Thesis (MBA)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: HIV/AIDS is one of the biggest challenges faced by many countries in this century. The rate of infection is rapidly increasing and more and more people are getting ill and dying from AIDS. Of all the people living with AIDS in the world, seven out of ten live in Sub-Saharan Africa. Namibia is one of the top five most HIV/AIDS affected countries in the world. There is therefore no question about the urgent need to accelerate actions to reduce prevalence, expand care and support and extend access to treatment. AIDS is eroding decades of progress made in extending life expectancy; thus hundreds of adults are dying young or in early middle age. The national strategic plan (2004) on HIV/AIDS indicated that the average life expectancy in Namibia is now 42 years, when it could have been 60 without AIDS. A 2003 study on the impact of HIV/AIDS on Windhoek indicated that the antenatal HIV/AIDS prevalence rate in Windhoek for 2002 was 27%, while the national prevalence rate was estimated at 22.3%. The prevalence rate for Windhoek is expected to reach its peak at 38% during 2005. Even though HIV/AIDS will have a diminishing effect on population growth, Windhoek's population is expected to continue growing, particular as a result of inward migration, but at a slower pace. Similarly, HIV/AIDS will have an abating effect on GDP growth as the virus will mainly affect the economic active and available labour force of the population and result in increased labour costs and skilled labour shortages. The impact on the informal sector is potentially more damaging than on the formal economic sector, as the majority of micro- enterprises and informal businesses are build around one individual. As the breadwinner dies, household income and expenditures levels deteriorate and increase poverty levels, because households within the city are very dependent on family structures to support their income levels. Informal settlements are also more volatile to HIV transmission and the majority of HIV infected individuals are likely to be found within these areas as the populations is poorer, crowded, has fewer social services facilities and is more likely migratory compared to those in affluent formal settlements. Considering that the incubation period of HIV/AIDS from infection to death takes about ten years, the real impact of current HIV infections in Windhoek will only be experienced during 2010. Health services will have to attend to a greater demand for curative services as well as to social care and support programs. Social welfare programmes will need to find ways of caring for a large population of HIV/AIDS orphans. Municipalities can playa critically important role in addressing HIV/AIDS at a local level as they are at the interface of community and government. They are ideally placed to playa coordinating and facilitating role that is needed to make sure that partnerships are built to bring prevention and care programmes to every community affected by AIDS. Therefore, in order to succeed in confronting HIV/AIDS, it is important to work closely with all levels of government as well as working with local partners in civil society that are fighting HIV/AIDS at the community level. By taking action against HIV/AIDS, municipalities are securing the future of their towns and communities. / AFRIKAANSE OPSOMMING: MIV/VIGS is een van die grootste uitdagings wat baie lande hierdie eeu in die gesig staar. Die koers van infeksie is vinnig aan die toeneem en al hoe meer mense word siek en sterf as gevolg van VIGS. Van al die mense wat met VIGS lewe in die wêreld, bly sewe uit tien in sub-Sahara Afrika. Namibië is een van die vyf mees MIV/VIGS geaffekteerde lande in die wêreld. Derhalwe is daar geen twyfel rakende die noodsaaklikheid om daadwerklike aksies te bewerkstellig om die voorkoms te verminder, sorg en ondersteuning te verhoog en toegang na behandeling uit te brei. VIGS vernietig dekades van groei behaal in die verlenging van lewensverwagting; dus sterf honderde volwassenes vroeg of gedurende hul middeljare. Die nasionale strategiese plan (2004) rakende MIV/VIGS toon dat die gemiddelde lewensverwagting in Namibië huidiglik 42 jaar is instede van 60 sonder VIGS. 'n Studie onderneem gedurende 2003, rakende die effek van MIV/VIGS in Windhoek, dui aan dat die voorgeboorte MIV/VIGS voorkoms koers 27% vir 2002 was, terwyl die nasionale voorkoms koers slegs 22.3% was. Daar word verwag dat die voorkoms koers vir Windhoek sy maksimum van 38% sal bereik gedurende 2005. Alhoewel MIV/VIGS 'n negatiewe effek op bevolkingsgroei groei gaan het, sal Windhoek se inwoners getalle steeds groei, alhoewel teen 'n stadiger koers, as gevolg van inwaartse migrasie. Terselfdertyd, gaan MIV/VIGS 'n verminderde effek het op die groei van die Bruto Binnelandse Produk (BBP), omdat die virus hoofsaaklik die ekonomiese aktiewe en beskikbare arbeidsmag van die bevolking affekteer wat as gevolg hiervan 'n verhoging in arbeidskoste en tekort aan geskoolde arbeid het. Die effek op die informele sektore is potensieel meer skadelik as op die formele ekonomiese faktore, aangesien die meeste klein en informele besighede rondom een persoon gebou is. lndien die broodwinner sterf, versleg die vlakke van huishoudelike inkomste en uitgawes wat lei tot verhoogde armoede, omdat huishoudings in die stad baie afhanklik is op familie strukture om hulle inkomste te ondersteun. Informele vestigings is meer kwesbaar in die oordrag van MIV en die meerderheid van die MIV geïnfekteerde individue word gewoonlik in hierdie areas aangetref omdat die bevolking armer is, meer persone huisves, minder welsyn dienste fasiliteite het en meer swerwend is in vergelyking met die meer welgestelde formele vestigings. As in ag geneem word dat die ontkiemings periode van MIV/VIGS vanaf infeksie tot en met sterfte omtrent tien jaar neem, sal die werklike effek van die huidige VIGS besmettings in Windhoek slegs ervaar word gedurende 2010. Gesondheidsdienste sal moet aandag skenk aan 'n groter aanvraag vir geneeslike dienste sowel as sosiale sorg en ondersteunings programme. Gemeenskaplike welsyn programme sal maniere moet vind om vir 'n groot populasie van MIV/VIGS weeskinders te sorg. Munisipaliteite kan 'n belangrike rol speel in die aanspreek van die MIV/VIGS epidemie op 'n plaaslike vlak omdat hulle die skakel is tussen die gemeenskap en die regering. Hulle is ideaal geplaas om 'n koordineerende en fasiliterende rol te speel wat nodig is om seker te maak dat vennootskappe gebou word om voorkomings en versorgings programme te lewer aan elke gemeenskap wat deur MIV/VIGS geraak word. Dus, om sukses te behaal in die bekamping van MIV/VIGS , is dit belangrik om nou saam te werk met alle vlakke van die regering sowel as met plaaslike vennote in die gemeenskap wat MIV/VIGS bekamp op gemeenskapsvlak. Deur aksie te neem teen MIV/VIGS , kan munisipaliteite die toekoms van hulle dorpe en gemeenskappe verseker.

The aim of this study was to assess the extent on how effective was the prevention of mother-to-child transmission of Human Immunodeficiency Virus (HIV) infection at Oshakati District Health Centre. Explanatory survey was used to conduct the research. A total of 160 nurses experienced in prevention of mother-to-child transmission and women who attended antenatal care and post natal care services participated in the study. Respondents expressed unsatisfactory with the promoting involvement of male partners, high quality voluntary counselling and testing services, couple counselling and testing, integration of Highly Active Antiretroviral Therapy services, administration of short course of Zidovudine to pregnant mothers and the provision of antiretroviral drugs to infants. Therefore, promoting involvement of male partners, couple counselling and testing, administration of short course of Zidovudine to pregnant mothers and educating women about exclusive breastfeeding prior to delivery are some of recommendations for effective prevention of mother-to-child transmission of HIV infections. / Health Studies / (M.A. (Public Health))

The aim of this study was to assess the extent on how effective was the prevention of mother-to-child transmission of Human Immunodeficiency Virus (HIV) infection at Oshakati District Health Centre. Explanatory survey was used to conduct the research. A total of 160 nurses experienced in prevention of mother-to-child transmission and women who attended antenatal care and post natal care services participated in the study. Respondents expressed unsatisfactory with the promoting involvement of male partners, high quality voluntary counselling and testing services, couple counselling and testing, integration of Highly Active Antiretroviral Therapy services, administration of short course of Zidovudine to pregnant mothers and the provision of antiretroviral drugs to infants. Therefore, promoting involvement of male partners, couple counselling and testing, administration of short course of Zidovudine to pregnant mothers and educating women about exclusive breastfeeding prior to delivery are some of recommendations for effective prevention of mother-to-child transmission of HIV infections. / Health Studies / M.A. (Public Health)