Electronic Theses and Dissertations (PhDs)
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Item Contraceptive use Transition and Fertility Dynamics and Reproductive Health Outcomes in Zambia(University of the Witwatersrand, Johannesburg, 2024) Phiri, MillionBackground: Improving access to and utilisation of contraceptive methods has been a major global goal of maternal health and development programming for over four decades now. Despite the benefits associated with contraceptive use, the prevalence in Zambia is still low. The country’s population policy has identified high fertility rate, population growth rate and maternal mortality rate as hindrances to the country’s socio-economic development agenda. Although the contraceptive prevalence rate in Zambia is still low, it has been increasing steadily from 15.2% in 1992 to 34.2% in 2001 and then from 40.8% in 2007 to 49.0% in 2018 among women of reproductive age. The sources of the observed increase in the contraceptive rate use were not known. This is because previous studies in Zambia concentrated on examining factors associated with using contraception use rather changes in usage. This study achieved the four specific objectives: (i) describe how contraceptive use has changed in Zambia over time regarding levels and trends; (ii) explore the geographic, social, economic, environmental and demographic factors that explain contraceptive use transition in Zambia; (iii) examine how contraceptive use transitions have affected fertility dynamics (iv) examine how contraceptive use transition has affected reproductive health outcomes in Zambia. Theoretical framework: The theoretical framework used in this study reflects the fact that a woman’s choice to use contraceptive is affected by a complex interplay of social, economic and interpersonal relationships at household or neighborhoods levels. It is in this regard that this study adopted the empowerment and social capital theories, reflecting social phenomena which operate at different level to influence contraceptive use. As such, contraceptive use can be viewed as a function of the level of empowerment among women, their access to social capital, and the degree to which gender inequality and problematic social norms are present in their social environment. The key woman empowerment elements include participation in the decision- making process, education attainment, access and ownership of resources, access to information, employment opportunity, and higher socioeconomic status. Methodology: This study employed a mixed methods research design to examine factors explaining contraceptive use transition in Zambia. Quantitative analysis used a pooled dataset comprising a sample of 44,762 fecund sexually active and non-pregnant women aged (15-49 years) captured in the demographic and health surveys (DHSs) conducted between 1992 and 2018. The DHS is a cross-sectional study which applies a two-stage stratified cluster sampling design to select Enumeration areas and households. Furthermore, qualitative data analysis was conducted on the data collected through focus groups (FGD) with women of reproductive age (n=4) and key informant interviews with key staff (n=10) from the Ministry of Health and stakeholder organisations implementing family planning programmes in Zambia. All the FGDs and key informant interviews were conducted in Lusaka and Chongwe districts. The first objective was achieved by conducting descriptive and trend analysis on data to examine the changes in contraceptive use overtime. Qualitative data was used to explain the reasons behind the observed changes in contraceptive use transition. Analysis for the second was done in two steps. The outcome variable for this study is current contraceptive use. All sexually active women in the DHS were asked a question “Are you currently using any contraceptive method to prevent a pregnancy”. The first step involved application of multilevel regression analysis to examine the influence of both individual and community factors on current contraceptive use in Zambia. The second step involved utilisation of multivariable nonlinear decomposition technique (Blinder Oaxaca decomposition techniques) to measure the contribution effects of both individual and contextual factors to the observed changes in contraceptive use in Zambia. This was also complimented by qualitative data to explain to ii | P a g e explain quantitative results. Objective three was achieved through application of multivariable Blinder- Oaxaca decomposition regression techniques to examine the effects of contraception use changes over time on fertility rate and maternal health outcomes in Zambia. Using a multivariable decomposition regression analysis technique is an improvement over previous similar research works that have been conducted in Zambia. All DHS analysis took into account the complex survey design and statistical significance was determined at α0.05. Key findings: Study findings show that in Zambia's contraceptive prevalence rate rose 30.8 percentage points (14.2% to 45.0%) throughout the analysis period, 1992 to 2018. This translates to an average of 1.2% annually. The major share of contraceptive use increase in Zambia happened between 1992 and 2001 (16.7%). The least change was during 2013 and 2018 (0.2%). Findings show that the rate of increase in CPR has been declining over time, even though overall CPR has increased during the analysis period. The findings show that overall, contraceptive use among sexually active women has increased significantly in Zambia, despite regional, residential, and socioeconomic differences. The study's findings support the proposed research hypothesis that contraceptive use has increased significantly in Zambia. Overall, both changes in women’s compositional structure and changes in women's contraceptive behaviour significantly contributed to the change in contraceptive use in Zambia. Multivariable decomposition analysis of the determinants of change in contraceptive use has revealed that between 1992 and 2018: increase in proportion of women with secondary education (5.20%), reduction experience of child mortality (7.70%), reduction in the proportion of women desiring 6 or more children (5.63%) and increase in proportion of woman decision with making autonomy (3.33%) were the major contributors to the trend change in contraceptive use among sexually active women in Zambia. Results from the decomposition analysis reveal that the observed increase in contraceptive use in Zambia has significantly affected reduction and fertility rate and teenage pregnancy. The study results confirm the hypothesis that the increase in contraceptive use has contributed to the reduction in fertility rate and teenage pregnancy. Conclusion: Contraceptive utilisation among sexually active women in Zambia has shown a steady and significant progressive increase of 30.8 percentages over the 26-year period from 1992 to 2018. The larger increase in contraceptive use happened during the period 1992-2001. Although there are still regional and area disadvantage in contraceptive prevalence rate, the gap in utilisation between urban and rural areas has narrowed. Women’s compositional factors have contributed differently to contraceptive use increase observed in the country. The observed increase in contraceptive use in Zambia is largely due to changes in the contraceptive behaviour of sexually active women. Positive change in women’s contraceptive behaviour could be attributed to the country’s huge investment in family planning programming by government and stakeholders. However, improvement in women compositional factors, such as education, decision-making autonomy, access to family planning information and child mortality experience reduction among other individual and community-level factors were key in driving contraceptive use transition. Therefore, as emphasized in the empowerment and social capital theories, social change among women is key in influencing contraceptive use transition. Furthermore, the study has established that the noted increase in contraceptive use in Zambia has positively contributed to fertility rate decline. iii | P a g e Implications of results The findings of this current study imply that both changes in women’s social factors and changes in the contraceptive use behaviour of sexually active women in Zambia have been driving contraceptive use transition in Zambia. This signifies that the investments in family planning programmes have been yield expected results by changing contraceptive behavior of women. The study findings further suggest that understanding social context is key to inform the design of new FP strategies and strengthening of exiting interventions aimed at further improving acceptance and utilisation of contraceptive methods among women. Contribution to knowledge of the study The study has made a contribution to research by delineating social factors that have contributed to the observed contraceptive use transition in Zambia. Such findings have not been explored before in the context of family planning research in Zambian. Furthermore, the study has provided evidence of how the observed increase in contraception use in the country has affected fertility, teenage pregnancy rates, and prevalence of unintended births. This information is relevant for understanding the country’s population and maternal health dynamics. The findings not only validate the relevance of core principles of the empowerment and social capital theories in explaining contraceptive use transition in Zambia, but also shed light on other theoretical aspects that should be considered when understanding contraceptive use transition. Future research Future studies should examine rural-urban and regional variations of the determinants of contraceptive use transition. This will generate information to inform regional specific interventions. More so future studies should examine the factors that may influence a person's decision to utilise contraception in the future among sexually active adolescent girls. Doing so will generate data to inform the design of future family planning programmes that appeal to specific target groups. Furthermore, an in-depth qualitative research is required to understand how to overcome barriers of contraceptive use behaviour relating gender norms, cultural beliefs and religious values.Item A Study of African and Western Epistemic Intuitions and Implications for Decolonisation(University of the Witwatersrand, Johannesburg, 2024) Lembethe, Nolwandle Ayanda; Etieyibo, EdwinDiscussions surrounding decolonisation in academic spaces in South Africa took a turn in 2015 when student protests forced the academy or academic landscape to revisit its relationship with Eurocentrism. This had far reaching consequences, as institutions of higher learning began to interrogate different aspects of academic culture including knowledge production. My thesis looks at decolonisation from an epistemic lens by principally interrogating the use of epistemic intuitions and their relevance to the decolonisation project. By examining experimental philosophy as a methodology, my research provides some meaningful ways in which we can broaden our understanding and use of epistemic intuitions. I draw on different ways scholars in feminist theory have extrapolated methods from lived experiences and epistemic standpoints of epistemically marginalised groups to point out the marginalizing nature of experimental philosophy. The contribution that my thesis makes to knowledge then is that it helps to show how and why experimental philosophy should be made more inclusive to worldviews that have been otherwise marginalised by dominant research methods.Item Women and emancipatory politics in the former Lebowa bantustan of South Africa, 1940s to present(University of the Witwatersrand, Johannesburg, 2024) Bruchhausen, Sarah Lynn; Nieftagodien, NoorThis thesis provides a gendered and subaltern historical perspective of women’s emancipatory politics in the former Lebowa bantustan of South Africa from the late-colonial period of segregation (1940s) to the post-apartheid present (2022). It begins with an examination of the popular uprisings during the period of the 1940s to the early-1960s in which black women championed radical insurgent struggles against colonial-cum-apartheid processes of land dispossession, enclosure of the commons, excessive taxation, and the criminalisation of women’s subsistence lifestyles. Attention then shifts to the intensely repressive period in the aftermath of these rural uprisings and the making of the Lebowa bantustan during the 1960s and 1970s. In this period, women’s emancipatory praxes were drastically constrained and their political resistance took on more diffused and less organised forms. A popular expression of emancipatory politics during this period was the creation of different local women-made grassroots organisations engaged in collective praxes of care- giving, mutual aid, and community development, aimed at creating life-affirming projects and dignified ways of living, under harsh socio-spatial and political constraints. These rural women’s grassroots organisations developed in response to the growing crisis of social reproduction in Lebowa’s villages during the 1970s and were eclipsed by more militant modes of resistance in the insurrectionary climate of the 1980s. A younger generation of women, involved as comrades in the youth and labour movements, came to the fore as protagonists of the popular struggle for freedom in Lebowa, and engaged in certain aspects of the longer history of black women’s struggles for self-determination and rights to the commons in rural South Africa. Lastly, this thesis considers the 1994 transition to democracy and the subsequent post-apartheid era in today’s Limpopo Province. Using the Makotse Women’s Club as a case study, it argues that grassroots women’s organisations presently engaged in the praxis of a radical politics of care in villages of the former Lebowa bantustan are the most recent expression of an emancipatory mode of politics in rural South Africa with a long and rich history that stretches back to the radical uprisings of the mid-twentieth century. Overall, the history presented in this thesis suggests that the creation of autonomous spaces of the common and the defence of subsistence lifestyles has been, and continues to be, a defining characteristic of rural women’s emancipatory politics in the former bantustans of South Africa.Item Intersecting Epidemics: The implications of COVID-19 in the utilisation of HIV treatment services among people living with HIV on antiretroviral treatment (ART) in Zimbabwe(University of the Witwatersrand, Johannesburg, 2024) Tapera, Talent; Odimegwu, CliffordZimbabwe has been working towards the last mile of controlling the Human Immunodeficiency Virus (HIV) epidemic where keeping people that are living with HIV on antiretroviral therapy (ART) is primarily important. Ensuring they are virally suppressed and can thwart opportunistic infections is key. The advent of COVID-19 potentially posed a threat of derailing or reversing the gains attained in the fight against HIV. Zimbabwe has more than one million people living with HIV (United Nations Programme on HIV and AIDS [UNAIDS], 2020). The question of whether the COVID-19 pandemic intensified barriers and redefined the utilisation of HIV treatment services by people who are living with HIV on ART in Zimbabwe has remained largely unanswered in the literature currently available. Thus, the main purpose of this research was to examine the implications of COVID-19 in the utilisation of HIV care treatment services among people who are living with HIV on ART in Zimbabwe and the factors associated with it. This study defined, the utilisation of HIV treatment services as accessing and taking up a package of services expected to be received by people who are living with HIV on ART such as scheduled ART drug refill collections, viral load monitoring, Tuberculosis (TB) preventative therapy and TB screening. In addition, the study investigated the predisposition of people who are living with HIV in using the COVID-19 vaccine and the reasons behind not getting vaccinated. The study was anchored in the fifth revision of the Andersen behavioural model of healthcare utilisation. This model argues that the use of health services is a based on of three factors classified as (1) predisposing, (2) enabling and (3) need factors. The fifth model version of the model allowed the addition of environmental factors. The dependent variable was the utilisation of HIV treatment services and also COVID-19 vaccination among people living with HIV. As such, it was critical to anchor the study in this framework as it sought to identify the critical factors of utilisation of HIV treatment services and COVID-19 vaccination among people living with HIV. Therefore, following the Anderson model, the predisposing factors for this study were age, sex, marriage, religion, education and COVID-19 vaccination. The enabling factors were COVID-19 lockdown restrictions, COVID- 19 transport stoppages, distance to a health facility, transport cost to a health facility, fear of contracting COVID-19, non-availability of community healthcare services, and COVID-19 related stigma among healthcare workers. The need factors were opportunistic infection during the COVID- 19 period, COVID-19 infection, and contact with a COVID-19 case, while environmental factors were residence and type of health facility.Item Migration, Motherhood and Subjective Wellbeing: Experiences of Transnational Mothers in Johannesburg(University of the Witwatersrand, Johannesburg, 2023-12) Zikhali, Thulisile; Vearey, Jo; Walker, RebeccaThe discussions on feminisation of migration have renewed research interests into the gendered nature of migration experiences. This highlights the implications of cultural norms and values on migrant women. Despite that there is a longstanding history of people migrating to Johannesburg from within the Southern African region, little is written about the experiences of cross border migrant mothers who leave their children behind. This study explores the intersections of migration, motherhood, and subjective wellbeing in Johannesburg inner city, drawing from the experiences of twenty women: originating from Zimbabwe (comprising 15 women), Ghana (consisting of 3 women), and the Democratic Republic of Congo (involving 2 women). Participant observations and semi-structured interviews are methods that were used to collect data in the following three Johannesburg inner city areas: Hillbrow, Berea, and Yeoville. These are migrant-dense urban spaces in Johannesburg. The study used matricentric feminism and constructivism as its philosophical resources. It also utilised concepts of precarity, embodied transnationalism and subjective wellbeing as analytical tools to examine transnational mothers’ experiences. Findings indicate that familial social history and cultural gender norms play a crucial role in shaping perceptions of motherhood and in determining what are seen as “acceptable” ways of mothering. The study also found that there were tensions and contradictions in mothers’ perceptions of motherhood: their convictions on meanings of motherhood and the roles that mothers are expected to play in families were not in alignment with their own contemporary realities. Contrary to studies that have been conducted elsewhere, for example in North America and Europe, this study suggests that transnational mothering strategies in Johannesburg inner city are largely mediated by localised contextual factors such as lack of documentation, unstable jobs, xenophobia and crime. These factors undermine mothering strategies by creating an environment of uncertainty which makes it difficult for mothers to fulfil their mothering obligations, for example, sending remittances on time, maintaining regular cross border communication and regular visits to home. This study contributes to conceptual advancement in transnational motherhood research by bringing the aspect of wellbeing to the fore. It does this by uniquely considering the use of subjective wellbeing in understanding mothers’ experiences and how migration was beneficial to their mothering goals and aspirations. Findings indicate that mothers demonstrated agency in dealing with various challenges. They found migration as emancipatory and they were determined to provide for their children as well as to secure their future.Item Bisexuality in Democratic South Africa: Experiences of Women in Johannesburg(University of the Witwatersrand, Johannesburg, 2024) Khuzwayo, Zuziwe; Roy, SrilaThe field of gender and sexuality studies has been growing in academic institutions since the 1970’s. One of the reasons for its growth is that women across the globe are challenging conservative ideas and norms on how they should engage in romance, sexuality and heteronormativity which has implications for broader society. There has also been an increase in LGBTQI+ rights globally including in parts of the world where historically these identities were viewed as illegal and foreign to the indigenous people. In recent years though, there has also been a growing anti-gender backlash across the globe that has resulted in hard-won legal rights being reversed, or new legislation being imposed that is homophobic and transphobic. When it comes to research on sexuality, studies on bisexuality, however, and specifically research stemming from Global South contexts, is limited. This research contributes to the field of sexuality studies by looking at how bisexual women construct and express their sexuality, looking at multiple factors such as race, class, age and space in the city of Johannesburg. Using qualitative methods of life-history and in-depth interviews conducted during the six years of the PhD, this study shows how each of these factors shapes and influence an individual’s sexuality in a democracy where LGBTQI+ rights exist but are inadequately materialised. Drawing on feminist and queer theory, the study delves into how bisexuality is expressed and performed by women living in Johannesburg, and how challenges in claiming their sexuality exist outside but also within LGBTQI+ spaces. The study shows how queer women continue to carve out public and private spaces for themselves amid high levels of violence against women. Lastly, the research shows the continued regulation of women’s sexuality through heteronormativity in public and private spaces, and what this says about how women living on the African continent claim their sexuality in different waItem Operating under the Radar: Forestry Plantation Workers Everyday Resistance in Chimanimani District, Zimbabwe(University of the Witwatersrand, Johannesburg, 2024) Mvundura, Wellington; Pillay, DevanThis thesis explores and analyses the everyday forms and practices of labour resistance that rural commercial forestry plantation labour crafts to navigate a highly insecure post-colonial capitalist plantation labour process. It attends to the scholarly puzzle that in Zimbabwe, Africa, and elsewhere quotidian forms and practices of resistance are in a much less or barely empirically demonstrated and theoretically elaborated state in both resistance and labour resistance studies. This is even more pronounced in agrarian labour politics studies, yet agriculture labour constitutes a significant proportion of the overall industrial labour-force in xii Africa and elsewhere and is arguably the most easily exploitable form of wage labour. This motivated my empirical focus on commercial plantation labour. In light of evidence from Barura plantation estate, I argue that the workers may have to accept the fact of post-colonial capitalist plantation wage employment, the plantation-specific modalities of statist ethno-national citizenship, and state-sanctioned partisan national politics while contesting the terms and conditions under which these mutual systems of domination and exploitation occur. The practices do not seek to radically decompose the historical material- cum-symbolic bases of these systems of power. The everyday practices of defiance mediate the workers’ realisation of piecemeal de facto material and status gains more than the de jure recognition of those gains. My major empirical contribution is the discovery and foregrounding of the quotidian practices of subaltern groups as an integral part of politics. In a specialised and methodical manner, I re- centre the mundane everyday acts of plantation labour as workplace politics namely labour resistance. Theoretically I deploy and test the conceptual-cum-theoretical positions of seminal scholars on (everyday) resistance and modify some of these positions in light of empirical evidence. Methodologically, I break from the intention-oriented and foreground the practice- oriented approach to everyday resistance. This study is based on a continuous fourteen-month long on-site ethnography at a state-owned commercial forestry plantation. Ethnography was instrumental for the contextualised in-depth discovery and thick description of the workers’ forms, practices, and dynamics of subterranean labour resistance. It also enabled the cultivation of high levels of trust and rapport required to discover a sensitive, incriminating, and largely backstage (hidden) social phenomenon like quotidian labour resistance. For data collection I used three levels of participant observation, unstructured in-depth interviews, casual conversations, and deep hangouts.Item Personhood and Gender in a Traditional African Community(University of the Witwatersrand, Johannesburg, 2024) Nyirenda, Vitumbiko; Etieyibo, EdwinThere is a common assumption that traditional African societies were gender-neutral and lacked hierarchical gender ordering. Proponents of this view argue that women in these societies held significant positions, challenging notions of subordination and oppression. They contend that women have historically been leaders, advisors to kings, queens, soldiers, and landowners. However, some scholars argue that this assumption does not reflect the lived experiences of many African women, who face discrimination and oppression by men and society. This perspective suggests a distinct conception of personhood, indicating that African communities are inherently gendered, which in turn shapes their concept of personhood. The primary claim is that personhood has often been presented in non-gendered terms, based on the general assumption of gender neutrality in traditional African communities. However, this does not align with the realities of these communities. This dissertation thoroughly explores the intellectual divergence surrounding various understandings of gender in African society and its relation to discussions on personhood. Regarding gender, I argue that in the African context, it is viewed as complementary, fluid, and relational, indicating healthy and positive gender relationships within the community. Concerning personhood, I argue that it is often presented in non-gendered ways. Those who fail to recognize this perspective often conflate modern social issues with the dominant values of traditional African communities.Item Women, State Law, And the Crisis of Chieftaincy: The Case Of Nswazi Village In Zimbabwe(University of the Witwatersrand, Johannesburg, 2024) Muradzikwa, Tracey C.; Dube, S.I.Increasingly, post-colonial African states have been grappling with the issue of the gender- gap within traditional leadership institutions, resulting in contestations between state laws and traditional customary laws. Using the landmark succession of Indunakazi Sinqobile Mabhena of Nswazi in Umzingwane district, Matabeleland South, Zimbabwe as a case study, the dissertation provides a new perspective on female traditional leadership through studying the in-depth the negotiation of the legitimacy of Mabhena’s chieftaincy. The study is a “feminist ethnography” of the daily life of Chief Mabhena in a Nswazi community to establish how the governance strategies of women chiefs are configured in practice, with a focus on debates and contention regarding the succession and legitimacy of Indunakazi Mabhena. Drawing on more than one year of fieldwork and making use of a qualitative narrative ethnographic research methods, the Zimbabwean case shows how African women play a significant role in the reconceptualization of legitimacy in traditional leadership and the perceptions of the people of Nswazi on the legitimacy of Indunakazi Mabhena in particular. A key finding of the thesis is that the legitimacy of traditional leaders primarily lies with the community accepting the rulership of the appointed leader through celebrations, ceremonies, and commitment to the well-being of the people that preserve their heritage and lineage. To that end, the naturalization of male chieftaincy primogeniture is put to question.Item Evolution of Enforcement: United Nations Enforcement Actions Under Article 42 of Chapter VII(University of the Witwatersrand, Johannesburg, 2024) Custer, Scott; Brosig, MalteThis dissertation presents a comprehensive examination of the evolution of peace enforcement operations under the framework of the United Nations Charter's Chapter VII, Article 42. Through a qualitative research methodology, incorporating in-depth case study analysis and process tracing, the dissertation explores the changing actor constellations in peace enforcement, highlighting the shift from predominantly Member State-led operations to more complex arrangements involving Regional Arrangement and the United Nations Department of Peace Operations (UNDPO). By analyzing seven specific cases in Somalia, the Democratic Republic of Congo (DRC), Libya, and Mali, the research identifies key causal mechanisms that have shaped the actor constellations of peace enforcement missions. The findings contribute to a nuanced understanding of the conditions under which peace enforcement operations are initiated and the strategic considerations that guide the international community's response to threats to peace and security. The study concludes by discussing the implications of these evolutions for future peace enforcement endeavors and the broader study of peace and conflict resolution within the field of International Relations.