Magister Curationis - MCur / Depo-Provera, an injectable contraceptive, is utilized by about 30% of married women in Malawi. Most women have reported their preference to use Depo-Provera due to its effectiveness in preventing pregnancy, reversibility and easy to use since it is given once at 12-weeks intervals. Despite the method having such advantages, it has menstrual effects, and one of the major concerns for women, particularly in Africa, is amenorrhea. In Malawi, 40% of Depo-Provera users report experiencing amenorrhea after one year of use. Despite the concern for amenorrhea, some women have continued using the method. Literature shows that there is limited information on women's experiences of amenorrhea following use of Depo-Provera. A descriptive phenomenological research design was used to explore and describe women’s experiences of amenorrhea following use of Depo-Provera in order to understand how women experience amenorrhea and give meaning to the experience. Data were collected through in-depth unstructured interviews with six women, who were selected using purposive sampling. The interviews were conducted in Tumbuka language. Data analysis was done using Colaizzi’s method of analyzing descriptive phenomenological data. Five themes and some sub-themes emerged from data analysis. The themes were: "Lack of knowledge on cause of amenorrhea", "Fear of pregnancy", "Misconceptions associated with Depo-Provera Induced Amenorrhea", "Lack of proper counseling on amenorrhea resulting from Depo-Provera use" and "Amenorrhea not perceived as a problem when midwives provide adequate information". The themes showed that women accessing family planning services from Chitipa district hospital were not provided with information on amenorrhea resulting from using Depo- Provera. Hence, they expressed fear when they experienced the side effect. Participants stated that they were afraid of becoming infertile after using the family planning method, getting pregnant as well as amenorrhea itself. Their intention to discontinue using the method was largely associated with negative rumors, beliefs and misconceptions. The conclusion of the study is that there is need for midwives to provide information on amenorrhea resulting from Depo-Provera use. This will assist clients to understand that amenorrhea could occur as a side effect, and hence improve continued utilization of the method.

Master of Public Health - MPH / The problem of the unmet need for contraception continues to affect contraceptive uptake particularly the use of long-acting reversible contraceptives. Globally, Sub-Saharan Africa is reported to have the highest unmet contraceptive need. For example, nearly 50 % of married women of reproductive age, wanting to avoid pregnancy or plan when to have children, are reportedly not using contraception. More specifically, the prevalence of contraceptive use, in the Midlands Province of Zimbabwe where the Gweru District is situated, is estimated to be only 11%. This study examined the uptake of and reasons for use of different types of modern contraceptives; the factors influencing contraceptive use; discontinuation of use and non-use and reasons thereof for contraception and for long-acting reversible contraception in particular, amongst women in the Gweru district attending contraceptive services.

Quality of life (QOL) is an important issue that should be addressed by nurses in all areas of practice. One patient population for whom this is important is patients who have cardiac valve replacement surgery. Research has shown that patients over 70 who have prosthetic valve implantation have an improved QOL. However, no research has been done on the QOL for children or women of childbearing age. This deficit in nursing research must be addressed in order for patients to have access to the information they deserve before making the decision to pursue surgical treatment. Medical research has shown that women of childbearing age face numerous complications that may render them functionally infertile, and mental health research has shown that infertility can greatly affect a woman's psychological state. The purpose of this thesis was to analyze and synthesize recent research for QOL in these populations. Implications for nursing practice, education and research were also addressed.