Mothers of the Future: A Parenting Curriculum Designed for Mothers Who Are Sex Workers in Cape Town, South Africa Open Access

Nelson, Kate Morgan (2015)

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Background: Sex workers are more vulnerable to HIV infection than persons in other occupations, but their professional work also carries additional health risks that are less commonly addressed. Violence, stigma, discrimination, substance abuse, mental health disorders, and lack of self-efficacy burden sex workers, especially in societies where the buying and selling of sex is criminalized. Most women report entering the sex work industry to meet pressing financial needs, but are faced with human rights violations that belittle, batter, and break their capability to thrive as women, professionals, and mothers.

Purpose: The purpose of this special studies project was twofold. First, it aimed to explore the needs, resources, barriers, and facilitators that sex workers living in Cape Town, South Africa experience in their role as mothers. The Sex Workers Education & Advocacy Taskforce (SWEAT) then implemented a social support program ("Mothers of the Future") aimed at reducing barriers female sex workers face as parents. To provide additional group structure, facilitator guidance, and session activities, a parenting curriculum was also developed to specifically address topics relevant to sex workers' daily lives.

Methods: A community needs assessment framework was utilized to interview key informants and SWEAT service users. This qualitative data was then thematically analyzed, and the results shaped the development of both the Mothers of the Future program and a nine module parenting curriculum.

Results: The community needs assessment revealed eight themes sex workers who are mothers identified as salient to their performance as parents: identity as a sex worker and mother, reproductive health, child care and safety, social support and education, social development, legal support, healthcare, and parental needs. A curriculum was created to educate and support sex workers who are mothers around these themes.

Discussion: Mothers of the Future aims to address the vulnerabilities of sex workers who are mothers via technical communication, and challenge barriers they face via transformative communication that is developed, led, and sustained by the sex workers themselves. After the program is piloted, adapted by sex workers, and evaluated, modifications can be made by peer educators and sex workers to better suit their needs and context.

Table of Contents

Chapter 1: Introduction and Background. 1

Problem Statement. 9

Purpose Statement. 10

Significance Statement. 11

Definitions of Terms. 12

Acronyms. 13

Chapter 2: Review of Literature. 14

Chapter 3: Methods. 23

Community Needs Assessment. 23

Key Informant Interviews. 23

In-Depth Interviews. 24

Curriculum Development. 28

Chapter 4: Results. 29

Key Informant Interviews. 29

In-Depth Interviews. 35

Chapter 5: Discussion. 58

Bibliography. 61

Appendices. 64

Appendix I: Mothers of the Future Pamphlet. 65

Appendix II: Pilot Mothers of the Future 2014 Schedule. 67

Appendix III: Mothers of the Future Abortion Campaign Sticker. 69

Appendix IV: Key Informant Interview Guide. 70

Appendix V: In-Depth Interview Guide. 73

Appendix VI: Interview Consent Discussion Form. 76

Appendix VII: SWEAT Media Consent Form. 79

Appendix VIII: Mothers of the Future Curriculum. 80

Session 1: Mothers Who Are Sex Workers. 80

Session 2: Planning Pregnancy and Protection. 103

Session 3: Options Counseling. 141

Session 4: Pregnancy. 171

Session 5: Child Health. 213

Session 6: Breastfeeding. 255

Session 7: Food & Fiances. 293

Session 8: Child Care & Safety. 323

Session 9: Teaching Moments. 358

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