This study investigated caregivers' perceptions with regard to vaccine-preventable diseases in terms of six constructs of the Health Belief Model. A qualitative research design that is explorative, descriptive and contextual in nature was employed in order to understand and describe the perceptions influencing access and utilisation of services that lead to missed immunisation opportunities and consequently outbreaks of vaccine-preventable diseases. The data-collection techniques were individual unstructured in-depth interviews, field notes and clinical records. The sample consisted of twenty two (N=22) caregivers who volunteered to be interviewed. The study has highlighted that caregivers' perceptions or cognitive factors play an important role for having children in completing immunisation schedule to protect the public from vaccine-preventable diseases. It is recommended that mass media programmes are needed to address the role of vaccines in reducing high morbidity and mortality rates caused by vaccine preventable diseases and improvement in access to immunisation services. / Health Studies / MPH (Health Studies)

In recent years, the move toward a more holistic perspective in health care has led to social scientists investigating psychosocial factors in chronic illness, such as the different languages used by health professionals when talking about nonhealth. However, there has been little inquiry into caregivers' illness experiences of stroke and Alzheimer's disease (AD). This study therefore explores the illness experiences of seven caregivers whose spouses are stroke or AD patients. A hermeneutic approach was adopted and two relatively unstructured interviews were conducted with each caregiver. Using Kleinman's work on illness narratives as an interpretive framework, it was found that - except for people questioning the authenticity of AD caregivers' experiences - similarities in caregivers' experiences outweighed differences. All described the extent to which their lives had been damaged by the illness and their reparation attempts. Critique of the research is presented and the findings' implications for treatment are suggested / M.A. (Clinical Psychology)

This study investigated caregivers' perceptions with regard to vaccine-preventable diseases in terms of six constructs of the Health Belief Model. A qualitative research design that is explorative, descriptive and contextual in nature was employed in order to understand and describe the perceptions influencing access and utilisation of services that lead to missed immunisation opportunities and consequently outbreaks of vaccine-preventable diseases. The data-collection techniques were individual unstructured in-depth interviews, field notes and clinical records. The sample consisted of twenty two (N=22) caregivers who volunteered to be interviewed. The study has highlighted that caregivers' perceptions or cognitive factors play an important role for having children in completing immunisation schedule to protect the public from vaccine-preventable diseases. It is recommended that mass media programmes are needed to address the role of vaccines in reducing high morbidity and mortality rates caused by vaccine preventable diseases and improvement in access to immunisation services. / Health Studies / MPH (Health Studies)

MPH / Department of Public Health / Autism spectrum disorder (ASD) is a life-long neurodevelopmental disorder, which does not affect the child only but the caregiver more. ASD characterized by impairments in social interactions, communication and repetitive behaviour. Therefore, caring for a child diagnosed with ASD can be a very challenging experience for caregiver especially when knowledge about the condition is limited. The aim of the study was to explore experiences of caregivers for children diagnosed with ASD in the Ehlanzeni District, Mpumalanga Province. The study adopted a qualitative approach, wherein data was collected using face-to-face semi-structured interviews, in which an interview guide was used. Participants were selected purposively from the three different schools and data was analysed using thematic content analysis. Twelve (12) participants were interviewed for the study. The caregivers’ children were aged 5-12 years. Ethical considerations and measures to ensure trustworthiness were adhered to throughout the study. The study findings indicated that caregivers for children diagnosed with ASD experienced psychological stress, social isolation and stigma, financial burden, lack of family support, services for children with ASD were perceived not to be accessible and available. The findings also indicated that there is limited knowledge of ASD amongst caregivers, health professionals and the community at large. Therefore, more awareness campaigns need to be done on ASD to increase knowledge on the condition. Furthermore, the study recommends that support groups for caregivers of children diagnosed with ASD should be formed and that information regarding a range of inexpensive interventions and educational programs should be made available for caregivers and their children, as well as continuous dissemination of information amongst caregivers. However, limited statistical information on ASD is available on the South African context. / NRF

HIV/AIDS is a global challenge and its impact is evident. This places a burden on hospitals and health professionals. To ease this burden there are home-based care programmes which, through home-based caregivers, provide patients living with HIV/AIDS with physical and palliative care. However, these HBCGs face various challenges such as poverty, discrimination and stigma when caring for PALHIV, and their own emotional strain, which becomes burdensome without sufficient support from the home-based care centre. The qualitative study undertaken investigates the challenges and coping mechanisms of the HBCGs. Thirteen research participants were drawn from a centre in Mamelodi. Data was gathered through interviews and observations, categorised into themes and analysed. Major findings revealed that social challenges faced by HBCGs include poverty, stigmatisation and discrimination. Emotions experienced by HBCGs include guilt, anger, hopelessness, but they have spiritual reliance through prayer as one of their coping mechanisms. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

school learnersChild-headed household is a phenomenon that is growing in South Africa. As such, it is imperative to uncover the realities of children in this situation. This study explores and describes the schooling experiences of secondary school learners from child-headed households. This qualitative study included a sample of 20 grade 10 and 11 learners from four secondary schools. Data were collected through structured interviews and document analysis. The Interpretative Phenomenological Analysis (IPA) was used to analyze the data. The findings suggest that secondary school learners from child-headed households live in poverty and encounter experiences such as absenteeism, psychological trauma, gender-based discrimination, lack of adequate food and scholastic materials, drug abuse and teenage pregnancy. These experiences impact negatively on their schooling. The study recommends that learners from child-headed households should get more care and support from educators and other stakeholders. / Science and Technology Education / M.A. (Socio-Education)

Thesis (MA)--Stellenbosch University, 2015 / ENGLISH ABSTRACT : It has been suggested that the complex needs of children with neurodevelopmental disorders are best addressed with a family-centred approach. As this approach has been increasingly incorporated into healthcare systems over recent years, most children with disabilities are now able to remain at home as opposed to living in institutions or group homes. Many parents have thus been forced to adopt the role of a primary caregiver for their child that has been diagnosed with a disability or chronic condition. This study aimed to investigate the experiences of caregivers for children with cerebral palsy in rural communities of the Western Cape, with a specific focus on the barriers and facilitators that they encounter. An exploratory qualitative design was employed and 15 individuals (aged 27-62), who were identified as caregivers for a child with cerebral palsy through purposive sampling were interviewed. Thematic analysis was used to analyse and generate themes from the semi-structured interviews that were conducted with participants. A number of barriers to caring emerged including the personal consequences of caregiving, difficulty adjusting to caregiving duties, environmental conditions, lack of access to healthcare services, lack of respite services, and negative perceptions towards disability. Various facilitators to caring were also identified, namely personal coping methods, personal transformation, social support, relationship with one’s child, community resources, child’s crèche, and financial assistance. The five levels of the Social Ecological Model were used to conceptualise the discussion of these findings and links were made to the existing literature on the caregiver experience in the developing context. In this process it was found that participants often encountered similar barriers and facilitators to caregivers for individuals with other types of conditions, such as HIV/AIDS, autism, mental illness, cancer, and neurological disorders. This could suggest that caregivers residing in developing countries share similar experiences, regardless of the condition of the care receiver. Although participants received support from a number of sources that aided them with their caregiving duties, it is evident that they still encountered gaps in the provision of a number of important services, including lack of information from healthcare professionals, lack of community programs to reduce stress and promote empowerment, and lack of disability-friendly facilities. It is vital that caregivers have access to these services to ensure their child’s well-being as well as their own. There is thus a need to explore how these services can be made more accessible to caregivers in rural communities. / AFRIKAANSE OPSOMMING : Daar word voorgestel dat die komplekse behoeftes van kinders met neuro-ontwikkelingsversteurings die beste aangespreek word deur ‘n familie-gefokusde benadering. Aangesien hierdie benadering meer geredelik geïnkorporeer is in die gesondheidsorg sisteem oor die afgelope paar jaar is meeste kinders met gestremdhede nou in staat om by die huis te kan bly in plaas daarvan om in inrigtings of groepshuise te woon. Baie ouers is dus geforseer om die rol as primêre versorger aan te neem vir hulle kind wat gediagnoseer is met ‘n gestremdheid of kroniese toestand. Hierdie studie se doel was om die ervarings van versorgers van kinders met serebrale gestremdheid in landelike gemeenskappe van die Wes-Kaap, te ondersoek, met ‘n spesifieke fokus op die hindernisse en fasiliteerders wat hulle ondervind. ‘n Ondersoekende kwalitatiewe ontwerp is gebruik en onderhoude is gevoer met 15 individue (ouderdomme 27-62) wat deur doelgerigte steekproefneming geïdentifiseer is as versorgers van ‘n kind met serebrale gestremdheid. Tematiese analise is gebruik om die semi-gestruktureerde onderhoude wat met die deelnemers gevoer is te analiseer en temas te genereer. ‘n Aantal van die hindernisse tot versorging het na vore gekom en sluit die persoonlike gevolge van versorging, probleme om aan te pas by die versorgingspligte, omgewingstoestande, tekort aan toegang tot gesondheidsorg dienste, tekort aan verligting dienste en negatiewe persepsies teenoor gestremdhede in. Verskeie fasiliteerders tot versorging is ook geïdentifiseer, naamlik persoonlike hanteringsmetodes, persoonlike transformasie, sosiale ondersteuning, verhouding met hulle kind, gemeenskapsfasiliteerders, kind se speelskool en finansiële hulp. Die vyf vlakke van die Sosiale Ekologiese Model is gebruik om die bespreking van hierdie bevindinge te konseptualiseer en verbintenisse is gemaak met bestaande literatuur wat handel oor die versorger se ervaring in die ontwikkellende konteks. In hierdie proses is gevind dat deelnemers dikwels dieselfde hindernisse en fasiliteerders ondervind as versorgers van individue met ander tipe toestande, soos MIV/VIGS, outisme, geestesiektes, kanker en neurologiese versteurings. Dit kan moontlik beteken dat versorgers wat in ontwikkellende lande woord dieselfde ervarings deel, ten spyte van die toestand van die persoon wat die versorging ontvang. Alhoewel deelnemers ondersteuning van ʼn aantal bronne ontvang het wat hulle help met hulle versorgingspligte, is dit duidelik dat hulle steeds gapings ervaar in die voorsiening van ʼn aantal belangrike dienste, insluitende ʼn tekort aan inligting van gesondheidsorg werkers, ʼn tekort aan gemeenskapsprogramme om stres verligting en bemagtiging te bevorder en ʼn tekort aan gestremdheid-vriendelike fasiliteite. Dit is baie belangrik dat versorgers toegang het tot hierdie dienste om die welstand van hulle kind en hulself te verseker. Daar is dus ʼn behoefte om te ondersoek hoe hierdie dienste meer toegangklik gemaak kan word vir versorgers in landelike gemeenskappe.

Thesis (MPhil(Rehabilitation))--Stellenbosch University, 2012. / ENGLISH ABSTRACT: This is a descriptive, phenomenological, qualitative study which explores the experiences of and coping strategies employed by the parents/caregivers of disabled children in the management of their care, including rehabilitation and schooling. The study was conducted in the rural communities of the Eastern Cape outside Mthatha, where parents/caregivers of disabled children have historically had challenges finding suitable schooling for their intellectually impaired children. In 1999, Happy Home community rehabilitation centre for disabled children was established by Mrs. V.V. Duma, a parent of a disabled child. Study participants comprised of parents or care-givers of the disabled children residing at Happy Home. A total of 37 participants took part in the study, comprising of six focus group discussions of six parents/caregivers per group, and one individual interview. Study findings revealed that parents/caregivers used a variety of coping strategies to manage the care of their disabled children. Both positive and negative coping strategies were used. Negative coping strategies included abandoning the child, which was justified by, for instance, belief that the child had been bewitched by in-laws, or on the pretext that the mother's HIV positive status had been caused by the father, leading to the mother abandoning the child. In cases where both parents had abandoned the baby, or the death of a parent occurred, a caregiver, often a relative, would take responsibility for the child. Positive strategies can be characterized as willingness by parents/caregivers to do whatever it takes to help the children to survive and access better opportunities. The caregivers/parents who adopted positive coping strategies were mainly from Christian backgrounds and consequently believed that a disabled child is God‟s gift. These parents/caregivers seek assistance from a number of different sources to help the disabled child, including from faith healers, traditional healers, and western medical treatments. Cultural influences on the reactions of parents, extended family and the wider community as revealed in the study show that disability is seen in negative terms and that the abuse of women, including while pregnant, is supported as a cultural norm. It was found that stress, abuse, and poverty during pregnancy were perceived by parents to be some of the causes of disability in new born babies. Parents/caregivers experienced barriers to health and rehabilitation including; long distances to health and rehabilitation centres with prohibitive transport costs. It appeared that health care providers did not communicate about children‟s conditions or would not treat sick disabled children. There were also data that indicated that there were some health care providers who were helpful and that parents/caregivers used other resources such as radio programmes to educate them about disability. The study sought to understand the challenges that disabled children and their parents/caregivers experienced. The results of the study indicate that workshops with the health professionals to change their attitudes, and enhance their understanding of disability should be conducted. In addition, community awareness and education campaigns about causes, and signs and symptoms of disabilities; and the issue of cultural norms that impact on the abuse of women and negative attitudes towards disabled children need to be conducted among the communities from which the study participants originate. Furthermore, the study recommends that the Health Science curriculum include a generic module on disability studies to be completed by all health science students, to ensure that as health practitioners such as therapists and nurses, they can be more effective in responding to the needs of disabled children. / AFRIKAANSE OPSOMMING: Die studie is ʼn beskrywende fenomenologiese navorsing, wat die ervaring van ouers/versorgers van gestremde kinders ondersoek; asook die strategiee wat deur hulle aangewent word om te help met die versorging, rehabilitasie en onderrig van gestremde kinders. Die studie het gebruik gemaak van kwalitatiewe data kolleksie metodes. Ouers/versorgers van gestremde kinders wat in Happy Home woon het aan die studie deelgeneem. Ses groepsbesprekings, met ses ouers in elke groep, sowel as individuele onderhoude met elke deelnemer was uitgevoer. In totaal was daar 37 deelnemers in die studie. Die studie was uitgevoer in die plattelandse gemeenskappe buite Mthatha, in die Oos Kaap. Ouers/versorgers van intelektueel gestremde kinders het probleme ondervind om geskikte onderwys te vind vir hulle kinders in hierdie area. Happy Home, `n gemeenskapsrehabilitasie sentrum vir gestremde kinders, is in 1999 deur Mev J.J.Duma, `n ouer van `n gestremde kind, gestig. Daar was bevind dat ouers/versorgers `n veskeidenheid hanterings meganismes, positief en negatief,gebruik om hulle gestremde kinders te versorg. Negatiewe stratigee soos om die kind te verlaat is ingesluit en is geregverdig deur, bevoorbeeld, die geloof dat die kind deur skoonouers betower was, of op die voorwendsel dat die moeder se HIV postief status, veroorsaak deur die vader, die oorsaak was dat die moeder gevolglik die kind verlaat het. In Ingevalle waar beide ouers die baba verlaat hetof waar `n ouer gesterf het, het `n versorger wat gewoonlik `n familielid was, verantwoordelikheid geneem vir die kind. Postiewe strategiee is kenmerkend van ouers/versorgers se gewilligheid om alles moontlik te doen, om die kinders te help om te oorleef en toegang te he tot beter geleenthede. Ouers/versorgers wie positiewe strategiee aangewent het was waarskynlik van Christelike agtergronde en het gevolglik geglo dat ʼn gestremde kind ʼn gesekenk van God is. Sulke ouers/versorgers soek bystand van ʼn verskydenheid hulpbronne, om die gestremde kind te help; insluitend die dienste van ʼn geloofsgeneser, tradisionele genesers, en westerse mediese behandelings. Die studie het gewys dat kulturele invloede op die reaksies van ouers, die familie en die wyer gemeenskap veroorsaak het dat gestremdheid in `n negatiewe lig gesien word en dat die mishandeling van vroue, insluitende swanger vroue, ondersteun word as `n kulturele norm. Daar was bevind dat spanning, mishandeling en armoede gesien word as oorsake van gestremdheid in pas gebore babas. Ouers/versorgers het struikelblokke teegekom met betrekking tot toegang tot gesondheids dienste en rehabilitasie. Dit het lang afstande na gesondheids- en rehabilitasie sentrums asook onbekostigbare vervoer uitgawes ingesluit. Dit het voorgekom asof gesondheidsorg voorsieners nie oor die kinders se toestande gekommunikeer het nie en nie siek gestremde kinders behandel het nie. Daar was data wat daarop gewys het dat sommige gesondheidsorg voorsieners behulpsaam was en dat ouers/versorgers ander hulpbronne soos radio programme gebruik het om hulself in te lig. Die studie het gepoog om die plattelandse konteks en die uitdagings wat gestremde kinders en hulle ouers/versorgers ondervind het te verstaan. Die studie resultate dui daarop dat werkswinkels met gesondheidsorg verskaffers gehou moet word om hulle begrip van gestremdheid te verbeter om sodoende hulle houding teenoor gestremdhied te verander. Daarbenewens moet opleidings en inligtings veldtogte oor die oorsake, tekens en simptome van gestremdheid, oor die impak wat kulturele norme het op die mishandeling van vroue, en oor die negatiewe houdings teenoor gestremde kinders, in die gemeenskappe waarvandaan die studie deelnemers kom gehou word ʼn Verdere aanbeveling is dat die kurrikulum vir Gesondheids Wetenskappe ʼn algemene module oor gestremdheid studies insluit; om voltooi te word deur all studente wie Gesondheids Wetenskappe studeer; sodat terapeute en verpleegsters grooter kennis sal dra van die behoeftes van gestremde kinders.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: This study examines the level of HIV and AIDS knowledge, attitudes, as well as practices amongst caregivers of HIV infected children in Pretoria, using Kalafong hospital as a case study. The study uses a questionnaire as survey instrument. A total of 30 respondents participated in the study, which took place in October of 2013. The respondents were selected via simple random sampling and the results were analyzed. The results showed a remarkably high level of HIV and AIDS knowledge amongst the respondents, from which it was evident, that: A significant number of caregivers were aware of and able to take care of existing medical conditions arising from HIV in children. Most of the home-based care of children living with HIV was carried out by women in a very disproportionate ratio to men. In this regard, the study offers a range of suggestions and recommendations as well as existing best practices, such as the UNAIDS booklet on caregiving within the context of HIV and AIDS. The study was undertaken with the realization that generalizations cannot be made through extrapolation to the larger society because of limitations, such as the sample size of this study. / AFRIKAANSE OPSOMMING:Hierdie studie ondersoek die vlak van MIV/VIGS kennis, houdings teenoor dieselfde, sowel as praktyke onder versorgers van MIV-besmette kinders in Pretoria, met behulp van Kalafonghospitaal as 'n gevallestudie. Die studie maak gebruik van 'n vraelys as opname instrument. 'n Totaal van 30 respondente het deelgeneem aan die studie, wat in Oktober 2013 plaasgevind het. Die respondente is gekies deur 'n eenvoudige ewekansige steekproefneming en die resultate is ontleed. Die resultate toon 'n merkwaardig hoë vlak van MIV en VIGS kennis onder die respondente. Hierdie kennis, houdings en praktyke opgedoen was voldoende om daarop te let: • 'n beduidende aantal van die versorgers is bewus van en in staat om bestaande toestande in MIV-sorg in kinders te versorg. • Die meeste van die tuisversorging van kinders wat met MIV leef is uitgevoer deur vroue in 'n baie oneweredige verhouding met mans. In hierdie verband bied die studie 'n verskeidenheid van voorstelle en aanbevelings sowel as die bestaande beste praktyke soos die UNAIDS boekie oor versorging binne die konteks van MIV en VIGS. Die studie is gedoen onder die besef dat veralgemenings nie gemaak kan word deur ekstrapolasie na die groter samelewing nie, as gevolg van beperkings soos die monster grootte van hierdie studie

A ready-to-use food (RUF), Sibusiso, has the potential to alleviate protein- energy malnutrition. However, its nutritional composition, physical properties, consumer acceptability, and economic feasibility for use are unknown. This study aimed to determine the nutritional composition and physical properties of a RUF, Sibusiso. As well as to assess the consumer acceptability of Sibusiso to healthy and HIV infected children on antiretroviral (ARV) medication, and the caregiver‟s attitudes towards Sibusiso. The feasibility of using Sibusiso for nutrition rehabilitation was also determined. Methodology: Four samples of Sibusiso and a peanut butter (control) were analysed for their nutritional composition and physical properties. The consumer acceptability of Sibusiso to healthy children and HIV infected children on ARVs (ART group) was determined using a five-point facial hedonic rating scale. Focus group discussions were conducted to assess the attitudes and perceptions of caregivers surrounding Sibusiso. These caregivers had children who were either malnourished or at risk of malnutrition. The financial feasibility of using Sibusiso for nutrition rehabilitation was determined using published data. The results revealed that Sibusiso was a good source of energy (2624 kJ/100 g) and quality protein (15.7 g/100 g). The nutritional composition of Sibusiso met the WHO/WFP/SCN/UNICEF recommendations for RUF. Instrumental colour analysis indicated that both Sibusiso and the peanut butter had a brown colour, although Sibusiso was slightly lighter. Sibusiso had the same spreadability or hardness as the peanut butter, but it was stickier than the peanut butter. Based on the sensory evaluation, Sibusiso was found acceptable to both healthy (n=121) and HIV infected children (n=51). Over 65% of the children in both the healthy and ART group liked the taste, smell and mouthfeel of Sibusiso. The caregivers also found Sibusiso acceptable and were willing to buy it, but at half its current price (60 ZAR/ 500 g). The price of Sibusiso and perception of the caregivers that Sibusiso was a peanut butter were the main factors that affected their willingness to buy the product. Financial feasibility analysis showed that the estimated cost (5.99 ZAR/day) of rehabilitating a child using Sibusiso was higher than the KwaZulu-Natal Department of Health nutrition budget of 0.02 ZAR/day. Sibusiso is a good source of energy and quality protein, and it is fairly acceptable to children with HIV and caregivers. This indicates that Sibusiso has a potential to alleviate protein-energy malnutrition in the targeted groups. Yet, Sibusiso is expensive. There would be a need to somehow reduce the cost of Sibusiso so that it would be financially feasible to use it in nutrition intervention programmes. / Thesis (M.Sc.Hum.Nut.)-University of KwaZulu-Natal, Pietermaritzburg, 2012.