Voluntary Counselling and Testing (VCT) is vital in the management of HIV/AIDS as it is the first step in treatment, care and behavioural change. Entrenched economic and gender inequities drive an increasingly feminized HIV/AIDS pandemic. This study investigated factors influencing VCT attendance by women in the Glen View high density suburb in Harare. A survey methodology was followed using a semi-structured, self-administered questionnaire that was distributed to randomly selected women of reproductive ages in the area. The analysis showed that VCT usage is low and that factors such as fear of the consequences of testing positive for HIV, such as violence and rejection by male partners are to blame. Importantly, the findings suggest that if the vulnerability of women is not addressed, then increased VCT uptake and better reproductive health outcomes for women are also unlikely. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

The purpose of the study was to determine the factors that predict women’s risky sexual behaviour and HIV and AIDS knowledge. A quasi-experimental, pre-test-post-test research design, with a non-equivalent comparison group was conducted to determine if there was an association between young women’s sexual behaviour and HIV/AIDS knowledge on aspects of HIV/AIDS transmission and prevention and behaviour change. The study used both quantitative and qualitative approach. Data collection was done using semi-structured interview schedule and focus group discussion guide. The respondents who participated in the study were women between the ages of 15-25 years. Two groups of respondents participated in the study. Women in the quasi-experimental site (N=200) who received the intervention and women in the control site (N=200) who did not receive any intervention. Quantitative data were analysed with the help of a statistician and the Epi Info statistical package was used. Qualitative data obtained from the focus group discussion were analysed using Tesch’s method of analysis. The major inferences drawn from this study are that young women lack knowledge relating to HIV/AIDS and that some young women were engaged in risky sexual behaviours such as having multiple sexual partners and having unprotected sex. The study indicates that peer education strategy has the potential to make an impact on these young women. It has also shown that peer education can play an important role in increasing knowledge and reducing risky sexual behaviour. / Health Studies / D. Litt. et Phil. (Health Studies)

Background: In many developing countries, maternal deaths occur mainly as a result of unsafe abortions, a situation reflecting the inaccessibility of safe abortion services in such countries. In Ethiopia, unsafe abortion accounts for 32% of maternal deaths and almost 60% of gynaecological admissions, and is one of the top ten causes of general hospital admissions. Purpose: The purpose of this study was to assess the views of women about the accessibility of safe abortion services in governmental health centres. Methods: A quantitative cross-sectional descriptive and non-experimental study using structured questionnaires was conducted. 342 women who had received abortion care services in governmental health centres participated. Findings: 46.8% of the participants do not know about the penal code regarding safe abortion care. 52.9% of the participants viewed safe abortion care as inaccessible because there are various and competing factors which make abortion service to be viewed as accessible or inaccessible and these include distance to nearest health centre, the time it takes to receive the service, the cost of the service, and the lack of appropriate skills in the service providers. Conclusion: An improvement in the accessibility of abortion services will prevent deaths resulting from unsafe abortions / Health Studies / M.A. (Public Health)

Background AIDS remains one of the world’s most serious health challenges affecting more females than men. The differences in the spread of Human Immunodeficiency Virus (HIV) among gender groups stem from biology, sexual behaviour and socially constructed gender differences between women and men in roles and responsibilities, access to resources and decision-making power. It could also be due to the females’ status in society which could be justified by lower economic and decision making ability. Purpose The purpose of this study was to explore and describe the role of gender in the spread of HIV among women of reproductive age in Ethiopia; with the view of developing gender sensitive HIV and AIDS prevention strategies. Methods The study used sequential mixed method with quantitative and qualitative paradigm. During first phase of the study, health facility based descriptive cross-sectional study design was used. Data was collected from 422 respondents using a structured questionnaire. Forty participants were recruited by purposive sampling from representatives working in reproductive health or related fields. Results About 83.2% of respondents reported that sexual intercourse discussion should be initiated by male partners. This showed that majority of respondents were dependent on their male partners in decision-making regarding sexual matters in their relationship. Multiple sexual partners were common among the respondents. One third of the respondents reported to have had intercourse with more than one partner during the past twelve months of the study period. Higher proportion of respondents (61.4%, n=259) had never used condom during sexual intercourse with their partner/s. As a result these risky sexual practices are a potential threat for spread of HIV and AIDS among women. Thus developed guidelines would alleviate the existing problems through implementation of strategies of HIV and AIDS prevention to enhance women’s status at household and different administrative structure level. Conclusion Gender disparities in relation to negotiating sexual relations among the study respondents were found to be still relevant. The culture that has placed men at the helm of leadership in sexual matters is strongly upheld and that includes who recommends use of preventive measures and who regulates when and how to enter into a sexual relationship. Guidelines for gender sensitive prevention strategies if applied appropriately would educate women and men to make decision about what directly affects their health / Health Studies / D. Litt. et Phil. (Health Studies)

This thesis examines the trans-border circulation and production of feminist knowledge through translation. More specifically, my research focuses the translation of the U.S. women’s health book, Our Bodies, Ourselves, by a Chinese feminist NGO in 1998. My dissertation studies the social, cultural and political aspects of feminist translation, and examines the relation between translation and feminist praxis. Through the lens of gender and (feminist) health politics in 1990s China, I examine how the 1998 Chinese translation conveys the book’s message about how women should relate to their bodies. Set in the context of Chinese society opening up during the late 1970s, my research outlines the emergence of gender awareness in China with the influx of translated feminist texts, especially in the realm of women’s health research. Medical discourses were then assigned a privileged position in the studies of women’s sexual and reproductive health. However, with increased communications between Chinese and foreign feminists, Chinese women scholars developed new ideas around women’s sexual and reproductive health. The Chinese translation of OBOS addresses the lack of gender awareness in local discussions about women’s health. With a multi-method study, I emphasize the social and linguistic dimensions of translating a feminist health project into post-reform China. This study is based on both interview and comparative textual analysis data. Using feminist translation theories, I examine how the Chinese translators handled the book’s presentation of women’s sexuality and reproductive health. This thesis also highlights the constraints on translating feminism from the local context. This raises questions about the power of (feminist) translation, and emphasizes the need to examine the social-political context of translation practices.

MPH / Department of Public Health / The high maternal mortality ratio is caused by various factors, including avoidable complications which can be reduced by attendance to antenatal care visits. The utilisation of antenatal care has been low in rural areas, especially in Africa. The purpose of this study was to explore the utilisation of antenatal care in Mutasa District of Zimbabwe. This study used a qualitative study approach, adopting the descriptive, explorative design that presented an active image of the research participants’ reality and capture live experiences. Participants of the study were pregnant women and women with children under the age of one. The participant were sampled using purposive and snow-ball sampling techniques. In-depth interviews were conducted. The participants were interviewed in their native language, Shona. The main question was: Can you explain in your own words how you use antenatal care services from the primary health care facility? The researcher clarified questions which the participant failed to understand. The researcher wrote down all responses and used a tape recorder to capture the responses. The researcher analysed data using thematic content analysis where themes and sub-themes were discussed. The main theme was low uptake of antenatal care in rural primary health care facilities. From the main theme there were factors influencing and perceptions of women on uptake of antenatal care services in primary health care facilities. Trustworthiness was ensured through credibility, dependability, transferability and conformability. Permission from the relevant authorities, such as the University of Venda Higher Degrees Committee, the Provincial Medical Director and the District Administrator was sought before conducting this study. Informed consent was also sought before interviewing the participants. The study concluded that socio-demography of participants affected antenatal care attendance. These are age, level of education, low income, high parity and distance to facility. Other hindering factors to utilization of antenatal care were lack of knowledge, religion and acceptability of antenatal care by the women in rural primary health care facilities. Findings will be disseminated through a research report and published in relevant accredited journals with the help of the supervisors. The study recommended that the Ministry of Health and Child Care of Zimbabwe review Antenatal Care policies to ensure friendliness and to increase awareness through health education and continuous dissemination of antenatal care information. / NRF

The aim of this study was to identify factors affecting facility-based delivery with the purpose of developing a framework for the promotion of facility-based delivery among women living in rural Ethiopia. Explanatory mixed methods design, comprising of four phases-the descriptive (quantitative), explorative (qualitative), meta-inference and development phases was employed. The quantitative phase was conducted first using a structured questionnaire to identify the variables influencing facility-based delivery care seeking behaviour. A sample of 389 responses were used for data analysis using Structural Equation Modeling. The quantitative phase conducted next to explain the determinants that contributed to influencing facility-based delivery care seeking behaviour. Sixteen participants who were involved the first phase were involved in the follow-up second phase. As illustrated by the results of the study, the majority of women in the study areas continued to deliver at home, putting themselves at risk of dying from pregnancy related causes. As highlighted by the key findings from the quantitative and qualitative data of this study, the most influential factors in predicting and explaining delivery care seeking behaviour are response efficacy, attitude, subjective norm, and perceived behavioural control which are shaped by mothers’ confidence in the outcome, quality of care, interpersonal relations with family members, willingness to conform, access to services, and their decision making power. The way these findings emphasized the factors attitude, subjective norm and perceived behavioural control were consistent with the Theory of Planned Behaviour, while the significance of response efficacy was in line with Protection Motivation Theory. The study developed a framework to help promote facility-based delivery among mothers living in rural Ethiopia. / Health Studies / D. Litt. et Phil. (Health Studies)

In 2011, African Americans in Tarrant County, Texas experienced an infant mortality rate of 14.3 per 1,000 live births. The leading cause of infant mortality in Tarrant County is prematurity and maternal nutritional status. Both maternal under-nutrition and over-nutrition are known risk factors for premature birth. Improving maternal nutrition, by reducing rates of gestational diabetes and preeclampsia, and by increasing consumption of essential prenatal vitamins and nutrients, is a road to decreasing preterm birth in African Americans. This qualitative study, based on both anthropology and public health theory, of the nutrition behavior of a group of African American expectant mothers and the experience of their health care providers and co-facilitators had a goal to provide a foundation for future development of nutrition behavior research and education for this specific population. The main finding of this study was the substantial gap of lived experience and education between the patients and their providers and co-facilitators, which hinders delivery of care and the patients’ acquiescence to nutrition recommendations. The discrepancies between the authoritative knowledge of the providers and the bodily knowledge of expectant mothers were responsible for the ineffectiveness of nutrition recommendations.

Antiretroviral therapy is an important public health strategy to reduce the risk of HIV vertical transmission. Implementation of such therapy depends on the identification of HIV-infected pregnant women. This study investigated how the biographical characteristics of the pregnant women (16-45 years) influenced their health decision-making in Bulawayo clinics. The study was guided by the theories of health behaviour. The study assumed that the respondents’ demographic characteristics will influence their attitudes towards PMTCT programme. Using a structured questionnaire, forty pregnant women who visited the Bulawayo clinics to have prenatal checkups were interviewed. The majority of respondents came from a poor, high-density township. Most of the respondents were married, but about a third were not married at the time data collection and 5% were separated. The survey items were demographic characteristics, knowledge of PMTCT, HIV risk perceptions and service utilisation. The levels of literacy among the respondents were high; more than 80% had completed primary education. Overall the respondents’ demographic characteristics influenced their attitudes towards PMTCT. Majority of the women knew that a mother with HIV can pass the virus to her child, during pregnancy, delivery and breastfeeding. The pregnant women’s health-seeking behaviour and their attitudes toward reproductive health services are influenced by their demographic situation. / Health Studies / (M.A. (Social Behavior Studies in HIV/AIDS))

Diabetes and related complications are one of the leading causes of death for Mexican American women. Although dietary behavior is a critical component of diabetes management, research is lacking in relation to the interplay of food habits, culture, and diabetes among this population. The specific aims of this ethnographic study were to: (1) explore the relationships between culture, food habits, and type 2 diabetes as experienced by low income Mexican American women; (2) examine the role of food in the cultural identity of low-income Mexican American women; (3) examine how trying to adhere to the ADA dietary guidelines for people with diabetes impacts the relationship between food and culture of low income Mexican American women with type 2 diabetes. This sample consisted of 16 Mexican American women between the ages of 39 to 60 years. Twelve of the sixteen had experienced diabetes for at least 10 years, and were considered experts in the management of their illness. The remaining four had experienced diabetes for a shorter period of time and were considered novices. Individual interviews were conducted with each informant. All interviews were audiotaped with the exception of one. The interviews, observations, and field notes were analyzed for data. The analysis of data rendered 6 themes: (1) “la dieta,” (2) the location and fluidity of food (3) confidence-defiance self-management connection, (4) negotiating sociocultural and biomedical expectations, (5) eating for diabetes is a family affair, and (6) strategies for self-care. In addition, preliminary comparisons were conducted between experienced and more novice individuals with diabetes. / text