scholarly journals Pregnancy-related healthcare utilisation in Agincourt, South Africa, 1993–2018: a longitudinal surveillance study of rural mothers

2021 ◽  
Vol 6 (10) ◽  
pp. e006915
Author(s):  
Daniel E Sack ◽  
Ryan G Wagner ◽  
Daniel Ohene-Kwofie ◽  
Chodziwadziwa W Kabudula ◽  
Jessica Price ◽  
...  
Keyword(s):  
South Africa ◽  
Health Facility ◽  
Contraceptive Use ◽  
Healthcare Utilisation ◽  
Skilled Birth Attendant ◽  
Healthcare Facility ◽  
Population Based ◽  
African Women ◽  
Health Priorities ◽  
Antenatal Visits

IntroductionPregnancy-related health services, an important mediator of global health priorities, require robust health infrastructure. We described pregnancy-related healthcare utilisation among rural South African women from 1993 to 2018, a period of social, political and economic transition.MethodsWe included participants enrolled in the Agincourt Health and Socio-Demographic Surveillance System in Mpumalanga Province, South Africa, a population-based longitudinal cohort, who reported pregnancy between 1993 and 2018. We assessed age, antenatal visits, years of education, pregnancy intention, nationality, residency status, previous pregnancies, prepregnancy and postpregnancy contraceptive use, and student status over the study period and modelled predictors of antenatal care utilisation (ordinal), skilled birth attendant presence (logistic) and delivery at a health facility (logistic).ResultsBetween 1993 and 2018, 51 355 pregnancies occurred. Median antenatal visits, skilled birth attendant presence and healthcare facility deliveries increased over time. Delivery in 2018 vs 2004 was associated with an increased likelihood of ≥1 additional antenatal visits (adjusted OR (aOR) 10.81, 95% CI 9.99 to 11.71), skilled birth attendant presence (aOR 4.58, 95% CI 3.70 to 5.67) and delivery at a health facility (aOR 3.78, 95% CI 3.15 to 4.54). Women of Mozambican origin were less likely to deliver with a skilled birth attendant (aOR 0.42, 95% CI 0.39 to 0.45) or at a health facility (aOR 0.43, 95% CI 0.41 to 0.46) versus South Africans. Temporary migrants reported fewer antenatal visits (aOR 0.35, 95% CI 0.33 to 0.38) but were more likely to deliver with a skilled birth attendant (aOR 1.91, 95% CI 1.66 to 2.2) or at a health facility (aOR 1.4, 95% CI 1.24 to 1.58) versus permanent residents.ConclusionPregnancy-related healthcare utilisation and skilled birth attendant presence at delivery have increased steadily since 1993 in rural northeastern South Africa, aligning with health policy changes enacted during this time. However, mothers of Mozambican descent are still less likely to use free care, which requires further study and policy interventions.

scholarly journals Predictors of contraceptive use among adolescent girls and young women (AGYW) aged 15 to 24 years in South Africa: results from the 2012 national population-based household survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
L. Makola ◽  
L. Mlangeni ◽  
M. Mabaso ◽  
B. Chibi ◽  
Z. Sokhela ◽  
...  
Keyword(s):  
South Africa ◽  
Adolescent Girls ◽  
Young Women ◽  
Contraceptive Use ◽  
Sexual Debut ◽  
Health Planning ◽  
Household Survey ◽  
Population Based ◽  
Stepwise Logistic Regression ◽  
Unintended Pregnancies

Abstract Background Despite a variety of contraceptives being available for women in South Africa, a considerable number of adolescent girls and young women still face challenges in using them. This paper examines socio-demographic and behavioral predictors of using contraceptives among adolescent girls and young women (AGYW) aged 15 to 24 years. Methods A secondary data analysis was conducted based on the 2012 population-based nationally representative multi-stage stratified cluster randomised household survey. Multivariate backward stepwise logistic regression model was used to examine socio-demographic and behavioural factors independently associated with contraceptive use amongst AGYW aged 15 to 24 years in South Africa. Results Out of 1460 AGYW, 78% (CI: 73.9–81.7) reported using some form of contraceptives. In the model, contraceptive use was significantly associated with secondary education [OR = 1.8 (1.2–2.7), p = 0.005], having a sexual partner within 5 years of their age [OR = 1.8 (1.2–2.5), p = 0.002], and sexual debut at age 15 years and older [OR = 2.5 (1.3–4.6), p = 0.006]. The likelihood of association decreased with other race groups-White, Coloured, and Indians/Asians [OR = 0.5 (0.3–0.7), p = 0.001], being married [OR = 0.4 (0.2–0.7), p = 0.001], never given birth [OR = 0.7 (0.5–0.9), p = 0.045], coming from rural informal [OR = 0.5 (0.3–0.9), p = 0.010] and rural formal settlements [OR = 0.5 (0.3–0.9), p = 0.020]. Conclusions Evidence suggest that interventions should be tailor-made to meet the needs of AGYW in order to, promote use and access to contraceptives. The results also suggest that family planning interventions should target those who had not given birth in order to reduce unplanned and or unintended pregnancies and associated risk factors. These findings contribute to public health discourse and reproductive health planning for these age groups in the country.

THE SINS OF THE FATHER: GENDER- BASED VIOLENCE IN POST-APARTHEID SOUTH AFRICA

2017 ◽  
Vol 14 (2) ◽  
pp. 57-70 ◽  
Author(s):  
Lyn Snodgrass
Keyword(s):  
South Africa ◽  
Black Women ◽  
South African ◽  
African Women ◽  
Gender Based Violence ◽  
Political Issues ◽  
Race And Gender ◽  
Gender Based ◽  
And Gender ◽  
South African Women

This article explores the complexities of gender-based violence in post-apartheid South Africa and interrogates the socio-political issues at the intersection of class, ‘race’ and gender, which impact South African women. Gender equality is up against a powerful enemy in societies with strong patriarchal traditions such as South Africa, where women of all ‘races’ and cultures have been oppressed, exploited and kept in positions of subservience for generations. In South Africa, where sexism and racism intersect, black women as a group have suffered the major brunt of this discrimination and are at the receiving end of extreme violence. South Africa’s gender-based violence is fuelled historically by the ideologies of apartheid (racism) and patriarchy (sexism), which are symbiotically premised on systemic humiliation that devalues and debases whole groups of people and renders them inferior. It is further argued that the current neo-patriarchal backlash in South Africa foments and sustains the subjugation of women and casts them as both victims and perpetuators of pervasive patriarchal values.

‘Limping, Yet Made to Climb a Mountain!’ Re-Reading the Vashti Character in the Hiv And Aids South African Context

2018 ◽  
Author(s):  
Madipoane Masenya (Ngwan’A Mphahlele)
Keyword(s):  
South Africa ◽  
South African ◽  
External Factor ◽  
Hiv And Aids ◽  
African Women ◽  
South African Context ◽  
Land Grabbing ◽  
The Bible ◽  
History Of ◽  
African Context

The history of the Christian Bible’s reception in South Africa was part of a package that included among others, the importation of European patriarchy, land grabbing and its impoverishment of Africans and challenged masculinities of African men. The preceding factors, together with the history of the marginalization of African women in bible and theology, and how the Bible was and continues to be used in our HIV and AIDS contexts, have only made the proverbial limping animal to climb a mountain. Wa re o e bona a e hlotša, wa e nametša thaba (while limping, you still let it climb a mountain) simply means that a certain situation is being aggravated (by an external factor). In this chapter the preceding Northern Sotho proverb is used as a hermeneutical lens to present an HIV and AIDS gender sensitive re-reading of the Vashti character in the Hebrew Bible within the South African context.

Predictors of Discontinuation of Modern Spacing Contraceptives in India

2020 ◽  
pp. 101053952098314
Author(s):  
Shahina Begum ◽  
Himanshu Chaurasia ◽  
Kusum V. Moray ◽  
Beena Joshi
Keyword(s):  
Contraceptive Use ◽  
Oral Contraceptive Pill ◽  
Family Health ◽  
Reproductive Age ◽  
Health Priorities ◽  
Unintended Pregnancies ◽  
Reproductive Age Women ◽  
One Year ◽  
Women In India

Data from National Family Health Survey (2015-2016) was analyzed to examine the contraceptive acceptance, discontinuation rates, and associated factors among reproductive age women in India over one year. Findings revealed that 11.7% accepted modern methods of which 68% were for spacing. Only 5% switched to other methods. Discontinuation rate was high among condom (56.8%) and oral contraceptive pill users (34.5%), among women aged less than 25 years, with parity less than 2, belonging to rural area, and having no education. Health concerns/side effects, husband’s disapproval, or method failure were most common reasons cited for discontinuation. The data show high discontinuation rates among some subgroups of women and for certain methods. Hence, women need to be provided options to switch methods to meet changing contraceptive needs and health priorities. Continuum of care with follow-up and counselling can facilitate sustained contraceptive use to avert unintended pregnancies.

Untangling discrimination in the private sector workplace in South Africa: Paving the way for Black African women progression to managerial positions

2021 ◽  
pp. 135822912199056
Author(s):  
Motlhatlego Dennis Matotoka ◽  
Kolawole Olusola Odeku
Keyword(s):  
South Africa ◽  
Black Women ◽  
Private Sector ◽  
South African ◽  
African Women ◽  
The South ◽  
Quota System ◽  
Black African ◽  
Managerial Positions ◽  
Action Measures

Black African women in South Africa are poorly represented at managerial levels in the South African private sector since the advent of democracy. Their exclusion at these occupational levels persists despite the Employment Equity Act 55 of 1998 (EEA) requiring that the private sector must ensure that all occupational levels are equitably represented and reflects the demographics of South Africa. The South African private sector demonstrates its lack of commitment to proliferating black African women into managerial positions by deliberately engaging in race-based recruitment and failing to develop and promote suitably qualified women into managerial positions. As such, the private sector is failing to create upward mobility for black African women to break the glass ceiling. The EEA requires the private sector to apply affirmative action measures in order to achieve equity in the workplace. It is submitted that since 1998, the private sector has been provided with an opportunity to set it own targets in order to achieve equity. However, 22 years later, black African women are still excluded in key managerial positions. However, the EEA does not specifically impose penalties if the private sector fails to achieve the set targets.This approach has failed to increase the representation of black women in managerial positions. However, the EEA does not specifically impose penalties if the private sector fails to achieve the set targets. Whilst this approach seeks to afford the private sector importunity to set its own target, this approach has failed to increase the representation of black women in managerial positions. Employing black African women in managerial levels enhances their skills and increases their prospects to promotions and assuming further leadership roles in the private sector. This paper seeks to show that the progression of black African women requires South Africa to adopt a quota system without flexibility that will result in the private sector being compelled to appoint suitably qualified black African women in managerial levels.

scholarly journals The association of smoking status with healthcare utilisation, productivity loss and resulting costs: results from the population-based KORA F4 study

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Margarethe Wacker ◽  
Rolf Holle ◽  
Joachim Heinrich ◽  
Karl-Heinz Ladwig ◽  
Annette Peters ◽  
...  
Keyword(s):  
Smoking Status ◽  
Productivity Loss ◽  
Healthcare Utilisation ◽  
Population Based

scholarly journals Trends in Antifungal Drug Susceptibility of Cryptococcus neoformans Isolates Obtained through Population-Based Surveillance in South Africa in 2002-2003 and 2007-2008

2011 ◽  
Vol 55 (6) ◽  
pp. 2606-2611 ◽  
Author(s):  
Nelesh P. Govender ◽  
Jaymati Patel ◽  
Marelize van Wyk ◽  
Tom M. Chiller ◽  
Shawn R. Lockhart ◽  
...  
Keyword(s):  
South Africa ◽  
Cryptococcus Neoformans ◽  
Amphotericin B ◽  
Fungal Infections ◽  
Antifungal Susceptibility ◽  
Drug Susceptibility ◽  
Population Based ◽  
Content Type ◽  
Microdilution Method ◽  
Broth Microdilution Method

ABSTRACTCryptococcus neoformansis the most common cause of meningitis among adult South Africans with HIV infection/AIDS. Widespread use of fluconazole for treatment of cryptococcal meningitis and other HIV-associated opportunistic fungal infections in South Africa may lead to the emergence of isolates with reduced fluconazole susceptibility. MIC testing using a reference broth microdilution method was used to determine if isolates with reduced susceptibility to fluconazole or amphotericin B had emerged among cases of incident disease. Incident isolates were tested from two surveillance periods (2002-2003 and 2007-2008) when population-based surveillance was conducted in Gauteng Province, South Africa. These isolates were also tested for susceptibility to flucytosine, itraconazole, voriconazole, and posaconazole. Serially collected isolate pairs from cases at several large South African hospitals were also tested for susceptibility to fluconazole. Of the 487 incident isolates tested, only 3 (0.6%) demonstrated a fluconazole MIC of ≥16 μg/ml; all of these isolates were from 2002-2003. All incident isolates were inhibited by very low concentrations of amphotericin B and exhibited very low MICs to voriconazole and posaconazole. Of 67 cases with serially collected isolate pairs, only 1 case was detected where the isolate collected more than 30 days later had a fluconazole MIC value significantly higher than the MIC of the corresponding incident isolate. Although routine antifungal susceptibility testing of incident isolates is not currently recommended in clinical settings, it is still clearly important for public health to periodically monitor for the emergence of resistance.

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