OBJECTIVE/ METHOD The study examined implementation challenges faced by primary health care workers within the Ekurhuleni Metropolitan Municipality in Gauteng South Africa. Data collection was based on semi-structured interviews carried out on a purposive sample (n=19) of frontline clinicians working within the district as primary health care practitioners. RESULTS Participants confirmed that work within the primary health care service disproportionately focussed on curative and rehabilitative functions of their roles with little prioritisation of preventive and promotive interventions. Primary identified reasons included, institutional culture that prioritised short-term curative approaches. Clinicians also cited a range of other organisational barriers, such as – poor strategic planning, and a lack of understanding of health promotion and illness prevention. CONCLUSIONS Although the challenges that exist in implementing primary health care are clearly understood, clinicians perceive the solutions for these as being within the control of policy makers and those with power within the organisation. / Health Studies / M.A. (Public Health)

The focused of this study is the role of capacity building in Community Home Based Care (CHBC) for HIV/AIDS patients. The study forms part of my Master's in Development Administration programme, undertaken through UNISA. The dissertation was accomplished by studying the TASO community initiative in Sseeta-Nazigo, Mukono District, Uganda. It explores the concept of capacity building and its applicability to CHBC. The primacy data was gathered by conducting Key Infonnant Interviews (KIIs) and Focus Group Discussions (FGD). The secondary data was gathered by reviewing literature to augment the primary data. In addition, data was gathered through observations within the community. The fmdings have identified seven critical components of capacity building: community mobilisation, skills development, Information, Education and Communication (IEC) Voluntary Counselling and Testing (VCT), networking and collaboration, support and supervision, Monitoring and Evaluation (M&E). The study observed that capacity built in the above areas resulted in three outcomes: skills development, improvement in procedures, and institutional development. Informed recommendations were subsequently made related to the seven componentsof capacity building in CHBC / Development Studies / M. A. (Development Studies)

Summaries in English, Afrikaans and Zulu / South Africa is facing an ongoing public health crisis with increasing and alarming human immunodeficiency virus (HIV) statistics. Farmworkers in South Africa are highly vulnerable and susceptible to HIV. This study involved the farmworker community on a farm in the North West province of South Africa. The purpose of this study was to explore the perceptions and acceptance of home-based HIV counselling and testing (HBHCT) in a rural farming community, using an interactive World Café method to stimulate creative discussions around questions that matter. Thirty-one farmworkers participated in the World Café. This study had an explorative approach and qualitative design. The study did not investigate the number of HIV infections or sexual practices on the farm, and did not offer an HIV test or any other medical treatment to any participant. Data were collaboratively analysed by the researchers and the participants. Content analysis of data was conducted. The findings indicated that majority of the farmworkers had a positive perception of HBHCT, and that there was a serious need for HIV prevention and intervention in this community. Some concerns were raised among the participants regarding the confidentiality of HBHCT, attention should therefore be paid to these concerns. More research is needed to establish linkage to care after HBHCT. It remains unclear whether the migrant farmworker population would be effectively linked to HIV care and treatment without legal identification documentation. The acceptance of HBHCT in the farming community by farmers, should be explored. The study found that there would be a high level of acceptability if HBHCT were to be offered to farmworkers in this region. This study created insight into the HIV care and prevention needs of the local farmworker community, as well as highlighted the barriers the farmworkers face in attending primary healthcare (PHCs) clinics for HIV testing. / Suid-Afrika staar ’n voortdurende openbare gesondheidskrisis in die gesig met toenemende en onrusbarende menslike immuungebrekkige virus (MIV)-statistieke. Plaaswerkers in Suid-Afrika is uiters kwesbaar en vatbaar vir MIV. Hierdie studie het die plaaswerkergemeenskap van ’n plaas in die Noordwes-provinsie van Suid-Afrika geteiken. Die doel van hierdie studie was om die sieninge en aanvaardingsvlakke van tuis-gebaseerde MIV-berading en -toetsing (TSMBT) te ondersoek, deur gebruik te maak van die “World Café”-metode om kreatiewe bespreking rondom belangrike vrae te stimuleer. Een-en-dertig plaaswerkers het deelgeneem aan die “World Café”. Hierdie studie het nie die aantal MIV-infeksies of seksuele praktyke op die plaas ondersoek nie, en ook nie ’n MIV toets of enige ander mediese behandeling vir enige deelnemer aangebied nie. Die studie het gevind dat die meerderheid van die plaaswerkers ’n positiewe persepsie van TSMBT gehad het, en dat daar ’n dringende behoefte aan MIV-voorkoming en - ingryping in hierdie gemeenskap is. Bekommernis is uitgespreek deur die deelnemers rakende die konfidensialiteit van TSMBT, dus moet aandag hieraan geskenk word. Die studie het gevind dat daar ’n hoë vlak van aanvaarding van TSMBT sal wees as dit aan die plaaswerkers in hierdie streek gebied word. Hierdie studie skep insig in die MIVsorg- en -voorkomingsbehoeftes van die plaaslike plaaswerkergemeenskap, en beklemtoon die hindernisse vir plaaswerkers om die primêre gesondheidsorgkliniek te besoek vir MIV-toetsing. / INingizimu-Afrika ibhekene nokuqhubeka kokukhula kwenkinga yezempilo, kanye nokudlondlobala okushaqisayo kwezibalo zegciwane lesandulela ngculazi (HIV). Abasebenzi basemapulazini eNingizimu-Afrika ibona abasengozini enkulu yokutheleleka ngegciwane lesandulela ngculazi. Lolucwaningo lwenziwe emphakathini wabasebenzi basemapulazini esifundazweni sase-North West eNingizimu-Afrika. Inhloso yalolucwaningo bekuwukubona imibono kanye nezinga lokwamukela ukululekwa nokuhlolela igciwane lesandulela ngculazi emakhaya(i-HBHCT) emphakathini wasemapulazini kusetshenziswa Isizinda sokucobelelana ngolwazi (i- World Cafe) ukukhuthaza izingxoxo ezakhayo nokubuza imibuzo esemqoka. Bangama- 31 abasebenzi basepulazini ababambe iqhaza esizindeni sokucobelelana ulwazi (i- World Cafe). Lolucwaningo aluzange luphenye izibalo zabantu abatheleleke ngegciwane lesandulela ngculazi kanye nezinga labo lokuzibandakanya ocansini, futhi aluzange lunike abebebambe iqhaza ithuba lokuhlolela igciwane lesandulela ngculazi(HIV) kanye nokulashwa kwanoma iluphi uhlobo. Imiphumela iveze ukuthi iningi labasebenzi basemapulazini babe nemibono emihle mayelana nosizo lokululekwa nokuhlolela igciwane lesandulela nngculazi (HIV) emakhaya (HBHTC), futhi kunesidingo esikhulu sokuthi kungenelelwe kulomphakathi ukuze kuvikelwe igciwane lesandulela ngculazi (HIV). Kube nokukhathazeka kwababebambe iqhaza mayelana nezimfihlo zokulekelelwa ngokwelulekwa kanye nokuhlolela igciwane lesandulela ngculazi emakhaya(HBHCT),ngalokhoke kufanele kubhekelelwe lokho kukhathazeka. Ucwaningo luveza ukuthi kuzokwamukelwa ukuqala usizo lokwalulekwa nokuhlolela igciwane lesandulela ngculazi (HBHCT) kubasebenzi basemapulazini kulesisifundazwe. Lolucwaningo luveze ngokujulile izidingo zokunakekela kanye nokuvikela igciwane lesandulela ngculazi (HIV) emphakathini wabasebenzi basemapulazini kulendawo, laphinde lwaveza nezithiyo (Barriers) abasebenzi basemapulazini abahlangana nazo mabevakasha emitholampilo (PHCs) ukuyohlola igciwane lesandulela ngculazi. / Health Studies / M.P.H. (Public Health)

The focused of this study is the role of capacity building in Community Home Based Care (CHBC) for HIV/AIDS patients. The study forms part of my Master's in Development Administration programme, undertaken through UNISA. The dissertation was accomplished by studying the TASO community initiative in Sseeta-Nazigo, Mukono District, Uganda. It explores the concept of capacity building and its applicability to CHBC. The primacy data was gathered by conducting Key Infonnant Interviews (KIIs) and Focus Group Discussions (FGD). The secondary data was gathered by reviewing literature to augment the primary data. In addition, data was gathered through observations within the community. The fmdings have identified seven critical components of capacity building: community mobilisation, skills development, Information, Education and Communication (IEC) Voluntary Counselling and Testing (VCT), networking and collaboration, support and supervision, Monitoring and Evaluation (M&E). The study observed that capacity built in the above areas resulted in three outcomes: skills development, improvement in procedures, and institutional development. Informed recommendations were subsequently made related to the seven componentsof capacity building in CHBC / Development Studies / M. A. (Development Studies)

The limited success of HIV-testing facilities in South Africa means that many people are not accessing necessary antiretroviral treatment services. This study investigates the practical implications of HIV exceptionalism inherent in Voluntary Counselling and Testing (VCT). A semi-structured interview schedule was used to survey participants for their perspectives on barriers to HIV-testing uptake as well as the effects of exceptionalist practices at VCT clinics. Responses showed marked perceptions of gender differences in people's willingness to test and several important barriers including problems of access to services. Significantly, exceptionalism displayed in certain clinic procedures was thought to contribute to stigma, and attempts to normalise HIV practice in order to combat the effects of stigma were being informally implemented. Participants' views on routine opt-out testing were explored. The researcher recommended further investigation on how HIV testing and treatment policies can be normalised so as to reduce stigma and increase testing uptake. / Social Work / M.A. Sociology (Social Behaviour Studies in HIV/AIDS)

The limited success of HIV-testing facilities in South Africa means that many people are not accessing necessary antiretroviral treatment services. This study investigates the practical implications of HIV exceptionalism inherent in Voluntary Counselling and Testing (VCT). A semi-structured interview schedule was used to survey participants for their perspectives on barriers to HIV-testing uptake as well as the effects of exceptionalist practices at VCT clinics. Responses showed marked perceptions of gender differences in people's willingness to test and several important barriers including problems of access to services. Significantly, exceptionalism displayed in certain clinic procedures was thought to contribute to stigma, and attempts to normalise HIV practice in order to combat the effects of stigma were being informally implemented. Participants' views on routine opt-out testing were explored. The researcher recommended further investigation on how HIV testing and treatment policies can be normalised so as to reduce stigma and increase testing uptake. / Social Work / M.A. Sociology (Social Behaviour Studies in HIV/AIDS)

The study explored, described and explained the current models of voluntary counselling and testing services delivery and analysed the extent to which a given VCT model had influenced uptake of VCT services in the fishing communities along the shores of Lake Victoria, in Wakiso District, with an aim of designing optimal VCT service delivery strategies. The study was therefore exploratory, descriptive and explanatory, and collected both qualitative and quantitative data in a three-phased approach. Phase I involved the Kasenyi fishing community respondents, while phases II and III involved VCT managers and VCT counsellors at the Entebbe and Kisubi Hospitals. The findings indicated that VCT services are generally available onsite at health facilities, and in the field through mobile VCT outreach or home-based VCT services provided at clients’ homes. Both client-initiated and health provider-initiated VCT services are available and services are integrated with other health services. Despite the availability of VCT, only about half of the respondents in phase I had accessed VCT services although almost all indicated a willingness to undergo HIV testing in the near future. The main challenges to service delivery and utilisation included limited funding and staffing as well as limited awareness in target communities. The strategies drawn are based on the need to increase availability, accessibility, acceptability and utilisation of VCT services. / Health Studies / D. Litt. et Phil. (Health Studies)

The study explored, described and explained the current models of voluntary counselling and testing services delivery and analysed the extent to which a given VCT model had influenced uptake of VCT services in the fishing communities along the shores of Lake Victoria, in Wakiso District, with an aim of designing optimal VCT service delivery strategies. The study was therefore exploratory, descriptive and explanatory, and collected both qualitative and quantitative data in a three-phased approach. Phase I involved the Kasenyi fishing community respondents, while phases II and III involved VCT managers and VCT counsellors at the Entebbe and Kisubi Hospitals. The findings indicated that VCT services are generally available onsite at health facilities, and in the field through mobile VCT outreach or home-based VCT services provided at clients’ homes. Both client-initiated and health provider-initiated VCT services are available and services are integrated with other health services. Despite the availability of VCT, only about half of the respondents in phase I had accessed VCT services although almost all indicated a willingness to undergo HIV testing in the near future. The main challenges to service delivery and utilisation included limited funding and staffing as well as limited awareness in target communities. The strategies drawn are based on the need to increase availability, accessibility, acceptability and utilisation of VCT services. / Health Studies / D. Litt. et Phil. (Health Studies)