scholarly journals “Without a mother”: caregivers and community members’ views about the impacts of maternal mortality on families in KwaZulu-Natal, South Africa

2015 ◽  
Vol 12 (S1) ◽  
Author(s):  
Lucia Knight ◽  
Alicia Ely Yamin
Author(s):  
Rachel Jewkes ◽  
Yandisa Sikweyiya ◽  
Robert Morrell ◽  
Kristin Dunkle

This article reports the findings of research conducted with a randomly selected sample of men aged 18–49 years from the general population of the Eastern Cape and KwaZulu-Natal, who were asked in an anonymously conducted survey about their rape perpetration practices, motivations, and consequences thereof. Overall 27,6 per cent (466/1686) of men had forced a woman to have sex with them against her will, whether an intimate partner, stranger or acquaintance. Some perpetrated alone, others with accomplices. Most men who had raped had done so more than once, started as teenagers, and often had different types of victims. Asked about motivations, men indicated that rape most commonly stemmed from a sense of sexual entitlement, and it was often an act of bored men (alone or in groups) seeking entertainment. Rape was often also a punishment directed against girlfriends and other women, and alcohol was often part of the context. A third of men had experienced no consequences from their acts, not even feelings of guilt. More commonly there was remorse and worry about consequences, and in a third of cases there had been action against them from their family, that of the victims, or respected community members, and about one in five had been arrested for rape. This research confirms that rape is highly prevalent in South Africa, with only a small proportion of incidents reported to the police. Many of the roots of the problem lie in our accentuated gender hierarchy. This highlights the importance of interventions and policies that start in childhood and seek to change the way in which boys are socialised into men, building ideas of gender equity and respect for women.


2020 ◽  
Author(s):  
Natsayi Chimbindi ◽  
Nondumiso Mthiyane ◽  
Thembelihle Zuma ◽  
Kathy Baisley ◽  
Deenan Pillay ◽  
...  

Abstract Introduction: Pre-exposure prophylaxis (PrEP) has the potential to alter the HIV epidemic in South Africa. Between 2016 and 2018 PrEP was rolled-out for 18-24 year-old female-sex workers (FSW) in a rural KwaZulu-Natal subdistrict with very high HIV incidence among adolescent girls and young women (AGYW). Using a ‘framework of access’ model, we describe PrEP access, awareness and uptake for AGYW, including community members’ attitudes towards PrEP for young people.Methods: We enrolled a cohort of 2184 AGYW aged 13-22 living within the subdistrict and quantitatively measured their eligibility, awareness and uptake of PrEP and other HIV prevention interventions in 2017 and 2018. We supplemented this insight with in depth exploration by conducting 19 group discussions with young people and community members, nine stakeholder key informant interviews, 58 in-depth interviews with 15-24 year-olds and 33 with implementing partners, and participatory observations. All interviews were recorded, transcribed and analysed using thematic analysis.Results: PrEP awareness increased from 2% to 9% from 2017 to 2018. Among 965 AGYW sexually-active by 2018, 13.4% (95%CI: 11.4-15.7%) reported transactional sex and 10.6% (95%CI: 8.8-12.7%) sex for money. Of these latter 194 PrEP-eligible AGYW, 21 were aware of PrEP, but none had ever used it. Wider community members were generally unaware of PrEP but imagined it would benefit young people, HIV-serodiscordant couples and those in long-distance relationships. Youth saw PrEP as a positive alternative to condoms since it “will be in their system” and not get in the way of sex. Teachers and healthcare providers were more apprehensive: worrying that PrEP would lower personal responsibility for sexual health.Conclusions: Although PrEP awareness increased and it was generally acceptable, uptake was low even among eligible AGYW, i.e., who reported FSW activity. Condom use remained undesirable suggesting a need to include PrEP in offers of alternative HIV prevention technologies to comdoms. The targeted nature of public-sector PrEP for FSW may have limited the reach, and the future broader roll-out, of PrEP in this setting. Inclusive approaches to PrEP provision integrated with wider sexual healthmay help improve demand and access to PrEP.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Pinky N. Manana ◽  
Sara Jewett ◽  
Jabulani Zikhali ◽  
Dumsani Dlamini ◽  
Nondumiso Mabaso ◽  
...  

Abstract Background An assessment of the Sterile Insect Technique (SIT) as a complementary malaria vector control tool, is at an advanced stage in South Africa. The technique involves the release of laboratory-reared sterilized male mosquitoes of the major malaria vector Anopheles arabiensis, raising social, ethical and regulatory concerns. Therefore, its implementation largely depends on community participation and acceptance. Against this background, it is critical that robust and effective community strategies are developed. This study describes the development of a cultural song to engage the community and increase awareness on SIT and malaria control in KwaZulu-Natal, South Africa. Methods An exploratory concurrent mixed-methods study was conducted to get opinions about the effectiveness of a cultural song developed to engage communities and increase acceptability of the SIT technology. Two self-administered surveys (expert and community) were conducted. Additionally, more in depth opinions of the song and its effectiveness in conveying the intended information were investigated through three community dialogue sessions with community members in the study area. Results A total of 40 experts and 54 community members participated in the survey. Four themes were identified in relation to the appropriateness and effectiveness of the song, with a fifth theme focused on recommendations for adaptations. Overall, the song was well received with the audience finding it entertaining and informative. Responses to unstructured questions posed after the song showed an increase in the knowledge on malaria transmission and SIT technology. In particular, the explanation that male mosquitoes do not bite allayed anxiety and fears about the SIT technology. Conclusion The song was deemed both culturally appropriate and informative in engaging community members about the SIT technology. It proved useful in promoting health messages and conveying SIT technology as a complementary malaria vector control tool. With minor adaptations, the song has potential as an area-wide community engagement tool in areas targeted for sterile male releases.


2021 ◽  
Vol 8 (3) ◽  
pp. 269-277
Author(s):  
Rose Maureen Makapi Mmusi-Phetoe ◽  
Brian Barasa Masaba

Abstract Objective High maternal mortality ratios (MMRs) remain a concern in many parts of the world, especially in developing countries like South Africa. Different models have been developed, tried, and tested worldwide, in the hope that they will reduce maternal mortality, but without much success. Methods A qualitative approach was used to conveniently select a sample of 10 women attending an antenatal clinic in a rural area, in one of the districts of KwaZulu-Natal (KZN) Province. Data were collected by means of interviews with the women. Data were analyzed employing Burnard's content analysis approach. Results Four themes emerged: (1) age at first pregnancy; (2) birth intervals, risks in pregnancy and hospitalization; (3) the use of contraception; and (4) HIV status. All themes that emerged revealed inattention to reproductive health (RH) needs, resulting in poor RH outcomes as an area of concern. Conclusions Greater emphasis needs to be placed on meeting the sexual and reproductive health (SRH) needs of South African women, if maternal mortality rates are to be reduced. An alternative model for reducing maternal mortality in South Africa is proposed.


Author(s):  
Sibonelo Nzimande ◽  
Urmilla Bob

Eco-cultural projects are initiated in host communities to create livelihood opportunities linked to tourism and concurrently supporting conservation efforts. Research tends to focus on the sustainability of the projects after implementation with limited understanding of stakeholder issues during the planning stages. This study focuses on stakeholder perceptions of the proposed Eco-Culture Resort (ECR) in the Chelmsford Nature Reserve (CNR) at Ntshingwayo Dam in Newcastle, KwaZulu-Natal (KZN), South Africa in relation to tourism potential. The methodological approach adopted entailed interviews with 50 respondents purposively selected from the ranks of three key stakeholder groups - government, business and community members. The main findings reveal that the stakeholders linked ECRs with conservation, sustainable development and tourism-related opportunities. Respondents also viewed the proposed resort as a tourist destination with huge economic development potential. The study reveals that ECRs have stakeholder support and perceived to have the potential to increase tourism opportunities and enhance the level of environmental awareness among both would-be visitors and the broader community. However, challenges arise that foreground the importance of extensive stakeholder engagement to ensure that tourism benefits are realised. There is limited research on examining stakeholder perceptions of tourism-related aspects of ECRs despite the growing recognition that understanding of different views, interests, opinions, expectations and concerns results in greater success of nature-based conservation and tourism projects. This research addresses this gap in the literature and addresses the issue of better understanding stakeholders' perceptions and concerns during the planning stages of ECRs.


Diagnostics ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 218 ◽  
Author(s):  
Tivani P. Mashamba-Thompson ◽  
Paul K. Drain ◽  
Desmond Kuupiel ◽  
Benn Sartorius

Background: Syphilis infection has been associated with an increased risk of HIV infection during pregnancy which poses greater risk for maternal mortality, and antenatal syphilis point-of-care (POC) testing has been introduced to improve maternal and child health outcomes. There is limited evidence on the impact of syphilis POC testing on maternal outcomes in high HIV prevalent settings. We used syphilis POC testing as a model to evaluate the impact of POC diagnostics on the improvement of maternal mortality in KwaZulu-Natal, South Africa. Methods: We extracted 132 monthly data points on the number of maternal deaths in facilities and number of live births in facilities for 12 tertiary healthcare facilities in KwaZulu-Natal (KZN), South Africa from 2004 to 2014 from District Health Information System (DHIS) health facility archived. We employed segmented Poisson regression analysis of interrupted time series to assess the impact of the exposure on maternal mortality ratio (MMR) before and after the implementation of antenatal syphilis POC testing. We processed and analyzed data using Stata Statistical Software: Release 13. (Stata, Corp LP, College Station, TX, USA). Results: The provincial average annual maternal mortality ratio (MMR) was estimated at 176.09 ± 43.92 ranging from a minimum of 68.48 to maximum of 225.49 per 100,000 live births. The data comprised 36 temporal points before the introduction of syphilis POC test exposure and 84 after the introduction in primary health care clinics in KZN. The average annual MMR for KZN from 2004 to 2014 was estimated at 176.09 ± 43.92. A decrease in MMR level was observed during 2008 after syphilis POC test implementation, followed by a rise during 2009. Analysis of the MMR trend estimates a significant 1.5% increase in MMR trends during the period before implementation and 1.3% increase after implementation of syphilis POC testing (p < 0.001). Conclusion: Although our finding suggests a brief reduction in the MMR trend after the implementation of antenatal syphilis POC testing, a continued increase in syphilis rates is seen in KwaZulu-Natal, South Africa. The study used one of the most powerful quasi-experimental research methods, segmented Poisson regression analysis of interrupted time series to model the impact of syphilis POC on maternal outcome. The study finding requires confirmation by use of more rigorous primary study design.


Author(s):  
Londeka Ngubane

After falling into absolute dereliction in the Zulu community, the traditional practice of virginity inspection made a retaliation some 10 years ago, after the country’s first democratic elections. This study investigates the perceptions and experiences of virginity inspection of female adolescents in Inchanga village, KwaZulu-Natal, South Africa. A focus group interview was conducted with 10 Zulu maidens for qualitative data collection. Proponents of virginity inspection believe that virginity inspection is a traditional practice that can assist in reducing HIV infection and teenage pregnancy among the youth, and in the detection of children who are sexually abused by adults. Opponents of virginity testing, such as several human rights groups in South Africa, as well as the South African Human Rights Commission of virginity inspection, strongly believe that the practice of virginity inspection interferes with human rights and constitutional prescripts that protect the rights to equality, privacy, bodily integrity, and sexual autonomy of young women. The study found that the participants have only positive experiences of the practice of virginity inspection, and the only negative experiences they encounter are negative responses from community members who do not support the practice. The findings also confirmed that virginity inspection is being done irrespective of different opinions from different scholars and experts on the subject, and most of the time, the age of the children is not considered.


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