Issues of fertility, population growth and birth control are synonymous with women. Therefore, there is a void of the male perspective on issues pertaining to reproductive health. There is a reproductive health discourse, in which bio-psychosocial service such as family planning is woman-based. Whilst on the other hand statistics on absent fathers and contested pregnancies, are reaching millions and thus the effectiveness of these services are questionable. Therefore, men’s health and sexuality requires careful understanding so as to unfold narrations of denied paternity and men’s ‘assumed’ lack of responsibility in questions of contraception. Through in-depth interviews with 14 unmarried men from the townships of Soweto and Kagiso, this research found that contraception is a gendered concept that constructs various experiences for men in how they perceive sexual reproductive health services. It also found that denied paternity and father absences are rooted not only in historical factors but also in feminised conceptions of contraception and how this conception speaks to notions of how responsibility is distributed and withheld. Furthermore, it acknowledges that there are different conceptions of denied paternity and father absence and thus, shapes men’s experiences and expectations of fatherhood. Finally, it argues that masculine sexualities, notions of pleasure and issues of fertility are shaped by sexual socialisation processes; this also links how men transition from boyhood to manhood through circumcision and initiation schools not only as a cultural and religious practice but as a health practice. These narratives were captured through using thematic content analysis in investigating unmarried men’s perceptions of contraceptives and ideas of father absence and denied paternity. This research contributes to the existing knowledge on family and children services, with specific attention to family planning and the provision of services to young men and women regarding reproductive rights and responsibilities.

Thesis (MBA)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Providing quality primary healthcare services in a scarce resource environment in South Africa is a challenge. This is exacerbated by segments of the population experiencing high unemployment and extreme poverty leading to a prevalence of diseases such as HIV/Aids and Tuberculosis. Long queues and staff shortages have led to the Department of Health decentralising the primary healthcare system into district facilities, with the intention of offering greater access to equitable healthcare for all South Africans. Sexual reproductive health falls under the category of primary healthcare and is a specialised function, often carried out by inadequately trained providers using quota systems, who consider this essential service to be a low priority. The area of sexual reproductive health includes termination of pregnancy, contraception, treatment of sexually transmitted infections and cancer screening. Although termination of pregnancy is legal in South Africa, reluctance on the part of service providers to offer this service, due to conscientious objection has created a shortage of safe, legal healthcare facilities. In an effort to provide these life-saving services, non-governmental organisations are attempting to fill the service delivery shortfall. With the assistance of international donor funding, Marie Stopes South Africa has established a number of sexual reproductive healthcare facilities in townships in Gauteng and KwaZulu Natal. These services take place from basic structures located within communities most in need of healthcare, and offer a range of sexual reproductive health services at low cost to men and women of reproductive age. As the operational focus is on provision of services otherwise not available, the organisation has not measured the levels of customer satisfaction adequately to date. Due to the preventative and potentially life-saving nature of these services, improved customer satisfaction levels could, through word of mouth advertising and customer retention, increase the use of these facilities by community members, reduce numbers of unplanned pregnancies, and ultimately contribute to a decrease in the incidence of maternal mortality due to unsafe abortions. In this study, the SERVQUAL instrument will measure the gap between customer expectations prior to services received, and perceptions of the services post-delivery, in order to establish the current service quality gaps in township healthcare facilities. Management of the organisation will use this information to implement actions to improve customer satisfaction and monitor the impact of these actions, with the aim of increasing positive word-of-mouth advertising, leading to greater use of services and ultimately the long-term sustainability of the facilities.

Abstract The Sakhi Resource Center is at the moment conducting an educational program for adolescent girls and village health care workers in the district of Trivandrum, Kerala. Gender and sexual reproductive health are taught among other things. Classes are structured in a participatory way, giving the girls the opportunity to develop and practice their leadership and organizational skills among other things. One of the aims of The Project is to increase the confidence and sense of coherence of the girls and thus raise their ability to act in an empowered way in their societies. Another is to educate and engage health care workers out in the villages. The health care workers are Facilitators in The Adolescent Project. The Facilitators are both being educated by the Project staff and then themselves educating adolescents in The Project. The purpose of my study has been to evaluate the role of The Facilitators in The Project with the focus on gender. My research method is case study, and my empirical results are based on observations and nine in-depth interviews with The Facilitators. I have also studied Project Documents. I have used gender theory and theories of empowerment along with postcolonial theories of intersectionality. The Facilitators have a key-function here as after the project they are intended to continue conducting classes in the villages. I have found for example that the motivation to become a Facilitator in the Project can often be traced back to personal experiences from adolescence. I have focused on the Facilitators’ attitudes and found a tendency for them to promote arranged marriages and set limits on gender equality. I have also focused on how the Facilitators experienced results gained from the Project, both for them themselves and for the adolescents. In the analysis I have suggested that Sakhi could put more emphasis on the student role of The Facilitator to ensure gender sensitive project running in the future.

TITLE: Motherhood of Under Age Girls AUTHOR: Pavla Skasková DEPARTMENT: Department of Psychology SUPERVISOR: PhDr. PaedDr. Anna Kucharská, Ph.D. The dissertation is focused on phenomenon of motherhood in adolescence. In the Czech Republic nearly one thousand children are given birth every year by mothers who according to current law are not full-aged. A very similar number of teenage girls decide for abortion. The study searches for answers to broad varieties of particular research questions. Qualitatively directed research outcomes reflect motives involved in young women's final decisions to become an under-age mother, the determinants of the decision making process in the context of sexual reproductive health. They watch as the participants prepare for the role of mother, what helped them solve the situation and what is it difficult to evaluate their experience and maternity and parental competence. The work focuses on the reflected experience of the new role in the self, and the identity of teenage mothers. A semi-structured interview was chosen as the fundamental method to gather the data; however, additional essays of all respondents are available as well. There is analyzed the data of 28 participants, under-age mothers, who are allocated with their children in an institutional care or in...

This thesis investigates the underlying factors behind sexual risk-taking and non-risk-taking behavior with regard to Sexual Reproductive Health (SRH) among adolescents in Lusaka, Zambia. The Qualitative Approach was used for data collection and analysis and using the theory of Social Construction, the author explains how different contexts and aspects in the Zambian Society, that is Traditional, Socio-economic, Political, etc., influence the sexuality or sexual behavior of young people in Zambia. Hermeneutics was used to interpret the meanings in the texts/transcripts acquired through data collection and from the author’s knowledge and understanding of the Zambian historical and cultural contexts within which the participants of the research were constructed. Max Weber’s Ideal Type concept was also used to explain that each young individual’s sexual behavior is uniquely constructed by societal aspects. It explains how that the discourses of these different aspects of society impact on young people individually causing them to be either Sexually Risk-taking or Non Sexually Risk-taking. Either tendency depends on whether the societal aspect that has most the dominating influence on a given individual's life is a Power factor (causing them to rationally think their way into Non Sexually Risk-taking behavior) or a Risk factor(causing them to rationally think their way into Sexually Risk-taking behavior). The author of this thesis introduces a new Model for Social Construction of Adolescent Sexuality with regard to Risk-taking. She uses it to explain how it is either power factors or risk factors that can have a greater impact on an individual's thinking, causing them to have either sexual risk-taking or non-sexual risk-taking behavior. The author concludes that the extent to which unsafe sex among the Zambian adolescents constitutes a product of interacting and/or main discourses in relation to mainly Traditional aspect risk factors, varies from person to person depending on the strength of given risk factors over any power factors that may be at play in an individual's life.

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)

BACKGROUND: Studies done in both developed and developing countries have reported the tendencies of adolescents to engage in risky behaviours. Such behaviours include indulging in early and unsafe sexual activities, having multiple sexual partners, alcohol and drug use and dropping out of school among others. PURPOSE: The main aim of the study was to develop intervention strategies for reducing sexual risk practices among adolescents in Ethiopia. METHODS: A mixed method approach using quantitative and qualitative approaches was employed in order to investigate the risks of sexual practices among urban and rural adolescents in the selected area. A cross-sectional survey was used to gather data quantitatively and focus group discussions were used for the qualitative part of data collection. A total of 449 students and 72 FGD participants were selected for quantitative and qualitative study respectively using systematic random sampling technique. Logistic regression was done to identify possible factors associated with knowledge on emergency contraceptive, condom utilisation, pre-marital sex practices and perception of risky sexual practices. RESULTS: One hundred and seventy (37.9%) respondents had experienced sexual intercourse at the time of the study. The higher proportion (42.6%) of those who had engaged in sexual relationships was from the rural school compared to 33.1% in the urban schools. The proportion of sexually active respondents was higher among males (44.8%) compared to (29%) females. Multiple partners were higher in rural adolescents (44.7%) compared to 31.8% among urban adolescents. Sexually Transmitted Diseases were reported by 28.6% of the sexually active adolescents and the prevalence was higher among males (73.5%) compared to 27% females. 87% of the sexually active adolescents rarely used a condom. CONCLUSION: The study identified a knowledge gap on ASRH which limited adolescents to access reproductive services. Social, cultural and economic factors contributed to adolescent engagement in risky sexual behaviours. Based on the major findings of this study, intervention strategies targeting behavioural, biomedical and structural interventions were proposed. / Health Studies / D. Litt. et Phil. (Health Studies)

BACKGROUND: Studies done in both developed and developing countries have reported the tendencies of adolescents to engage in risky behaviours. Such behaviours include indulging in early and unsafe sexual activities, having multiple sexual partners, alcohol and drug use and dropping out of school among others. PURPOSE: The main aim of the study was to develop intervention strategies for reducing sexual risk practices among adolescents in Ethiopia. METHODS: A mixed method approach using quantitative and qualitative approaches was employed in order to investigate the risks of sexual practices among urban and rural adolescents in the selected area. A cross-sectional survey was used to gather data quantitatively and focus group discussions were used for the qualitative part of data collection. A total of 449 students and 72 FGD participants were selected for quantitative and qualitative study respectively using systematic random sampling technique. Logistic regression was done to identify possible factors associated with knowledge on emergency contraceptive, condom utilisation, pre-marital sex practices and perception of risky sexual practices. RESULTS: One hundred and seventy (37.9%) respondents had experienced sexual intercourse at the time of the study. The higher proportion (42.6%) of those who had engaged in sexual relationships was from the rural school compared to 33.1% in the urban schools. The proportion of sexually active respondents was higher among males (44.8%) compared to (29%) females. Multiple partners were higher in rural adolescents (44.7%) compared to 31.8% among urban adolescents. Sexually Transmitted Diseases were reported by 28.6% of the sexually active adolescents and the prevalence was higher among males (73.5%) compared to 27% females. 87% of the sexually active adolescents rarely used a condom. CONCLUSION: The study identified a knowledge gap on ASRH which limited adolescents to access reproductive services. Social, cultural and economic factors contributed to adolescent engagement in risky sexual behaviours. Based on the major findings of this study, intervention strategies targeting behavioural, biomedical and structural interventions were proposed. / Health Studies / D. Litt. et Phil. (Health Studies)