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An exploration of barriers that women experience when seeking addiction treatment services in the Western Cape
Thesis (DPhil)--Stellenbosch University, 2026.
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| Format: | Thesis |
| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2026
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| _version_ | 1869484206251311104 |
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| access_status_str | Open Access |
| author | Jacobs, Danyschka Ania Werner |
| author2 | Slabbert, I. |
| author_browse | Jacobs, Danyschka Ania Werner Slabbert, I. |
| author_facet | Slabbert, I. Jacobs, Danyschka Ania Werner |
| author_sort | Jacobs, Danyschka Ania Werner |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (DPhil)--Stellenbosch University, 2026. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/136082 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-07-01T04:11:12.428Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/136082 An exploration of barriers that women experience when seeking addiction treatment services in the Western Cape Jacobs, Danyschka Ania Werner Slabbert, I. Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Social Work. Drug abuse -- Treatment -- South Africa -- Western Cape Women drug addicts -- Rehabilitation -- South Africa -- Western Cape Health services accessibility -- South Africa -- Western Cape Thesis (DPhil)--Stellenbosch University, 2026. Jacobs, D. A. W. 2026. An exploration of barriers that women experience when seeking addiction treatment services in the Western Cape. Unpublished doctoral dissertation. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/5bf72a78-2011-4384-929d-4cfbedcf8206 ENGLISH ABSTRACT: Globally, substance abuse has reached epidemic proportions, with more than 284 million people having been documented as substance users in 2020, of which 35 million have a substance use disorder (SUD) that requires addiction treatment. In South Africa, 11 to 18% of the population is affected by harmful substance abuse and dependency, costing the economy more than R130 billion annually, and contributing significantly to gender-based violence (GBV), child neglect, and high rates of HIV, Hepatitis C and other communicable diseases. In the Western Cape, substance abuse continues to plague the province, sharply demonstrating the substance abuse crisis with the world’s highest record of Fetal Alcohol Spectrum Disorder (FASD). Yet, despite the growing number of women using substances, women remain profoundly underrepresented in addiction treatment services, notwithstanding the country’s progressive Constitution protecting their rights to dignity, equality, and access. This contradiction is disturbing, as only 22% of national treatment admissions over two decades were women. Moreover, women experience a variety of barriers, including limited availability of addiction treatment services across the continuum of care, heightened levels of stigma, poverty, social exclusion, and trauma. This study examined the barriers women experience when attempting to access addiction treatment services in the Western Cape through the lens of a biopsychosocial approach and human rights perspective. A qualitative study with an exploratory and descriptive research design was used. Purposive sampling was utilised to recruit two sample groups: 20 women with SUDs and 12 social service providers of addiction treatment services. Semi-structured interview guides were used to collect data through face-to-face interviews conducted with the participants. Ethical clearance was obtained for this medium-risk study before the commencement of any interviews, with all participants signing informed consent forms. The interviews were then transcribed verbatim and underwent thematic analysis, wherein the data were analysed and broken down into relevant themes, subthemes, and categories. The data obtained from the interviews were verified to ensure the trustworthiness of the study, further ensuring credibility, transferability, conformability, and dependability. Six themes were identified: biological barriers (pregnancy and health); psychological barriers (mental health and trauma); social barriers (interpersonal relationships and stereotypes); cultural barriers (community barriers and intersectionality); structural barriers (logistical barriers and attitudinal barriers by staff); and systemic barriers (programme development). The findings derived from these themes, subthemes and categories indicated how various intersecting barriers compromised, and in some instances violated women’s rights to equitable, effective, and gender-responsive addiction treatment services. This study concluded that addiction treatment services in the Western Cape remained largely unresponsive and inappropriate to the lived realities of women with SUDs. Addiction care in the Western Cape must undergo a process of reconceptualisation to uphold, protect, and implement constitutional and international human rights obligations. This requires addiction treatment programmes and subsequent services to be rooted in gender-responsive and trauma-informed approaches, with principles of dignity and empowerment not just being promoted but implemented at every stage of treatment. Without this reform, women will continue to be denied their fundamental right to appropriate services. The recommendations call for the strengthening of social work practice and training in addiction, it demands the inclusion of women’s voices in programme development, as well as implementing policy reform that ensures that addiction care across the continuum is recognised, respected and executed – not as a privilege for the few, but as a fundamental human right for all. AFRIKAANSE OPSOMMING: Middelmisbruik het wêreldwyd epidemies toegeneem, met meer as 284 miljoen mense wat in 2020 as middelgebruikers gedokumenteer is, waarvan 35 miljoen mense 'n middelmisbruikversteuring (SMV) het wat verslawingbehandeling benodig. In Suid-Afrika word 11 tot 18% van die bevolking geraak deur skadelike middelmisbruik en afhanklikheid. Dit kos die ekonomie jaarliks meer as R130 miljard en dra aansienlik by tot geslagsgebaseerde geweld, kinderverwaarlosing en hoë koerse van MIV, Hepatitis C en ander oordraagbare siektes. In die Wes-Kaap bly middelmisbruik ʼn groot uitdaging. Middelmisbruik word bevestig deurdat die Wes-Kaap die hoogste rekordgetal van Fetale Alkoholspektrumversteuring (FASV) in die wêreld het. Ten spyte daarvan dat die aantal vroue wat middels gebruik skerp toeneem, is daar steeds ʼn groot onderverteenwoordiging in vir vroue, desnieteenstaande die land se progressiewe Grondwet wat vroue se regte op waardigheid, gelykheid en toegang beskerm. Hierdie teenstrydigheid is ontstellend, aangesien slegs 22% van die nasionale behandelingsopnames oor twee dekades vroue was. Boonop ervaar vroue talle struikelblokke, soos die beperkte beskikbaarheid van verslawingbehandelingsdienste oor die hele kontinuum van sorg, verhoogde vlakke van stigma, armoede, sosiale uitsluiting en trauma. Hierdie studie het die struikelblokke wat vroue ervaar wanneer hulle probeer om toegang tot verslawingbehandelingsdienste in die Wes-Kaap te verkry, ondersoek deur middel van ʼn biopsigososiale- en menseregteperspektief lens. 'n Kwalitatiewe studie met 'n verkennende en beskrywende navorsingsontwerp is gebruik. Doelgerigte steekproefneming is benut om twee steekproefgroepe te werf, naamlik 20 vroue wat dienste ontvang het vir verslawing en 12 maatskaplike diensverskaffers wat dienste lewer in die middelafhanklikheidsveld. Daar is gebruik gemaak van semi-gestruktureerde vraelyste om data in te samel. Aangesig-tot-aangesig onderhoude is met die deelnemers gevoer nadat etiese klaring verkry is vir hierdie mediumrisiko-studie. Alle deelnemers het ook ingeligte toestemmingsvorms onderteken voor die onderhoude. Na afhandeling van die onderhoude is dit woordeliks getranskribeer en is daar van tematiese analise gebruik gemaak om die data te analiseer en te orden in relevante temas, subtemas en kategorieë. Die data wat uit die onderhoude verkry is, is geverifieer om die betroubaarheid van die studie te verseker ten einde geloofwaardigheid, oordraagbaarheid, konformiteit en betroubaarheid te verseker. Ses temas is geïdentifiseer in die studie naamlik biologiese hindernisse (swangerskap en gesondheid); sielkundige hindernisse (geestesgesondheid en trauma); sosiale hindernisse (interpersoonlike verhoudings en stereotipes); kulturele hindernisse (gemeenskapshindernisse en interseksionaliteit); strukturele hindernisse (logistiese hindernisse en houdingshindernisse deur personeel); en sistemiese hindernisse (programontwikkeling). Die bevinding wat afgelei is van die temas, subtemas en kategorieë dui aan hoe verskeie verbanhoudende struikelblokke vroue se regte op billike, effektiewe en geslagsresponsiewe verslawingbehandelingsdienste in gevaar stel, en in sommige gevalle skend. Hierdie studie het tot die gevolgtrekking gekom dat verslawingsbehandelingsdienste in die Wes-Kaap grootliks onresponsief en onvanpas bly vir die werklike realiteite van vroue met verslawingsversteurings. Verslawingsorg in die Wes-Kaap moet 'n proses van herkonseptualisering ondergaan om grondwetlike en internasionale menseregteverpligtinge te handhaaf, te beskerm en te implementeer. Dit vereis dat verslawingsbehandelingsprogramme en daaropvolgende dienste gewortel is in geslagsresponsiewe en trauma-ingeligte benaderings, met beginsels van waardigheid en bemagtiging wat nie net bevorder word nie, maar in elke stadium van behandeling geïmplementeer word. Sonder hierdie hervorming sal vroue steeds hul fundamentele reg op toepaslike dienste ontsê word. Die aanbevelings doen 'n beroep op die versterking van maatskaplikewerkpraktyk en -opleiding in verslawing, dit vereis die insluiting van vrouestemme in programontwikkeling, asook die implementering van beleidshervorming wat verseker dat verslawingsorg oor die kontinuum heen erken, gerespekteer en uitgevoer word, nie as 'n voorreg vir net sekere persone nie, maar as 'n fundamentele mensereg vir almal. Doctoral 2026-04-22T07:23:02Z 2026-04-22T07:23:02Z 2026-03 Thesis https://scholar.sun.ac.za/handle/10019.1/136082 en_ZA Stellenbosch University 331 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Drug abuse -- Treatment -- South Africa -- Western Cape Women drug addicts -- Rehabilitation -- South Africa -- Western Cape Health services accessibility -- South Africa -- Western Cape Jacobs, Danyschka Ania Werner An exploration of barriers that women experience when seeking addiction treatment services in the Western Cape |
| title | An exploration of barriers that women experience when seeking addiction treatment services in the Western Cape |
| title_full | An exploration of barriers that women experience when seeking addiction treatment services in the Western Cape |
| title_fullStr | An exploration of barriers that women experience when seeking addiction treatment services in the Western Cape |
| title_full_unstemmed | An exploration of barriers that women experience when seeking addiction treatment services in the Western Cape |
| title_short | An exploration of barriers that women experience when seeking addiction treatment services in the Western Cape |
| title_sort | exploration of barriers that women experience when seeking addiction treatment services in the western cape |
| topic | Drug abuse -- Treatment -- South Africa -- Western Cape Women drug addicts -- Rehabilitation -- South Africa -- Western Cape Health services accessibility -- South Africa -- Western Cape |
| url | https://scholar.sun.ac.za/handle/10019.1/136082 |
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