Research studies have revealed that male circumcision (MC) reduces the transmission of HIV infection from infected women to circumcised men by up to 60% (UNAIDS 2007:2), hence the adoption of MC as an HIV-infection prevention strategy by the United Nations (WHO 2007:2). Botswana, a sub-Saharan African (SSA) country, has HIV as a leading health and developmental challenge. The government adopted male circumcision as one of the strategies to combat the infection. Apparently, not all tribes in Botswana practise male circumcision as part of their culture. The purpose of this study was to develop and describe a model for HIV-infection prevention using MC. Three theory-generating research objectives were used to develop the model, namely to explore and describe perceptions of men regarding the use of MC, to develop and describe a model for MC service delivery, and to develop and describe guidelines for service providers to facilitate delivery of MC. A theory-generating research design which is qualitative, exploratory, descriptive, and contextual was used to develop the model in three phases. Phase 1 involved concept identification, concept definition, and concept classification. Data was collected using focus group discussions and individual in-depth interviews among 38 men aged 18-49 years and analysed according to recommendations made by Tesch (1990), as cited in Creswell (2009:186). Four themes emerged in the study, namely perceived effects on values, perceived source and provision of information, perceived knowledge of benefits of male circumcision, and perceived risks of male circumcision. The concept of “culture congruence” was derived from the themes as the main concept for the development of a “culture-congruent MC model for HIV prevention”. Phase 2 involved a description of the structure and the process of the model, by organising the concepts in relation to one another. The model was also evaluated. Phase 3 of the model involved the development of guidelines to support health service providers to provide MC services in a culture-congruent way in preventing HIV infection. Recommendations made were incorporation of transcultural health care instruction in nursing and medicine curricula, research on secondary audiences, such as women, and application of a culture-congruent MC model among diverse cultures. / Health Studies / D. Litt. et Phil. (Health Studies)

Research studies have revealed that male circumcision (MC) reduces the transmission of HIV infection from infected women to circumcised men by up to 60% (UNAIDS 2007:2), hence the adoption of MC as an HIV-infection prevention strategy by the United Nations (WHO 2007:2). Botswana, a sub-Saharan African (SSA) country, has HIV as a leading health and developmental challenge. The government adopted male circumcision as one of the strategies to combat the infection. Apparently, not all tribes in Botswana practise male circumcision as part of their culture. The purpose of this study was to develop and describe a model for HIV-infection prevention using MC. Three theory-generating research objectives were used to develop the model, namely to explore and describe perceptions of men regarding the use of MC, to develop and describe a model for MC service delivery, and to develop and describe guidelines for service providers to facilitate delivery of MC. A theory-generating research design which is qualitative, exploratory, descriptive, and contextual was used to develop the model in three phases. Phase 1 involved concept identification, concept definition, and concept classification. Data was collected using focus group discussions and individual in-depth interviews among 38 men aged 18-49 years and analysed according to recommendations made by Tesch (1990), as cited in Creswell (2009:186). Four themes emerged in the study, namely perceived effects on values, perceived source and provision of information, perceived knowledge of benefits of male circumcision, and perceived risks of male circumcision. The concept of “culture congruence” was derived from the themes as the main concept for the development of a “culture-congruent MC model for HIV prevention”. Phase 2 involved a description of the structure and the process of the model, by organising the concepts in relation to one another. The model was also evaluated. Phase 3 of the model involved the development of guidelines to support health service providers to provide MC services in a culture-congruent way in preventing HIV infection. Recommendations made were incorporation of transcultural health care instruction in nursing and medicine curricula, research on secondary audiences, such as women, and application of a culture-congruent MC model among diverse cultures. / Health Studies / D. Litt. et Phil. (Health Studies)

Quantitative, descriptive research, using self-completion questionnaires, was conducted to determine the level of HIV/AIDS knowledge of the learners in Sefhare. The sample, comprising 92 learners, was selected from forms 1-3. Of the learners, 53.4% knew what HIV/AIDS stand for, but only 13.6% said AIDS is caused by HIV and only 4.5% said AIDS is an incurable disease. The ABC of protecting oneself against HIV (abstain from sex, be faithful to one sex partner, use condoms) was mentioned by merely 57.6% of the learners. The learners’ lack of knowledge should be addressed by school HIV/AIDS programmes offered at schools in Botswana. As 81.5% of the learners were willing to be tested for HIV, this service should be made available with simultaneous confidential personal HIV/AIDS education, irrespective of the HIV test results. Teachers’ and parents’ HIV/AIDS knowledge should also be updated regularly. / Health Studies / M.A. (Public Health)

Stakeholder involvement in strategic planning: a strategy to mitigate the effects of HIV and AIDS on secondary education in Botswana. This study explores the involvement of stakeholders in strategic planning to mitigate the effect of HIV and AIDS in secondary education in Botswana. The prevalence of HIV and AIDS-related illness and deaths is high in Botswana and affects both teachers and learners. Education provision has been affected through increased mortality and morbidity and increased absenteeism which affect education-related personnel and the demand for education has been reduced due to growing numbers of orphaned and vulnerable children as a consequence of parent/guardian mortality and morbidity related to HIV and AIDS. The problem was investigated by means of a literature review and an empirical inquiry which combined quantitative and qualitative data collection. Based on the findings, in addition to medical and other interventions, an education management approach is required to mitigate the effects of HIV and AIDS on secondary education in Botswana. The strategies of coping, caring and preventing have been effective in this regard. Some internal stakeholders of the Department of Secondary Education (DSE) are not meaningfully involved in strategic planning. Similarly, most of the selected external stakeholders were not involved in the DSE HIV and AIDS strategic plan. Both external and internal stakeholders should be involved at all stages of planning. Furthermore, inducement-contribution exchanges and teacher credibility should be considered in a strategic plan. To improve the current DSE strategic plan, a stakeholder involvement model to involve internal and external stakeholders was designed. Based on this model and the above findings, recommendations for practice and suggestions for future research are made. / Educational Studies / D.Ed.(Educational Management)

Stakeholder involvement in strategic planning: a strategy to mitigate the effects of HIV and AIDS on secondary education in Botswana. This study explores the involvement of stakeholders in strategic planning to mitigate the effect of HIV and AIDS in secondary education in Botswana. The prevalence of HIV and AIDS-related illness and deaths is high in Botswana and affects both teachers and learners. Education provision has been affected through increased mortality and morbidity and increased absenteeism which affect education-related personnel and the demand for education has been reduced due to growing numbers of orphaned and vulnerable children as a consequence of parent/guardian mortality and morbidity related to HIV and AIDS. The problem was investigated by means of a literature review and an empirical inquiry which combined quantitative and qualitative data collection. Based on the findings, in addition to medical and other interventions, an education management approach is required to mitigate the effects of HIV and AIDS on secondary education in Botswana. The strategies of coping, caring and preventing have been effective in this regard. Some internal stakeholders of the Department of Secondary Education (DSE) are not meaningfully involved in strategic planning. Similarly, most of the selected external stakeholders were not involved in the DSE HIV and AIDS strategic plan. Both external and internal stakeholders should be involved at all stages of planning. Furthermore, inducement-contribution exchanges and teacher credibility should be considered in a strategic plan. To improve the current DSE strategic plan, a stakeholder involvement model to involve internal and external stakeholders was designed. Based on this model and the above findings, recommendations for practice and suggestions for future research are made. / Educational Studies / D.Ed.(Educational Management)

The purpose of this study was to investigate the perceptions of young people regarding the O Icheke MCP campaign who are members of Selebi Phikwe District Youth Council, in a mining town in central Botswana. The main objective of the study was to explore young people‘s views about MCP, to solicit their views on the key strength and weaknesses of the campaign, and to make recommendations to further strengthen the campaign. Within the framework of the Health Belief Model, a qualitative research approach was employed and data was collected using four focus group discussions categorised into the following strata  Males aged 18-24 years  Females aged 18-24 years  Males aged 25-35 years  Females aged 25-35 years The overall study finding was that financial issues, the apparent need for sexual variety, quest for material possession, and the impact of unemployment, migration and alcohol abuse are seen as some of the major factors underlying MCP in Botswana. The O Icheke Multiple Concurrent Partnership campaign was positively viewed as playing a key role in addressing the apparent knowledge gap regarding the impacts of these partnerships and in changing people‘s attitudes towards MCP and discouraging wide sexual networks. The campaign‘s target population, funding, stakeholders and delivery mode of the program were identified as its pillars and an effective vehicle to achieve its goals. The consultation between funding office and implementing organisations, coverage of the programme in surrounding areas and growing non-profit organisation were identified to affect the MCP campaign to achieve its goals. The recommendation is that more has to be done to improve the implementation of O Icheke programme through more funding, consultation with programme implementers, tailor made for people with disability and covering surrounding areas. The recommendation is that more has to be done to improve the implementation of O Icheke programme through more funding, consultation and capacity building of volunteers. / Health Studies / MA (Social Behaviour Studies in HIV and AIDS)

The purpose of this study was to investigate the perceptions of young people regarding the O Icheke MCP campaign who are members of Selebi Phikwe District Youth Council, in a mining town in central Botswana. The main objective of the study was to explore young people‘s views about MCP, to solicit their views on the key strength and weaknesses of the campaign, and to make recommendations to further strengthen the campaign. Within the framework of the Health Belief Model, a qualitative research approach was employed and data was collected using four focus group discussions categorised into the following strata  Males aged 18-24 years  Females aged 18-24 years  Males aged 25-35 years  Females aged 25-35 years The overall study finding was that financial issues, the apparent need for sexual variety, quest for material possession, and the impact of unemployment, migration and alcohol abuse are seen as some of the major factors underlying MCP in Botswana. The O Icheke Multiple Concurrent Partnership campaign was positively viewed as playing a key role in addressing the apparent knowledge gap regarding the impacts of these partnerships and in changing people‘s attitudes towards MCP and discouraging wide sexual networks. The campaign‘s target population, funding, stakeholders and delivery mode of the program were identified as its pillars and an effective vehicle to achieve its goals. The consultation between funding office and implementing organisations, coverage of the programme in surrounding areas and growing non-profit organisation were identified to affect the MCP campaign to achieve its goals. The recommendation is that more has to be done to improve the implementation of O Icheke programme through more funding, consultation with programme implementers, tailor made for people with disability and covering surrounding areas. The recommendation is that more has to be done to improve the implementation of O Icheke programme through more funding, consultation and capacity building of volunteers. / Health Studies / M.A. (Social Behaviour Studies in HIV and AIDS)

A needs assessment during 2000 guided the design of a buddy system in Botswana. Implementation of this care and support system for and by 39 HIV+ve female buddy-client pairs started in 2002. During April and November 2002, levels of disclosure, self-care, support and quality of life of buddy-client pairs and the controls (n = 38) were compared. Orem's self-care theory, Maslow's hierarchy of needs and Cohen and Syme's conceptualisation of social support formed the theoretical framework. By November 2002, clients' disclosure levels, self-care for TB, and antiretroviral therapy adherence had improved. Higher income, higher education and older age predicted higher levels of self-care for antiretroviral therapy. The social support survey reported satisfaction with types of support available in November 2002 (N = 112). Clients' scores for self-care for TB, antiretroviral therapy and social support improved more than those of controls over the study period. The personal resource questionnaire measured perceptions of support: buddies' scores increased more than those of clients. Women on antiretroviral therapy completed the adherence attitudes inventory in April and November 2002 and reported a downward trend in adherence. Findings of the quality of life (SF 36) instrument showed that during the six-month study period, physical and mental health component summary scores improved but remained low (N = 112). During 2003 Botswana's community-based buddy-support programme was adopted by four other countries in Southern Africa in an attempt to enhance the quality of life of HIV+ve women in these countries. / Health Studies / D. Litt. et Phil. (Health Studies)

A needs assessment during 2000 guided the design of a buddy system in Botswana. Implementation of this care and support system for and by 39 HIV+ve female buddy-client pairs started in 2002. During April and November 2002, levels of disclosure, self-care, support and quality of life of buddy-client pairs and the controls (n = 38) were compared. Orem's self-care theory, Maslow's hierarchy of needs and Cohen and Syme's conceptualisation of social support formed the theoretical framework. By November 2002, clients' disclosure levels, self-care for TB, and antiretroviral therapy adherence had improved. Higher income, higher education and older age predicted higher levels of self-care for antiretroviral therapy. The social support survey reported satisfaction with types of support available in November 2002 (N = 112). Clients' scores for self-care for TB, antiretroviral therapy and social support improved more than those of controls over the study period. The personal resource questionnaire measured perceptions of support: buddies' scores increased more than those of clients. Women on antiretroviral therapy completed the adherence attitudes inventory in April and November 2002 and reported a downward trend in adherence. Findings of the quality of life (SF 36) instrument showed that during the six-month study period, physical and mental health component summary scores improved but remained low (N = 112). During 2003 Botswana's community-based buddy-support programme was adopted by four other countries in Southern Africa in an attempt to enhance the quality of life of HIV+ve women in these countries. / Health Studies / D. Litt. et Phil. (Health Studies)