A quantitative and descriptive type of study design was followed using structured self-administered questionnaires distributed among 84 conveniently selected male adolescent learners from Nanogang Community Junior Secondary School (NCJSS) in Gaborone. The purpose of this study was to describe factors that influence the uptake of safe male circumcision (SMC) as a human immune-deficiency virus (HIV) prevention strategy among male adolescent learners. The study findings show that protection from HIV and other sexually transmitted infections (STIs) was found to be the main reason for adolescent learners undergoing male circumcision (MC) (p<.01). Reasons such as maintenance of genital hygiene, culture, religion, and the enhancement of sexual pleasure were not found to be significant factors. Misconceptions such as the belief that girls do not like circumcised partners were found to be the main reason for adolescent learners not undergoing MC (p<.05). A number of factors which were claimed in previous studies to be obstacles for the uptake of MC, such as surgical complications, peer pressure, stigma, and discrimination, were not found to be major obstacles / Health Studies / M.A. (Public Health)

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Background: Safe Male circumcision (SMC) divides people for or against it, depending upon their attitudes. The Ministry of health (MOH) has built capacity in the country for rapid scale up of the program since 2009. However, despite the efforts, the number of men circumcised is lagging behind set targets. We do not know to what extent attitudes of the managers at national and district levels do influence this underperformance? The effectiveness of the managers at workplace at large will depend on their attitudes towards SMC. Managers with positive attitudes bring at workplace energy, creativity and momentum to fulfill the work objectives and goals. Objectives: The objectives of the study were to; 1) establish the current situation of SMC implementation in Botswana, 2) establish the required attitudes for managers towards SMC program, 3) establish the attitudes of SMC managers at all levels toward SMC program, 4) determine the gap between the required attitudes and SMC managers’ current attitudes toward SMC, and 5) Provide recommendation for reinforcing positive attitudes toward SMC program. Methods: The study used an explorative qualitative design. It was carried out at the Ministry of health headquarters and in ten districts in Botswana. A total of 26 SMC program managers were interviewed using a semi-structured interview guide. Results: The study found that the managers were confirming to positive attitudes toward the program as prescribed by the MOH’s standards. Data revealed a positive trend in scaling up of the program albeit lagging behind set targets. Conclusion: This study looked at the desired attitudes of SMC managers should posses and the level of attitudes currently have towards the program. It was not easy to link attitude and performance of individuals. High turnover rate of SMC officers was a worrisome finding that calls for further study. / AFRIKAANSE OPSOMMING: Agtergrond: Na gelang van hul houdings, is die meeste mense hetsy sterk ten gunste van of heftig gekant teen veilige manlike besnydenis (VMB). Die Ministerie van Gesondheid is reeds sedert 2009 besig met vermoëbou-inisiatie we om die VMB-program vinnig uit te brei. Ondanks hierdie pogings, is die aantal mans wat ingevolge dié program besny word egter veel minder as die vasgestelde teikens. Dit is nie bekend in watter mate die houdings van VMB-programbestuurders op nasionale en distriksvlak hierdie onderprestasie beïnvloed nie. Die algehele doeltreffendheid waarmee dié bestuurders die program in werking stel, sal immers grootliks afhang van hul houdings jeens VMB. Bestuurders met ’n positiewe houding sal energie, kreatiwiteit en stukrag aan die werkplek verleen ten einde die programoogmerke en -doelwitte te verwesenlik. Oogmerke: Die oogmerke van die studie was: 1) om die huidige stand van VMB-inwerkingstelling in Botswana te bepaal; 2) om te bepaal watter houdings bestuurders behóórt te hê jeens die VMB-program; 3) om te bepaal watter houdings bestuurders op alle vlakke wél het jeens die VMB-program; 4) om vas te stel in watter mate bestuurders se vereiste houdings en huidige houdings jeens VMB verskil; en 5) om aanbevelings te doen vir die versterking van positiewe houdings jeens die VMB-program. Metode: Die studie het van ’n verkennende kwalitatiewe ontwerp gebruik gemaak. Dit is by die hoofkantoor van die Ministerie van Gesondheid sowel as in tien gesondheidsdistrikte in Botswana onderneem. Onderhoude aan die hand van ’n semigestruktureerde onderhoudsgids is met altesaam 26 VMB-programbestuurders gevoer. Resultate: Die studie bevind dat die bestuurders wél positiewe houdings jeens die program toon soos wat die standaarde van die Ministerie van Gesondheid vereis. Data dui op ’n positiewe tendens in die uitbreiding van die program, al word die vasgestelde teikens nie bereik nie.

A quantitative and descriptive type of study design was followed using structured self-administered questionnaires distributed among 84 conveniently selected male adolescent learners from Nanogang Community Junior Secondary School (NCJSS) in Gaborone. The purpose of this study was to describe factors that influence the uptake of safe male circumcision (SMC) as a human immune-deficiency virus (HIV) prevention strategy among male adolescent learners. The study findings show that protection from HIV and other sexually transmitted infections (STIs) was found to be the main reason for adolescent learners undergoing male circumcision (MC) (p<.01). Reasons such as maintenance of genital hygiene, culture, religion, and the enhancement of sexual pleasure were not found to be significant factors. Misconceptions such as the belief that girls do not like circumcised partners were found to be the main reason for adolescent learners not undergoing MC (p<.05). A number of factors which were claimed in previous studies to be obstacles for the uptake of MC, such as surgical complications, peer pressure, stigma, and discrimination, were not found to be major obstacles / Health Studies / M.A. (Public Health)

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)