Experiences of youths participating in combination social protection and HIV prevention programme in resource constrained settings of Gauteng Province in South Africa: a collective case study design
- Authors: Zibengwa, Enock
- Date: 2023-04
- Subjects: HIV infections -- Prevention , HIV (Viruses) , HIV infections -- Africa
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/27347 , vital:66944
- Description: South Africa continues to experience unacceptably high Human Immunodeficiency Virus HIV incidence rates among youths aged 15 to 24 years. Remarkably, this is despite the numerous youth HIV prevention programmes that have been implemented in the country. Unfortunately, the programmes have not significantly curbed the spread of HIV due to the partial and fragmented nature of their implementation. The programmes are also observed to be weak in addressing complex economic factors recognised as important structural drivers for vulnerabilities that put youths at risk of HIV infection. To address this challenge, there is increased adoption and implementation of the Combination Social Protection introduced in this research as the CSP by Non-Governmental Organisations NGOs. The CSP is a youth empowerment programming strategy whose critical foundations are entrenched in combining economic strengthening interventions and HIV prevention education. CSP could provide youths with a set of indispensable life skills that enhance their competencies and agency to make informed and effective decisions regarding their health and economic lives. Despite its growing traction, little is known regarding links between the CSP and its abilities to improve HIV prevention outcomes for youths. Given the paucity of research, this study aimed to explore the experiences of youths participating in the CSP and HIV prevention programme, with a particular focus on the resource-constrained settings of Gauteng Province in South Africa. This study employed a collective case study design, within the qualitative approach, and was exploratory. In-depth individual interviews were conducted with 30 youths from six established NGOs in the City of Johannesburg (CoJ). Qualitative thematic analysis was employed as a data analysis strategy. Focus groups were separately with six practitioners from the same six NGOs, and five officials from the Department of Social Development (DSD). Both phases of data collection were guided by interview themes, which were aligned with the objectives of the study. The findings of the study point to the fact that the CSP’s innovative and holistic approach offered numerous transformative and empowering benefits to youths. It equipped them with basic informational resources, capabilities, and social assets to safeguard their health and aid their economic advancement. The programme’s mixedgender sessions provided space, freedom, and support for youths to engage on issues of gender, differential access to health and socio-economic opportunities. Another major finding of the study was that improvement of economic aptitude (brought about by financial literacy education), employability, and entrepreneurship training stirred a sense of agency and purposefulness among youths, which in turn, prompted them to be more focused on achieving long-term objectives instead of indulging in risky sexual practices. Conversely, findings revealed that the programme had limited opportunities and did not create an adequate supportive environment for youths to develop successful entrepreneurial or income-generating projects. There was also no structure to assist youths to access apprenticeship and employment markets. The study specifically recognised that the programme’s efforts to develop youths’ entrepreneurship and employability capabilities were curtailed by a lack of mentorshipnand access to financial capital for start-up costs. With these findings in mind, recommendations are made for the creation of an enabling environment by purposefully engaging youths, establishing collaborative relations with communities, and building networks with businesses and financial institutions that can help youths with capital, mentorship, and linkages to internship and wage employment. Such collaborations could be fundamental in unravelling the impact of the programme on building livelihoods and reducing HIV among youths. Hence, this study proposes a model with strategies to support the successful implementation of economic strengthening interventions for youths. , Thesis (PhD) -- Faculty of Social Sciences and Humanities, 2023
- Full Text:
- Authors: Zibengwa, Enock
- Date: 2023-04
- Subjects: HIV infections -- Prevention , HIV (Viruses) , HIV infections -- Africa
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/27347 , vital:66944
- Description: South Africa continues to experience unacceptably high Human Immunodeficiency Virus HIV incidence rates among youths aged 15 to 24 years. Remarkably, this is despite the numerous youth HIV prevention programmes that have been implemented in the country. Unfortunately, the programmes have not significantly curbed the spread of HIV due to the partial and fragmented nature of their implementation. The programmes are also observed to be weak in addressing complex economic factors recognised as important structural drivers for vulnerabilities that put youths at risk of HIV infection. To address this challenge, there is increased adoption and implementation of the Combination Social Protection introduced in this research as the CSP by Non-Governmental Organisations NGOs. The CSP is a youth empowerment programming strategy whose critical foundations are entrenched in combining economic strengthening interventions and HIV prevention education. CSP could provide youths with a set of indispensable life skills that enhance their competencies and agency to make informed and effective decisions regarding their health and economic lives. Despite its growing traction, little is known regarding links between the CSP and its abilities to improve HIV prevention outcomes for youths. Given the paucity of research, this study aimed to explore the experiences of youths participating in the CSP and HIV prevention programme, with a particular focus on the resource-constrained settings of Gauteng Province in South Africa. This study employed a collective case study design, within the qualitative approach, and was exploratory. In-depth individual interviews were conducted with 30 youths from six established NGOs in the City of Johannesburg (CoJ). Qualitative thematic analysis was employed as a data analysis strategy. Focus groups were separately with six practitioners from the same six NGOs, and five officials from the Department of Social Development (DSD). Both phases of data collection were guided by interview themes, which were aligned with the objectives of the study. The findings of the study point to the fact that the CSP’s innovative and holistic approach offered numerous transformative and empowering benefits to youths. It equipped them with basic informational resources, capabilities, and social assets to safeguard their health and aid their economic advancement. The programme’s mixedgender sessions provided space, freedom, and support for youths to engage on issues of gender, differential access to health and socio-economic opportunities. Another major finding of the study was that improvement of economic aptitude (brought about by financial literacy education), employability, and entrepreneurship training stirred a sense of agency and purposefulness among youths, which in turn, prompted them to be more focused on achieving long-term objectives instead of indulging in risky sexual practices. Conversely, findings revealed that the programme had limited opportunities and did not create an adequate supportive environment for youths to develop successful entrepreneurial or income-generating projects. There was also no structure to assist youths to access apprenticeship and employment markets. The study specifically recognised that the programme’s efforts to develop youths’ entrepreneurship and employability capabilities were curtailed by a lack of mentorshipnand access to financial capital for start-up costs. With these findings in mind, recommendations are made for the creation of an enabling environment by purposefully engaging youths, establishing collaborative relations with communities, and building networks with businesses and financial institutions that can help youths with capital, mentorship, and linkages to internship and wage employment. Such collaborations could be fundamental in unravelling the impact of the programme on building livelihoods and reducing HIV among youths. Hence, this study proposes a model with strategies to support the successful implementation of economic strengthening interventions for youths. , Thesis (PhD) -- Faculty of Social Sciences and Humanities, 2023
- Full Text:
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
- Full Text:
- 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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Human rights implications of the compulsory HIV/AIDS testing policy: a critical appraisal of the law and practice in South Africa, Uganda and Canada
- Authors: Chiringa, Kudakwashe E M
- Date: 2013
- Subjects: HIV infections -- Prevention , HIV-positive persons -- Civil rights , AIDS (Disease) -- Patients -- Legal status, laws, etc. , AIDS (Disease) -- Law and legislation
- Language: English
- Type: Thesis , Masters , LLM
- Identifier: vital:11106 , http://hdl.handle.net/10353/d1017298 , HIV infections -- Prevention , HIV-positive persons -- Civil rights , AIDS (Disease) -- Patients -- Legal status, laws, etc. , AIDS (Disease) -- Law and legislation
- Description: HIV/AIDS has been an obstacle to socio-economic development and a major cause of loss of human life. It has also caused vast inequities and frustration to the public health sector. One of the significant efforts made by the public health sector to combat the epidemic is the implementation of a mandatory HIV/AIDS testing policy to scale-up HIV treatment. This dissertation examines the impact of this policy on the human rights of people infected with and affected by HIV/AIDS. Coercive government policies aimed at controlling the AIDS pandemic often infringe on the rights of individuals known to be or suspected of living with HIV/AIDS and this decreases the effectiveness of public health measures. The research methodology involved the study of written literature and a comparative literature study of the law and practice obtaining in South Africa, Uganda and Canada. It revealed that voluntary testing is effective and suitable in South Africa. This dissertation aimed to show that any public health approach that aims to achieve a comprehensive prevention strategy must be consistent with respect for human rights as enshrined in regional and international human rights law. Public health and human rights should, therefore, not be regarded as opposing forces; rather they should be seen as a unified system of protection of human welfare under the Bill of Rights and the Constitution. The solution to the crisis lies not only in testing every single person but also requires a shift of focus to more pressing issues that include gender equality, stigma and discrimination; prioritizing human rights, institutional capacity and resources; and an end to extreme poverty. A human rights-based approach to HIV/AIDS testing, such as the Voluntary Counselling and Testing (VCT) is recommended. Therefore, failure to adhere to the core principles of testing - which are informed consent, counselling and confidentiality of the test result - will only hinder the global fight against HIV/AIDS. The rights of those affected by HIV/AIDS need to be protected in order to address public health imperatives. This can be done through the use of the law as an instrument of social change as well as education and awareness. Key words, HIV/AIDS, mandatory testing, Voluntary Counselling and Testing, public health, human rights-based approach.
- Full Text:
- Authors: Chiringa, Kudakwashe E M
- Date: 2013
- Subjects: HIV infections -- Prevention , HIV-positive persons -- Civil rights , AIDS (Disease) -- Patients -- Legal status, laws, etc. , AIDS (Disease) -- Law and legislation
- Language: English
- Type: Thesis , Masters , LLM
- Identifier: vital:11106 , http://hdl.handle.net/10353/d1017298 , HIV infections -- Prevention , HIV-positive persons -- Civil rights , AIDS (Disease) -- Patients -- Legal status, laws, etc. , AIDS (Disease) -- Law and legislation
- Description: HIV/AIDS has been an obstacle to socio-economic development and a major cause of loss of human life. It has also caused vast inequities and frustration to the public health sector. One of the significant efforts made by the public health sector to combat the epidemic is the implementation of a mandatory HIV/AIDS testing policy to scale-up HIV treatment. This dissertation examines the impact of this policy on the human rights of people infected with and affected by HIV/AIDS. Coercive government policies aimed at controlling the AIDS pandemic often infringe on the rights of individuals known to be or suspected of living with HIV/AIDS and this decreases the effectiveness of public health measures. The research methodology involved the study of written literature and a comparative literature study of the law and practice obtaining in South Africa, Uganda and Canada. It revealed that voluntary testing is effective and suitable in South Africa. This dissertation aimed to show that any public health approach that aims to achieve a comprehensive prevention strategy must be consistent with respect for human rights as enshrined in regional and international human rights law. Public health and human rights should, therefore, not be regarded as opposing forces; rather they should be seen as a unified system of protection of human welfare under the Bill of Rights and the Constitution. The solution to the crisis lies not only in testing every single person but also requires a shift of focus to more pressing issues that include gender equality, stigma and discrimination; prioritizing human rights, institutional capacity and resources; and an end to extreme poverty. A human rights-based approach to HIV/AIDS testing, such as the Voluntary Counselling and Testing (VCT) is recommended. Therefore, failure to adhere to the core principles of testing - which are informed consent, counselling and confidentiality of the test result - will only hinder the global fight against HIV/AIDS. The rights of those affected by HIV/AIDS need to be protected in order to address public health imperatives. This can be done through the use of the law as an instrument of social change as well as education and awareness. Key words, HIV/AIDS, mandatory testing, Voluntary Counselling and Testing, public health, human rights-based approach.
- Full Text:
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