- ItemThe same in all but name: marriage, slavery, patriarchy and politics, Sierra Leone 1890–1990(2022) Delius, SarahWomen and girls captured during times of violent conflict have frequently been forced to marry their captors. Following the recent civil war in Sierra Leone (1991- 2002), the Special Court for Sierra Leone determined that women who had been forced into wartime marriages had been subjected to a specific criminal offence that combined elements of sexual enslavement and ‘forced conjugal association’. This ruling can best be understood as the latest in a series of attempts to classify and demarcate both slavery and marriage in Sierra Leone. Drawing upon a range of archival sources, this interdisciplinary dissertation explores how the intersecting categories of slavery and marriage have been defined and deployed from the late nineteenth century to the present day. The dissertation foregrounds three key concepts, namely kinship, households and rights-in-persons that have played a continuous yet constantly evolving role in the ways in which peoples in Sierra Leone have organised their political and personal relationships within an historical context chiefly defined by British colonial conquest and authority. In the colonial period, the persistence of domestic slavery was concealed or legitimated by references to ‘marriage’. By maintaining a fluid definition of slavery and marriage, colonial officials maintained and extended their authority via local intermediaries. Though never entirely successful, these alliances were designed to maintain colonial authority. I show how women in rural Sierra Leone made the most of limited opportunities to challenge the prevailing status quo. It is a mistake to assume, as a number of recent analysts have done, that both the 1880s and 1990s are symptoms of an unchanging and immutable social order.
- ItemA programme to improve birth preparedness and complication readiness in Johannesburg, South Africa(2022) Keoreng, EzekielBackground: Birth preparedness and complication readiness (BPCR) is a strategy to mitigate maternal mortalities (MM) by addressing the three delays associated with timely access to skilled maternal care, identifying a health care facility and getting adequate and appropriate care once you reach the facility. When maternal health care (MHC) users are well prepared for birth and ready for probable complications, preventable maternal deaths can be avoided. Objective: This study aimed to develop a functional and locally relevant programme to guide and improve the BPCR of MHC users and their partners in a multi-cultural urban area of South Africa. Methods: This study used a sequential multi-method, two-phase qualitative approach. The first phase employed a scoping review, while the second phase consisted of two stages in which a Nominal Group Technique (NGT) was used to collect data, firstly with MHC users and latterly with health care professionals. The scoping review followed a five-stage framework laid out by Arksey and O’ Malley and later advanced and described by Levac et al. and the Joanna Briggs Institute. A non-probability convenience sampling was used to select MHC users in the first nominal group, while purposive sampling was used for the second nominal group to determine MHC professionals. Both quantitative and qualitative data analysis methods were employed to analyse data from the NGT meeting process. The researcher verified the collected information through inductive content analysis. Results: The scoping review revealed several interventions that improved the level of BPCR. These included community intervention, mass media and technology, male involvement, ANC counselling & education, and multisectoral interventions. On the other hand, the interview with MHC users also highlighted significant measures that can be incorporated into a programme that can improve their BPCR status. Some of the mentioned interventions agreed with the finding of the scoping review. The partner’s involvement, counselling, use of social media, staff attitude and general pregnancy-related information were the measure raised by MHC users. Conclusion: The findings of the scoping review and NGT interview with the MHC users were combined to develop a programme that was presented to MHC professionals for refinement to fit the local settings. BPCR strategy is one of the ways through which MM can be mitigated; however, we need more studies that specifically measure the level of BPCR in South Africa. In addition, we need to deal with a wide range of factors, including socioeconomic, educational, and sociocultural, that affect the utilisation of the BPCR strategy. In moving forward, to improve the utilisation of the BPCR strategy, health sectors must strengthen their collaboration with various other governmental and non-governmental sectors, including the community, and consequently reduce MM.
- ItemPerceptions of student nurses of their career progression opportunities(2022) Nkhoma, CatherineAim: This research aims at exploring the perceptions of student nurses towards their career progression opportunities that are available to them. The probability of a student pursuing and remaining in the nursing profession is influenced by the student's view of the profession. Background: This study is all about how the student nurses perceive their opportunities as they progress in their career. In this report, the researcher looked at the perception of the nursing career by undergraduate students. The findings from this research will help to understand the perceptions that student nurses have about their career, career plans and their understanding of progression once they have completed their training. Once this is known, it would help nursing educators on how to prepare for working life realities of nurses, thereby minimising the connection between this and the students’ expectations. Methodology: Semi-structured interviews were used for gathering data in this study as part of a qualitative research approach. Thirteen (n = 13) participants from the study population, (N = 90) nursing students at a university in Gauteng, South Africa, were invited to take part in the study. All thirteen interviews were conducted upon which theoretical data saturation was reached at interview number ten. Due to the Covid-19 restrictions and students being taught remotely interviews were conducted using an electronic meeting platform familiar with the students namely ZOOM. The interviews were transcribed verbatim and analysis was done using thematic analysis approach. Findings: Three themes were generated and were categorised as: (i) Careers opportunities after graduation, (ii) Support for career progression and (iii) Barriers to career progression. Conclusion: The study’s major goal was to find out student nurses’ perceptions when it comes to career progression. The study used a qualitative research method and managed to achieve this goal. Participants mentioned what career progression is all about, they highlighted the career opportunities available to them, what they consider to be barriers to career progression as well as what they thought is the support they would need to promote career progression.
- ItemThe prevalence and correlates of alcohol use and alcohol use disorders among young people (15 – 24 years) and adults in eSwatini, Malawi and Zambia(2022) Msibi, Zethu SandrahIntroduction Globally, excessive alcohol use is a remarkable substantial risk for poor public health outcomes. It is escalating in Sub Saharan Africa due to marketing aggressively and lack of individual and policy level interventions. We used the national representative population-based HIV Impact Assessment (PHIA) data to determine the prevalence and correlates of ‘alcohol use’ (AU) and ‘alcohol use disorders’ (AUD) in young people and adults in Eswatini, Malawi and Zambia. Methods PHIA surveys 2015 – 2017 data was analyzed. The surveys employed a multistage sampling strategy to recruit study participants at household level. The sample in each country dataset were as follows Eswatini (n=9885) Malawi (n=19405), and Zambia (n=27,382). The analysis utilized multivariate logistic regression models that identify the correlates of AU and AUD. Analyses were adjusted for weights, stratification, and clustering using the survey platform analysis in Stata version 15. We considered the p values of <0.05 statistically significant. Results Alcohol use prevalence in young people and adults was 17.9% and 23.3% in Eswatini, 10.9% and 22.1% in Malawi, and 14.6% and 32.4% in Zambia. The prevalence of AUD in young people and adults was 9.1% and 14.2% in Eswatini, 3.5% and 11.2% in Malawi, and 7.6% and 20.6% in Zambia. The correlates which had more risk of alcohol use and AUD encompass being male (aOR: 4.62 (95% CI: 3.35 -5.79), 20 – 24 year age group, higher education level (aOR: 1.70, 95% CI: 1.16 -2.48), divorced or separated or widowed in all 3 countries (aOR: 1.96, 95% CI: 1.55 -2.48), HIV positive status in Zambia (aOR: 1.49, 95% CI: 1.12 -1.99), multiple sexual partners in Malawi (aOR: 11.90, 95% CI: 6.76 -20.93), employed class in Zambia (aOR: 2.06, 95% CI: 1.64 -2.59) and engaging in commercial sexual relations in Malawi. Conclusion The reported ‘alcohol use and AUD’ are common in youth and adults in Eswatini, Malawi and Zambia. ‘Both alcohol use and AUD’ are related with being male, age group 20 – 24 years old, educational level (higher), HIV status, transactional sex and multiple sexual partners, widowed or separated and HIV status and risky sexual behaviours in the three countries. There is an urgent need for targeted alcohol interventions and such interventions could be integrated with sexual and reproductive health programs.
- ItemThe problem of thinking in black and white: race in the South African clinical dyad(2022) Esprey, Yvette M.This thesis explores the assumption that race, as an inextricable dimension of subjectivity, is ubiquitous in the clinical encounter, shaping the intersubjective overlap between patient and therapist, fundamentally impacting the passage and integrity of the therapeutic task. Whilst the thesis considers race against the backdrop of psychoanalytic thinking globally, its particular focus is on the South African psychoanalytic environment, taking into consideration the moulding influence of context on the idiosyncratic ways in which race is insinuated into the clinical space. The study progresses through four core papers, the first of which offers commentary on, and a critique of the relationship between mainstream psychoanalytic thinking and race. It contends that the absence of a consideration of race in the forces which shape the psyche, betrays an avoidance of the potency of race, and its capacity to destablise the mainstays of psychoanalytic thinking, including analytic neutrality. Drawing on the experience of a working group of clinicians grappling with race, the second paper engages with the interpersonal violence of race and racism, considering the iterative cycles of rupture and repair which inevitably accompany engagements margined by race. Through the use of clinical vignettes, the third paper investigates the subjectivity of racialised encounters in the intimacy of the consulting room, considering, in particular, the impact on the therapist’s capacity to think when race enters the room. Qualitative in nature, the thesis is intentionally self-reflexive throughout. This reflexivity is foregounded in the fourth paper wherein the researcher/clinician’s subjectivity, and the way in which it has been disrupted by race, and indeed by the progression of the thesis, is engaged with. This subjectivity, and the influence of the researcher’s particular lens, is intrinsic to the passage of the research, and to its outcomes.