Reproductive health and emergency contraception in South Africa: Policy context and emerging challenges

This report reflects the preliminary findings of an ongoing collaborative project to investigate the impact of trade liberalisation on reproductive health rights. The project is being undertaken simultaneously by researchers at the School of Development Studies, University of KwaZulu-Natal in South Africa and by researchers from the International Center for Research on Women (ICRW)-India. In response to the growing international attention given to free trade, trade related intellectual property rights (TRIPS) and the accessibility of essential drugs and medicines, the project aims to examine the links between trade policy and reproductive health commodities. In South Africa, the project focuses on the availability and use of emergency contraception pills (ECPs). Emergency contraception (EC) has been recognised both internationally and locally as being an important commodity with respect to the realisation of reproductive health rights. Emergency contraception is clinically defined as the use of a drug or device as an emergency measure to prevent, or reduce the risk of an unwante

Support for Voluntary Medical Male Circumcision (VMMC) for HIV Prevention among Men and Women in Zimbabwe

Background: Medical male circumcision was introduced in Zimbabwe in 2009 as an additional HIV prevention method. This study sought to investigate support for the roll-out of voluntary medical male circumcision (VMMC) and men’s willingness to get circumcised for HIV prevention. Data and Methods: Data for this study was collected from a randomly selected sample of 681 men and women in the age group 18-49 years in Harare, Zimbabwe. The obtained data was analysed using descriptive statistics, bivariate and regression analysis. Results and Conclusion: The results of the study suggest that knowledge and acceptability of VMMC is high. However, despite the relatively high knowledge and acceptability of VMMC, less than half of the male participants were willing to undergo circumcision for HIV prevention. The study concluded that there is anapparent gap between knowledge and acceptability of VMMC and men’s willingness to undergo circumcision for HIV prevention.

Termination of pregnancy: Perspectives of female students in Durban, South Africa

Pregnancy termination among young women constitutes a public health problem particularly in South Africa where high prevalence of abortion has been recently recorded. The primary objective of this study was to assess the social context in which decisions about termination of pregnancy are taken. In particular, it examines the perspectives of young women with regard to abortion and abortion methods, specifically medical abortion. The study draws on in-depth interviews with female students at a university in Durban, KwaZulu-Natal. The findings suggest that for the majority of women, abortion is a context-driven choice. While women were opposed to abortion for themselves, it was seen as justifiable under certain circumstances. There was a feeling that abortion services should be made accessible to all women that seek them, including medical abortion. The major identified barriers to accessing abortion services were: stigma and cultural beliefs; finances; and negative attitudes of health providers. Termination of pregnancy services should take into account the context in which women make decisions on abortion as well as the barriers women face in accessing abortion services in order to reduce its prevalence.

The dual risks of unwanted pregnancy and HIV/AIDS : the case of KwaZulu-Natal, South Africa

This thesis is divided into two parts. The broad aim of the first part of the study is to provide insights into the perspectives and behaviour of sexually active individuals and couples with regard to the prevention of unwanted pregnancy and HIV/AIDS in KwaZulu-Natal, South Africa. A combination of qualitative and quantitative data is used: focus group discussions, a survey of individuals and couples and in-depth interviews. The study found that knowledge of family planning is virtually universal. Most men and women approve of family planning as a method of fertility regulation, although women are more likely than men to report using a method of family planning. Family planning is seen as the woman's domain and as a result, the wife often takes the initiative in using a method of family planning, sometimes without her husband's knowledge. With regard to HIV, awareness is also virtually universal among men and women. Despite this, there is much resistance to condom use especially in marital unions. Condoms are more likely to be used in non-marital than marital unions. However, there are some encouraging indications that condom use in marital unions is occurring and the wife's risk perception is a major factor influencing use. In the second part of the study, the emphasis shifts from the perspectives of individuals to the role of services. The broad aim of this part of the study is to consider how health services are responding to the needs of sexually active men and women by obtaining information from providers and clients. The study found that while condom promotion is an important component of integrated services, it is not consistently undertaken by providers. Moreover, in most health facilities, clients are only usually offered services for which they present at the health facility. Clients feel that they would benefit from additional information that will protect them against the dual risks of unwanted pregnancy and STIs/HIV.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

The social identities of Indians in a changing South Africa.

Masters Degree. University of KwaZulu-Natal, Pietermaritzburg.Abstract available in PDF.Quality of scanned PDF has been compromised owing to poor condition of original document

Challenges with couples HIV counselling and testing among black MSM students: perspectives of university students in Durban, South Africa

Research suggests that HIV infections among men who have sex with men (MSM) are acquired  rom primary partners, yet MSM continually fail to take part in couples HIV counselling and testing (CHCT). To identify factors that inhibit MSM in universities from regularly testing for HIV with their sexual partners, this study considered the perspectives and experiences of 15 MSM students in Durban, South Africa. The findings show that despite appreciating the value of couple testing it is relatively uncommon. MSM resist doing so with their casual partners as this would presumably signal an intention to advance the relationship beyond the short-term. Other barriers included; experienced and perceived homophobia at public testing centres, trust-based assumptions that primary partners need not test for HIV and fear of discord. They also employed alternative strategies to purportedly determine their casual and primary partners’ status in the absence of CHCT. Alternative strategies include; initiating sexual relationships with casual partners whose sexual history is known and making use of home-based testing kits to avoid CHCT at public testing centres. These findings emphasise the need for LGBTIQ-friendly couple-based approaches as a necessary component of HIV prevention interventions among MSM in universities

Missing opportunities for preventing unwanted pregnancy: a qualitative study of emergency contraception.

Accepted for publication to the Journal of Family Planning and Reproductive Health Care 37(2):October 2010. doi: 10.1136/jfprhc.2011.0055.BACKGROUND AND METHODOLOGY:High levels of unplanned pregnancy among young people are a huge public health problem in South Africa. However, use of emergency contraception (EC) remains low. Studies suggest that providers constitute an important link to increasing access to EC use. The aim of the study was to provide greater insights into the attitudes of providers towards EC in order to better understand factors influencing uptake. The study drew upon 30 in-depth interviews with providers at private and public health facilities in Durban, South Africa. RESULTS: The results of the study highlight several barriers to the provision of EC in both public and private health facilities. The cost of EC products in commercial pharmacies is likely to be a major barrier to use for many women. In addition, providers in both public and private facilities are often reluctant to provide EC over the counter because they feel that the use of EC is likely to discourage regular use of contraception and increase the risk of unprotected sexual intercourse and, as a result, contribute to the spread of HIV/AIDS in South Africa. In addition, they reported that they do not have an opportunity to counsel women about EC because of time constraints. Providers in both the public and private sectors also demonstrated a level of uncertainty about the clinical effects of EC pills and on the regulations surrounding their provision. DISCUSSION AND CONCLUSIONS: Despite relatively progressive legislation on EC provision and the widespread availability of EC products in South Africa, providers in pharmacies, family planning clinics and public health clinics need more training on EC provision. Interventions should aim to educate health providers on both the clinical and social aspects of EC provision

Handbook of Active Ageing and Quality of Life: From Concepts to Applications

La edición de este libro estuvo a cargo de Fermina Rojo-Pérez y Gloria Fernández-Mayoralas.El documento adjunto contiene la cubierta, portada e índice del libro.This handbook presents an overview of studies on the relationship of active ageing and quality of life. It addresses the new challenges of ageing from the paradigm of positive ageing (active, healthy and successful) for a better quality of life. It provides theoretical perspectives and empirical studies, including scientific knowledge as well as practical experiences about the good ageing and the quality of later life around the world, in order to respond to the challenges of an aged population. The handbook is structured in 4 sections covering theoretical and conceptual perspectives, social policy issues and research agenda, methods, measurement instrument-scales and evaluations, and lastly application studies including domains and geographical contexts.Peer reviewe

The dual risks of unwanted pregnancy and HIV/AIDS : the case of KwaZulu-Natal, South Africa

This thesis is divided into two parts. The broad aim of the first part of the study is to provide insights into the perspectives and behaviour of sexually active individuals and couples with regard to the prevention of unwanted pregnancy and HIV/AIDS in KwaZulu-Natal, South Africa. A combination of qualitative and quantitative data is used: focus group discussions, a survey of individuals and couples and in-depth interviews. The study found that knowledge of family planning is virtually universal. Most men and women approve of family planning as a method of fertility regulation, although women are more likely than men to report using a method of family planning. Family planning is seen as the woman's domain and as a result, the wife often takes the initiative in using a method of family planning, sometimes without her husband's knowledge. With regard to HIV, awareness is also virtually universal among men and women. Despite this, there is much resistance to condom use especially in marital unions. Condoms are more likely to be used in non-marital than marital unions. However, there are some encouraging indications that condom use in marital unions is occurring and the wife's risk perception is a major factor influencing use. In the second part of the study, the emphasis shifts from the perspectives of individuals to the role of services. The broad aim of this part of the study is to consider how health services are responding to the needs of sexually active men and women by obtaining information from providers and clients. The study found that while condom promotion is an important component of integrated services, it is not consistently undertaken by providers. Moreover, in most health facilities, clients are only usually offered services for which they present at the health facility. Clients feel that they would benefit from additional information that will protect them against the dual risks of unwanted pregnancy and STIs/HIV