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Item The social contexts of childhood malnutrition in South Africa(University of the Witwatersrand, Johannesburg, 2024) Sello, Matshidiso Valeria; Odimegwu, Clifford; Adedini, SundayBackground: Childhood malnutrition is a major public health challenge of global importance. It may result from either excessive or deficient nutrients. Despite investments and several efforts made by the South African government and civil society organizations to improve child health, the prevalence of childhood malnutrition remains high in South Africa. South Africa is still lagging in in achieving the sustainable development goals 1-3 (i.e., 1- no poverty, 2 – zero hunger and 3 –good health and wellbeing). This is because the indicators of childhood malnutrition are significantly higher with one in four children being stunted, 13% overweight, and 7.5% underweight. These figures highlight a troubling trend that is echoed in many other African nations, where malnutrition rates are similarly concerning. For instance, while countries like Nigeria and Ethiopia face severe challenges with stunting rates exceeding 30%, South Africa’s rates are comparatively lower but still indicative of a significant public health challenge. In contrast, developed nations such as the United States report much lower stunting rates—around 3.4%—and face different nutritional issues, such as rising obesity rates among children. The current malnutrition status is worrisome in South Africa given that these conditions have not changed much in nearly three decades. Among other factors recognised as the leading causes of poor nutrition outcomes is food insecurity in households -defined as the lack of regular access to safe, sufficient, and nutritious foods, disrupted eating patterns and reduced food intakes. Despite South Africa being a net exporter of food, it is characterised by high poverty, reduced opportunities for higher education, employment challenges, environmental hazards, substandard housing, and health disparities, still have challenges in access to affordable safe nutritious foods. Furthermore, due to the complexity of childhood malnutrition, an integrated multisectoral approach among families, communities, and government systems is critical to ensuring positive child health and nutritional outcomes. Addressing poor nutritional outcomes among under-5 children requires policy-relevant evidence. While the literature shows that childhood malnutrition is a multifaceted issue influenced by poverty and poor socio-economic outcomes, evidence is sparse on how structural and environmental factors operating at different levels influence childhood malnutrition. Therefore, an understanding of social contexts of childhood malnutrition is required to improve children’s health outcomes in South Africa. Hence, this study examined the social context of childhood malnutrition in South Africa with a focus on individual child, 15 caregiver, and household-level characteristics. The study addressed five specific objectives: i) to determine the levels and patterns of childhood malnutrition in South Africa, (ii) to examine the individual child, caregiver, and household factors associated with childhood malnutrition in South Africa, (iii) to investigate the influence of food insecurity on childhood malnutrition, (iv) to explore the extent to which the socio-cultural and childcare practices of caregivers predispose under-5 children to malnutrition in selected low-income communities in South Africa, and (v) to investigate the role of a multi-sectorial approach in improving child nutritional outcomes in SA. This study was guided by the 2020 UNICEF conceptual Framework on Maternal and Child Nutrition as well as the Food and Nutrition Security Theory. Methods: This study adopted an explanatory sequential mixed methods design (i.e., analysis of quantitative data followed by qualitative data collection and analysis). The research methodology was broken into the quantitative and qualitative study. The quantitative study entailed analysing the quantitative secondary data from the 2017 South Africa National Income Dynamics Study (NIDS Wave 5). The NIDS data was nationally representative. The sample was weighted using post-stratified weights. Data of 2 966 children and their mothers were analysed. These children were selected on the basis that they had complete anthropometric measurements (height and weight measurements) and were suitable and selected for the investigation of childhood malnutrition (stunting, overweight, and underweight). We also conducted qualitative in-depth interviews with Early Childhood Development (ECD) practitioners to gain a deeper understanding of their experiences in childcare and perceptions of feeding practices. They were key informants since under-5 children spent a lot of time at ECD centres. Data were analysed at the univariate level to obtain descriptive statistics, and at the bivariate level using the chi-square test of association. At the multivariate level, multi-level binary logistic regression was employed, and odds ratios were reported. The multilevel analysis involved two levels – the individual level (child and mother characteristics) and the household-level characteristics. Data were analysed using Stata software (version 17). The selection of the independent variables was guided by the literature review and conceptual framework of the study. The second part of the study was qualitative and was collected between June and August 2022. Twenty in-depth interviews, and five focus group discussions with mothers of under-5 children, and five in-depth interviews with early childhood development practitioners (ECD practitioners) were conducted. Interviews were conducted using semi-structured questionnaires in selected low-income communities in urban 16 Gauteng (i.e., Thulani in Soweto), and in rural Limpopo (i.e., GaMasemola in Sekhukhune District). These communities were selected based on high poverty and unemployment rates, had substandard houses, insufficient infrastructure and environmental issues. The qualitative data provided deeper understanding about ethe quantitative findings and explored questions that were not available to the researcher in the NIDS dataset. The focus group discussions and key-in- depth interviews further provided a follow-up and an explanation of the quantitative findings. Thematic analysis was used to analyse qualitative data. Key findings from objective 1: In terms of descriptive findings, found that 22.16% of children were stunted, 16.40% were overweight, and 5.04% were underweight. The distribution of children among female and male children in the study population was almost the same. About 40% of the children had a low birth weight (<3 kg), 80.59% relied on the child support grant, and 67.22% were cared for at home during the day. Different patterns of malnutrition were observed. The highest percentage of children ages 12-23 months were stunted (33.43%) and overweight (32.69%), while the highest proportion of children ages 0-11 months and 48-59 months were underweight. Among children with a low birth weight of 1-2.9 kg, the highest percentage of stunting (30.07%) (p = 0.001, χ² = 71.2) and underweight (7.05%) (p = 0.026, χ² = 16.9) was observed. There was a relationship between access to medical aid, access to the child support grant, and childhood stunting (p < 0.05), while being cared for at home during the day was associated with stunting (24.98%) and overweight (18.99%) (p = 0.002, χ² = 36.3). Caregivers’ religion was associated with overweight (p = 0.007, χ² = 25.6) among under-5 children, while caregiver’s ethnicity (p = 0.024, χ² = 18.4) was associated with underweight. Key findings from objective 2: Female children had a lower likelihood (0.63 times) of being stunted compared to males. Children aged 12-23 months face a 60% higher risk of being overweight than those aged 0-11 months (AOR = 1.6). However, the risk of overweight declines steadily as age increases. Children aged 48-59 months are 83% less likely to be overweight compared to the youngest group of 0-11 months (AOR = 0.17). Children with a birthweight of 3 kg are 63% less likely to be underweight compared to those weighing 1-2 kg at birth (AOR = 0.37). Children attending crèches/day moms are 69% less likely to be underweight compared to those cared for at home (AOR = 0.31). Children cared for at home are 1.5 times more likely to be stunted (AOR=1.49) compared to children at a creche/day mom. Caregivers who were Nguni 17 had a 26% lower likelihood of having stunted children. Caregivers of other religions had 2 times higher likelihood of having overweight children compared to Christian caregivers (AOR=1.21). Middle-income households were associated with having overweight children (AOR=1.35) compared to low-income households. Children from structurally sound households had a 54% of high risk of being overweight compared to children from dilapidated household structures. The study found that a significant portion of the variation in child malnutrition (stunting, overweight, and underweight) occurred within communities. This is evident from the intraclass correlation of stunting (ICC) values from 27.9% to 30.2% variation, 34.3% to 38.2% overweight variation and 19.6% to 33,9% underweight variation within communities. The increase in ICC after adding additional variables suggest that these factors explain more of the variation within communities. Key findings from objective 3: The results showed that nearly 30% of the households were below the lower-bound food poverty line of R890 per person per month in South Africa, and just about half of the households did not always have enough available foods all the time. The qualitative findings show that the COVID-19 pandemic exacerbated the food insecurity during the COVID-19 lockdown, when many caregivers lost their income sources due to job losses. Food affordability and availability in the households became a major issue, forcing households to make hard decisions between deciding on foods with high nutrition that should be eaten against diverting financial resources and paying for other household expenses such as rent or electricity. Caregivers understood that they should be feeding their children nutritious foods but due to financial constraints, they were forced to give children the available but less nutritious foods in the households. Key findings from objective 4: Qualitative findings further showed that caregivers had various socio-cultural and childcare practices which influenced children’s nutritional and health outcomes. Socio-cultural practices that influenced childhood malnutrition included dietary choices – these were not necessarily affected by cultural beliefs, but they were rather influenced by the lack of income. Traditional beliefs on food- such as foods like eggs and dairy products such as milk or yoghurts were not given to girls. This was from a belief that this food would make girls more fertile and grow much faster. Traditional healing practices influence the dietary restrictions, limiting access to some nutritious foods, which are based on superstitions and lead to stigma. With regards to the childcare practices, there was also a lack of clarity by caregivers 18 on the duration of exclusive breastfeeding as well as the duration when the children should stop breastfeeding. Caregivers did not have adequate knowledge about when to resume weaning. Some caregivers highlighted that the last time they received nutrition knowledge was when their children were infants, and they had taken the children for vaccinations. Caregivers were not aware of how responsive caregiving such as child feeding frequency and portion sizes could improve children’s nutritional outcomes. Key findings from objective 5: From the qualitative interviews with early childhood development (ECD) practitioners, findings indicated a growing disintegration of childcare systems, including the family, health, and social systems, where a lack of parental support in nutrition programmes, a lack of support in health services and other social services when making referrals. Furthermore, various systems of care were working in silos in childcare service provision, resulting in children facing multiple adversities. Conclusions: The study demonstrated that individual-level child characteristics appear to exacerbate childhood malnutrition more than the mother and household-level characteristics. For example, the child level characteristics showed high significance, with age, sex, and child support grant, compared to the caregiver characteristics such as education, employment, and income. At the household level, variables such as household size and income did not show any significance. While this is the case, it does not necessarily mean that the mother and household-level characteristics were not important. This gap can be explained by the small sample, which can cause challenges of limited statistical power, making it harder to detect statistically significant differences. Furthermore, the qualitative assessment filled some gaps regarding these findings and gave an in-depth understanding on how the income disparities among caregivers and households result from high unemployment rates, highlighting the importance of socio-economic status and food security in child nutritional outcomes. From the ECD practitioners’ interviews, given the disintegration of childcare systems, the coordination and multisectoral collaboration of different sectors of care for children is urgently needed to improve children’s nutritional outcomes. Understanding the social context in which a child is brought up is important for the design of programmes and policies that will be effective in addressing this public health challenge. This understanding will enable efficient and effective service referral and service delivery to improve childhood nutrition in South Africa. This study highlights the need for a good 19 coordination of food, family, health, and social systems to ensure a positive childhood nutritional outcome.Item Depression Demographic Profiling of Young Adults in South Africa(University of the Witwatersrand, Johannesburg, 2024) Bambo, Matsidiso Princess; Hassem, TasneemIn young people aged 15 and 29 years, mental illnesses accounted for 23% of Years Lived with Disability (YLD) and among mental disorders, depressive disorders emerged as the second largest worldwide contributor to YLD at approximately 5.6%. In addition, one in every six individuals suffered from depression in South Africa. However, there is limited recent research about the demographic characteristics of South African emerging adults who may be vulnerable to depression. This research aimed to conduct demographic profiling of emerging adults (N=819) in South Africa who present with depressive symptoms. Additionally, using Pearson’s Product-Moment Correlation, T-test, and ANOVA, this cross- sectional research analysed secondary data from the Africa Long Life Study to determine relationships as well as statistical differences among demographic variables and depressive symptoms. Results indicated a low presence of depression in the sample. Significant relationships were found between depressive symptoms and demographic variables (socioeconomic status and religiosity). While no significant differences were found among language groups, a higher presence of depressive symptoms was found among females and those experiencing moderate to great financial difficulties. The findings emphasised the critical need for mental health policies and initiatives that promote prevention or early detection, prevention, and enhanced access to quality mental healthcare, particularly among vulnerable emerging adults like females and individuals who are economically disadvantaged. Mental health interventions should adopt comprehensive approaches that incorporate aspects of religiosity and spirituality to buffer against the presence of depressive symptoms among emerging adultsItem The experiences of COVID-19 related lockdown and social media usage among the youth in Vosloorus, Mfundo Park, Gauteng(University of the Witwatersrand, Johannesburg, 2024) Dlamini, Lindokuhle Sibahle; Ndimande-Khoza, Nomhle; Langa, MaloseThis research sought to understand how the COVID-19 lockdown affected young people from the Vosloorus Township as well as their social media usage throughout the lockdown. The study targeted seven individuals, both male and female, through semi-structured interviews to gain rich data for this research. The research used a qualitative approach that allowed the researcher to adequately document these individuals’ life experiences in a naturalistic and interpretive way. Additionally, the interpretive phenomenological approach (IPA) which allowed the researcher to get an in-depth understanding of how the research participants understand or interpret their world, more especially how they describe their personal experiences. The findings have shown that young people from townships have suffered significantly from the impact of the pandemic. They experienced notable psychological distress at the hands of the military and police who were sent to maintain order in the townships during the lockdown. They were forced to adapt to a new way of life which included letting go of traditional burial rituals. The social distancing measures meant that the majority of the population could not express their final goodbyes to relatives who have passed on in order to control the rate of infection. Furthermore, the social recession had a more devastating impact on these young people as they naturally thrive under social interaction for their growth and developmental trajectory. The lack of social and/or physical interaction with peers affected not only their growth, but it also affected their academic performance. Social media became the only digital tool they relied on for any form of learning and communication with peers, relatives as well as educators. Although social media provided these young people with some form of connection to the outside world, it became an eminent threat to their overall welfare. The spread of fake news about the virus caused a lot of confusion, chaos, emotional and psychological stress among these young people.Item The requirements of ethical journalism: An analysis of COVID-19 related news coverage by South African print and online media(University of the Witwatersrand, Johannesburg, 2024) Goba, Lindi Mpumelelo; Sithole, EnockThe media provides people with medical scienYfic informaYon during a health crisis. This funcYon of the media is even more crucial when there are lockdown restricYons as seen during the COVID-19 pandemic. Previous studies of media coverage of pandemics show that reporYng was generally negaYve in that the stories were of an alarmist nature and there were high levels of sensaYonalism. The compromised standards of reporYng could be a`ributed to the need for print and online news media outlets to a`ract audiences and increase profits given the bad state of the economy, parYcularly during the COVID-19 pandemic. This study aimed to analyse the extent to which the South African print and online media met the requirements of ethical journalism, as set out in the South African Press Code, in their reporYng on COVID-19. The researcher uYlised a mixed methods approach as the study includes both qualitaYve and quanYtaYve aspects. The data was collected through the Press Council’s website and was sampled using the keyword COVID-19. In total, there were 105 complaints submi`ed to the Press Council of South Africa during March 2020 and March 2022. Out of the 105, the researcher analysed 13 complaints that were related to COVID-19 reportage made during the same period. This period includes the outbreak of the pandemic, the second wave, and concludes with the third wave which is when the pandemic began to wind down. The results and findings of this study show that the number of complaints submi`ed during the pandemic was significantly low and that the publicaYons that breached the Press Code were mainly sancYoned for serious breaches. This suggests that print and online publicaYons that subscribe to the Press Council pracYced ethical journalism and adhered to the requirements of the Press Code to a moderate extent.Item The Impact of Loadshedding on the Mental Health of Small Business Owners in the Alexandra Township(University of the Witwatersrand, Johannesburg, 2024) Tladi, Lesedi Mosenngwe; Marchetti-Mercer, MariaSouth Africa is currently experiencing an electricity crisis which is slowly progressing to unmanageable levels as a result of ongoing loadshedding. Loadshedding has become a part of everyday life, and it affects all aspects of people’s lives including their mental health. Numerous studies address the economic impact of loadshedding, while the mental health impact is often neglected. The purpose of this study is to explore the impact of loadshedding on the mental health of small business owners in the Alexandra township. Eight small business owners from Alexandra township were interviewed with the use of semi-structured interviews. The data was analysed using thematic analysis. Findings reveal that loadshedding affects the experiences of small business owners and their mental health negatively. Small business owners face several challenges including operational, economic, and psychological challenges as a result of the ongoing electricity disruptions. Loadshedding extends beyond hampering the financial stability of small business owners, it also affects their families and employees. There was evidence of stress, anxiety, and feelings of helplessness impacting participants’ psychological and personal well-being. Ultimately the larger township community has also been negatively impacted by the ongoing energy crisis. Moreover, there was perceived government accountability for loadshedding.Item An analysis of the relationship between HIV-testing and cervical cancer screening uptake among females of reproductive age (15-49 years old) in South Africa(University of the Witwatersrand, Johannesburg, 2024) Madubye, Koketšo Tholo; Wet-Billings, Nicole DeBackground: Higher income countries (HIC) have threefold testing coverage over lower to middle income countries (LMIC). Cervical cancer is the 4th most prevalent cancer among females globally, and a key contributor to mortality in Southern Africa. In LMIC, including South Africa, only 9% of the eligible screening cohort had ever undergone cervical cancer screening. This study examined the gap in understanding the relationship between HIV testing behaviours and the uptake of cervical cancer screening. Methods: The study was conducted in South Africa, utilising the 2016 South African Demographic and Health Survey (SADHS), as a secondary data source. The sample size of this study was a weighted (n) distribution of 4,199 females. The study design is cross-sectional, the outcome variable of interest in this study was the uptake of cervical cancer screening and the predictor variable is HIV Testing. The data by SADHS (2016) was analysed through the three phases: univariate, bivariate and multivariate. At the bivariate level, contingency tables were employed, using the Pearson chi-square test of association which examined the strength of crude relationships between cervical cancer screening and the study of independent variables. In addition, a multivariate analysis through the employment of a binary logistic regression as the outcome of the study was categorised with ‘yes’ and ‘no’ binary responses. Results: The findings of this study indicated that 33% of females of reproductive age had ever undergone cervical cancer screening, while 62.5% responded affirmatively to having tested for HIV. Females who tested for HIV displayed a higher propensity to having undergone cervical cancer screening, 37.43% female respondents who tested for HIV had undergone screened for cervical cancer, as opposed to those who didn’t test, which only 10.19 % screened for cervical cancer. Conclusions: 37.43% female respondents who tested for HIV had undergone screened for cervical cancer. Among those who did not test for HIV, 10.19 % screened for cervical cancer. There is still much to be done to improve cervical cancer screening among females, while HIV testing remains high, cervical cancer screening is alarmingly low. The 2017 Cervical Cancer Prevention and Control Policy functions as a mediating apparatus, additional supplementations targeting females below the age of 30 remain a necessityItem Exploring the involvement of HIV patients in person-centred care: The case of Nancholi Youth Organization (NAYO) in Blantyre, Malawi(University of the Witwatersrand, Johannesburg, 2024) Magola, Delipher; Dickinson, David; Lewins, KeziaThis research report explored the involvement of HIV patients in person-centred care (PCC). PCC is the collaboration between healthcare providers, patients, and their support system to achieve the desired goals of quality treatment and care. PCC has been implemented in high- income countries where definitions, theories, and frameworks have been made. The literature review focuses on six major concepts namely PCC, expert patient, Greater Involvement of People with HIV/AIDS (GIPA), community-based care, patient support system, and stigma. PCC, expert patient and GIPA are core to understanding community-based initiatives and the need to implement PCC and community-based care. Community care, patient support systems and stigma drive person-centred care implementation, especially in low-income countries. The main research question was: What is the involvement of HIV patients in the Malawian Nancholi Youth Organization (NAYO) Programmes in Blantyre? In its methodological considerations, the study used the following research approaches: (1) A qualitative design to explore the involvement of HIV patients in NAYO Programmes; (2) A purposive sampling technique in the identification of seven respondents from NAYO staff and five community volunteers; (3) A stratified sampling technique in recruiting 11 HIV patients on the first line of HIV treatment; (4) Semi-structured interviews to gather information from NAYO staff members, HIV patients, and community volunteers; (5) Adopted the participant observation method in observing interactions between patients and healthcare providers; (6) Thematic analysis was adopted to draw themes based on research-specific questions and NAYO programmes. Findings reveal that NAYO uses a community-based approach for the implementation of its services and much of the involvement of patients is on a community level. NAYO Community volunteers facilitate and coordinate the collaboration between patients and healthcare providers. NAYO relies on community volunteers to implement its programmes. Finally, the research revealed that patients’ support system includes family relations, friends, church members and community leaders who provide psychosocial-moral support. Felt and enacted stigma are barriers to the implementation of community-centred care. Financing programmes and services is a major challenge for NAYO in the implementation of its activities.Item Factors and Levels Associated with HIV Knowledge among Non- Heteronormative Youth in South Africa(University of the Witwatersrand, Johannesburg, 2024) Peter, Andrea Nathania; Wet- Billings,Nicole DeIntroduction Within the South African context, non-heteronormative individuals, those who do not relate to heterosexuality and mainly differ from heterosexual practices regarding their sexual orientation such as the Lesbian, Gay, Bisexual, Queer and other (LGBTQ+) communities, face great levels of social exclusion due to their sexual orientation. Much of the LGBTQ+ community remains hidden and in fear of the potentially harsh – and sometimes lethal – consequences that follow ‘coming out’. Furthermore, those who identify as non-heteronormative face several sexual and reproductive health challenges. Individuals in same-sex relationships find it difficult to access safe sex measures in health clinics. In many cases, non-heteronormative individuals are unaware of the needed measures to practice safe sex to avoid health detrimental implications such as HIV. Methodology This study aimed to determine the demographic, socioeconomic and sexual behaviour factors that are associated with HIV knowledge among non-heteronormative youth (15-34 years old) in South Africa. The study used data from the 2017 Fifth South African National, HIV, Behaviour and Health Survey (SABSSM). The survey interviewed people 15 years and older who reside in South Africa. The study focused on non-heteronormative youth (15-34 years old) with a weighted national sample size of 365,237 individuals who indicated they had been in a same-sex relationship. Various demographic, socioeconomic and risky sexual health behaviour factors were used as independent variables to test for any association with HIV knowledge, the dependent variable. To test for association chi-square, proportion calculations and a probit regression were used to assess the level of HIV knowledge among non-heteronormative youth and the level of association with the independent variables. Results More than 50% of non-heteronormative youth indicated high levels of HIV knowledge, with females aged 25-29 years old having the highest level of knowledge. When running the adjusted and unadjusted probit regression, the variables sex, marital status and multiple sexual partners were shown to influence HIV knowledge. With these factors indicating a relationship with HIV knowledge among non-heteronormative youth, there is an association with the demographic, socioeconomic and risky sexual behaviour factors with HIV knowledge. Conclusion Although an association was found between the variables and HIV knowledge among non- heteronormative youth, it did not provide indicate a full view of the various factors that could 9 influence HIV knowledge among non-heteronormative population in South Africa. This study contributed data and research regarding the non-heteronormative, which has limited information available. Results indicated that there are high levels of HIV knowledge among non-heteronormative youth but further insight is required to assess where this information is from and how accessible it iItem The Relationship Between Sensory Disability Status and Contraceptive Use Among Women Aged 15- 49 Years Old In South Africa(University of the Witwatersrand, Johannesburg, 2024) Sifora, Kutlwano Katlego Kimberly; De Wet-Billings, NicoleBackground: Studies suggest that disability significantly hinders access to reproductive health services, particularly family planning, in low- and middle-income countries. Women with disabilities have a low contraceptive use rate, leading to increased risks of unintended pregnancies and health complications. This study examined the relationship between sensory disability status and contraceptive use in South Africa. A sensory disability is a condition that affects one or more of the body's sensory functions like sight, hearing, touch, taste, or smell. In this study, sensory disabilities focused on hearing and visual impairments. Methods: The study employed a cross-sectional design using the 2016 South Africa Demographic and Health Survey. The study focused on women of reproductive age (15–49 years old) in South Africa, who were sexually active and provided information on both their contraceptive use and sensory disability status. The outcome variable of this study was contraceptive use, and the main independent variable was sensory disability status. The control variables included demographic characteristics namely age, race, marital status, province, and place of residence, as well as socioeconomic characteristics such as employment status, wealth status, education, family planning messages, and contraceptive knowledge. The analysis was conducted using Stata 17.0 on a weighted sample of 6 683 sexually active women aged 15–49 years old who answered questions on contraceptive use. The data analysis was done in three phases. For the first phase, cross-tabulations and chi-square analysis were used to demonstrate the levels of contraceptive use as well as all characteristics of women. For the second phase, bivariate binary logistic regression models were used to determine the relationship between each of the independent variables and the outcome variable of contraceptive use. Lastly, for the third phase, a stepwise multivariate binary logistic regression was utilised to determine the relationship between sensory disability status and contraceptive use among women aged 15– 49 years old in South Africa. Results: Among South African women of reproductive age, 55.4% were using contraceptives. Women with sensory disabilities were shown to have lower odds of using contraceptives than those without sensory disabilities, even after adjusting for all other variables [OR: 0.78, CI: 0.63873 - 0.95227]. Significant associations with contraceptive use were observed for factors xi including age, race, marital status, education and province. Compared to women aged 15–24, women aged 35–39 had a much lower likelihood of using contraceptives. [OR: 0.46, CI: 0.38150 - 0.55364]. Women from races other than black were also observed to have lower odds for contraceptive use compared to black women [OR: 0.75, CI: 0.61098 - 0.92237]. Conversely, married women were significantly more likely to use contraceptives than women who were never married [OR: 1.23, CI: 1.05328 - 1.42899]. Additionally, women with secondary [OR: 1.98, CI: 1.28089 - 3.07512] or higher education [OR: 2.40, CI: 1.49931 - 3.83750] exhibited a significantly higher likelihood of contraceptive usage compared to those lacking formal education. Women residing in Western Cape [OR: 1.83, CI: 1.29743 - 2.57637], Eastern Cape [OR: 1.66, CI: 1.27747 - 2.15886], Northern Cape [OR: 1.61, CI: 1.18574 - 2.19087], KwaZulu Natal [OR: 1.51, CI: 1.17797 - 1.92456], North West [OR: 1.43, CI: 1.01266 - 2.01228], and Mpumalanga [OR: 1.50, CI: .15808 - 1.93439] were found to have a higher likelihood of using contraceptives compared to women residing in Limpopo. Conclusions: Low contraceptive use among women with sensory disabilities in South Africa highlights the need for inclusive reproductive health services, addressing communication, information access, and societal attitudes to ensure informed decisions.Item The Mental Health Needs of South African Mainstream High School Learners: Teachers’ Experiences and Perceptions(University of the Witwatersrand, Johannesburg, 2023) Abreu, Leandra Imilia; Amod, ZaytoonThis qualitative study set out to explore teachers’ experiences and perceptions of South African high school learner mental health. Mainly, what teachers believe to contribute towards learner mental health, what they deem to be the barriers and how they believe these barriers can be addressed. The study aimed to provide insight into facilitative factors and challenges concerning adolescent learner mental health in addition to offering support to teachers in managing the mental health of their learners, an important factor in assisting the overall development of South African learners. To better understand these views, twelve qualified and registered teachers practicing in South African high schools were interviewed using a non-probability, purposive sampling technique and following an interpretive phenomenological approach. The use of semi-structured individual interview questions was used to ascertain the perceptions and experiences of 12 teachers in South Africa. The teachers were approached via online platforms, due to social restrictions during the COVID-19 pandemic. The data was analysed using Braun and Clarke's (2006) thematic analysis to establish the main themes brought up by the participants. The findings uncovered numerous themes and subthemes surrounding teachers’ perceptions of aspects contributing to the mental health of their learners namely: challenging households and the role of parents, social pressures and stressors, anxiety, depression, ADHD and the influence of self-esteem. The impacts of COVID-19 were also prominent due to the interviews being conducted during the initial lockdown period in South Africa. The teachers identified a lack of resources and teacher mental health training/knowledge, stigma and poverty as three of the major barriers to learners accessing mental health support. Finally, the teachers identified multilayered responsibilities, interventions pertaining to teacher training and curriculum adaptions as possible approaches to address these barriers. These findings suggest that managing the mental health of learners is extremely burdensome for teachers who feel unsupported. Obtaining teachers’ perceptions, experiences and beliefs about learner mental health is thus important to improve school psychological services. The findings contribute to research regarding factors influencing learner mental health and adds to the limited empirical research available surrounding South African teachers’ experiences and perceptions. It is recommended that future research be carried out on several different aspects surrounding adolescent mental health in South Africa.