The study aimed to explore indigenous methods used to prevent teenage pregnancy from the perspective of traditional healers and traditional leaders. Furthermore, it aimed to explore with traditional healers and traditional leaders whether these methods have relevance today as form part of teenage pregnancy intervention. The data were collected through conducting semistructured interviews with ten traditional healers and five traditional leaders from the rural area of Umhlathuzane, Eshowe. The interviews were guided by an interview schedule which allowed the researcher to keep in touch with the purpose of the study while having face to face conversation with participants. All interviews were tape recorded and transcribed. The findings of the study revealed that traditional healers and traditional leaders are concerned by high rate of teenage pregnancy within the community. They felt strongly that ignoring indigenous cultural practices due to modernity has led to major non-resolvable social issues such as teenage pregnancy, spread of HIV/AIDS related diseases, poverty, drugs and alcohol misuse. The study findings also revealed that there is a high demand for re-instituting elders' and family roles in addressing the erosion of cultural practices and traditional methods. Traditional practices such as virginity testing, ukusoma (non-penetrative thigh sex), ukushikila (physical maturity examination) as well as traditional ceremonies were identified as indigenous methods previously used to groom girls and to prevent teenage pregnancy. Furthermore, traditional healers and traditional leader were totally against contemporary teenage pregnancy interventions and policies around this issue, and have mixed views towards the idea of combining modern and traditional methods for teenage pregnancy prevention. Based on the findings of the study, recommendations were made regard to collaboration between South African government and indigenous experts so that to deal effectively with teenage pregnancy. Recommendations for further research were also made. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2012.

Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The alarming rate of teenage pregnancies among South Africans became a driving force for the researcher to investigate this particular phenomenon. The goal of this study was to explore and describe the experiences of pregnant teenagers about their pregnancy. Guided by the research question “ What are the experiences of pregnant teenagers about their pregnancy?” a scientific investigation was undertaken. The objectives set for the study were to determine their experience of their current pregnancy; to determine their knowledge of contraceptives; and to explore their experience regarding the services delivered by the health care workers. A phenomenological descriptive design with a qualitative approach was the most suitable scientific method to describe the experiences of pregnant teenagers who attend an antenatal clinic in Chatsworth, Kwazulu Natal. An interview guide or protocol that includes a list of open-ended questions based on the objectives, the literature review, and the professional experience of the researcher was designed and used to explore during each interview. The final sample consisted of ten participants. Experts in the field of nursing and research methodology were consulted to determine the feasibility and content of the study, to evaluate the research process and outcome. The researcher collected the data personally. Data was collected by means of individual interviews. The researcher did the transcription of the interviews. Ethical approval was obtained from Stellenbosch University and the relevant health authorities. Informed written consent was obtained from the participants. Parental permission was obtained for participants under the age of 18 years. Participants younger than 18 years of age also completed an assent form. Data that emerged from the data analysis was coded and categorised into sub-themes and themes. The researcher compiled a written account of the interpretations that emerged from the data analysis. In addition, member checking was done with each participant after individual interviews, to validate the transcribed data. The conceptual framework for this study was adapted from Maslow (1968). The findings suggest that there is a need for parental intervention as far as teenage pregnancy is concerned, financial difficulties associated with poverty was identified as one of the major contributing factor to teenage pregnancy, and attitudes of providers of contraceptives led to teenagers, not using contraceptives in some cases. It is recommended that services at the clinic be improved; health care workers undergo extensive training and education regarding teenage health and sexuality needs. Furthermore review and revitalisation of education programs at schools, to meet the needs of teenagers, which are constantly changing according to the times, are recommended. The involvement of parents and the community in combating issues surrounding teenage pregnancy is vital. Further research is recommended to find solutions to alleviate this problem of teenage pregnancy. All stakeholders need to work together to remedy this social problem as it is not an issue that can be dealt with in isolation. / AFRIKAANSE OPSOMMING: Die veronrustende voorkoms van tienerswangerskappe onder Suid-Afrikaners was die motiverende faktor vir die navorser om die studie te onderneem. Die doel van die studie was om die ervaringe van swanger tieners ten opsigte van hul swangerskap te identifiseer en te beskryf. Die wetenskaplike ondersoek is gelei deur die navorsingsvraag, “wat is die ervaringe van swanger tieners betreffende swangerskap?” Die doelwitte vir die studie was om te bepaal: die ervaringe van die huidige swangerskap; kennis betreffende voorbehoedmiddels sowel as die ervaring ten opsigte van die dienste soos gelewer deur die gesondheidswerkers. 'n Fenomenologiese, beskrywende ontwerp met 'n kwalitatiewe benadering is as die mees geskikte wetenskaplike metode beskou om die ervaringe van swanger tieners wie 'n voorgeboorte-kliniek in Chatsworth, KwaZulu-Natal bywoon, te beskryf. Die navorser het gebruik gemaak van 'n vooraf opgestelde onderhoud gids, protokol bestaande uit 'n lys van oop vrae gebaseer op die doelwitte, die literatuuroorsig en die professionele ervaring van die navorser. Die finale steekproef was tien deelnemers. Kundiges op die gebied van verpleging en navorsingsmetodologie is geraadpleeg ten opsigte van die haalbaarheid, inhoud van die studie sowel, as om die proses en uitkoms van die navorsing te evalueer. Die data is persoonlik deur die navorser versamel. Data is ingesamel deur middel van individuele onderhoude. Transkripsie van die onderhoude is deur die navorser self-gedoen. Etiese goedkeuring is vooraf verkry vanaf die Universiteit van Stellenbosch sowel as die betrokke gesondheidsowerhede. Ingeligte skriftelike toestemming is verkry van die deelnemers sowel as van die ouers in geval van minderjaige tieners. Tydens die data-analise is data gekodeer en in temas en sub- temas kategoriseer. 'n Skriftelike verslag is saamgestel ooreenkomstig die interpretasie uit die data-analise. Die navorser het na transkripsie met elke onderskeie deelnemer gekontroleer ten einde geldigheid van die data te verseker. Maslow (1968) se teorie is gebruik as konseptuele raamwerk vir die studie. Die bevindinge dui daarop dat daar 'n behoefte is aan ouerlike tussentrede betreffende tienerswangerskappe. Finansiële probleme in verband met armoede is ïdentifiseer as een van die groot bydraende faktore tot tienerswangerskappe, sowel as dat houdings van diegene wat kontrasepsie verskaf daartoe kan lei dat tieners nie wil gebruik maak van voorbehoedmiddels nie. Dit word aanbeveel dat die dienste by die kliniek moet verbeter; gesondheidswerkers uitgebreide opleiding en onderrig moet kry ten opsigte van tienergesondheid en seksualiteit behoeftes. Hersiening en vernuwing van opvoedkundige programme by skole om in die voortdurende veranderende behoeftes van tieners, te voldoen. Die betrokkenheid van ouers en die gemeenskap in die bestryding van kwessies rondom tienerswangerskappe is noodsaaklik. Verdere navorsing word aanbeveel om oplossings te vind om hierdie probleem van tienerswangerskappe aan te spreek. Alle belanghebbendes moet saamwerk om hierdie sosiale probleem op te los.

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ABSTRACT Teenage pregnancy is a health and social problem in Malawi as a result of physical, psychological and socio-economic consequences on the teenage mother, family and the society as a whole. Although studies have been conducted on the prevalence and risk factors that cause teenage pregnancy in Malawi before, detailed reports are scanty, especially for Zomba district. In spite of studies and interventions that have been and are being implemented, the prevalence of unplanned teenage pregnancy in Malawi is still high, suggesting that more efforts are required to achieve effective preventive measures. The aim of this study was to explore risk factors such as cultural issues, non-use of contraceptives, lack of knowledge on sexual and reproductive health, circumstances of first sex, gender power dynamics, sexual and physical violence, age difference between teenage girls and their partners and socio-economic status for unplanned teenage pregnancy in Zomba district of Malawi. A cross-sectional analytic design was used. Five antenatal clinics were selected using a stratified and simple random sampling technique. Data were obtained from 505 participants under the age of 20 years using a questionnaire administered through face-to-face interviews. Descriptive statistics were used to analyse data and comparisons between planned and unplanned teenage pregnancy were conducted using the Chi-squared (P ≤ 0.05) and logistic regression model to predict factors for unplanned pregnancy. Findings reveal that unplanned pregnancy accounted for 76.4% of teenagers attributable to early sex and marriage, low contraceptive use, educational levels and socio-economic status, lack of knowledge of reproductive and sexual health, physical and sexual violence and substance abuse, transactional sex due to poverty, early school dropout, misleading counselling causing a lack of knowledge on sexual and reproductive health and gender inequalities. Recommendations made are aimed at eliminating myths and misconceptions surrounding the use of contraceptives and condoms, empowering teenagers economically and in decision making, promoting career guidance, awareness on human rights, including sexual and reproductive rights and implications of early marriage and training of traditional counsellors. A multisectoral approach, including government, Non-Governmental Organisations (NGOs) and communities, is required to implement these recommendations.

Abstract not on disk

Typescript (photocopy). / Digitized by Kansas Correctional Industries

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A OrganizaÃÃo Mundial da SaÃde (OMS) define a faixa etÃria da adolescÃncia como sendo entre 10 e 19 anos e o Estatuto da CrianÃa e do Adolescente (ECA) entre 12 e 18 anos. à uma fase da vida em que ocorrem a maturaÃÃo sexual, o acirramento de conflitos familiares e a formaÃÃo e cristalizaÃÃo de atitudes, valores e comportamentos. Lidar com essas situaÃÃes exige das equipes de saÃde uma abordagem integral e interdisciplinar. A polÃtica nacional de saÃde do adolescente, oferece orientaÃÃes bÃsicas para nortear a implantaÃÃo e/ou implementaÃÃo de aÃÃes e serviÃos de saÃde aos adolescentes e jovens de forma integral, resolutiva e participativa. Reconhece como desafio o acesso de adolescentes a serviÃos de qualidade, com a compreensÃo do significado e importÃncia das dimensÃes econÃmica, social e cultural que permeiam a vida desse grupo. O estudo objetivou analisar as prÃticas de enfermeiras na promoÃÃo da saÃde do adolescente, adotadas na EstratÃgia de SaÃde da FamÃlia (ESF), visando à prevenÃÃo da gravidez na adolescÃncia. O mÃtodo utilizado foi descritivo- exploratÃrio, com abordagem qualitativa. Teve como ambiente investigativo oito Centros de SaÃde da FamÃlia (CSF) do MunicÃpio de Fortaleza. A populaÃÃo constou de enfermeiras vinculadas à ESF, cujo grupo pesquisado foi constituÃdo por oito participantes. A tÃcnica utilizada para a coleta de dados foi o grupo focal e, como mÃtodo de anÃlise dos dados, as prÃticas discursivas e produÃÃo de sentido no cotidiano, tendo como recursos os mapas de associaÃÃo de idÃias. Os resultados das discussÃes foram dispostos em colunas temÃticas e em categorias de anÃlise, previamente definidas como: ConcepÃÃo de saÃde; ConcepÃÃo de promoÃÃo da saÃde e AtuaÃÃo/prÃticas na prevenÃÃo da gravidez na adolescÃncia. O estudo aponta como resultado que as enfermeiras concebem a saÃde e a promoÃÃo da saÃde entre o conceito tradicional (prevenÃÃo da doenÃa) e o mais amplo, pautado na promoÃÃo da saÃde; o planejamento das aÃÃes de promoÃÃo da saÃde do adolescente na prevenÃÃo da gravidez na adolescÃncia à feito na maioria das vezes de forma contingÃnte e de cunho campanhista, sem privilegiar o indivÃduo em sua integralidade; fragilidade na organizaÃÃo do sistema de referÃncia e contra-referÃncia; as aÃÃes intersetoriais sÃo incipientes; hà necessidade de ampliar o conhecimento, por parte das enfermeiras, sobre as polÃticas pÃblicas voltadas ao adolescente. As aÃÃes de promoÃÃo da saÃde permeiam a consulta de enfermagem e as atividades em grupo, ressaltando o acolhimento e a Ãtica como dispositivos que contribuem para promover um ambiente favorÃvel à saÃde do adolescente. Recomenda-se que as diretrizes propostas pela polÃtica de saÃde do adolescente sejam fortalecidas, no Ãmbito municipal, de forma que proporcionem à enfermeira condiÃÃes de promover aÃÃes intersetoriais e interdisciplinares de educaÃÃo sexual na perspectiva de prevenÃÃo da gravidez precoce, que integrem famÃlia, escola, e comunidade, contribuindo para o exercÃcio de uma sexualidade mais responsÃvel e segura. / The World Health Organization (WHO) defines the age of adolescence as being between 10 and 19 years and the Statute of the Child and Adolescent (ECA) between 12 and 18 years. It is a stage of life that occur the sexual maturation, the fierce of family conflicts and formation and crystallization of attitudes, values and behaviors. Dealing with such situations requires of health teams an integrated approach, including the prevention of adolescent pregnancy. The national health policy for the adolescent, offers a basic guidelines to guide the implantation and / or implementation of actions and health services to adolescents and young people in integral, participatory and decisive way. Recognizes as a challenge the access of adolescents to quality services, with the understanding of the meaning and importance of economic, social and cultural fields that permeate the lives of this group. The study aimed to examine the practices of nurses in promoting health of adolescents, adopted in the Strategy of Family Health (SFH), aimed the prevention of teenage pregnancy. The method used was descriptive and exploratory, with a qualitative approach and had as investigative environment eight Family Health Centers (CSF) of the city of Fortaleza. The population consisted of nurses linked to the SFH, which the researched group consisted of eight participants. The technique used to collect data was the focus group and as a method of data analysis, the discursive practices and production of meaning in everyday life, having as resources, the maps of association of ideas. The results of the discussions were arranged in columns on topics and categories of analysis, previously defined as: Conception of health, Conception of health promotion and Practice / practices in the prevention of teenage pregnancy. The study points as a result the nurses concepts the health and health promotion between the traditional concept (prevention of the disease) and broader, based on health promotion and the planning of actions to promote the health of adolescents in the prevention of teenage pregnancy has been most often on campaigns, without focusing on the individual on its integrality; weakness in the organization of the reference and cross-reference system, the inter-sector actions are incipient, there is need to expand the knowledge, by the nurses, about public policies focused on the adolescent. The actions of health promotion permeate the nursing consultation and the activities in groups, emphasizing the reception and ethics as devices that help to foster an environment conducive to the health of adolescents. It is recommended that the guidelines proposed by the Health Policy of adolescent be strengthened, in the municipal level, in order to provide the nurse, conditions to promote inter-sector and interdisciplinary actions of sex education in the context of prevention of early pregnancy, which includes the family, school and community, contributing to the pursuit of a safer and more responsible sexuality.

Thesis (Ph.D)--Virginia Commonwealth University, 2009. / Prepared for: Dept. of Maternal Child Nursing. Title from title-page of electronic thesis. Bibliography: leaves 120-159.

This dissertation is based on an ethnographic study of the lives of six student-parents (four young women and two young men) from Barlow High School in northwest Austin, Texas. The lived experiences of student-parents from a predominately Latina/o high school and my interactions with Barlow High School's student body, staff, educators, administrators, and social workers from an on-campus organization called A-Space illustrate how the discursive construction of teenage pregnancy as a social problem intersects with the schooling process to (re)produce gendered, classed, and racialized notions of belonging in the American body politic. My analysis considers the development of an American cultural concern with teenage pregnancy through a history of reproductive and racial politics, and it examines the work of The National Campaign to Prevent Teenage and Unplanned Pregnancy, which, I argue, is a racializing campaign. An American cultural concern with teenage pregnancy has yielded a discourse of teenage pregnancy prevention that constructs the solution to teenage pregnancy around responsibility rather than access to contraception and information. The lives of Barlow High students and student-parents highlight the complexity of deterritorialized lived experiences, which sometimes include early family formation. While Barlow High School's student body of color learned about belonging in the first decade of the new millennium, educators vacillated between understanding the intersecting hierarchies of power impeding socioeconomic mobility and academic achievement in the community and believing that they did the best they could in the given situation. Educators and social workers, as agents of the state, failed to recognize their role in creating community. In sum, this dissertation documents a borderlanding or the creation of a borderlands in the new millennium. / text

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