Abstract
Ph.D. (Community Nursing Science)
The provision of reproductive health promotion services to females in South Africa is
the responsibility of the national and provincial governments, while in primary
healthcare (PHC) settings the local government is responsible for the provision of
free reproductive health promotion services to females. The prevalence of sexually
transmitted infections (STIs), the human immunodeficiency virus (HIV) and acquired
immune deficiency syndrome (AIDS) led to the development and provision of noncollaborated
vertical PHC reproductive health programmes. The purpose of this
study was to develop a model to collaborate the provision of reproductive health
promotion services in PHC settings.
A qualitative, descriptive phenomenological design, exploratory and descriptive
approaches and contextual and theory generating design were used. The study was
conducted in three phases. In phase 1, data collection consisted of individual indepth
interviews and focus group interviews. Non-probability purposive sampling
was used to include three population groups: females who utilised the reproductive
health promotion services and reproductive health promotion service providers and
those who provide clinical teaching regarding reproductive health promotion in two
different PHC settings who were sampled through non-probability convenience
sampling methods. Throughout the study, ethical principles were strictly adhered to
and trustworthiness was ensured.
Data analysis was done according to Tesch’s open coding data analysis method.
The findings revealed four emerging themes: service provision factors that impact on
reproductive health promotion provision; barrier factors towards safer sex practice;
low health literacy of females regarding reproductive health promotion, and
disclosure of positive HIV status.
In phase 2, the conceptual framework was described according to the survey list of
Dickoff, James and Wiedenbach (1968) and the Research Model in Nursing as
described in the Theory for Health Promotion in Nursing (University of
Johannesburg, 2009). In phase 3, the described conceptual framework served as the
guideline for the model development guided by Chinn and Kramer’s (2008) theory
and model generating design.
Two phases of model evaluation was done: firstly by clinical experts and secondly by
academic experts. The model that was developed was based on collaboration,
community participation, and cooperative decision making processes and was
named: A model to collaborate the provision of reproductive health promotion
services in PHC settings. The outcomes from implementing this model envisaged to
be the reduction of unintended pregnancy, STIs, and HIV and AIDS among females
and males.