Sexual and reproductive health care have become key priorities both within developing and developed nations. Young people have been identified as particularly vulnerable to negative health outcomes. South Africa is one such example of a country that presently faces significant challenges in addressing the unmet sexual and reproductive health needs of young people. With the enormous burden of reproductive health problems and the accelerating HIV epidemic, the provision of sexual and reproductive health services remains a challenge. Though various studies highlight the importance of comprehensive services targeted at youth, there is a lack of adequate research in evaluating the extent to which health services are addressing the health needs of clients. This study aimed to address this gap by examining a health care facility for students at one of the largest tertiary institutions in KwaZulu-Natal. The core objective was to determine the extent to which the health services are responding to the sexual and reproductive needs of young people by, exploring the experiences and perspectives of service providers and young men and women in relation to comprehensive, youth-friendly sexual and reproductive health care. This was assessed using a revised version of the Bruce-Jain quality of care framework. Information for this study was obtained using quantitative and qualitative data collection methods including: an inventory of the facility and services, in-depth interviews with staff and exit interviews with 200 clients aged 18 to 24 years. The findings of the study reveal that logistical constraints hindered effective implementation of comprehensive, youth-friendly services by providers. Providers missed opportunities to provide clients with much needed information and services due to staff shortage, client overload, lack of infrastructure, and poor continuity mechanisms. HIV, STIs and unwanted pregnancies were some of the most important health issues among young people visiting the health facility. Very few young men utilised the services. Some of the key findings were that clients continue to experience barriers in interpersonal relations while many expressed the need for more information from providers. In addition, many young women still have an unmet need for contraception. Policy makers need to incorporate the needs of young clients within sexual and reproductive health initiatives. Ideally young people should be involved in the design and implementation process of comprehensive, youth-friendly health initiatives. This would form a platform for addressing the barriers that hinder health service provision. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2011.

Thesis (MCur)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: he sexual health clinic at Stellenbosch University is attended by staff members and students. Yet, limited evidence exists regarding the views and expectations of the clients on service delivery at the sexual health clinic. The aim of the study was to explore the experiences and perceptions of clients attending the sexual health services offered at the campus health clinic. The following objectives were set:  To explore the experiences and perceptions of the clients attending the sexual health service on service delivery.  To identify the needs of the clients attending the sexual health service A descriptive qualitative approach was applied utilizing in-depth interviews. A sample of n=15 was drawn through purposive sampling and data saturation was achieved with the sample. Since the researcher is employed as a registered professional nurse at the clinic, data collection was completed by a researcher not affiliated to the university. Data was analyzed utilizing an interpretive approach. All applicable ethical principles such as anonymity, confidentiality and privacy were taken into consideration. The validity of the findings was enhanced through efforts to attain credibility, transferability, dependability and conformability. The findings of the study revealed that accessibility of the clinic is influenced by the geographical location of the clinic and that marketing and awareness of services requires attention. Other themes that emerged were operational hours, waiting period, building relationships, consultations and financial implications. / AFRIKAANSE OPSOMMING: Die seksuele gesondheidskliniek by Universiteit Stellenbosch word deur personeel en studente besoek. Daar is egter min bewyse oor die sieninge en verwagtinge van die kliente aangaande dienslewering by die seksuele gesondheidskliniek. Die doel van die studie was om die ervaringe en sieninge van kliente wat die seksuele gesondheidsdienste bywoon, aangebied deur die seksuele gesondheidskliniek, te ondersoek. Die volgende doelwitte was gestel:  Om die ervaringe en sieninge van kliente aangaande dienslewering by die seksuele gesondheidskliniek te ondersoek.  Om die behoeftes van die kliente wat die seksuele gesondheidsdienste bywoon, te identifiseer. ʼn Beskrywende kwalitatiewe benadering was toegepas deur van in-diepte onderhoude gebruik te maak. ʼn Steekproef van n=15 was deur doelgerigte steekproefneming verkry en data-versadiging was met die steekproef bereik. Siende die navorser as ʼn geregistreerde professionele verpleegster by die kliniek in-diens is, was data-versameling deur ʼn navorser wat nie aan die universiteit verbonde is nie, voltooi. Data was deur ʼn interpreterende benadering geanaliseer. Alle verwante etiese beginsels soos anonimiteit, vertroulikheid en privaatheid was in berekening geneem. Die geldigheid van die bevindinge was versterk deur pogings om geloofwaardigheid, oordraagbaarheid, betroubaarheid en bevestigbaarheid te verkry. Die bevindinge van die studie het getoon dat die toeganklikheid van die kliniek beïnvloed word deur die geografiese ligging van die kliniek en dat bemarking en die bewusmaking van dienste aandag benodig. Ander temas wat na vore gekom het, is operasionele tye, wagperiodes, verhoudinge, konsultasies en finansiële implikasies.

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)

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)

Worldwide, the Human Immunodeficiency Virus (HIV) pandemic has proven to be a health care challenge from the perspective of testing and treatment, including how to create sustainable positive prevention, prevention after becoming HIV positive, that is culturally relevant and gender sensitive. South Africa has been severely affected by the HIV and AIDS epidemic and the agricultural sector is no exception. This statement is supported by the findings of the International Organisation for Migration (IOM) study. According to an IOM study, the HIV prevalence rate among farm workers in the country is about 40%, the highest ever recorded in Southern Africa. A study conducted in Limpopo and Mpumalanga farms revealed that the prevalence of the twenty-three farms was 39, 5% which is twice the UNAIDS (Joint United Nations Programme on HIV and AIDS) national prevalence percentage of 18, 1% in South Africa. The researchers of this study could not pin-point a single factor causing this high rate of HIV infection on these farms. A multitude of factors, such as multiple and concurrent partnerships, transactional sex, irregular condom use, presence of sexually transmitted infections and sexual violence. The research also showed that almost half of the women working on farms around these provinces are HIV positive, compared to only a third of the male workforce. Purpose: The purpose of this study was to explore and describe the role of culture and gender in the spread of HIV and AIDS among farm workers in South Africa; with the view of developing culture and gender sensitive HIV and AIDS prevention strategies. descriptive and explorative qualitative approach was adopted. In depth individual semi-structured interviews were used to explore and describe the role of culture and gender in the spread of HIV and AIDS among farm workers. Purposive and convenient sampling methods were used to select participants who met the inclusion criteria in the Tshitwani and Barota farming community in the Vhembe District, Limpopo Province, South Africa. Religious and cultural beliefs were believed to be fuelling the spread of HIV among farm workers. Multiple sexual partners and inconsistent condom usage was common among participants. It was evident that stigma and social isolation leading to non- disclosure had adverse repercussions as some participants stated that they would spread HIV intentionally. Powerlessness and lack of decision-making by female farm workers was common as they were dependent on their male partners to make decisions regarding sexual matters in their relationship. Conclusion: More HIV prevention programmes tailored to dispel fears about stigma and correct myths about HIV-transmission should reach ordinary men and women in order to curb the spread of HIV among farm workers. The researcher believes that the strategies that emanate from this study would be applied in other settings other than the farming community. / Health Studies / D. Litt. et Phil. (Health Studies)

The purpose of the study was to explore and describe the perceptions of adolescents about sexuality and sexually transmitted infections, which probably contribute towards the high incidence of sexually transmitted infections amongst this group.The study was designed as a qualitative, exploratory and descriptive research. A focus group interview and unstructured observation were used to collect data, using a nonprobability snowball sample. The group consisted of 12 male and female adolescents residing in a specific geographical area in Pretoria and attending different high schools. Recommendations made focus on: the approach to sex education programmes factors that need to be addressed in order to improve adolescent sexual health empowerment strategies of teachers, parents and community leaders on adolescent sexuality and sexually transmitted infections so that in turn, they should be able to empower adolescents on their sexual roles and thus make informed choices The impact of implementing the recommendations will benefit individuals, families and communities. / Health Studies / M.A.(Health Studies)

The purpose of the study was to explore and describe the perceptions of adolescents about sexuality and sexually transmitted infections, which probably contribute towards the high incidence of sexually transmitted infections amongst this group.The study was designed as a qualitative, exploratory and descriptive research. A focus group interview and unstructured observation were used to collect data, using a nonprobability snowball sample. The group consisted of 12 male and female adolescents residing in a specific geographical area in Pretoria and attending different high schools. Recommendations made focus on: the approach to sex education programmes factors that need to be addressed in order to improve adolescent sexual health empowerment strategies of teachers, parents and community leaders on adolescent sexuality and sexually transmitted infections so that in turn, they should be able to empower adolescents on their sexual roles and thus make informed choices The impact of implementing the recommendations will benefit individuals, families and communities. / Health Studies / M.A.(Health Studies)