provided TOP services during the study period. Out of the 20 interviewed nurses, 74.0% (n=14) regarded the Choice on Termination of Pregnancy Act, Act 92 of 1996 (CTOP Act) was being unclear requiring a revision. These professional nurses provided TOP services in NWP, by choice. Unless more facilities and more nurses can provide TOP services to the women of the NWP, these services will continue to remain inaccessible, necessitating the continued utilisation of illegal abortion services, in spite of the TOP Act’s prescriptions. It is also recommended that management will provide sufficient support and training opportunities for professional nurses working in TOP services in the NWP. / Health Studies / (D. Litt. et Phil. (Health Studies))

Adolescent and sexual reproductive health has been identified as among the most important health and development priorities by the South African development (Department of Health, 1995; African National Congress, 1994). The South African government, like many governments in the sub-Saharan region view with concern the region’s rapid population growth and high birth rates particularly among adolescents. This study investigated the perceptions of young mothers regarding teenage pregnancy. Eight participants who live in Vredendal, a predominantly Coloured area in the Western Cape Province of South Africa, were selected for interviewing using convenient sampling. Transcripts of unstructured interviews were analysed using thematic content analysis. The findings of the study suggest that young mothers initially perceive teenage pregnancy negatively. These perceptions progressively changes to a positive one. Furthermore, the results indicate a limited awareness of available preventative interventions. Results further show participants tend to experience their relationships with significant others as positive. / Psychology / M. A. (Research Consultation)