Basic Antenatal Care (BANC) is a way of training or upgrading the knowledge and skills of all nurses, midwives and doctors involved in antenatal care at the primary health care level so that the minimum care can be provided effectively. This study was conducted to investigate the implementation of the BANC program by midwives in the Mdantsane clinics during February 2009. Methods: A descriptive study design was undertaken targeting midwives providing antenatal care to pregnant women, in 14 clinics of Mdantsane. Data was collected from 25 midwives in the clinics, and from 140 ANC cards of women attending ANC on the day of their visit to the clinic. Results: The majority of midwives providing BANC in Mdantsane clinics were not trained in BANC. There were 10 trained midwives and 15 not yet trained. A total of twenty five midwives were involved in the study. The number of visits according to the BANC schedule was well known by the midwives in the study. The content of the visits was well known for the first visit, but for subsequent visits, the participating midwives could not state exactly what they do on these visits. They perceived BANC as something beneficial for both midwives and pregnant women with 24 of the participating midwives rating BANC as advantageous. In completing an ANC card, the midwives scored between 48 percent and 100 percent. Under examination, they scored between 52 percent and 100 percent. Lastly on interpretation and decision making, they scored between 0 percent and 92 percent. This could have troubling consequences for the health status of the mother and baby. Weaknesses in providing antenatal care identified in the study included participating midwives failing to fill in the last normal menstrual period (LNMP) and the estimated date of delivery (EDD), which was a worrying observation. Plotting of the gestational age at first visit was also not carried out well as only 47 percent of the midwives in the study did this, meaning that there would be a miscalculation of the gestational age thereafter throughout the pregnancies. The body mass index (BMI) was not calculated as the maternal height and weight were not written on the ANC card. This should be completed in order to check the nutritional status of the pregnant woman to help supplement, if malnourished, and educate on diet, if overweight. Only 17 percent of the midwives in the study plotted the foetal presentation. Failure to plot foetal presentation could lead to complications during delivery because women with abnormal presentations could end up delivering in a clinic instead of the hospital.Conclusion: This study showed that even though midwives are implementing BANC among pregnant women, it is not being carried out correctly. Therefore the programme will not be as beneficial as it would be if put into practice correctly. This is highlighted by the lack of knowledge from the untrained midwives regarding the content of care on subsequent visits. Thus there is an urgent need for BANC training to be conducted and monitored at various sites.

Utilizing a mixed methods approach in assessing cities and metropolitan areas with the highest rates of breast cancer disparities in African-American communities, this study presents the Affiliate perspective of the Susan G. Komen non-profit organization in combination with available socioeconomic data and academic literature. Analyzed through an anthropological lens, qualitative and quantitative data illuminate the lived experiences and dynamic circumstances in which breast cancer disparities are disproportionately experienced in 21 of the nation’s populations of African-Americans. Two main recommendations arose from this research: prioritization of granting to activities such as patient navigation, usage of patient narrative messaging, community-based participatory research methods of program development and implementation, mobile mammography delivery, usage of lay health educators, and self-advocacy education to alleviate barriers to healthcare and supplementation of the current educational activities of the Komen Affiliates through program sharing and leverage of current assets with consideration of current Affiliate capacity. These recommendations may help in alleviating breast cancer disparities present in African-American communities with the highest levels of disparities in the nation.

Indiana University-Purdue University Indianapolis (IUPUI) / This thesis project aims to address the following question: How do women who were planning a vaginal birth with limited medical intervention experience an unplanned c-section? Specifically, this research project involved: completing in-depth interviews with 15 women who planned a vaginal birth with limited medical intervention but instead experienced an unplanned c-section between six months and two years ago; discovering and describing the nature of the birth the mothers originally envisioned for their child; exploring the women’s experiences with, and feelings about, the birth itself and how it might differ from what they envisioned; developing a better understanding of how these experiences and feelings affected the women during the first two years following the birth; describing any challenges they faced and how, if at all, they managed such challenges; and identifying strategies that could be used to improve the experience of women recovering from an unplanned c-section who envisioned a vaginal birth with limited medical intervention.

Indiana University-Purdue University Indianapolis (IUPUI) / The Catholic Church is widely known for its opposition to birth control. Yet statistics show that the vast majority of American Catholics use birth control. While multiple studies have been conducted on a larger quantitative scale about the use or attitudes of American Catholics toward birth control, there have not been qualitative studies to understand the experiences of Catholics who use contraception. This study is particularly timely given the recent Catholic opposition to the Affordable Care Act’s mandate of employee healthcare provided birth control as well as, the extraordinary synod of bishops to discuss pastoral challenges to family life in October 2015. Fourteen married Catholic women were interviewed about their religious identities and experiences using contraception. Analysis demonstrated how these women constructed a religious identity by maximizing certain aspects, such as prayer and service, while minimizing other aspects, such as individual autonomy and denominational distinctions, of their religious identity. However in order to cope with the tension between their salient religious identity and their contraceptive decision making women utilizing multiple mechanisms. Specifically, they made boundaries around which types of contraception were acceptable and limits to church or individual authority; they justified their decisions based on medical necessity or betrayal they felt from the church; they legitimated their decisions by discussing God’s control and their husband’s perceptions of NFP; and they normalized their decisions through their desire to care for their children and be sexually intimate with their husbands. This research illuminates unique challenges that religious women face in their sexual decision making and sexual health practices that can help sex educators and health care providers care for women. Additionally, the Catholic Church and American Catholics make up huge forces in education, health care, charity, politics, and employment. However, not all Catholics follow the rules of the church. Those members who remain an active part of the Catholic Church, such as the practicing Catholics in this study can influence the way the church changes. By better understanding the experience of these dissenters, social researchers may be able to better understand the future of the Catholic Church.

This study focussed on determining the knowledge and understanding of Angolan women pertaining to the causes and consequences of HIV/AIDS with the aim of developing an information leaflet about HIV/AIDS for disseminating information to the vulnerable community. A quantitative approach was applied using an exploratory and descriptive design, utilising a self-developed questionnaire to collect the data, from 100 females who accompanied sick children to a specific hospital in Luanda. The findings indicated that even though the respondents were aware of certain key issues in the transmission and consequences of the HIV infection, there were many areas in which a great measure of uncertainty existed such as the causes of the disease, prevention methods, risk factors and precautions to take when living with an HIV positive person. Recommendations were made in view of enhancing the distribution of information regarding the causes and consequences of HIV and AIDS by means of different structures. / HEALTH STUDIES / MA (HEALTH STUDIES)

The purpose of this study was to investigate the role of food gardens in influencing the vulnerability of women in rural communities to HIV-infections. The study was conducted at the Makotse Women's Club in rural Limpopo. Qualitative field research was used and five participants were purposefully selected for participation in face-to-face interviews. The study found that the women's involvement in the food gardens enabled them to take responsibility for their own lives. Participation in food gardens gave these women an opportunity for income generation, the chance to access healthy food sources to improve their and their families' diets and a sense of meaning and purpose in their lives. Financial independence from husbands and male partners freed them from poverty and male domination. Through exposure to HIV and AIDS education programmes offered at the food gardens the women were empowered with knowledge about sexual health, hence reducing their vulnerability to HIV-AIDS. / Sociology / M. A. ((Social Behaviour Studies in HIV/AIDS))

This phenomenological study examined the experiences of women in midlife. The primary purpose of the study was to develop and describe a model of health promotion that will facilitate self-care of women in midlife to support them in the attainment of wholeness. A theory-generative, qualitative, explorative, descriptive and contextual design was utilized to achieve the objectives of the study, namely to explore and describe women's experience of midlife transition; classify concepts of the model; describe the structure and process of a model for support of women during midlife transition, and develop guidelines for operationalization of the model. The study was undertaken in one of the northwest states of the United States of America. Purposive sampling of eight women included women between the ages of 40 and 55 years of age. Women who had undergone surgical menopause were excluded as the influence of prolonged hormone replacement therapy was seen as a bias. Data was collected by using an unstructured interview technique. Data was analyzed according to Tesch's protocol (in Cresswell, 1994:155). Guba's model (in Krefting 1991:215) was utilized to ensure the trustworthiness of the study. Ethical issues were considered throughout and these are reflected in chapter one of the thesis. The study identified two themes: (1) how the women experienced midlife and (2) how they managed it. The experiences of midlife were expressed in physical, psychosocial and spiritual changes while the management of the process was accomplished in two ways, namely self-care and the services of healthcare professionals. The researcher identified that health promotion was essential to facilitate the self-care practices of women in midlife. Essential and related attributes of health promotion were identified, analyzed and synthesized to define health promotion. The process of health promotion was then defined with a description of the structure and process of the model. Concepts identified were classified, defined and placed into relationship statements after which the model was described and evaluated. Guidelines to operationalize the model were then formulated to assist health professionals to support women in self-care for the attainment of wholeness. / Health Studies / D.Litt et Phil (Health Studies)

Women throughout the world are suffering the brunt of HIV/AIDS. They carry the unenviable tag of being the suffering group who are at risk. Women's vulnerability to HIV/AIDS is a subject that has not received adequate attention to date. This empirical study examines the socio-cultural factors and practices that impede upon behavioural change of Zimbabwean women in an era of HIV/AIDS. Firstly, a sample of 1002 women respondents is purposefully drawn from the six major Zimbabwean ethnic groups to participate in this research study. A survey questionnaire is administered to respondents in the age group 18 to 59 years to quantify the levels and magnitude of the HIV/AIDS problem among women. Secondly, fifty in-depth interviews with key informants are conducted to assess the nature of the problem confronting and impeding upon women's quest to attain good reproductive health. Thirdly, six focus group discussions for each of the respective six ethnic groups are conducted with forty-eight mature women to understand broadly the concepts of the study. This study employs a combination of mainly qualitative and some quantitative methods of data collection and analysis, which is called triangulation. Underlying the methodology of this study is an overarching functionalist theoretical perspective, also referring to gender development theory which serves as the basis for data analyses. The main findings of this study include the view that power dynamics, gender roles and cultural practices have impacted negatively on women's quest to attain safe sexual behaviour. The problem of HIV/AIDS remains a complicated and awesome one among Zimbabwe's ethnic groups. For Zimbabwean women the HIV/AIDS problem begins with a total lack of control over sexual lives and behaviour of their husbands especially outside marriage. The women have noted that the majority stay faithful to their husbands and partners according to cultural prescriptions and roles, while their husbands do not comply. Women noted that cultural prescriptions in their various ethnic settings condone male infidelity but expect women to stay faithful to their partners. As a result it is found that women sometimes contract HIV/AIDS straight on their matrimonial beds. / SOCIOLOGY / Thesis (D. Phil. (Sociology))

Reproductive health is very important as it shapes a woman's whole life. Currently there are a lot of obstacles which deny women their rights to reproductive health. The aim of this research was to find out what obstacles deny women the freedom to enjoy their reproductive health in order to establish a contribution which can be used by the Department of Health to improve their services. Descriptive research was conducted, using a survey approach. Convenience sampling was utilized. Participants were selected from a sample of people attending the reproductive health clinic at a hospital and a clinic in the Northern Province. The findings indicate that women are not enjoying reproductive health rights due to low educational level, cultural and societal constraints, low socio economic status and the negative attitude of the providers, of reproductive health services. / Contraceptives / Family planning / Health and gender / Health rights / Reproductive choice / Reproductive health / Reproductive rights / Reproductive health care / Women's rights / Rural women / Health Science / M.A.Cur.(Nursing Science)

Background: Group B streptococcus (GBS) is regarded as one of the most important causes of maternal and neonatal morbidity and mortality in many parts of the world. GBS recto-vaginal colonization is important in the health of a mother and her neonate, especially in developing countries. Maternal vaginal colonization with GBS at the time of delivery can cause vertical transmission to the neonate. Multilocus sequence typing (MLST) is a technique used to characterize microbial isolates by means of sequencing internal fragments of housekeeping genes and has the advantage of reproducibility and has been shown to correlate with the other typing techniques and thus has emerged as the standard for delineating the clonal population of GBS. The study aimed to investigate the epidemiology of GBS colonization among pregnant women and their neonates, and to characterize the isolates by multilocus sequence typing technique at Dr George Mukhari Academic Hospital, Pretoria. Methodology: A total of 413 pregnant women who visited the antenatal clinic were recruited and screened. Participants were interviewed using a questionnaire to gather demographic and other relevant information such as history of current pregnancy, previous miscarriages and still births. Samples from maternal rectum and vagina as well as neonate ear and umbilical cord were taken for culture using colistin and nalidixic acid (CNA) blood agar and incubated for 24-48 hours. If negative after 48 hours, Todd-Hewitt broth was subcultured after 18-48 hours onto sheep blood agar. Multilocus sequence typing (MLST) was used to characterize seven group B streptococcus isolates collected at Dr George Mukhari academic hospital. Fragments of seven housekeeping genes were amplified by polymerase chain reaction (PCR) for each strain and sequenced. CLC bio software (Inqaba biotech, South Africa; Pretoria) was used to analyse sequenced loci and UPGMA dendrogram was constructed. Results: The colonization rate for GBS in pregnant women and their neonates was 30.9% and 0%, respectively. A higher proportion of GBS were isolated from the rectum (37.9%) as compared to the vagina (20.6%). Most socio-economic, demographic and obstetric factors analysed were not significantly associated with.GBS colonization. On 128 positive samples, the results of Todd-Hewitt enrichment broth and direct plating method using CNA were compared. A total of 45.3% of colonised were positive on direct selective agar (CNA); an additional 54.7% samples were recovered from Todd-Hewitt broth. Three genes (adhP, glnA and tkt) were sequenced successfully for six samples (1, 2. 4,6,12 and 65). The UPGMA tree with 1000 bootstrap showing the relationship between six samples was drawn.Conclusion: This study revealed that pregnant women of all ages are at risk of group B streptococcus colonization. Group B streptococcus was common among pregnant women at Dr George Mukhari Academic Hospital. No socio-economic risk factor was associated with group B streptococcus colonization. Results confirm that the combination of Todd-Hewitt broth and CNA agar plate is a time saving and sensitive method. The allelic profile, characteristics such as G+C (guanine+cytosine) content and dN/dS ratio were not analysed because of the smaller sample size used in this study, which shows that the MLST method was unsuccessful in this study. The UPGMA tree based on differences in consensus of the isolates showed that all group B streptococcus isolates are clustered and descend from a single node. / Life & Consumer Sciences / Life Sciences / M.Sc. (Life Sciences)