Browsing Faculty of Community & Health Sciences by Title
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Pillay, Tanushree; Frantz, Jose M. (Faculty of Community and Health Sciences, University of the Western Cape, 2009)[more][less]
Abstract: Introduction: The increase in physical inactivity is thought to be one of the main risk factors for the development of diseases of lifestyle. This has highlighted the need for prevention and intervention programmes that are thought to assist in influencing the modifiable risk factors. Physical activity programmes have been proven to positively influence risk factors such us blood pressure and body mass index (BMI). Interventions by health professionals can assist in combating the problem. This study aimed to determine the effects of a short term physical activity programme on the BMI, body fat and blood pressure of high school learners in a local community in the Western Cape. Methods: The total number of learners who volunteered to participate in the study was 106. The study used a pre-test post-test design. The intervention programme was a 6 week programme run for 3 days per week for a period of 40 – 60 minutes per session. The intervention consisted of moderate to vigorous activities. Data was analysed by comparing learners who participated in the intervention and those who did not. Descriptive and inferential statistics were used in this study. Results: Prior to the intervention it was found that 18% were found to be obese and at least 10% were hypertensive. Following the intervention it was reported that blood pressure as well as BMI and percentage body fat was influenced in positive way. Conclusion: One can conclude that, a short term physical activity intervention programme conducted three times a week with moderate activities can affect the BMI and blood pressure levels of adolescents. URI: http://hdl.handle.net/10566/119 Files in this item: 1
PillayEffects2009.pdf (71.62Kb) -
Igbinosa, Isoken H.; Igumbor, Ehimario U.; Aghdasi, Farhad; Tom, Mvuyo; Okoh, Anthony I (Hindawi Publishers Corporation, 2012)[more][less]
Abstract: Aeromonas species are ubiquitous bacteria in terrestrial and aquatic milieus. They are becoming renowned as enteric pathogens of serious public health concern as they acquire a number of virulence determinants that are linked with human diseases, such as gastroenteritis, soft-tissue, muscle infections, septicemia, and skin diseases. Proper sanitary procedures are essential in the prevention of the spread of Aeromonas infections. Oral fluid electrolyte substitution is employed in the prevention of dehydration, and broad-spectrum antibiotics are used in severe Aeromonas outbreaks. This review presents an overview of emerging Aeromonas infections and proposes the need for actions necessary for establishing adequate prevention measures against the infections. URI: http://hdl.handle.net/10566/434 Files in this item: 1
IgbinosaAeromonas2012.pdf (571.7Kb) -
Joubert, Jane; Puoane, Thandi (South African Medical Association, 2007)[more][less]
Abstract: OBJECTIVE: To estimate the burden of disease attributable to excess body weight using the body mass index (BMI), by age and sex, in South Africa in 2000. DESIGN: World Health Organization comparative risk assessment (CRA) methodology was followed. Re-analysis of the 1998 South Africa Demographic and Health Survey data provided mean BMI estimates by age and sex. Population attributable fractions were calculated and applied to revised burden of disease estimates. Monte Carlo simulation-modelling techniques were used for the uncertainty analysis. SETTING: South Africa. SUBJECTS. Adults ≥ 30 years of age. OUTCOME MEASURES. Deaths and disability-adjusted life years (DALYs) from ischaemic heart disease, ischaemic stroke, hypertensive disease, osteoarthritis, type 2 diabetes mellitus, and selected cancers. RESULTS: Overall, 87% of type 2 diabetes, 68% of hypertensive disease, 61% of endometrial cancer, 45% of ischaemic stroke, 38% of ischaemic heart disease, 31% of kidney cancer, 24% of osteoarthritis, 17% of colon cancer, and 13% of postmenopausal breast cancer were attributable to a BMI ≥ 21 kg/m2. Excess body weight is estimated to have caused 36 504 deaths (95% uncertainty interval 31 018 - 38 637) or 7% (95% uncertainty interval 6.0 - 7.4%) of all deaths in 2000, and 462 338 DALYs (95% uncertainty interval 396 512 - 478 847) or 2.9% of all DALYs (95% uncertainty interval 2.4 - 3.0%). The burden in females was approximately double that in males. CONCLUSIONS: This study shows the importance of recognising excess body weight as a major risk to health, particularly among females, highlighting the need to develop, implement and evaluate comprehensive interventions to achieve lasting change in the determinants and impact of excess body weight. URI: http://hdl.handle.net/10566/284 Files in this item: 1
PuoaneEstimating2007.pdf (412.1Kb) -
Bozalek, Vivienne (Department of Social Work, University of Johannesburg, 2007)[more][less]
Abstract: This article describes the design and implementation of a module on Advanced Social Work Ethics using a blended learning approach and relying substantially on e-learning as a pedagogical tool. The design is contextualised by elaborating on the parameters in which the module was developed – viz. the minimum standards of the Bachelor of Social Work pertaining to ethics, as well as the e-learning and assessment policies at UWC. The module design and implementation was informed by constructivist pedagogical principles, and made use of the notion of ‘critical friends’ as a means of providing opportunities for students to interact as peers and provide input on each others’ learning, thus decentralising the traditional role of the university lecturer. Examples of assessment tasks devised for the module to illustrate the pedagogical principles are also provided. Students’ responses to their experiences of undertaking the module are drawn from their final journal entries and provide an indication of how the module was operationalised. URI: http://hdl.handle.net/10566/49 Files in this item: 1
Bozalek_Ethics(2007)[1].pdf (205.9Kb) -
Taliep, Naiema; Florence, Maria (Psychological Society of South Africa, 2012)[more][less]
Abstract: The absence of a suitable measure to assess the health-related quality of life (HRQoL) of children and adolescents in South Africa, led to the use of the KIDSCREEN-52 questionnaire which was developed and standardised in Europe. The current study is part of a broader study conducted in the Western Cape, which used the KIDSCREEN-52 to explore the influence of exposure to community violence on the subjective HRQoL of a sample of South African adolescents. This study aimed to investigate the reliability and construct validity of the KIDSCREEN-52 in a South African context. The broader study employed stratified interval criterion sampling to select 565 Grade 9 learners, aged 14-18. Participants were selected from six public schools in areas specified by the South African government as comprising key nodal areas in terms of crime in the Western Cape. The dataset for the current study comprised all participants (N=565) of the primary study. As the initial step in validation of the KIDSCREEN-52 in South Africa, the current study examined its factor structure by means of exploratory factor analysis, using principal component analysis with oblimin rotations. It also assessed the internal consistency reliability of each of the scales, using Cronbach’s alpha. Exploratory factor analysis extracted 10 factors as identified by previous studies, with some deviation in the loadings of the last three factors. Items of two scales (“Feelings” and “About Yourself”) divided into three scales, and “Bullying” items were not sufficiently presented in the factor solution. Internal consistency of the measure was shown to be acceptable to good, with Cronbach’s alpha values ranging from 0.76 to 0.81 for the 10 scales. URI: http://hdl.handle.net/10566/402 Files in this item: 1
TaliepQualityofLife2012.pdf (262.4Kb) -
Goga, Ameena; Dinh, Thu-Ha; Jackson, Debra (South African Medical Research Council, National Department of Health South Africa and PEPFAR/US Centers for Disease Control & Prevention, 2012)[more][less]
Abstract: Aims and Objectives: The overall aim of this evaluation was to conduct a national facility-based survey to monitor the effectiveness of the South African National PMTCT programme. The primary objective was to measure rates of early MTCT of HIV at six weeks postpartum. The secondary objective was to periodically estimate coverage of key PMTCT interventions and services (e.g., HIV testing, CD4 cell count testing, infant antiretroviral (ARV) prophylaxis, infant feeding counselling). URI: http://hdl.handle.net/10566/462 Files in this item: 1
GogaPMTCT2012.pdf (5.124Mb) -
Tylleskar, Thorkild; Jackson, Debra; Meda, Nicolas; Ingrebetsen, Ingunn Marie S; Chopra, Mickey; Diallo, Abdoulaye Hama; Doherty, Tanya; Ekström, Eva-Charlotte; Fadnes, Lars T; Goga, Ameena; Kankasa, Chipepo; Klungsøyr, Jørn I; Lombard, Carl; Nankabirwa, Victoria; Nankunda, Jolly K; Van de Perre, Philippe; Sanders, David; Shanmugam, Rebecca; Sommerfelt, Halvor; Wamani, Henry; Tumwine, James K; PROMISE-EBF Study Group (Elsevier, 2011)[more][less]
Abstract: Background: Exclusive breastfeeding (EBF) is reported to be a life-saving intervention in low-income settings. The effect of breastfeeding counselling by peer counsellors was assessed in Africa. Methods:24 communities in Burkina Faso, 24 in Uganda, and 34 in South Africa were assigned in a 1:1 ratio, by use of a computer-generated randomisation sequence, to the control or intervention clusters. In the intervention group, we scheduled one antenatal breastfeeding peer counselling visit and four post-delivery visits by trained peers. The data gathering team were masked to the intervention allocation. The primary outcomes were prevalance of EBF and diarrhoea reported by mothers for infants aged 12 weeks and 24 weeks. Country-specific prevalence ratios were adjusted for cluster effects and sites. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00397150. Findings 2579 mother–infant pairs were assigned to the intervention or control clusters in Burkina Faso (n=392 and n=402, respectively), Uganda (n=396 and n=369, respectively), and South Africa (n=535 and 485, respectively). The EBF prevalences based on 24-h recall at 12 weeks in the intervention and control clusters were 310 (79%) of 392 and 139 (35%) of 402, respectively, in Burkina Faso (prevalence ratio 2·29, 95% CI 1·33–3·92); 323 (82%) of 396 and 161 (44%) of 369, respectively, in Uganda (1·89, 1·70–2·11); and 56 (10%) of 535 and 30 (6%) of 485, respectively, in South Africa (1·72, 1·12–2·63). The EBF prevalences based on 7-day recall in the intervention and control clusters were 300 (77%) and 94 (23%), respectively, in Burkina Faso (3·27, 2·13–5·03); 305 (77%) and 125 (34%), respectively, in Uganda (2·30, 2·00–2·65); and 41 (8%) and 19 (4%), respectively, in South Africa (1·98, 1·30–3·02). At 24 weeks, the prevalences based on 24-h recall were 286 (73%) in the intervention cluster and 88 (22%) in the control cluster in Burkina Faso (3·33, 1·74–6·38); 232 (59%) and 57 (15%), respectively, in Uganda (3·83, 2·97–4·95); and 12 (2%) and two (<1%), respectively, in South Africa (5·70, 1·33–24·26). The prevalences based on 7-day recall were 279 (71%) in the intervention cluster and 38 (9%) in the control cluster in Burkina Faso (7·53, 4·42–12·82); 203 (51%) and 41 (11%), respectively, in Uganda (4·66, 3·35–6·49); and ten (2%) and one (<1%), respectively, in South Africa (9·83, 1·40–69·14). Diarrhoea prevalence at age 12 weeks in the intervention and control clusters was 20 (5%) and 36 (9%), respectively, in Burkina Faso (0·57, 0·27–1·22); 39 (10%) and 32 (9%), respectively, in Uganda (1·13, 0·81–1·59); and 45 (8%) and 33 (7%), respectively, in South Africa (1·16, 0·78–1·75). The prevalence at age 24 weeks in the intervention and control clusters was 26 (7%) and 32 (8%), respectively, in Burkina Faso (0·83, 0·45–1·54); 52 (13%) and 59 (16%), respectively, in Uganda (0·82, 0·58–1·15); and 54 (10%) and 33 (7%), respectively, in South Africa (1·31, 0·89–1·93). Interpretation: Low-intensity individual breastfeeding peer counselling is achievable and, although it does not affect the diarrhoea prevalence, can be used to effectively increase EBF prevalence in many sub-Saharan African settings. URI: http://hdl.handle.net/10566/516 Files in this item: 2
TylleskarExclusiveBreastfeeding2011.pdf (1.030Mb) -
September, Rose (University of Johannesburg, 2007)[more][less]
Abstract: The author reflects on the findings of a study commissioned by the Human Science Research Council (HSRC). A qualitative research methodology was used to explore the perceptions of service providers in the early childhood development (ECD) sector on job creation through government’s Expanded Public Works Programme (EPWP). The EPWP is aimed at drawing significant numbers of unemployed people into productive work by increasing their capacity to earn a sustainable income through training. In response, the national departments of Social Development, Health, and Education developed a Social Sector Plan (SSP) for EPWP in which the ECD sector was identified as one of the key areas for expansion. From a developmental social work perspective, both Early Childhood Development and productive employment are important strategies to alleviate persistent poverty. This article is intended to create dialogue, further research and action towards realizing the potential of the ECD sector to create more sustainable jobs in order to improve the quality of people’s lives. URI: http://hdl.handle.net/10566/210 Files in this item: 1
SeptemberExpandedWorks2007.pdf (220.1Kb) -
Stern, Ruth; Puoane, Thandi; Tsolekile, Lungiswa (Centers for Disease Control and Prevention, 2010)[more][less]
Abstract: Introduction Noncommunicable diseases are increasing in developing countries, exacerbated by growing urbanization. We examined the experiences and perceptions about noncommunicable diseases of people who migrated from rural areas to urban Cape Town, South Africa. Methods We conducted a qualitative study in an impoverished periurban township that has a noncommunicable disease prevention program, including health clubs. We used in-depth interviews, participatory reflection and action groups, and focus group discussions. Results Participants described changes in eating patterns and levels of physical activity. These changes were a result of socioeconomic and environmental constraints. However, respondents were not concerned about these changes. Despite hardships, they were pleased with their urban lifestyle. Furthermore, they approved of their weight gain because it signified dignity and respect. Participants who attended health clubs found them informative and socially and emotionally supportive. Conclusion The study highlighted the complexity of the risk factors for noncommunicable diseases and the need to develop prevention strategies that extend beyond the traditional focus on diet and exercise. URI: http://hdl.handle.net/10566/292 Files in this item: 1
PuoaneExplorationNCD2010.pdf (381.1Kb) -
Nankwanga, Annet; Phillips, Julie; Neema, Stella (Faculty of Community and Health Sciences, University of the Western Cape, 2009)[more][less]
Abstract: Introduction: This paper presents HIV/AIDS experiences of elderly persons in Uganda as revealed by an ongoing descriptive cross-sectional study covering eight districts, namely: Pallisa, Kampala, Jinja, Lira, Nebbi, Ntungamo, Luwero and Mbarara. These districts represent both the rural and urban areas of the four regions of Uganda, including: Western, Northern, Eastern and Central region. Methods: The study employed a mixed method approach using a sequential exploratory strategy. Data was collected using not only focus group discussions and in-depth interviews held with 165 elderly persons but also a validated interview schedule administered to 50 key informants. Elderly persons participated in the study by providing data on their HIV/AIDS-related experiences. Key respondents were selected to provide data on strategies that could be adopted to curb the effects of the epidemic. This paper is based on one of the study's objectives, which focussed on exploring the effects of HIV/AIDS on Uganda's elderly people; coping mechanisms used to deal with HIV/AIDS; and strategies for curbing its effects. Data was analysed using content analysis and the descriptive method of SPSS. Results: Results show that HIV/AIDS affected most of the elderly people in Uganda by killing their children and spouses, and leaving them with a big burden of taking care of AIDS orphans; yet majority of these people were financially too incapacitated to shoulder it amply. HIV/AIDS also infected the elderly people. The epidemic introduced the need for ARVs and other health services that elderly people found too difficult to access due to poor health service delivery systems in Uganda. Most elderly people used food cultivation as a mechanism for coping with the burden of orphans. These results lead to recommending that government should economically empower elderly people through formulation and effective implementation of welfare policies regarding pension and special fund for these people. Conclusion: There is a need for the government to provide adequate and free HIV/AIDS-related health services and also increase educational support for HIV/AIDS orphans. URI: http://hdl.handle.net/10566/121 Files in this item: 1
AnnetHIV2009.pdf (178.8Kb) -
Moshabela, Mosa; Schneider, Helen; Silal, Sheetal; Cleary, Susan (BioMed Central, 2012)[more][less]
Abstract: Background: In low-resource settings, patients’ use of multiple healthcare sources may complicate chronic care and clinical outcomes as antiretroviral therapy (ART) continues to expand. However, little is known regarding patterns, drivers and consequences of using multiple healthcare sources. We therefore investigated factors associated with patterns of plural healthcare usage among patients taking ART in diverse South African settings. Methods: A cross-sectional study of patients taking ART was conducted in two rural and two urban sub-districts, involving 13 accredited facilities and 1266 participants selected through systematic random sampling. Structured questionnaires were used in interviews, and participant’s clinic records were reviewed. Data collected included household assets, healthcare access dimensions (availability, affordability and acceptability), healthcare utilization and pluralism, and laboratory-based outcomes. Multiple logistic regression models were fitted to identify predictors of healthcare pluralism and associations with treatment outcomes. Prior ethical approval and informed consent were obtained. Results: Nineteen percent of respondents reported use of additional healthcare providers over and above their regular ART visits in the prior month. A further 15% of respondents reported additional expenditure on self-care (e.g. special foods). Access to health insurance (Adjusted odds ratio [aOR] 6.15) and disability grants (aOR 1.35) increased plural healthcare use. However, plural healthcare users were more likely to borrow money to finance healthcare (aOR 2.68), and incur catastrophic levels of healthcare expenditure (27%) than non-plural users (7%). Quality of care factors, such as perceived disrespect by staff (aOR 2.07) and lack of privacy (aOR 1.50) increased plural healthcare utilization. Plural healthcare utilization was associated with rural residence (aOR 1.97). Healthcare pluralism was not associated with missed visits or biological outcomes. Conclusion: Increased plural healthcare utilization, inequitably distributed between rural and urban areas, is largely a function of higher socioeconomic status, better ability to finance healthcare and factors related to poor quality of care in ART clinics. Plural healthcare utilization may be an indication of patients’ dissatisfaction with perceived quality of ART care provided. Healthcare expenditure of a catastrophic nature remained a persistent complication. Plural healthcare utilization did not appear to influence clinical outcomes. However, there were potential negative impacts on the livelihoods of patients and their households. URI: http://hdl.handle.net/10566/547 Files in this item: 1
MoshabelaAntiretroviralTherapy2012.pdf (419.5Kb) -
Kanyoni, Maurice; Phillips, Julie (Faculty of Community and Health Sciences, University of the Western Cape, 2009)[more][less]
Abstract: Background: The size of the elderly population both in numbers and proportions of the whole world is increasing rapidly. The increase in the number of elderly people in the world will exert a big impact on health and social services. It is established that physical activity is one way of limiting age related disabilities. Objectives: This study aims to asses the levels of physical activity and the factors associated with it among older adults in selected institutions for the elderly in the Southern Province of Rwanda. Method: A cross-sectional descriptive study was conducted at 2 institutions for older adults in Rwanda. An interview questionnaire with close-ended questions was used to collect data. Results: More than one-third of the study sample was categorized as sedentary. Physical activity levels decrease with age. Females reported higher prevalence of physical activity than males. Conclusion: Older adults should be encouraged to engage in physical activity to gain the physical and mental health benefits associated with it. URI: http://hdl.handle.net/10566/114 Files in this item: 1
KanyoniPhysicalActivity2009.pdf (62.78Kb) -
Mabunda, Jabu; Bradley, Hazel A. (LAM Publications Ltd, 2011)[more][less]
Abstract: The purpose of the study was to assess factors contributing to poor performance of Directly Observed Treatment Short-Course (DOTS) in Mopani district of Limpopo Province, South Africa. An exploratory qualitative approach was used to investigate the factors that contribute to poor performance of the DOTS Strategy. Four focus group discussions were conducted, two with Directly Observed Therapy (DOT) Supporters and two with patients on treatment for more than 6 months. The focus groups (4) discussions were tape-recorded. Data collected were descriptively analyzed using thematic methods. The patients generally found supervision of TB treatment helpful as they were motivated and encouraged to continue treatment. Some of the aspects identified as being unhelpful were the inconvenient times for treatment support and stigma due TB supporters’ visit to patients home. Patients often preferred family members as supporters, whereas health workers favoured trained volunteers as DOT supporters. Other factors affecting DOTS were poverty, food shortage, cultural beliefs, and side-effects of the medication. Patients receiving disability grants prefer to remain uncured so as to continue receiving the grant. Behavioural factors seem to play a major role in noncompliance with TB treatment. The findings of the study support the importance of initial counseling and motivation of patients in improving adherence in the programme. Self-motivation was mentioned rather than the motivation from the DOT supporters. Further exploration of alternative DOTS supporters other than trained volunteer demands further investigation. URI: http://hdl.handle.net/10566/315 Files in this item: 1
MabundaTBDOTS2011.pdf (108.3Kb) -
Figaji, Tamara; Phillips, Julie (Faculty of Community and Health Sciences, University of the Western Cape, 2010)[more][less]
Abstract: BACKGROUND: Although the health benefits of physical activity have been proven, many children and adolescents still do not meet the recommended guidelines for sufficient physical activity. The purpose of this investigation was thus to examine the levels of PA, and learners perception of support from teachers, family and friends at an independent school in the Western Cape. Furthermore, the investigation aimed to examine the influence of social support on physical activity. METHOD: A cross-sectional design using quantitative methods was used in this study, which included 100 learners in the senior phase of the school (i.e. grades 5 to 7). The data was obtained with a self-admininstered questionnaire. The data was analyzed with the Statistical Package for Social Sciences (SPSS) version 16.0. The Chi-square test was used to explore associations between nominal and numerical data. The T-test was used to determine statistical significance between groups (independent t-tests) and within groups (paired sample t-test). RESULTS: Overall the sample responded positively when asked about support for physical activity from teachers. Furthermore, the study sample had a positive perception of both physical education (PE) and physical activity (PA) enjoyment. Boys participated in vigorous physical activity significantly more regularly than girls. CONCLUSION: As children are spending a considerable time at school, teachers, friends and parents should be encouraged to be supportive of their participation in physical activity. URI: http://hdl.handle.net/10566/181 Files in this item: 1
FigajiPhillips2010.pdf (58.32Kb) -
Hughes, Gail; Hoyo, Catherine; Puoane, Thandi (South African Medical Association, 2006)[more][less]
Abstract: BACKGROUND: In South Africa, former apartheid laws encouraged rural males seeking employment to migrate to urban areas, moving weekly, monthly or annually between their rural families and urban workplaces. The combination of the migrant labour system and long family separations caused an explosion of serious health consequences, among others sexually transmitted infections (STIs) in the migrant population. OBJECTIVE: To describe some correlates of male migration patterns for the rural women left behind, especially the fear of STIs that this engendered in them and their risk-avoidance behaviour. Setting and subjects. In KwaZulu-Natal, 208 prenatal patients who were partners of oscillating male migrant workers were interviewed to determine their demographic and behavioural characteristics, and their fear of STIs. RESULTS: Thirty-six per cent of the rural women said that they were afraid of contracting STIs from their returning migrant partners. Women who saw their partners infrequently were more fearful of STI transmission, and were less able to have sexual communication. However, almost none of the women protected themselves, while only 8% used condoms, primarily for contraceptive purposes. CONCLUSIONS: These results reflect the gender-based power relationships of South African male migrants and their rural partners, the social and economic dependency of the women on their migrant partners, and the women’s social responsibility to bear children. The results point to the need to go beyond interventions that simply seek to modify behaviour without altering the forces that promote risk taking and discourage risk reduction, and the need to develop appropriate interventions to curb STIs and decrease HIV. URI: http://hdl.handle.net/10566/260 Files in this item: 1
PuoaneSTIs2006.pdf (563.5Kb) -
Dewing, Sarah; Matthews, Catherine; Schaay, Nikki; Cloete, Allanise; Simbayi, Leickness; Chopra, Mickey (Springer, 2011)[more][less]
Abstract: This case study with one lay adherence counsellor assessed the implementation of Options for Health, a sexual risk-reduction intervention based on Motivational Interviewing (MI), in an antiretroviral clinic in Cape Town, South Africa. In most cases Options was not delivered with fidelity and less than one-third of intended recipients received it; the counsellor often forgot to do Options, was unsure how to deal with particular cases and felt that there was not always time to do Options. Options was not implemented in a way that was consistent with MI. Revisions to the implementation plan and training programme are required. URI: http://hdl.handle.net/10566/473 Files in this item: 1
DewingAntiretroviralClinic2011.pdf (162.5Kb) -
Schneider, Helen; Govender, Veloshnee; Harris, Bronwyn; Cleary, Susan; Moshabela, Mosa; Birch, Stephen (Blackwell Publishing Ltd, 2012)[more][less]
Abstract: Objectives: A mixed methods study exploring gender differences in patient profiles and experiences of ART services, along the access dimensions of availability, affordability and acceptability, in two rural and two urban areas of South Africa. methods Structured exit interviews (n = 1266) combined with in-depth interviews (n = 20) of women and men enrolled in ART care. results Men attending ART services were more likely to be employed (29% vs. 20%, P = 0.001) and were twice as likely to be married ⁄ co-habiting as women (42% vs. 22% P = 0.001). Men had known their HIV status for a shorter time (mean 32 vs. 36 months, P = 0.021) and were also less likely to disclose their status to non-family members (17% vs. 26%, P = 0.001). From both forms of data collection, a key finding was the role of female partners in providing social support and facilitating use of services by men. The converse was true for women who relied more on extended families and friends than on partners for support. Young, unmarried and unemployed men faced the greatest social isolation and difficulty. There were no major gender differences in the health system (supply side) dimensions of access. conclusions Gender differences in experiences of HIV services relate more to social than health system factors. However, the health system could be more responsive by designing services in ways that enable earlier and easier use by men. URI: http://hdl.handle.net/10566/474 Files in this item: 1
SchneiderART-Services2012.pdf (66.55Kb) -
Zarowsky, Christina (BioMed Central, 2011)[more][less]
Abstract: The papers in this important collection reflect a mature and confident way of doing global health research which is anything but business-as-usual. In the context of increasing competition for individual or institutional “leadership” of the field (and business) of gobal health, these contributors instead speak of active and sustained collaboration -- listening, responsiveness, flexibility, willingness and capacity to follow as well as to lead -- in learning what to transform or sustain, and how, in order to move towards greater equity in both health and health research. Each paper and the collection as a whole is an important contribution to the evidence base for a range of issues from maternal health, HIV and access to services, to chronic disease, health system strengthening, occupational health, ecosystemic approaches to health, and social inclusion, exclusion, and neglect. In addition, they challenge conventional models of research focused on narrowly defined research questions and a narrow range of pre-specified research methods, documenting instead how both the research questions and the methods most appropriate to address them change over time. Finally, they challenge both the idea of “pure” science undertaken by independent researchers on behalf of science and specific communities, and the conventional wisdom that North-South and research-research user-community partnerships are necessarily either North and researcher-driven, or scientifically dubious. URI: http://hdl.handle.net/10566/460 Files in this item: 1
ZarowskyGlobalHealthPartnership2011.pdf (155.1Kb) -
London, Leslie; Schneider, Helen (Elsevier Ltd, 2012)[more][less]
Abstract: While neoliberal globalisation is associated with increasing inequalities, global integration has simultaneously strengthened the dissemination of human rights discourse across the world. This paper explores the seeming contradiction that globalisation is conceived as disempowering nations states' ability to act in their population's interests, yet implementation of human rights obligations requires effective states to deliver socio-economic entitlements, such as health. Central to the actions required of the state to build a health system based on a human rights approach is the notion of accountability. Two case studies are used to explore the constraints on states meeting their human rights obligations regarding health, the first drawing on data from interviews with parliamentarians responsible for health in East and Southern Africa, and the second reflecting on the response to the HIV/AIDS epidemic in South Africa. The case studies illustrate the importance of a human rights paradigm in strengthening parliamentary oversight over the executive in ways that prioritise pro-poor protections and in increasing leverage for resources for the health sector within parliamentary processes. Further, a rights framework creates the space for civil society action to engage with the legislature to hold public officials accountable and confirms the importance of rights as enabling civil society mobilization, reinforcing community agency to advance health rights for poor communities. In this context, critical assessment of state incapacity to meet claims to health rights raises questions as to the diffusion of accountability rife under modern international aid systems. Such diffusion of accountability opens the door to 'cunning' states to deflect rights claims of their populations. We argue that human rights, as both a normative framework for legal challenges and as a means to create room for active civil society engagement provide a means to contest both the real and the purported constraints imposed by globalisation. URI: http://hdl.handle.net/10566/475 Files in this item: 1
LondonGlobalInequalities2012.pdf (178.5Kb) -
Njoki, Emma; Frantz, Jose M.; Mpofu, Ratie (Informa Healthcare, 2007)[more][less]
Abstract: Purpose. To determine the health promotion needs through an exploration of health-related behaviours and the factors that influence the behaviour of physically disabled youth with spinal cord injury. Methods. A descriptive and exploratory study that utilized a qualitative approach was carried out among ten participants aged between 15 and 29 years who were purposely selected. Information was obtained from individual face-to-face interviews and a focus-group discussion. Results. The participants were involved in risky health behaviours including sedentary lifestyles, use of alcohol, tobacco, and drugs. Various factors that influenced their participation in these behaviours were identified including personal struggles with identity and adjustment issues. Conclusions. The results emphasize that participants were involved in health-risk behaviours, which are associated with development of secondary conditions such as respiratory problems, heart diseases, and stroke. Health-promotion strategies employed for these individuals should address the psychological impact of spinal cord injury (SCI) on the individual as an influence to participation in health risk behaviours. URI: http://hdl.handle.net/10566/399 Files in this item: 1
FrantzHealthPromotion2007.pdf (246.3Kb)