Thesis (MCur)--Stellenbosch University, 2001. / ENGLISH ABSTRACT: Informal discussions and the work experience of the researcher in the field of health care raised concerns about the problems regarding the sexual health of adolescents. This demonstrated the need for an integrated health care system to promote adolescent sexual health. Against this background the study was undertaken to: • Identify the attitudes of adolescents towards sexual health. • Determine their knowledge of sexual health • Determine what the practice of sexual health by adolescents entail. • Provide recommendations where applicable. Triangulation, which is a combination of qualitative and quantitative research methods, was used. The findings reflected the following: • A positive attitude towards sexual health, but adolescents are involved in high risk sexual behaviour. • Sub-optimal knowledqë regarding sexual issues. • A need for sexual education by parents and health workers, especially nurses. The following recommendations, are proposed: • Sex education should start at an age as early as possible, at home, by parents. • Health workers should be trained to give proper information and advice to adolescents about their sexual health. • Condoms should be freely available and accessible to all the people of Namibia. • Adolescents should be actively involved in the promotion of their own sexual health. Keywords: Prevention of teenage pregnancy I Sexually transmitted diseases I HIV I AIDS and Sex education. / AFRIKAANSE OPSOMMING: Informele besprekings en praktiese ervaring van die navorser in die gesondheidsorgveld het probleme rakende die seksuele gesondheid van adolessente uitgewys. Dit het gedui op die behoefte aan 'n geïntegreerde gesondheidsorgsisteem ten einde die seksuele welsyn van adolessente te bevorder. Teen dié agtergrond is die studie onderneem om: • Die houding van adolessente teenoor seksuele welsyn te bepaal. • Die kennis van adolessente omtrent seksuele welsyn te bepaal. • Te bepaal wat die praktyk van seksuele welsyn van adolessente behels. • Aanbevelings soos van toepassing te maak. Die metode van triangulasie, wat 'n kombinasie van 'n kwalitatiewe en kwantitatiewe navorsingsmedotiek is, is gebruik. Die bevindings reflekteer die volgende: • 'n Positiewe houding jeens seksuele gedrag, maar adolessente is betrokke by riskante seksuele ged rag. • Suboptimale kennis ten opsigte van seksuele kwessies. • 'n Behoefte aan seksuele onderrig deur ouers en gesondheidswerkers, veral verpleegkundiges. Die volgende aanbevelings word voorgestel: • Onderrig ten opsigte van seksuele gedrag moet op die jongste moontlike ouderdom deur die ouers tuis gedoen word. • Gesondheidswerkers moet opgelei word om die regte en relevante advies en inligting aan adolessente oor te dra rakende hul seksuele gesondheid. • Kondome moet vrylik beskikbaar en bekombaar wees vir alle inwoners van Namibië.Adolessente moet aktief betrokke wees in die bevordering van hul eie seksuele welsyn. Sleutelwoorde: Voorkoming van tienerswangerskappelseksueel oordraagbare siektes I MIV I VIGS en seksuele voorligting.

Thesis submitted in fulfillment of the requirements for the M Tech: Nursing in the Faculty of Health and Wellness Sciences at the Cape Peninsula University of Technology, Bellville Campus 2014 / Recent reports suggest that there has been an alarming increase in the pregnancy rate of young adults especially in the Outjo district, the northwestern part of Namibia. No formal studies have been conducted recently to get a better understanding of this phenomenon, which is of great concern to all social and healthcare stakeholders. According to the annual report of the Outjo hospital 2009/2010, 36% of the pregnancies reported at the hospital were youth still at school (Namibian 2011). Negative health outcomes of early pregnancy and sexually transmitted infections (STIs), including HIV/AIDS (Human immunodeficiency virus infection / Acquired immunodeficiency syndrome), threaten the health of these young adults who will become the mature adults and parents of the future. This study aimed to assess factors that hinder young adults both male and female from utilizing contraceptives in Outjo district in the north-western part of the Republic of Namibia. Some of the objectives of this study were to explore the personal factors that influence the decision to use contraceptives among young adult of the Outjo district; examine socio-economic factors that influence young adult’ decision to use contraceptives, and determine pregnancy rate amongst female young adults in the Outjo district. In order to achieve the objectives of the study, a quantitative descriptive survey method and retrospective analysis of the records was used. The study population was young adults 18 to 24 years of age. A semi-structured validated questionnaire was utilized to collect data. Data was analyzed by using SPSS 19 software to generate frequency, percentage, mean and standard deviation. The findings can contribute and play a significant role in developing new strategies by all stakeholders including the Ministry of Health and Education, to approach non adherence of contraceptive use amongst the young adult population in an innovative ways, and ultimately stem the tide against the high rate of youth pregnancies in the Outjo district. Keywords: Adherence, contraceptives, young adults, youth, teenage pregnancy Namibia, Outjo district, quantitative descriptive survey

Thesis (MTech (Nursing))--Cape Peninsula University of Technology, 2014. / Recent reports suggest that there has been an alarming increase in the pregnancy rate of young adults especially in the Outjo district, the northwestern part of Namibia. No formal studies have been conducted recently to get a better understanding of this phenomenon, which is of great concern to all social and healthcare stakeholders. According to the annual report of the Outjo hospital 2009/2010, 36% of the pregnancies reported at the hospital were youth still at school (Namibian 2011). Negative health outcomes of early pregnancy and sexually transmitted infections (STIs), including HIV/AIDS (Human immunodeficiency virus infection / Acquired immunodeficiency syndrome), threaten the health of these young adults who will become the mature adults and parents of the future.

Condom use is promoted as an effective method for prevention and contraception for people who practice or are at risk of practicing high-risk sexual behaviors. According to the UNAIDS (2009) report, condoms are the only resource available to prevent the sexual spread of the HI-Virus; and with regard to family planning, the same report proposes that condoms expand the choices, have no medical side effects, and thus provide dual protection against pregnancy and disease. However, in Africa as elsewhere in the world, condom use has been fiercely debated. The debates on the accessibility, availability and distribution of condoms in schools are not new nor are they uncontested. In Namibia, the HIV and AIDS policy in education does not explain how, when and by whom condoms should be made available to learners. This leaves it to schools to decide on how (and whether) to make condoms available to learners. As a result, individual school‘s choices not only vary, but are mediated by different factors that are not always in the best interest of learners who, as the foregoing discussion suggests, continue to participate in behaviour that, amongst other things, puts them at risk of HIV infection and falling pregnant. Relying on Foucault‘s theory of discourses, this study investigated the dominant discourses that shape learner, teacher, parent religious and traditional leader and traditional healer perspectives, responses, and experiences with regard to the accessibility, availability, and distribution of condoms in school. The study was conducted in nine schools in Kavango Region in Namibia using a mixed methods approach. The study used triangulation in the data collection process through the use of questionnaires where 792 learners participated in this component, and focus group discussions and individual interviews targeting four groups namely, learners, teachers, parents and religious leaders, traditional leaders and traditional healers. The quantitative data were analyzed using the Statistical Packages for Social Sciences (SPSS), and findings from the focus group discussions and individual interviews were analyzed identifying themes and patterns and then organizing them into coherent categories with sub-categories. The study revealed that the majority of adult participants opposed the idea of making condoms available in schools; advocating abstinence instead. This was despite evidence on the prevalence of sexual activity amongst youth in the community. Reasons had to do with various competing and hierarchized discourses operating to shape participant beliefs, perspectives, and responses in a highly regulated and surveilled social and cultural context. Put differently, the dominant discourses invoked a particular sexual subject; authorized and legitimated who invoked such a subject; who was and was not allowed to speak on sexual matters; as well as how sexual matters were brought into the public space of schools. Such authorization and legitimation regulated the discursive space in which discussions on sexual health, safe sex, and resources such as condoms were permitted; with negative consequences for the sexual well-being of youth in Kavango Region. The study also highlighted the tension between freedom, choice, and rights, showing how complex in fact is decision to make condoms available in school. On the one hand, teenagers positioned themselves as capable subjects who had the right to exercise choice over their sexual lives. Requesting parent consent was thus viewed as a violation of this right to choose. Such a position displayed authority and agency by learners that was pitted against views amongst adults in this study that positioned youth as having no agency. In their view, youth (a) were still children and thus innocent and pure, (b) ought to abstain, and (c) were difficult to control given the modern context. Adults believed that early sexual involvement by learners did not result from lack of vigilance and control on their part, but rather from exposure to modern social mores. The study concluded that (a) schools remain difficult spaces not only for mediating discussions of sex and sexuality, but also for providing resources to mitigate sexual risk amongst leaners, (b) in highly regulated societies, dominant religious discourses are produced and reproduced in and through existing institutions such as family, church, and schools; highlighting how these serve to normalize beliefs and perspectives, (c) the dominant discourses shaping communities in which schools find themselves remain inconsistent with school discourses that are shaped by modernist conceptions of childhood and youth, and (b) adult choices to sanction and obstruct schools from making condoms available (and in the case of teachers, not accessible and distributable) put the very children at risk that they propose to be protecting.