This descriptive study aimed to assess the Infant and Young Child Feeding (IYCF) policy implementation in the Prevention of Mother-to-Child Transmission of HIV (PMTCT) among healthcare workers in the Nelson Mandela Bay Municipality public health care facilities. A convenience sampling method was used to gather information from nurses (n=32) rendering maternal and child health services in nineteen permanent Nelson Mandela Bay public health care facilities (MOU’s, paediatric sections, well baby clinics and PMTCT sites). Recommendations included to the need develop indicators for measuring the IYCF policy objectives and regularly collect data on infant and young child feeding, standardising infant feeding education given by peer educators / lay counsellors from various organisations, capacity building and training of staff on IYCF and scaling up monitoring and evaluation of the IYCF policy impact.

This study explored and described the strategies used by nurses to manage newly diagnosed HIV positive pregnant women who do not return to the clinic within a month following diagnosis, for continuity of care. The main aim was to prevent mother-to-child transmission of HIV (PMTCT). Method: The study sites were two accredited antiretroviral- ante-natal care (ARV-ANC) clinics at the Dimbaza community health centre (CHC) and the East London Hospital Complex (ELHC) which comprises of Cecilia Makiwane and Frere hospitals, in the Buffalo City Metropolitan Municipality (BCM). The majority of health personnel at these clinics are professional nurses. An in-depth semi structured interview guide was used to collect data through focus group interviews from professional nurses who work in these units. They were required to share their experiences about intervention strategies used for newly diagnosed HIV- positive, pregnant women who fail to return for continuity of care within a month after diagnosis. Results: Follow up of these women is done by tracking them (by calling them; calling the clinic nearest to their homes and doing home visits). Decentralisation of further management and care to the nearest clinic was also cited, especially for the patients who stay far from these accredited sites. Family support was also mentioned as a strategy to intervene for the non-compliant patients. Challenges: The challenges that were encountered with these interventions include wrong contact details, wrong addresses and being evasive when visited at home. Another challenge cited was related to the stigma attached to the diagnosis and the tracking devices used, for example, the car as it is familiar to the community it serves. Despite known benefits for early initiation of HIV treatment newly diagnosed HIV- positive, pregnant women continue to refrain from accessing care after diagnosis, thus posing a risk to the transmission of HIV to the baby and further comprising their own health. They miss out on general HIV management and ante-natal care. Conclusion: The identified intervention strategies used by nurses to follow up newly diagnosed HIV- positive, pregnant women need to be reinforced and strategies put in place to control the related challenges for a better response by the patients.

This study will look at the possible interpretations and implementation methods that a state may adopt in accordance with internationally recognised standards and best practices. This will be in light of the special context of Africa and specifically as regards the disposition of women in the HIV and AIDS pandemic. The author critically analyse article 14(1)(e)of the African Women’s Protocol and establish possible interpretations that best advance the public health goal of arresting the spread of HIV in Africa / Thesis (LLM (Human Rights and Democratisation in Africa)) -- University of Pretoria, 2008. / A Dissertation submitted to the Faculty of Law University of Pretoria, in partial fulfilment of the requirements for the degree Masters of Law (LLM in Human Rights and Democratisation in Africa). Prepared under the supervision of Dr. Patrice E. Vahard of the Faculty of Law, Addis Ababa University / http://www.chr.up.ac.za/ / Centre for Human Rights / LLM

Thesis in English, Annexure E: Consent form (leaf 81) as well as KABP Survey Questionnaire (leaves 87-91) in English and SiSwati. / The purpose of the study was to assess knowledge, explore attitudes and determine practices of breastfeeding mothers living with HIV regarding post-natal PMTCT interventions and services. The study was quantitative and descriptive in nature, utilising a retrospective cohort design. The study sample included breastfeeding mothers living with HIV, who attended the King Sobhuza II public health unit in the Manzini region of Swaziland. A written questionnaire was administered to a non-random sample of 90 consecutively selected mothers living with HIV attending the above-cited public health unit for post-natal health purposes. The overall study results revealed that the majority of breastfeeding mothers living with HIV in the afore-mentioned region (77.8%) presented high levels of knowledge on PMTCT, and 90% demonstrated a positive attitude; while a further 90% also demonstrated positive behaviour towards PMTCT. However, stigma and discrimination among family members, non-disclosure of HIV status to sexual partners; as well as poverty and fear of future drug-resistance are the cause of non-adherence to ARV prophylaxis. Furthermore, inconsistent condom use, mixed-feeding methods and wet-nursing also emerged as other contributing factors to the increase of post-natal mother-to-child transmission of HIV among breastfeeding mothers living with HIV. / Health Studies / M.A. (Nursing Science)

In its efforts to reduce maternal mortality and prevent Mother-to-Child Transmission of HIV, the government of Swaziland developed and implemented several programmes including a special antenatal care package for HIV-positive pregnant women in line with the WHO (2009) guidelines. Since the implementation of this latest special ANC package for HIV-positive women, little is known about how these services are experienced by the intended recipients. The purpose of this study was to explore and describe the actual experiences of HIV-positive women with the antenatal care services provided at a regional referral hospital in Swaziland, with the view of providing more insight into the quality of ANC services from the users' perspectives. A qualitative descriptive, exploratory design was used to address the above purpose. The researcher used purposive sampling to select the participants who met the inclusion criteria for the study. Semi-structured individual interviews were used and saturation was reached after 18 individual face-to-face interviews. Thematic content analysis was used to analyse the collected data. Forteen themes related to the participants experiences with the ANC services and seven related to measures for improvement emerged from data. In general HIV positive pregnant women expressed positive views towards ANC services they received at the target institution. The results give an indication on the quality of the focussed ANC package provided at the hospital and specific recommendations for improvement are outlined. / Health Studies / M. A. (Nursing Science)

Thesis in English, Annexure E: Consent form (leaf 81) as well as KABP Survey Questionnaire (leaves 87-91) in English and SiSwati. / The purpose of the study was to assess knowledge, explore attitudes and determine practices of breastfeeding mothers living with HIV regarding post-natal PMTCT interventions and services. The study was quantitative and descriptive in nature, utilising a retrospective cohort design. The study sample included breastfeeding mothers living with HIV, who attended the King Sobhuza II public health unit in the Manzini region of Swaziland. A written questionnaire was administered to a non-random sample of 90 consecutively selected mothers living with HIV attending the above-cited public health unit for post-natal health purposes. The overall study results revealed that the majority of breastfeeding mothers living with HIV in the afore-mentioned region (77.8%) presented high levels of knowledge on PMTCT, and 90% demonstrated a positive attitude; while a further 90% also demonstrated positive behaviour towards PMTCT. However, stigma and discrimination among family members, non-disclosure of HIV status to sexual partners; as well as poverty and fear of future drug-resistance are the cause of non-adherence to ARV prophylaxis. Furthermore, inconsistent condom use, mixed-feeding methods and wet-nursing also emerged as other contributing factors to the increase of post-natal mother-to-child transmission of HIV among breastfeeding mothers living with HIV. / Health Studies / M.A. (Nursing Science)

In its efforts to reduce maternal mortality and prevent Mother-to-Child Transmission of HIV, the government of Swaziland developed and implemented several programmes including a special antenatal care package for HIV-positive pregnant women in line with the WHO (2009) guidelines. Since the implementation of this latest special ANC package for HIV-positive women, little is known about how these services are experienced by the intended recipients. The purpose of this study was to explore and describe the actual experiences of HIV-positive women with the antenatal care services provided at a regional referral hospital in Swaziland, with the view of providing more insight into the quality of ANC services from the users' perspectives. A qualitative descriptive, exploratory design was used to address the above purpose. The researcher used purposive sampling to select the participants who met the inclusion criteria for the study. Semi-structured individual interviews were used and saturation was reached after 18 individual face-to-face interviews. Thematic content analysis was used to analyse the collected data. Forteen themes related to the participants experiences with the ANC services and seven related to measures for improvement emerged from data. In general HIV positive pregnant women expressed positive views towards ANC services they received at the target institution. The results give an indication on the quality of the focussed ANC package provided at the hospital and specific recommendations for improvement are outlined. / Health Studies / M. A. (Nursing Science)

Text in English / This qualitative descriptive phenomenological study explored the experiences of HIV positive women utilising PMTCT services at a central hospital in Zimbabwe. Data was collected using in-depth interviews of fifteen participants. The interviews were audio recorded and transcribed verbatim. Using the Interpretive Phenomenological Analysis framework for data analysis, two super-ordinate themes emerged, namely resources for provision of PMTCT services and approaches and nature of PMTCT care. The study revealed challenges experienced by HIV positive women emanating from material, financial and human resource related constraints in the PMTCT setting. The resource challenges negatively affected access and utilisation of PMTCT services. A practice model, whose purpose is to enhance the quality and utilisation of PMTCT services, was developed and described. The model was evaluated using Chin and Krammer (2011) criteria plus a modified form of the Delphi technique. These findings have implications for effective PMTCT service provision. The key lessons learnt for programmatic improvement were that in order to provide quality and accessible PMTCT services the health care system will need to be well resourced. There is need to strengthen the health care system in line with HIV related programmatic changes. / Health Studies / D. L.itt. 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)

The study into the socio-economic challenges of HIV and AIDS on widowed women in rural communities of Zimbabwe was carried out in the village of Mukadziwashe. The main aim of the study was to find out the socio-economic challenges that are faced by HIV and AIDS widows. Of particular concern has been role played change agent since the dawn of the HIV and AIDS pandemic and its devastating socio-economic impact on families, especially widows. The findings of this study are based on a sample of limited number (12) widows based in the village of Mukadziwashe in Gutu Central District, as well interviews of key informants who happen to be representatives of change agents in the main. In-depth interviews were the tool used to collect information from the research participants identified above. The findings of the study revealed that widows still suffer from the serious social and economic challenges posed by HIV and AIDS such as cultural oppressions and prevention of women from inheriting their late husbands’ wealth The continued denial of women of their constitutionally enshrined rights is difficult to understand, because many studies have been conducted on this subject. It is reasonable to expect noticeable progress in promoting the rights of women, especially widows. What is apparent in this sad story is the mute role of change agents, be they government, non-governmental or community based, in affirming widows’ rights. Based on these observations, the study strongly recommends the design, implementation and constant monitoring of intervention programmes aimed at women empowerment in general. / Sociology / M.A. (Social Behaviour Studies in HIV and AIDS)