Thesis (MA. (Clinical Psychology)) -- University of Limpopo, 2013 / The current study aimed at investigating the relationship between attitudes towards termination of pregnancy (TOP) and family structure and functioning, religiosity, and death anxiety. Participants of this study consisted of 330 school-going, adolescent, female participants aged 12 to 19 years. The results indicated that no relationship exists between attitudes towards TOP and the type of family structure from which an individual stems. The relationship between attitudes towards TOP and the Family Assessment Device (FAD) general family functioning scale did not reach statistical significance either. When attitudes towards TOP were correlated with the more specific family functioning subscales, the FAD problem-solving subscale was negatively associated with attitudes towards TOP. Additionally, the relationship between attitudes towards TOP and death anxiety was not statistically significant. However, analysis indicated that there is a statistically significant, negative relationship between attitudes towards TOP and intrinsic religiosity among school-going adolescents. Final analysis involved the regression of variables of FAD problem-solving and intrinsic religiosity on attitudes towards TOP. Both intrinsic religiosity and FAD problem-solving scores were predictors of attitudes towards TOP.

Thesis (MPH.) -- University of Limpopo, 2014 / Legalising Termination of Pregnancy (TOP) in South Africa has given women the choice to decide to terminate an unwanted pregnancy. The implementation of the Choice on Termination of Pregnancy (CTOP) Act No. 92 of 1996 which was promulgated in 1997 engendered many challenges for the registered midwives performing TOP. A qualitative phenomenological study was conducted to explore and describe the experiences of registered midwives performing TOP at Polokwane / Mankweng Hospital Complex, which is one of the public hospitals in Limpopo Province. Registered midwives with 12 months or more experience in the TOP clinics participated in this study. Interviews were conducted with the participants. The audiotaped interviews and observational notes were transcribed and coded using Tesch’s qualitative and systematic approach of analysing textual data. The major themes that emerged from the data analysis include lack of resources, emotional and psychological trauma, lack of support, religious and cultural beliefs, blaming and coping mechanisms. Several sub-themes were identified that reflected the themes in greater detail. These were shortage of human and material resources, stress and frustration of midwives, rejection and labelling of midwives performing TOP, conscientious objection, cultural beliefs, lack of support by colleagues and management, failure by the community to use contraceptives, self-blaming, debriefing to assist registered midwives and self-acceptance. Guidelines based on contextualisation of these themes and sub-themes to improve identified challenges included retention of personnel through recognition and incentives, increase budgeting for essential equipment, planned debriefing sessions, promotion of positive attitudes by colleagues and intense training on reproductive health, including TOP.

MPH / Department of Public Health / See the attached abstract below

MCur / Department of Advanced Nursing Science / See the attached abstract below

Thesis (MPH.) -- University of Limpopo, 2022 / Background: Termination of pregnancy among young women is a public health issue, particularly in South Africa where high prevalence of pregnany terminations has lately been reported. It is estimated that 260000 terminations of pregnancy take place in South Africa every year. Studies in South Africa have reported that risk factors associated with termination of pregnancy such as financial problems, being poorly educated, being young, unemployed, dependent on parents, widowed or single and other relationship problems were most common. Approximately 1200 pregnancies were terminated in the District Hospital of Limpopo Province between 2017 and 2018. There is also an increased rate of unintended pregnancy among HIV positive women which suggest that women with HIV may be more likely to terminate pregnancy but chooses not to terminate due to fear of being judged. Therefore, the primary objective of this study was to investigate the risk factors associated with termination of pregnancy at a District Hospital in Limpopo Province. Methodology: A cross-sectional descriptive retrospective review study in which convenience sampling of the records of women who terminated pregnancies was used in this study. A self-constructed data extraction tool was used to extract the data from patients records. The tool covered variables such as the age of the women, educational status, marital status, year and month of termination of pregnancy, gestational age, parity, and gravidity, HIV status and circumstances leading to termination of pregnancy. Data analysis was done using the STATA statistical software version 12 for Windows (STATA Corporation, College Station, Texas). The independent t-test was used for variables having two categories as it assesses whether the difference between means of two groups are statistically significant. This test was performed at the 95% confidence level. The p-value of less than 0.05 in the study results was used for statistical significant difference in means between the categories which were investigated. vi Results: The mean age was 27.9 years (standard error [Std. Err.] =0.37) and majority of women who terminated pregnancies were in the age group 20 – 24 years, single and had a secondary educational level. There was a statistical significance difference between age groups and the gestational age, parity and gravidity at p=0.004 and p<0.001 respectively. The proportion of women who were at gestational age of 1 to 8 weeks decreased with increasing maternal age from 22.4% in age ≤20 years to 13% in age group 30 – 34 years. There was again a statistical significance difference (p<0.001) in relation to number of pregnancies that have each resulted in the birth of an infant capable of survival (parity) and similarly to gravida. The prevalence of HIV amongst women who terminated pregnancy in the current study was found to be 21.3% and the risk of women who terminated pregnancies being HIV positive increased significantly with age as older women (age 20 years and above) were 6.5 times more likely to be HIV positive as compared to younger ones (p<001). Low educational level, gestational age of more than 13 weeks and parity of 1 – 2 were significantly associated with termination of pregnancy. The association of gravida of women who terminated pregnancies and HIV revealed that women who were in their second or third pregnancies (gravida) while HIV positive were 3.9 times more likely to terminate pregnancies as compared to those who were first pregnancy (p<0.001). Marital status was not significantly associated with termination of pregnancy. Conclusion: Termination of pregnancies among adolescents and youth is a major public health issue and the findings of this study highlight the need to address the structural socio-economic drivers of family planning which results in high number of termination of pregnancy amongst the youth. Structural interventions, such as increasing contraceptive use which may be useful for reducing the burden of unplanned pregnancies. These findings suggest the need for targeted interventions for women of child-bearing age to access reproductive health interventions to prevent unintended pregnancies and the associated risk of termination.

The South African government promulgated the Choice on Termination of pregnancy Act (CTOP Act, 92 of 1996). This was a dramatic declaration of intent unprecedented in the African continent and globally. This act changed the outlook of the practice of termination of pregnancy by ensuring that services play a critical role in the delivery of the service. This study, which is qualitative in nature, explored the experiences of Termination of Pregnancy service providers working in three designated public health institutions in the Limpopo Province. Interviews were conducted with six service providers to look at how they construct their practice of providing termination of pregnancy services. The information was analyzed and interpreted by means of a thematic analysis method. Major themes that emerged from the participants’ experiences centred on their relationship with family, colleagues, management, clients, and the community reflecting a sense of alienation and lack of adequate infrastructural support. Inadequate support has been found to greatly contribute to the loss of interest in the work around abortion. / Psychology / M. A. (Clinical Psychology)

The South African government promulgated the Choice on Termination of pregnancy Act (CTOP Act, 92 of 1996). This was a dramatic declaration of intent unprecedented in the African continent and globally. This act changed the outlook of the practice of termination of pregnancy by ensuring that services play a critical role in the delivery of the service. This study, which is qualitative in nature, explored the experiences of Termination of Pregnancy service providers working in three designated public health institutions in the Limpopo Province. Interviews were conducted with six service providers to look at how they construct their practice of providing termination of pregnancy services. The information was analyzed and interpreted by means of a thematic analysis method. Major themes that emerged from the participants’ experiences centred on their relationship with family, colleagues, management, clients, and the community reflecting a sense of alienation and lack of adequate infrastructural support. Inadequate support has been found to greatly contribute to the loss of interest in the work around abortion. / Psychology / M. A. (Clinical Psychology)

Department of Public Health / MPH

The purpose of this research study is to determine the factors influencing reproductive health choices of women living with HIV attending primary health care services. The need for this research study is evident in that most women attending health care services at primary health care clinics, and who are HIV positive report unintended pregnancy. The study sought to provide answers to factors influencing their reproductive choices. A quantitative, descriptive and cross-sectional research study was used in this study. The sample consisted of 83 females between the ages of 18 and 40. The findings of the research study provided the researcher with adequate evidence on the factors influencing reproductive health choices of women living with HIV attending primary health care services. The approach to reproductive health services was still acceptable but needs to be improved. Moreover, the identified factors therefore influenced one’s perceptions on reproductive health decisions among HIV-infected women. / Health Studies / M.A. (Public Health)