A comparative appraisal of access and quality of sexual and reproductive health services for gays and lesbians in Bulawayo (Zimbabwe) and Pretoria (South Africa)
- Authors: Jasi, Phineas
- Date: 2021-11
- Subjects: Reproductive health , Sexual health
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/21959 , vital:51854
- Description: This study investigated the extent to which gays and lesbians access quality sexual and reproductive health (SRH) services in Pretoria and Bulawayo. The study also examines the facilitators and barriers for accessing the same services. Theoretically, the study was grounded in the Health Belief Model (Hochbaum, 1958, modified by Rosenstock, 1974 and Siddiqui, 2016). To answer the research questions, a mixed methods approach was applied involving both qualitative and quantitative data collection methods. A total of 30 key informant interviews, eight focus group discussions and 387 questionnaires were administered using purposive, time location and snowball sampling approaches in the two cities. The study found that the most commonly available sexual and reproductive health (SRH) services were contraceptive services, sexually transmitted infections (STI) services and Human immunodeficiency syndrome (HIV) services. The services were provided at public health facilities, drop-in centres and through outreach activities operated by Civil Society Organizations (CSOs). The least available services that gays and lesbians required as part of a comprehensive package were access to information, education and communications (IEC) materials and mental health and psychosocial support services (MHPSS). Several service providers were not adhering to the World Health Organization (WHO) guidelines for provision of comprehensive services for key populations including gays and lesbians. Critical gaps noted included the absence of key populations-only service hours, lack of options for clinicians to attend to them, presence of a stigma and discrimination free environment and provision of comprehensive package of services under one roof. Most of the referral facilities had limited drugs, equipment and supplies for cancer screening and they had no HIV prevention, sex change, in-vitro fertilization, and sterilization services and procedures. The quality of physical facilities and SRH services in both cities did not meet the expectations of gays and lesbians, acting as a barrier to their health seeking behaviour. Stigma and discrimination from healthcare workers was a huge barrier affecting access across all public health facilities. The acts of stigmatisation and discrimination affected the perceptions that gays and lesbians had regarding the quality of the services and compromised access of the same. In view of these health system challenges, the study recommends that there is need for public authorities in both cities to address the bottlenecks and barriers affecting access to SRH services and products such as lubricants, affordable quality condoms, dental dams and latex gloves while reinforcing the facilitating factors promoting access. Healthcare workers need further training on how to provide comprehensive services for gays and lesbians according to the WHO guidelines. Public health authorities in Bulawayo and Pretoria should build upon the identified factors which facilitated the access to SRH services and use of products such as condoms and lubricants. These factors require strengthening of community-based organizations and networks that work directly with gays and lesbians in both Bulawayo and Pretoria. , Thesis (PhD) -- Faculty of Social Sciences and Humanities, 2021
- Full Text:
- Date Issued: 2021-11
- Authors: Jasi, Phineas
- Date: 2021-11
- Subjects: Reproductive health , Sexual health
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/21959 , vital:51854
- Description: This study investigated the extent to which gays and lesbians access quality sexual and reproductive health (SRH) services in Pretoria and Bulawayo. The study also examines the facilitators and barriers for accessing the same services. Theoretically, the study was grounded in the Health Belief Model (Hochbaum, 1958, modified by Rosenstock, 1974 and Siddiqui, 2016). To answer the research questions, a mixed methods approach was applied involving both qualitative and quantitative data collection methods. A total of 30 key informant interviews, eight focus group discussions and 387 questionnaires were administered using purposive, time location and snowball sampling approaches in the two cities. The study found that the most commonly available sexual and reproductive health (SRH) services were contraceptive services, sexually transmitted infections (STI) services and Human immunodeficiency syndrome (HIV) services. The services were provided at public health facilities, drop-in centres and through outreach activities operated by Civil Society Organizations (CSOs). The least available services that gays and lesbians required as part of a comprehensive package were access to information, education and communications (IEC) materials and mental health and psychosocial support services (MHPSS). Several service providers were not adhering to the World Health Organization (WHO) guidelines for provision of comprehensive services for key populations including gays and lesbians. Critical gaps noted included the absence of key populations-only service hours, lack of options for clinicians to attend to them, presence of a stigma and discrimination free environment and provision of comprehensive package of services under one roof. Most of the referral facilities had limited drugs, equipment and supplies for cancer screening and they had no HIV prevention, sex change, in-vitro fertilization, and sterilization services and procedures. The quality of physical facilities and SRH services in both cities did not meet the expectations of gays and lesbians, acting as a barrier to their health seeking behaviour. Stigma and discrimination from healthcare workers was a huge barrier affecting access across all public health facilities. The acts of stigmatisation and discrimination affected the perceptions that gays and lesbians had regarding the quality of the services and compromised access of the same. In view of these health system challenges, the study recommends that there is need for public authorities in both cities to address the bottlenecks and barriers affecting access to SRH services and products such as lubricants, affordable quality condoms, dental dams and latex gloves while reinforcing the facilitating factors promoting access. Healthcare workers need further training on how to provide comprehensive services for gays and lesbians according to the WHO guidelines. Public health authorities in Bulawayo and Pretoria should build upon the identified factors which facilitated the access to SRH services and use of products such as condoms and lubricants. These factors require strengthening of community-based organizations and networks that work directly with gays and lesbians in both Bulawayo and Pretoria. , Thesis (PhD) -- Faculty of Social Sciences and Humanities, 2021
- Full Text:
- Date Issued: 2021-11
Adolescent sexual reproductive health and rights in the Alice area, Eastern Cape Province of South Africa
- Authors: Moko, Zukhanye
- Date: 2021-02
- Subjects: Reproductive health , Right to health , HIV infections
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/20676 , vital:46423
- Description: Sexual Reproductive Health (SRH) is a significant aspect of adolescent’s growth. Adolescents particularly girls face the risk of exposure to Human Immunodeficiency Virus (HIV), Sexually Transmitted Diseases (STDs), child marriages, high rates of unwanted pregnancy and the risk of those pregnancies can lead to unsafe abortion. In South Africa, considerable progress has been made in achieving improved access to Sexual Reproductive Health and Rights (SRHR) among the general population, however, some factors influencing SRHR of adolescents and young people have been slow to achieve. The study aims to investigate factors influencing Sexual Reproductive Health and Rights of adolescents in Alice, which is located in the Eastern Cape Province of South Africa. The Social-Ecological Model was considered appropriate for this study as it provides a comprehensive understanding of the multiple and interacting determinants of Sexual Reproductive Health and Rights. A qualitative methodology was adopted, involving focus groups with high school learners, in-depth interviews with institutional actors (Department of Health, Basic Education and Social Development), and participant observations. The study reveals that adolescents’ have access to Sexual Reproductive Health services from healthcare centres but only a few utilize or access them due to barriers such as the geographical location, denial and judgement about young people's sexuality limits their access to comprehensive knowledge to protect and promote their Sexual and Reproductive Health. The findings show that the adolescents who were most affected by Sexual Reproductive Health and Rights challenges were those from deep rural areas. They had minimal information/education compared to those residing in areas close to the town of Alice and major roads. Multi-sectoral interventions empowering adolescents and young people to exercise their rights to optimize SRHR service yield better results. , Thesis (MSc) -- Faculty of Science & Agriculture, 2021
- Full Text:
- Date Issued: 2021-02
- Authors: Moko, Zukhanye
- Date: 2021-02
- Subjects: Reproductive health , Right to health , HIV infections
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/20676 , vital:46423
- Description: Sexual Reproductive Health (SRH) is a significant aspect of adolescent’s growth. Adolescents particularly girls face the risk of exposure to Human Immunodeficiency Virus (HIV), Sexually Transmitted Diseases (STDs), child marriages, high rates of unwanted pregnancy and the risk of those pregnancies can lead to unsafe abortion. In South Africa, considerable progress has been made in achieving improved access to Sexual Reproductive Health and Rights (SRHR) among the general population, however, some factors influencing SRHR of adolescents and young people have been slow to achieve. The study aims to investigate factors influencing Sexual Reproductive Health and Rights of adolescents in Alice, which is located in the Eastern Cape Province of South Africa. The Social-Ecological Model was considered appropriate for this study as it provides a comprehensive understanding of the multiple and interacting determinants of Sexual Reproductive Health and Rights. A qualitative methodology was adopted, involving focus groups with high school learners, in-depth interviews with institutional actors (Department of Health, Basic Education and Social Development), and participant observations. The study reveals that adolescents’ have access to Sexual Reproductive Health services from healthcare centres but only a few utilize or access them due to barriers such as the geographical location, denial and judgement about young people's sexuality limits their access to comprehensive knowledge to protect and promote their Sexual and Reproductive Health. The findings show that the adolescents who were most affected by Sexual Reproductive Health and Rights challenges were those from deep rural areas. They had minimal information/education compared to those residing in areas close to the town of Alice and major roads. Multi-sectoral interventions empowering adolescents and young people to exercise their rights to optimize SRHR service yield better results. , Thesis (MSc) -- Faculty of Science & Agriculture, 2021
- Full Text:
- Date Issued: 2021-02
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