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ABSTRACT Most of the documented benefits of contraceptive service lack in-depth exploration of the lived experiences of service users. This study of contraceptive users in the Sidama Zone, Southern Region, Ethiopia; was conducted with the aim of improving the overall understanding of contraceptive use towards women’s health and empowerment. This knowledge enables alignment of contraceptive service provision with the International Conference on Population Development declaration of rights-based approach. The study employed a mixed method design. The quantitative aspects include use of a descriptive retrospective approach to generate a five year snapshot contraceptive use from health institutions. Percentages were used to compute the contraceptive prevalence in the last five years. The bulk of the study was a qualitative design using interpretive phenomenology- guided by a Heideggerian approach. Data were collected using key informant interviews, focus group discussions and individual in-depth interviews. Data were analyzed using an interpretive phenomenological analysis with hermeneutic circle approach. Results were presented in broad themes following the study questions. The findings of the study indicated that contraceptive use in the study area is steadily improving. In 2008 contraceptive prevalence was twenty- five percent and after five years, it reached forty- two percent. Injectable contraceptive is the leading method, with nearly three-fourth of current users on this method. Recently, every health post offers at least one long acting and two short acting methods. The qualitative finding revealed that women’s experiences regarding the benefits of contraceptive use is encouraging. Women explicated that contraceptive service is an emancipatory and transformative experiences for them as it enabled them to control their bodies, reproduction and fertility by averting unwanted pregnancy thereby engaging in various socio-economic, religious, and political affairs. Controlled fertility gave them more time to plan their livelihood issues. The study’s title, a participant quote, captures the sentiment well: “we got peace, rest and stability”. The study finding further revealed the unique contributions of the health extension program in improving access and convenience to contraceptive service by removing many cultural, gender, and linguistic barriers. The study concludes that contraceptive service pattern has improved greatly in access and coverage; however, the majority of current users are merely on a single method indicating gaps in expanding contraceptive method mix. Women’s experiences about internalizing contraceptive use benefits towards their empowerment and health are encouraging in that they wholeheartedly expressed that the service is emancipatory and transformative. However, there are grey areas from the perspectives of ensuring support from men and dominant community members such as elders. Moreover, there is observed disconnect in conceptualizing and practicing contraceptive service provision from a broader human rights premises among health care workers across the service delivery hierarchy. The research recommends the establishment of smooth and functional mechanisms to ensure all stakeholders involved in service provision develop a shared understanding about the human rights rationale and practice while providing contraceptive service. More efforts are needed to ensure sustainable contraceptive service use by removing the existing cultural and gender barriers. Efforts should be amplified to increase men’s involvement in the reproductive services. Further study is recommended to investigate the nature and factors that influence the incorporation of human rights rationale across the health care system.

Chapter One: This chapter presents a review of the literature with reference where possible to work originating within the United Kingdom. It considers the causes and consequences of teenage pregnancy and reviews strategies for primary prevention. Chapter Two: Chapter Two describes the aims and objectives of the research. Teenage women with recent experience of pregnancy-related services within Aberdeen Royal Hospitals were interviewed in order to determine the adequacy of current service provision and identify any requirement for additional dedicated services. The opportunity was taken to further explore their experiences of obtaining and using contraception and to document their opinions of current secondary school sexual health education. Chapter Three: Chapter Three describes the development of the semi-structured interview schedules, the conduct of the pilot study and the data collection and analysis during the study proper. Chapter Four: This chapter presents the results of the semi-structured interviews conducted with 100 teenage women consecutively undergoing termination of pregnancy in Aberdeen Royal Hospitals from February 1992. The interviews confirmed the frequency of unprotected intercourse amongst these women and revealed deficiencies in the provision of abortion services for teenagers. Chapter Five: This chapter presents the results of the semi-structured interviews conducted with 100 teenage women consecutively giving birth within Aberdeen Maternity Hospital from February 1992. The teenagers were generally satisfied with the maternity services provided. Chapter Six: Chapter Six presents the views of both groups of teenagers concerning the region's school sex education. The teenagers described specific criticisms of the sex education they received and suggested improvements. Chapter Seven: This chapter describes the development and evaluation of a dedicated clinic for teenagers requesting termination of pregnancy. The specific problems revealed in Chapter Four were used to guide the development of a new clinic which was then evaluated using an original research instrument. The evaluation demonstrated that attention to the stated needs of teenagers will allow providers to create a more acceptable service.

Adolescent pregnancy and birth rates in the United States continue to decline, however, approximately four in ten adolescent girls become pregnant before they reach 20 years old (Kirby, 2001). There is a paucity of research on the perceptions of mothers and how they relate to their young pregnant adolescents (15 years old and younger) during pregnancy. This study describes the attitudes, values, beliefs, and cultural meaning from the mothers' perspective of the relationship with their pregnant daughters. A descriptive design and naturalistic approach (Lincoln & Guba, 1985) was taken to allow the researcher to learn from people rather than to simply study them (Spradley, 1979). Audio taped interviews were conducted using a semi-structured interview guide. A non-random, purposive, convenience sample of five mothers of pregnant adolescents (ages 13 to 15) were recruited and interviewed when their daughters were 30 to 35 weeks gestation. Three cultural themes emerged from the analysis: (1) mothers' relationship with their young pregnant adolescent daughter although somewhat conflicted prior to pregnancy, draws them closer together as the pregnancy progresses focusing on caring for and meeting the needs ofthe pregnancy; (2) reactions of mothers to finding out about the pregnancy have qualities similar to the process of grief/loss; and (3) mothers' advice to parents of preteens/young teens is to keep communication open and teach about sex and birth control, however, ifthe teen becomes pregnant, be there for her. This study confirms previous literature and research about the relationship of mothers and daughters and adds groundbreaking new information about how mothers relate to their young pregnant adolescents during pregnancy. This study adds to nursing science insight into changes in the mother-daughter relationship caused by pregnancy and related issues of parenting a pregnant adolescent. The notion that the mother needs to continue parenting her daughter while she is pregnant is important. Further research needs to be done to explore the needs of mothers of young pregnant adolescent daughters. The risk status of mothers needs to be addressed, practice approaches need to be generated and developmental programs for mothers at risk may need to be created and tested.

Thesis (LL. M.)--University of Toronto, 2005. / Includes bibliographical references.

Thesis (M. Div.)--St. Vladimir's Orthodox Theological Seminary, Crestwood, N.Y., 2002. / Abstract. Includes bibliographical references (leaves 93-103) and index.

Thesis (M.C.S.)--Regent College, Vancouver, BC, 1999. / Abstract and vita. Includes bibliographical references (leaves 166-171).

Thesis (M.S.)--University of Wisconsin--Madison. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 47-51).

Thèse (M.Sc.)--Université Laval, 2004. / Bibliogr.: f. 80-89. Publ. aussi en version électronique.