Browsing by Author "Orner, Phyllis"

Now showing 1 - 9 of 9
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    An assessment of the factors that influence the infant feeding practices of HIV-positive mothers in The Mothers' Programmes : a qualitative study
    (2005) Mackowski, Amy M; Orner, Phyllis; Hoffman, Margaret
    Many researchers consider breastfeeding as the best way to feed an infant, as it provides numerous benefits both physical and psychological for mother and child (Baumslag & Michels, 1995; Preble & Piwoz, 1998; Smith & Kuhn, 2000; World Health Organization (WHO), 2000; WHO, 2003). However, breast milk is a body fluid, like blood or semen, which can transmit the Human Immunodeficiency Virus (HIV) from mother to baby (White, 1999). A woman infected with HIV may pass the virus on to her child via pregnancy, labour or delivery or through breastfeeding (WHO, 2003). In developing countries where the prevalence of HIV/AIDS is high, particularly among women of reproductive age, protecting children from HIV infection is a critical public health concern.
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    Delays in seeking an abortion until the second trimester: a qualitative study in South Africa
    (BioMed Central Ltd, 2007) Harries, Jane; Orner, Phyllis; Gabriel, Mosotho; Mitchell, Ellen
    BACKGROUND:Despite changes to the South African abortion legislation in 1996, barriers to women accessing abortions still exist. Second trimester abortions, an inherently more risky procedure, continue to be 20% of all abortions. Understanding the reasons why women delay seeking an abortion until the second trimester is important for informing interventions to reduce the proportion of second trimester abortions in South Africa. METHODS: Qualitative research methods were used to collect data. Twenty-seven in-depth interviews were conducted in 2006 with women seeking a second trimester abortion at one public sector tertiary hospital and two NGO health care facilities in the greater Cape Town area, South Africa. Data were analysed using a grounded theory approach. RESULTS: Almost all women described multiple and interrelated factors that influenced the timing of seeking an abortion. Reasons why women delayed seeking an abortion were complex and were linked to changes in personal circumstances often leading to indecision, delays in detecting a pregnancy and health service related barriers that hindered access to abortion services. CONCLUSION: Understanding the complex reasons why women delay seeking an abortion until the second trimester can inform health care interventions aimed at reducing the proportion of second trimester abortions in South Africa.
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    Developing a psychosocial understanding of child sexual abuse disclosure among a group of child and adolescent females in Cape Town, South Africa.
    (2012) Hendricks, Natasha; Orner, Phyllis; Mathews, Shanaaz
    To develop an understanding of the factors that promotes and inhibits child sexual abuse (CSA) disclosure and its impact on the child and caregiver. Young girls and adolescents between the ages of 8-17 years who experienced penetrative sexual abuse were recruited from two sexual assault centres in the Western Cape, South Africa. On arrival at the centre, caregivers were approached and informed about the study and informed consent was obtained from those who agreed to participate in the study. This study has shown that factors promoting CSA disclosure include circumstances around the incident, caregiver concerns around the child's behavior, which made caregivers suspicious and allowed them to create an enabling environment to facilitate disclosure for the child as well as coercion by caregivers to talk.
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    A gendered perspective of a community's perception of microbicide introduction
    (2005) Harries, Jane; Orner, Phyllis; Cooper, Di
    South Africa is currently experiencing one of the worst HIV/AIDS epidemics in the world. The epidemic features distinctive age and gender distributions, with young women at greatest risk, and overall proportionally more women affected than men. Current HIV prevention strategies are limited as women's risk is frequently derived from their partners' behaviours rather than their own. The development of a microbicide for HIV prevention may offer the possibility of reducing women’s risk of infection in situations where other more effective methods cannot be used. An environment conducive to introducing a microbicide is critical to avoid some of the obstacles that have historically inhibited similar technological innovations. This study, which formed part of a larger qualitative research project, explored local sexual practices as they related to a female-initiated intra-vaginal product and the broader gender and sexual relations that underpin perceptions around possible microbicide use. An understanding of gender related factors is crucial in exploring women's access and ability to use a microbicide. Twenty-two focus groups and 11 in-depth interviews were held with community participants who resided in Langa, Cape Town. Data was analyzed using a grounded theory approach. Respondents expressed keen support for microbicides, underscored by desperation related to the AIDS epidemic and recognition of women's greater risk. Discussions amongst both women and men around microbicide use revealed numerous ways in which a new preventive technology could impact on broader gender relations. Issues around condom use, partner communication, meanings attributed to changes in vaginal moisture levels, covert use, potential for partner discord, and gender-based violence were linked by respondents to the varying ways in which the microbicide could impact on their daily lives. While the microbicide has the potential to "empower" women, inequitable gender relations and other social and economic problems will need to be addressed in order to halt the spread of the AIDS epidemic in South Africa.
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    Health care providers' attitudes towards termination of pregnancy: A qualitative study in South Africa
    (BioMed Central Ltd, 2009) Harries, Jane; Stinson, Kathryn; Orner, Phyllis
    BACKGROUND:Despite changes to the abortion legislation in South Africa in 1996, barriers to women accessing abortion services still exist including provider opposition to abortions and a shortage of trained and willing abortion care providers. The dearth of abortion providers undermines the availability of safe, legal abortion, and has serious implications for women's access to abortion services and health service planning.In South Africa, little is known about the personal and professional attitudes of individuals who are currently working in abortion service provision. Exploring the factors which determine health care providers' involvement or disengagement in abortion services may facilitate improvement in the planning and provision of future services. METHODS: Qualitative research methods were used to collect data. Thirty four in-depth interviews and one focus group discussion were conducted during 2006 and 2007 with health care providers who were involved in a range of abortion provision in the Western Cape Province, South Africa. Data were analysed using a thematic analysis approach. RESULTS: Complex patterns of service delivery were prevalent throughout many of the health care facilities, and fragmented levels of service provision operated in order to accommodate health care providers' willingness to be involved in different aspects of abortion provision. Related to this was the need expressed by many providers for dedicated, stand-alone abortion clinics thereby creating a more supportive environment for both clients and providers. Almost all providers were concerned about the numerous difficulties women faced in seeking an abortion and their general quality of care. An overriding concern was poor pre and post abortion counselling including contraceptive counselling and provision. CONCLUSION: This is the first known qualitative study undertaken in South Africa exploring providers' attitudes towards abortion and adds to the body of information addressing the barriers to safe abortion services. In order to sustain a pool of abortion providers, programmes which both attract prospective abortion providers, and retain existing providers, needs to be developed and financial compensation for abortion care providers needs to be considered.
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    HIV/AIDS clients and their caregivers' perceptions of a community home-based care support programme in Botswana : a qualitative study
    (2006) Diseko, Agnes Nkeba; Harries, Jane; Orner, Phyllis
    The study was undertaken at a village called Ramotswa in Botswana. Botswana is a small country in Southern Africa with a population of 1.7 million people (Botswana Housing and Population Census, 2001). The study explores HIV/AIDS clients' and caregivers' perceptions of the Community Home-Based Care support programme. The people involved in the community home-based care programme included nurses, family welfare educators (FWEs), social workers, community volunteers, and drivers. An exploratory qualitative design was used. Collection of data was through in-depth interviews, as well as a focus-group discussion. The sample was obtained through purposeful sampling, and there were nine HIV/AIDS clients, and seven caregivers who participated in the study. Results of the study were analysed themeativally. Resulst showed that many caregivers are women, and that they perform the task of care-giving under very difficult situations of poverty, social isolation, fear and stigma. They needed financial, material spiritual, as well as professional support from the home-based care team and community members.
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    Perception of menopause : black and white working-class women's experiences
    (1997) Orner, Phyllis; De la Rey, Cheryl
    This thesis aimed to address the ways in which class, race, culture, gender and power shape experiences of menopause by exploring the experiences of South African black and white working-class women. The main implications for theorization on menopause from this study are that (1) there is no single comprehensive model or perspective which alone adequately explains the meanings of menopause for women, and (2) that it is essential to understand the ways in which bodies (the "lived body") shape experiences of menopause when conceptualising theory, taking into account the specific historical and socioeconomic conditions in South Africa. Health policy recommendations in this thesis are aimed towards promotion of more equitable health care for older women, but also to help promote gender equity more generally.
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    Policy maker and health care provider perspectives on reproductive decision-making amongst HIV-infected individuals in South Africa
    (BioMed Central Ltd, 2007) Harries, Jane; Cooper, Diane; Myer, Landon; Bracken, Hillary; Zweigenthal, Virginia; Orner, Phyllis
    BACKGROUND:Worldwide there is growing attention paid to the reproductive decisions faced by HIV-infected individuals. Studies in both developed and developing countries have suggested that many HIV-infected women continue to desire children despite knowledge of their HIV status. Despite the increasing attention to the health care needs of HIV-infected individuals in low resource settings, little attention has been given to reproductive choice and intentions. Health care providers play a crucial role in determining access to reproductive health services and their influence is likely to be heightened in delivering services to HIV-infected women. We examined the attitudes of health care policy makers and providers towards reproductive decision-making among HIV-infected individuals. METHODS: In-depth interviews were conducted with 14 health care providers at two public sector health care facilities located in Cape Town, South Africa. In addition, 12 in-depth interviews with public sector policy makers and managers, and managers within HIV/AIDS and reproductive health NGOs were conducted. Data were analyzed using a grounded theory approach. RESULTS: Providers and policy makers approached the issues related to being HIV-infected and child bearing differently. Biomedical considerations were paramount in providers' approaches to HIV infection and reproductive decision-making, whereas, policy makers approached the issues more broadly recognizing the structural constraints that inform the provision of reproductive health care services and the possibility of "choice" for HIV-infected individuals. CONCLUSION: The findings highlight the diversity of perspectives among policy makers and providers regarding the reproductive decisions taken by HIV-infected people. There is a clear need for more explicit policies recognizing the reproductive rights and choices of HIV-infected individuals.
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