Infertility in the public health care system in South Africa : patients' experiences, reproductive health knowledge and treatment-seeking behaviour

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dc.contributor.advisorvan der Spuy, Zephne Margareten_ZA
dc.contributor.authorDyer, Silke Julianeen_ZA
dc.date.accessioned2014-10-29T10:02:26Z
dc.date.available2014-10-29T10:02:26Z
dc.date.issued2006en_ZA
dc.descriptionIncludes bibliographical references (leaves 231-252).en_ZA
dc.description.abstractInfertility is a common reproductive health problem in Africa. The experiences of men and women who are unable to conceive, their constructs of infertility, their motives for parenthood, and their health-seeking behaviour are, however, inadequately documented in South Africa. In order to improve our understanding of the patients' perspective of infertility, seven studies were conducted employing both qualitative and quantitative research methodology. Study participants were recruited from the infertility clinic at Groote Schuur Hospital, Cape Town, a tertiary referral centre within the public health care system. The central themes explored in the qualitative studies included reproductive health knowledge, health-seeking behaviour, barriers to health care, experiences related to involuntary childlessness, and the reality of infertility and HIV infection. Data from both men and women were collected through in-depth interviews, and the results were analysed according to the principles of descriptive analysis. In the quantitative studies psychological distress was measured and motives for parenthood were assessed with the use of two standardised instruments ( the Symptom Checklist-90-R for the measurement of acute psychological symptom status and the parenthood motivation list). In addition, participants' attitudes towards reproduction in HIV-infected individuals were evaluated. Standard statistical methods were used to analyse quantitative data. The results of these studies demonstrated that men and women had limited knowledge about fertility, infertility, and biomedical infertility management. Some men and women held traditional beliefs and had accessed traditional healers. Most informants appeared highly motivated to engage in biomedical infertility management. Treatment satisfaction varied and reasons for non-compliance were both service and patient-related. Infertile couples gave many reasons for wanting a child and expressed a strong desire for parenthood. For many men and women the inability to conceive was associated with negative emotions, marital instability, abuse, stigmatisation, and loss of social status. Psychological distress levels were significantly higher in infertile women when compared to women using contraception, and in infertile men when compared to fertile men. Infertile women who reported intimate partner abuse were particularly distressed. The diagnosis of HIV infection did not eliminate the wish for a child in infertile couples, and in the absence of medical assistance many continued to attempt conception. The concomitant experience of infertility and HIV infection was associated with considerable suffering The majority of HIV-negative, infertile men and women opposed reproduction in HlV-positive couples. Collectively, the results of these studies provide new insights into the manner in which men and women who access the public health system in South African construct, experience, and respond to infertility. Understanding those details of the patients' perspective should improve the management of infertility in this patient population.en_ZA
dc.identifier.apacitationDyer, S. J. (2006). <i>Infertility in the public health care system in South Africa : patients' experiences, reproductive health knowledge and treatment-seeking behaviour</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology. Retrieved from http://hdl.handle.net/11427/8905en_ZA
dc.identifier.chicagocitationDyer, Silke Juliane. <i>"Infertility in the public health care system in South Africa : patients' experiences, reproductive health knowledge and treatment-seeking behaviour."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology, 2006. http://hdl.handle.net/11427/8905en_ZA
dc.identifier.citationDyer, S. 2006. Infertility in the public health care system in South Africa : patients' experiences, reproductive health knowledge and treatment-seeking behaviour. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Dyer, Silke Juliane AB - Infertility is a common reproductive health problem in Africa. The experiences of men and women who are unable to conceive, their constructs of infertility, their motives for parenthood, and their health-seeking behaviour are, however, inadequately documented in South Africa. In order to improve our understanding of the patients' perspective of infertility, seven studies were conducted employing both qualitative and quantitative research methodology. Study participants were recruited from the infertility clinic at Groote Schuur Hospital, Cape Town, a tertiary referral centre within the public health care system. The central themes explored in the qualitative studies included reproductive health knowledge, health-seeking behaviour, barriers to health care, experiences related to involuntary childlessness, and the reality of infertility and HIV infection. Data from both men and women were collected through in-depth interviews, and the results were analysed according to the principles of descriptive analysis. In the quantitative studies psychological distress was measured and motives for parenthood were assessed with the use of two standardised instruments ( the Symptom Checklist-90-R for the measurement of acute psychological symptom status and the parenthood motivation list). In addition, participants' attitudes towards reproduction in HIV-infected individuals were evaluated. Standard statistical methods were used to analyse quantitative data. The results of these studies demonstrated that men and women had limited knowledge about fertility, infertility, and biomedical infertility management. Some men and women held traditional beliefs and had accessed traditional healers. Most informants appeared highly motivated to engage in biomedical infertility management. Treatment satisfaction varied and reasons for non-compliance were both service and patient-related. Infertile couples gave many reasons for wanting a child and expressed a strong desire for parenthood. For many men and women the inability to conceive was associated with negative emotions, marital instability, abuse, stigmatisation, and loss of social status. Psychological distress levels were significantly higher in infertile women when compared to women using contraception, and in infertile men when compared to fertile men. Infertile women who reported intimate partner abuse were particularly distressed. The diagnosis of HIV infection did not eliminate the wish for a child in infertile couples, and in the absence of medical assistance many continued to attempt conception. The concomitant experience of infertility and HIV infection was associated with considerable suffering The majority of HIV-negative, infertile men and women opposed reproduction in HlV-positive couples. Collectively, the results of these studies provide new insights into the manner in which men and women who access the public health system in South African construct, experience, and respond to infertility. Understanding those details of the patients' perspective should improve the management of infertility in this patient population. DA - 2006 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2006 T1 - Infertility in the public health care system in South Africa : patients' experiences, reproductive health knowledge and treatment-seeking behaviour TI - Infertility in the public health care system in South Africa : patients' experiences, reproductive health knowledge and treatment-seeking behaviour UR - http://hdl.handle.net/11427/8905 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/8905
dc.identifier.vancouvercitationDyer SJ. Infertility in the public health care system in South Africa : patients' experiences, reproductive health knowledge and treatment-seeking behaviour. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology, 2006 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/8905en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Obstetrics and Gynaecologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherObstetrics and Gynaecologyen_ZA
dc.titleInfertility in the public health care system in South Africa : patients' experiences, reproductive health knowledge and treatment-seeking behaviouren_ZA
dc.typeDoctoral Thesis
dc.type.qualificationlevelDoctoral
dc.type.qualificationnamePhDen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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