Description
- Abstract:
- Background: In South Africa, individuals who visit a healthcare setting during pregnancy are tested for HIV, and if positive, are started on antiretroviral therapy (ART) immediately. Unfortunately, the rates of disengagement from HIV care after giving birth are alarming. With regards to birthing individuals’ ability to remain engaged in healthcare postpartum, it is paramount that literature investigate aspects of their lives which are intricately linked to their identity, lived experiences, and self-efficacy. Black women in South Africa are not only at an increased disadvantage for attaining employment compared to their white counterparts, but when employed they are compensated at much lower rates than their male counterparts. Therefore, our main research question for this paper centers Black feminist thought, and aims to explore how Women Living with HIV (WLHIV) in South Africa perceive their financial security and remain engaged in care during the pregnancy-to-postpartum transition. Specific Aims: 1. Use intersectionality as a praxis to understand how financial (in)security presents for the participants within their sociocultural context 2. Apply a resilience framework to explore financial security as a factor in engaging with healthcare from pregnancy to 6-months postpartum Methods: This paper uses a secondary analysis of data from a larger study which was conducted in Cape Town, South-Africa between March 2018 and May 2019. All study sampling, recruitment, data collection materials and procedures were reviewed and approved by University of Cape Town's and Brown University’s IRB. Recruitment took place at Gugulethu Midwife Obstetrics Unit (GMOU) using the following eligibility criteria: a) individuals 18 years or older, b) at 32-35 weeks of pregnancy, c) diagnosed with HIV, d) prescribed antiretroviral therapy, and e) fluent in isiXhosa or English. A trained study recruiter identified participants who were diagnosed with HIV –from clinic records– explained the study, and enrolled participants who gave informed consent. We used thematic analysis of interviews from pregnancy (n=30) and 4 - 6 months postpartum (n=23), and utilized cross-sectional profiling to compare prevalent themes at each timepoint. Results: Three major themes were identified. Firstly, there was an increased financial strain on participants between pregnancy and 6-months postpartum due to a limited ability to work and the unique health needs of both the mother and newborn. In order to navigate limited financial resources, most participants had to rely on the child support grant and financial assistance from their partner/families. Finally, participants equated being a “strong, independent woman” with financial security, and negotiated means for financial empowerment as a result. Conclusion: Intersectionality as a praxis explains how structural violence in South Africa placed our participants at a disproportionate disadvantage for equitable employment and compensation. During this transition, they had to rely on social grants and their partners for financial support; both of which proved unreliable and rendered them in a precarious financial state. Although our participants were resilient regardless of these odds; we recommend that low-income women be eligible to apply for the child support grant during (instead of following) pregnancy, and receive subsidized childcare services to lessen the postpartum financial strain.
- Notes:
- Thesis (M. P. H.)--Brown University, 2023
Citation
Kopeka, Mamaswatsi Pearl,
"“I hustle to put food on the table for my children”: A Longitudinal Qualitative Analysis Of Financial (In)Security Among Pregnant And Postpartum Women Living With HIV In Cape Town, South Africa"
(2023).
Public Health Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://repository.library.brown.edu/studio/item/bdr:686ue882/
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Public Health Theses and Dissertations
Theses and Dissertations for the Public Health department....