Background: Across the globe a large proportion of pregnancies have been reported as unintended. There are no available reports from South Africa concerning the prevalence of unintended pregnancies. This study explored the prevalence of unintended pregnancies among South African women attending a public primary health care (PHC) clinic in KwaZulu-Natal (KZN), South Africa. It also investigated the relationship between demographic factors, contraceptive use, substance abuse and unintended pregnancy in this setting. Methods: A descriptive cross-sectional survey was conducted among patients (n = 328) attending a PHC clinic. Participants were recruited by convenience sampling. Women who attended the clinic on their first antenatal visit were invited to participate. Participants filled out questionnaires in either English or isiZulu. Association between pregnancy and categorical variables was assessed. Results: Participants were mostly single (89.9%; n = 267), unemployed (70.8%; n = 222) with a monthly income of less than R 1 500 per month (63.8%; n = 81). Two-thirds of the women (64.33%; n = 211) had unintended pregnancies. There was a significant relationship between marital status and unintended pregnancy. Women who were married or living with their partners were more likely to have planned their pregnancies as compared with those who were single or divorced. Unemployed women were more likely to have had unintended pregnancies. No other socio-demographic factors were linked to unintended pregnancy. Conclusion: It is concluded that in this population of South African women with low education levels and low income, the prevalence of unintended pregnancies is high. These unintended pregnancies are linked to single status as well as unemployment.

Background Students are often inadequately prepared for higher education, particularly concerning independent learning and critical thinking. These attributes are essential, especially in health science students as health care needs are complex. Innovative methods of teaching that promote these attributes are thus required. One such method, which has been included previously in other disciplines is photovoice, a participatory method, in which students become co-creators of knowledge. The aim of the study was to determine whether photovoice would promote critical thinking in students enrolled for a module in Public Health. The study also aimed to analyze the experiences of students using this methodology, as part of their learning. Methods Photovoice was introduced to a class of 56 chiropractic and homeopathy students registered for a module on Epidemiology: Public Health in 2019. Students working in self-selected groups were required to take photographs of environmental factors, involved in causing disease. After engaging in a group dialogue, one photograph was selected for presentation in class, with a discussion of how environmental factors visible in the photograph affect the health of individuals. Presentations were assessed based on the picture, presentation quality and ability to answer questions. Focus group discussions were subsequently held to understand the experience of students with this new teaching method. Data was analyzed using thematic analysis. Results Students established that it was a positive experience. They recognized the lived realities, within the community, that cause disease. The assignment demonstrated how learning can occur beyond the lecture room and extend into communities. Students offered realistic solutions to health problems that were confronted by communities. In addition, students participated in unintended community engagement. Conclusions The incorporation of photovoice into undergraduate teaching in the health science module promoted higher order learning such as problem solving and critical-thinking. Students transformed from rote learners to critical thinkers who reflected upon what they were taught and how this related to the lived realities of the community. Student communication improved as they disseminated knowledge to others. Teaching using this alternative pedagogy has the potential to produce graduates who are responsive to the local needs of the community.

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Cervical cancer screening rates remain suboptimal among women in South Africa (SA), where cervical cancer prevalence is high. The rollout of HIV-related services across SA may provide a means to deliver cervical cancer screening to populations with limited access to healthcare systems. In this mixed methods study, psychosocial factors influencing cervical cancer prevention and perceptions of the provision of Pap smears in HIV care settings were examined. Structured interviews were conducted with women (n=67) from a municipal housing estate in Durban, SA. Key informants (n=12) also participated in semi-structured interviews. Findings revealed that participants had low cervical cancer knowledge, but desired more information. Relevant themes included the normalization of HIV and beliefs that cervical cancer might be worse than HIV. A comprehensive community clinic was desired by most, even if HIV-positive patients were treated there. This study provides important insight into integrating cervical cancer screening with HIV clinics, which may increase cancer screening among South African women.

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