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Knowledge, attitude and perception of uninitiated adolescents towards customary male initiation practices in selected schools in Buffalo City Municipality, Eastern Cape

  • Authors: Igaba, Nelson Kibiribiri
  • Date: 2022-07
  • Subjects: Circumcision , HIV infections -- Prevention , Initiation rites
  • Language: English
  • Type: Master's theses , text
  • Identifier: http://hdl.handle.net/10353/26896 , vital:66061
  • Description: Background: Based on evidence that Voluntary Medical Male Circumcision (VMMC) significantly reduces the risk of human immunodeficiency virus- HIV transmission by 60percent, the World Health Organization (WHO) recommends implementing VMMC programs in countries with a high HIV prevalence, considering the unique sociocultural and economic dynamics of each setting. However, in South Africa (SA), multiple tribes including the AmaXhosa in the Eastern Cape (EC) province practice Customary Male Initiation (CMI) also known as Ulwaluko as a rite of passage of males from boyhood to manhood, and this involves circumcision. In recent years, this practice has been riddled with deaths of initiates, admissions to hospital, amputation of penis, assaults, drug and alcohol, and crime. Hence, this study aimed at understanding the knowledge, attitude, and perceptions of uninitiated adolescents towards the CMI practice in Buffalo City Municipality (BCM), EC to aid in developing strategies to solve current challenges. Methods: Between June and December 2021, this cross-sectional descriptive study was conducted in selected schools within BCM, in the EC, using a quantitative research approach. The study population included adolescent males aged 15 to 19 years who had not attended CMI. Applying a multistage random sampling technique, three (3)BCM towns (Bhisho, King William Town-KWT and East London-EL) and the Mdantsane township (MT) were selected and further the schools from which consenting pupils were enrolled into the study. Data was collected using a validated self-administered questionnaire which was captured on excel and analysed using STATA version 16.1. Categorical variables were summarized using percentages. Bivariate and multivariate regression was used to determine factors associated with a level of knowledge, attitude, and perception towards CMI and VMMC. The odds ratio with a 95percent confidence interval was calculated. A p–value of <0.05 was considered statistically significant. Results: Among 297 participants that responded 251 (84.51percent) were between the ages of 15-19 years and had not undergone circumcision or CMI. These were included in this analysis. Majority of participants 181 (72.11percent, 95percent CI 66.21-77.33) lacked knowledge on whether circumcision reduces risk of HIV acquisition. More than three quarters of participants 195 (77.69percent, 95percent CI 72.09-83.87) showed absence of knowledge on whether circumcision reduces risk of STIs. Close to all participants 244 (97.21percent, 95percent CI 94.25-98.67) indicated that they would choose CMI over VMMC due to cultural reason. More than three quarters of participants 193 (76.89percent, 95percent CI 71.24-81.72) agreed that CMI/Ulwaluko proves manhood. The presence of knowledge on the benefits of VMMC was positively dependent on the location where a participants lived (uOR 2.32, 95percent CI 1.09-4.97, p-value 0.029) and access to internet more than once a week (uOR 3.44, 95percent CI 1.14-10.43, p-value 0.029. The choice for CMI over VMMC was positively associated with participants living in Mdantsane Township than those living in urban areas (Coef. 1.55, 95percent CI 0.77-2.33, p-value 0.001). Conclusion: This study found lack of knowledge on benefits of VMMC, laws governing and on risks associated with CMI/Ulwaluko practices among uninitiated adolescents. The study further found that CMI/Ulwaluko was still highly regarded despite current challenges and most adolescents would choose CMI/Ulwaluko over VMMC. There is urgent need to integrate VMMC services into CMI/Ulwaluko to include health education on benefits of VMMC, infection prevention and control, male circumcision by trained medical personnel and education on laws governing CMI/Ulwaluko. These interventions should also target uninitiated adolescents. , Thesis (MPA) -- Faculty of Health Sciences, 2022
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  • Date Issued: 2022-07

Exploration of the factors influencing the upscaling of medical male circumcision targets in selected hospitals in eThekwini District, South Africa

  • Authors: Tshabalala, Sandile Clement
  • Date: 2022-03
  • Subjects: Circumcision
  • Language: English
  • Type: Master's theses , text
  • Identifier: http://hdl.handle.net/10353/22005 , vital:51930
  • Description: Medical male circumcision has been shown to reduce female to male HIV transmission. This study was designed to examine the underlying factors responsible for, or influencing, the inability of the health care system to achieve the MMC targets in selected hospitals in KZN. The objective of this study to was explore the challenges that lead to failure of the government to meet set targets, regarding the implementation of the MMC programme in the province of KZN, as perceived by the health care workers. Methodology A mixed quantitative and qualitative study where 150 questionnaires were used and in-depth open-ended interviews were conducted. Participants were from Clairwood and Wentworth hospitals in the district of eThekwini, KwaZulu-Natal. Eighteen healthcare workers (nurse managers, doctors, nurses and counsellors) were purposively selected from the two hospitals. Results Findings showed that poor marketing of MMC, in line with the cultural and religious inclination of the catchment populations, had an effect on the targets. The fear of pain by the male clients came out as the biggest factor followed by the fear of having an HIV test done. The six weeks healing period before indulgence in sexual intercourse had a part to play in the reluctance of clients to do MMC. Some clients feared losing the ability to have an erection post MMC and would therefore not come for MMC. Other contributory factors for failure to reach targets included shortage of staff, poor mobilisation by the staff due to lack of training on how to mobilise and how to market MMC, lack of availability of mobilisation and marketing resources, inadequate and inequitable allocated of resources. Other factors include, lack of incentives for staff to stay in the programme or even within the Department, lack of training, cultural and religious beliefs in the community. The staff also felt that the MMC targets were too high. Notwithstanding, the staff members were willing to learn how to market MMC and to mobilise clients. Clients and community education on the importance of MMC and the combination of this process with good sexual behaviour would improve MMC uptake and reduce HIV prevalence and the incidence. Conclusions The fear of pain, fear to do HIV test and the fear to loose erection were the most prominent reasons why the males would not come for MMC procedure. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2022
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  • Date Issued: 2022-03

Comparison of behaviour between traditional male circumcision initiates of the yesteryears and those of the contemporary epoch in Cala and Mdantsane, Eastern Cape

  • Authors: Mpateni, Aphiwe https://orcid.org/0000-0002-6823-9179
  • Date: 2021-04
  • Subjects: Circumcision , Xhosa (African people) -- Rites and ceremonies
  • Language: English
  • Type: Doctoral theses , text
  • Identifier: http://hdl.handle.net/10353/22045 , vital:51968
  • Description: Unequivocally, the traditional male circumcision as rite of passage in South African communities has been embraced for its role in shaping the behaviour among the initiates. This rite was highly valuable during the yesteryears as the traditional male circumcision initiates portrayed compliance with the society’s moral codes and cultural goalposts. Inopportunely, on the other hand, during the contemporary epoch this rite of passage and the cultural underpinnings embedded in it appear to be eroding and shifting from the initial purpose of inculcating good behaviour and morals. This study seeks to compare the behaviour of the yesteryears’ traditional male circumcision initiates and those of the contemporary epoch in Cala, Sakhisizwe Local Municipality and Mdantsane, Buffalo City Municipality in Eastern Cape. This study aimed to achieve the following objectives: (i) to explore the policy differences informing TMC practices in yesteryears and in the contemporary epoch; (ii) to identify the similarities and differences between the behaviour of the contemporary initiates and those of yesteryears; and (iii) to establish the environmental factors motivating the change of the behaviour apparent among the contemporary initiates as well as those of the yesteryears. This study is underpinned by the socio- cultural perspective, anomie theory, and social learning theory. Methodologically, this study was qualitative in nature, where the data was collected through one-on-one in-depth interviews, focus group discussions, and Key informants interviews. An interview guide with open-ended questions was used to collect the data. A sample size of forty (40) participants was purposively selected for interviews. The data collection process was cross- sectional in design. Content analysis was employed to analyze the data and findings were presented thematically. The study established policy differences informing TMC during the yesteryears and the contemporary epoch, in that the yesteryears’ policy environment was culturally grounded; while the contemporary one’s is informed by the current national constitution and human rights perspectives. In relation to the policy issues, the study further established elements of illusionary interpretation of rights by the contemporary TMC initiates; poor implementation of policy guiding TMC practice. Further, the study revealed behavioural and morality differences between the yesteryears’ and the contemporary TMC initiates. For instance, the yesteryears’ TMC initiates were reported to be more responsible and well- mannered as compared to the contemporary ones. The shortfalls in expected behaviour and morality for the contemporary TMC initiates were attributed to modernization, and education in the contemporary initiation schools, which does not meet the societal expectations. On the environmental factors motivating the change of behaviour of the TMC initiates; Yesteryears’ TMC initiates complying with moral codes and cultural goalposts; Non-compliance to the moral codes and cultural goalposts by the contemporary TMC initiates; Culture of alcoholism during the contemporary epoch. Based on these findings, this study recommends that the government of South Africa should augment the existing TMC policies to ensure that traditional male circumcision as rite of passage achieves its socio-cultural objective of shaping behaviour and morals. The study further recommends training for traditional nurses “amakhankatha” and traditional surgeons “iingcibi”; and hosting cultural events for cultural resuscitation. The conclusions of this study state that the government must work hand in hand with cultural custodians to ensure that traditional male circumcision practice shapes good behaviour and morals of the initiates. This is because glaring gaps associated with the rite. , Thesis (PhD) -- Faculty of Social Sciences and Humanities, 2021
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  • Date Issued: 2021-04

Challenges experienced by xhosa single mothers during the traditional circumcision of their adolescent sons

  • Authors: Mdunyelwa, Akhona
  • Date: 2020-07
  • Subjects: Circumcision
  • Language: English
  • Type: Master's theses , text
  • Identifier: http://hdl.handle.net/10353/21004 , vital:46891
  • Description: Culturally, amongst Amaxhosa, traditional male circumcision is known to be a men subject and that women are supposed to be passive and submissive in the entire process (Kang’ethe & Nomngcoyiya, 2016). Women play a huge role in nurturing children, however, when it comes to traditional male circumcision of their sons, their role is limited to preparing food and traditional beer for the initiation ceremony. These women include single mothers, therefore, the interest of this study is on how Xhosa single mothers encounter challenges in the traditional circumcision of their sons, thus the main purpose of the study was to investigate the challenges experienced by Xhosa single mothers during traditional circumcision of their adolescent sons. The following three objectives were set out to guide the investigation A. To investigate challenges experienced by Xhosa single mothers during the traditional circumcision of their adolescent sons. B. To determine the extent to which Xhosa single mothers participate in the plans and decision making during the circumcision of their adolescent sons. C. To explore the support that Xhosa single mothers require during the process of their sons’ circumcision. A purposive sampling procedure was employed, and ten Xhosa single mothers were interviewed on a one-to-one basis. In addition, a focus group consisting of four men was conducted. The following are the main findings of the study: •Traditional male circumcision is the most respected custom amongst the AmaXhosa nation. Women are in fear of speaking publicly about the challenges they experience in traditional male circumcision processes. • There are various challenges experienced by Xhosa single mothers which include the need for involvement of men to usher their sons into the ritual. • The absence and lack of support from the biological fathers of the sons results in aconsiderable burden for the Xhosa single mothers that includes financial challenges. • The religious orientation or Christian faith of some of the Xhosa single mothers clashes with the request of their sons to participate in traditional male circumcision. • The individuals and societal drop in cultural standards and being stormed by the dominant Western culture as opposed to Ubuntu was identified as the greatest challenge in the Xhosa communities. • There is a clash of cultural norms and values with the current equality lifestyle as well as the enjoyment of constitutional rights by the Xhosa single mothers during traditional circumcision of their sons. There is a lack of support for Xhosa single mothers in relation to traditional circumcision of their adolescent sons from the families, community, and the government. Much of the support is directed to strategies to preserve the custom, improve the procedure and to curb the casualties. • The study proved that, traditional male circumcision is a stressful process for the Xhosa single mothers which inflict strain and anxiety. Some of the concepts from Bowen`s family systems theory were proven and discussed as part of the findings. , Thesis (MSoc) -- Faculty of Social Science and Humanities, 2020
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  • Date Issued: 2020-07

Psychosocial behaviour of male learners after traditional male circumcision in Mdantsane, Eastern Cape

  • Authors: Bokolo, Nokwanda
  • Date: 2019
  • Subjects: Circumcision
  • Language: English
  • Type: Thesis , Masters , MPH
  • Identifier: http://hdl.handle.net/10353/16709 , vital:40764
  • Description: Male circumcision is an old Xhosa tradition that is still widely practised throughout South Africa. The Xhosa community in Eastern Cape, South Africa, values traditional male circumcision and regard it as a heritage from the ancestors, which prepares the initiate for transition to manhood. There are health problems and physical complications related to circumcision, although parental decisions regarding circumcision and the medical hygiene have been widely researched. However, scanty information exists on the psychological and social behaviours of male learners after male circumcision. The present study aims to fill the gap by exploring the psychosocial behaviors of male learners after traditional male circumcision in Eastern Cape, South Africa
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  • Date Issued: 2019

An anthropological investigation into the challenges that affect Xhosa traditional circumcision: a case of Mngqesha Village, Buffalo City Metropolitan Municipality

  • Authors: Qegu, Mzukisi
  • Date: 2018-06
  • Subjects: Circumcision , Xhosa (African people)
  • Language: English
  • Type: Master's theses , text
  • Identifier: http://hdl.handle.net/10353/26683 , vital:65851
  • Description: The purpose of this study is to investigate the challenges that affect Xhosa traditional circumcision in Mngqesha village. Mngqesha village is situated in Dimbaza, Eastern Cape Province, Republic of South Africa. The study population employed random and purposive sampling to draw a representative sample of 25 research informants traditional leaders, traditional surgeons, traditional nurses, Initiates, elders of the community and Department of Health officials, each group was represented by five research informants from the population of this study. This study employed a mixed research approach. Questionnaires were distributed amongst research informants for quantitative purposes, and interviews were conducted for qualitative purposes, among the selected representative sample. Qualitative data was analyzed using thematic analysis and was used to substantiate quantitative findings. The findings of this study prolonged on how injuries, diseases and high death rates of initiates affect Xhosa Traditional Circumcision in Mngqesha village. The findings of this study divulge that carelessness amongst parents of initiates, dehydration, physical abuse and lack of proper screening of initiates have a tremendous contribution to injuries, diseases and high death rates of initiates in Mngqesha villages. , Thesis (MSoc) -- Faculty of Social Sciences and Humanities, 2018
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  • Date Issued: 2018-06

Health factors associated with traditional circumcision of adolescent males in Alice, Raymond Mhlaba local municipality, Eastern Cape

  • Authors: Mpateni, Aphiwe https://orcid.org/0000-0002-6823-9179
  • Date: 2016-06
  • Subjects: Circumcision , Penis -- Surgery http://id.loc.gov/authorities/subjects/sh85099485
  • Language: English
  • Type: Master's theses , text
  • Identifier: http://hdl.handle.net/10353/19726 , vital:43183
  • Description: This research explored the health challenges associated with male adolescents during traditional male circumcision in Alice,Raymond Mhlaba Local Municipality in Eastern Cape. This researcher used the views, attitudes and perceptions of the male adolescents who recently underwent traditional male circumcision, the parents of the male adolescents, health practitioners, community leaders, traditional nurses, traditional surgeons and a member of Association of Ingcibi Namakhankatha. The research study aimed at achieving the following specific objectives: 1. to interrogate the attitudes and views of people on the health factors associated with male adolescents who undergo traditional male circumcision 2; to establish the psychological, social, emotional and behavioural impacts of health challenges experienced by male adolescents undergoing male traditional circumcision; and 3. to document the health hazards experienced by male adolescents undergoing during traditional male circumcision. This researcher espoused a qualitative research method. The study was conducted through qualitative research instruments such as in-depth interviews, focus groups interviews and key informants in collecting the data. The study utilized socio cultural theory. The smaple in this study was made up of 25 participants: five (5) traditionally circumcised youth, ten (10) health practitioners, five (5) parents, one (1) traditional surgeon, two (2) traditional nurses, one (1) community leader and one (1) member of Association of Ingcibi Namakhankatha. Non probability sampling methodology was used, specifically purposive sampling to select the participants because of their knowledge and experiences about traditional male circumcision. Data was analysed thematically. The study came with the following findings: An array of health hazard experienced associated with circumcision rite; Horror emanating from the deaths of the initiates; Possible contraction and transmission of diseases during the rite; Cultural custodians disregarding health ethos and sanitation; Traditional male circumcision becoming a forum of learning immoral behaviours; Tightening of the bandages was believed to expedite healing; Amputation of penis due to complications; Psychological and emotional state of the initiates who suffer clinical hazards; Incompetence of traditional surgeons and untrained traditional nurses compromising the health of the initiates; Parental ignorance leading to their sons falling victims of the clinical health hazards; and subjugation of women in cultural practices. The research study made the following recommendations: strengthening the monitoring and evaluation of traditional practitioners; Community engagements by training boys to prepare for traditional male circumcision; Emphasizing the role of culture as stated by section 31 of the South African constitution; bolstering the selection criteria of traditional nurses.The traditional male circumcision practice to enlist the role of women as important stakeholders because they are the mothers; and imposing strict penalties against cultural custodians operating illegal schools This researcher, therefore, hopes that all the health hazards associated with male adolescents during traditional male circumcision can be addressed and that the government and the communities need to engage one another inorder to come with ways and strategies of managing cultures. , Thesis (MSoc) -- Faculty of Social Sciences and Humanities, 2016
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  • Date Issued: 2016-06

"Litsebe nka lengolo y ec hae." (Take this letter home)

Asazi kambe (We don't know what will happen)

Bawo nilele na? (Fathers, are you sleeping)

Uyinkuku nje waibamba (Hold the fowl with your own hands)

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