Thabo Letsoalo - Academia.edu (original) (raw)

Papers by Thabo Letsoalo

Sexual & Reproductive Healthcare, Dec 1, 2016

Objective(s)-The childbearing needs of people living with HIV (PLHIV) and the experiences of heal... more Objective(s)-The childbearing needs of people living with HIV (PLHIV) and the experiences of healthcare providers serving them are explored. We examine provider and client knowledge and views on safer conception methods. Methods-The study uses exploratory qualitative research to understand provider and client perspectives on childbearing and safer conception. Interviews were conducted at 3 sites (1 rural, 2 urban) in eThekwini District, KwaZulu-Natal, South Africa between May 2011 and August 2012, including in-depth interviews with 43 PLHIV, 2 focus group discussions and 12 in-depth interviews with providers. Results-Clients had little knowledge and providers had limited knowledge of safer conception methods. While clients were eager to receive counseling on safer conception providers had some hesitations but were eager to receive training in delivering safer conception services. Clients and providers noted that biological parentage is a major concern of PLHIV. Clients were willing to use any of the described methods to have biological children but some expressed concerns about potential risks associated with timed unprotected intercourse. Male clients required access to reproductive health information.

Global Perspectives on Women's Sexual and Reproductive Health Across the Lifecourse, 2017

Women’s perception of quality of care has a decisive impact on health-seeking behavior. This chap... more Women’s perception of quality of care has a decisive impact on health-seeking behavior. This chapter reveals how mobile technology can be utilized to improve health care by creating a feedback system to draw from women’s perception of quality of care in service delivery at health facilities. The chapter registers how piloting a Mobile Monitor for Quality of Care (MoM-QC)– developed by the White Ribbon Alliance for Safe Motherhood, India (WRAI), led by its secretariat organization, Centre for Catalyzing Change (formerly CEDPA India), Merck for Mothers, a health initiative of the global pharmaceutical company Merck, and the mobile technology firm Gram Vaani (meaning “voice of the village”)– in 20 villages in the Indian state of Jharkhand with the support of the government of Jharkhand, became a successful, fully crowdsourced reserve of information on health facilities for use by women. The chapter also highlights how MoM-QC improved users’ knowledge of their entitlements as well as quality of maternal care by firstly educating women on the maternal care they should expect and demand and the entitlements they are eligible to, secondly providing women with a forum to record their experiences based on recognized, evidence-based standards and share this data with communities to help them seek high-quality providers, and finally creating a forum to promote sharing of actionable data with providers in a way that would help drive quality improvements.

The transition to adulthood is a significant period III the lives of many young people throughout... more The transition to adulthood is a significant period III the lives of many young people throughout the world. HIV/AIDS continues to attract much attention from researchers as it is a matter of particular concern for young people. Recent data suggests that the HIV prevalence among females aged 15-24 in South Africa is 12.7%, and 4 % among males. Increasingly there has been a major outcry especially among international donor agencies that despite widespread HIV/AIDS campaigns in South Africa behaviour change has not been realised. Given the fact that in South Africa HIV/AIDS is fuelled by heterosexual intercourse, it is imperative to monitor trends in sexual behaviour among young adults in order to be able to identify and understand those sexual behaviours that fuel the epidemic. This study uses the Cape Area Panel Study (CAPS) data conducted in the Cape Town Metropolitan between 2002 and 2005. It tracks trends in sexual behaviour, and determines the predictors of risky sexual behaviou...

Sexual & Reproductive Healthcare, 2016

Http Dx Doi Org 10 1080 13691058 2012 740074, Jan 10, 2013

Increasing evidence suggests that medical male circumcision is associated with a reduced risk of ... more Increasing evidence suggests that medical male circumcision is associated with a reduced risk of HIV infection for men in sub-Saharan Africa. The aim of this study was to understand the importance of male circumcision as a risk-reducing strategy by exploring perceptions of young men and women. The study draws on focus-group discussions conducted with both men and women in South Africa. The findings suggest that there is widespread support for traditional male circumcision. Traditional circumcision is viewed as a key part of the initiation process. However, a number of concerns were raised about the traditional initiation process, which may lead to risky sexual behaviours, including early sexual debut and multiple sexual partners. In addition, the risky sexual behaviour of men puts women at risk of HIV infection.

AIDS Care, 2014

Men and women living with HIV with access to ARVs are living longer, healthier lives that can and... more Men and women living with HIV with access to ARVs are living longer, healthier lives that can and often do include bearing children. Children occupy a key space in men and women's personal and social lives and often play a fundamental role in maintaining these relationships, irrespective of illness concerns. Couples living with HIV need to balance prevention needs and ill health while trying to maintain healthy relationships. Health care providers serving the reproductive needs of HIV-affected couples need to consider the social and relational factors shaping reproductive decisions and associated periconception risk behaviors. This paper based on qualitative research at three hospital sites in eThekwini District, South Africa, investigates the childbearing intentions and needs of people living with HIV (PLHIV), attitudes and experiences of healthcare providers serving the reproductive needs of PLHIV, and client and provider views and knowledge of safer conception. This research revealed personal, social, and relationship dynamics shape the reproductive decisions of PLHIV and "unplanned" pregnancies are not always unintended. Additionally, conception desires are not driven by the number of living children, rather clients are motivated by whether or not they have had any children with their current partner/spouse. Providers should consider the relationship status of clients in discussions about childbearing desires and intentions. Although many providers recognize the complex social realities shaping

Journal of the International AIDS Society, 2014

Introduction: Safer conception interventions should ideally involve both members of an HIV-affect... more Introduction: Safer conception interventions should ideally involve both members of an HIV-affected couple. With serodiscordant couples, healthcare providers will need to manage periconception risk behaviour as well tailor safer conception strategies according to available resources and the HIV status of each partner. Prior to widespread implementation of safer conception services, it is crucial to better understand provider perspectives regarding provision of care since they will be pivotal to the successful delivery of safer conception. This paper reports on findings from a qualitative study exploring the viewpoints and experiences of doctors, nurses, and lay counsellors on safer conception care in a rural and in an urban setting in Durban, South Africa. Methods: We conducted six semistructured individual interviews per site (a total of 12 interviews) as well as a focus group discussion at each clinic site (a total of 13 additional participants). All interviews were coded in Atlas.ti using a grounded theory approach to develop codes and to identify core themes and subthemes in the data. Results: Managing the clinical and relationship complexities related to serodiscordant couples wishing to conceive was flagged as a concern by all categories of health providers. Providers added that, in the HIV clinical setting, they often found it difficult to balance their professional priorities, to maintain the health of their clients, and to ensure that partners were not exposed to unnecessary risk, while still supporting their clients' desires to have a child. Many providers expressed concern over issues related to disclosure of HIV status between partners, particularly when managing couples where one partner was not aware of the other's status and expressed the desire for a child. Provider experiences were that female clients most often sought out care, and it was difficult to reach the male partner to include him in the consultation. Conclusions: Providers require support in dealing with HIV disclosure issues and in becoming more confident in dealing with couples and serodiscordance. Prior to implementing safer conception programmes, focused training is needed for healthcare professionals to address some of the ethical and relationship issues that are critical in the context of safer conception care.

Culture, Health & Sexuality, 2013

Journal of Development Studies, 2012

Abstract This article investigates inequalities in school attainment in South Africa using commun... more Abstract This article investigates inequalities in school attainment in South Africa using community-based data collected in 2008 by the National Income Dynamics Study. Schools-based research has concluded that poor children, who are mostly African, remain disadvantaged by the continuing low performance of former African schools. In contrast, this analysis finds that most educational disadvantages of African children, including their low matriculation rates, are accounted for by household poverty and their mothers&#x27; own limited ...