Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: An estimated 34 million people worldwide are infected with HIV with 52% of them being women (UNAIDS, 2011), of this figure, an estimated 3.4 million are said to be children below the age of 15years. Sub Saharan Africa accounts for up to 90% of this burden in children. Nigeria, the most populous nation is Saharan African still contributes up to 30% of the global burden of mother to child transmission of HIV which is a major source of infection in children. According to the Federal ministry of health 2010 ANC survey report, the country has a prevalence of 4.1%. The Federal Capital Territory (FCT) where Karu village is located ranked 5th among the 36 states and Federal capital territory in Nigeria with a prevalence of 8.7%. Urban prevalence is 8.6% while the rural prevalence is 8.2%. An exploratory descriptive study was conducted among women of child bearing age (18 to 49years) living in Karu village, Abuja, FCT, North central Nigeria. A semi structured questionnaire designed to assess the knowledge, attitude and practices of prevention of mother to child transmission of HIV was administered by the researcher on 120 women of child bearing age living in Karu village after obtaining their consent. The study received an ethical review and approval from FCT human research ethics committee at the Health Department of the Federal capital development agency and Stellenbosch University, ethic committee. Findings from the 120 women who gave consent to participate showed that 28.33% had sufficient knowledge of how MTCT can occur with 77% having insufficient knowledge of how MTCT occur, 51.67% of them have sufficient knowledge of how PMTCT can be achieved while 48.33% do not. Of the participant surveyed, 89.17% of them have ever been pregnant while 24.17% were pregnant at the time of the survey, the bulk of the participants were between the ages of 18 to 34 with only 22.5% of them within the age of 35 – 49 years. From this study, women in Karu village were identified to have high level of general knowledge regarding MTCT and PMTCT of HIV but in-depth knowledge of both is still insufficient among a large group of women. Health workers and mass media were identified as key sources of information regarding MTCT and PMTCT of HIV and majority of women have favourable attitude towards PMTCT interventions but practices of these interventions is still relatively low. / AFRIKAANSE OPSOMMING: Ongeveer 34 miljoen mense is wêreldwyd aangetas deur MIV, waarvan 52% vroue is (UNAIDS, 2011). Hiervan is ongeveer 3.4 miljoen na bewering kinders onder die ouderdom van 15 jaar. Tot 90% van hierdie infeksie by kinders kom in sub-Sahara-Afrika voor. Nigerië, die digsbevolkte staat in sub-Sahara-Afrika, dra tot 30% van die globale las van moeder-tot-kind-oordrag van MIV, wat ’n groot bron van infeksie onder kinders is. Volgens die Federale Ministerie van Gesondheid 2010 ANC-opnameverslag het die land ’n voorkomssyfer van 4.1%. Die Federal Capital Territory (FCT), waar die dorp Karu geleë is, is as 5de van die 36 state in Nigerië geklassifiseer met ’n voorkomssyfer van 8.7%. Die stedelike voorkomssyfer is 8.6% teenoor die landelike voorkomssyfer van 8.2%. ’n Ondersoekende, beskrywende studie is uitgevoer onder vroue van vrugbare leeftyd (18 tot 49 jaar) wat in die dorp Karu, Abuja, FCT, Noord-sentrale Nigerië, woon. ’n Halfgestruktureerde vraelys is ontwerp om die kennis, houdings en voorkomingspraktyke van moeder-tot-kind-oordrag (MTCT) van MIV te beoordeel. Dit is deur die navorser toegepas op 120 vroue van vrugbare leeftyd wat in die dorp Karu woon nadat hul toestemming daartoe verkry is. Die studie het ’n etiese oorsig en goedkeuring van die FCT mensenavorsing-etiekkomitee by die Departement van Gesondheid van die federale hoofstad se ontwikkelingsagentskap en die Universiteit Stellenbosch se etiekkomitee ontvang. Bevindings van die 120 vroue wat ingestem het om deel te neem het getoon dat 28.33% toereikende kennis gehad het van hoe MTCT kan voorkom, met 77% wat onvoldoende kennis gehad het van hoe MTCT voorkom. Van hulle het 51.67% genoegsame kennis gehad van hoe PMTCT verkry kan word, terwyl 48.33% nie oor hierdie kennis beskik het nie. Van die deelnemers wat waargeneem is, was 89.17% al swanger, terwyl 24.17% tydens die opname swanger was. Die meerderheid van die deelnemers was tussen 18 en 34 jaar oud, met slegs 22.5% wat in die ouderdomsgroep 35 – 49 jaar geval het. Uit hierdie studie het geblyk dat vroue van die dorp Karu geïdentifiseer is as mense wat ’n hoë vlak van algemene kennis omtrent MTCT en PMTCT van MIV gehad het, maar dieptekennis van albei sake is steeds ontoereikend by ’n groot groep vroue. Gesondheidswerkers en die massamedia is geïdentifiseer as sleutelbronne van kennis oor MTCT en PMTCT van MIV en die meeste vroue het ’n gunstige houding teenoor PMTCT-intervensies, maar die toepassing van hierdie intervensies is nog betreklik laag.

The health care industry in Nigeria is increasingly grappling with challenges of meeting end users’ requirements and expectations for quality antiretroviral therapy (ART) service provision. This study sought to explore and describe the quality of antiretroviral therapy in public health facilities in Nigeria and the perceptions of the end users. A descriptive qualitative research design was used in the study in order to generate ideas from end users for improving quality of ART service provision, and prompt additional research activities. Unstructured focus group discussions were conducted with end users (n=64) in 6 locations across the 6 geopolitical zones of Nigeria. Data was analysed using the framework approach because it reflects the original accounts and observations of the end users and the Weft QDA version 1.0.1 software to validate the results. Findings revealed that end users were satisfied with uninterrupted antiretroviral drug supplies, courtesy treatment, volunteerism of support group members and quality counselling services. End users expect public health facilities to accept diagnostic results from collaborating facilities, implement continuous quality improvement (CQI), maintain clean and adequate health infrastructure, reduce end user waiting time, reduce stigma, comprehensively assess end users during each clinic visit and ensure uninterrupted ART services. They also expect effective collaboration between healthcare providers and support group members, to enhance the quality of life of people living with HIV (PLHIV). End users identified the following as quality gaps in ART service provision: weak health facility leadership, non-attractive ART service infrastructure, frequently interrupted laboratory services, demotivated and inadequate health care workers, long waiting time, interrupted medicine supplies and inadequate procedure for complaints management. In conclusion, the following recommendations were proffered: deploy and train additional health care workers, integrate ART into regular health services, improve supply chain management of health commodities, and reduce end user overload in clinics. Finally, a best practice guideline for the provision of end user focused ART service provision was developed. / Health Studies / D.Litt. et Phil. (Health Studies)

The health care industry in Nigeria is increasingly grappling with challenges of meeting end users’ requirements and expectations for quality antiretroviral therapy (ART) service provision. This study sought to explore and describe the quality of antiretroviral therapy in public health facilities in Nigeria and the perceptions of the end users. A descriptive qualitative research design was used in the study in order to generate ideas from end users for improving quality of ART service provision, and prompt additional research activities. Unstructured focus group discussions were conducted with end users (n=64) in 6 locations across the 6 geopolitical zones of Nigeria. Data was analysed using the framework approach because it reflects the original accounts and observations of the end users and the Weft QDA version 1.0.1 software to validate the results. Findings revealed that end users were satisfied with uninterrupted antiretroviral drug supplies, courtesy treatment, volunteerism of support group members and quality counselling services. End users expect public health facilities to accept diagnostic results from collaborating facilities, implement continuous quality improvement (CQI), maintain clean and adequate health infrastructure, reduce end user waiting time, reduce stigma, comprehensively assess end users during each clinic visit and ensure uninterrupted ART services. They also expect effective collaboration between healthcare providers and support group members, to enhance the quality of life of people living with HIV (PLHIV). End users identified the following as quality gaps in ART service provision: weak health facility leadership, non-attractive ART service infrastructure, frequently interrupted laboratory services, demotivated and inadequate health care workers, long waiting time, interrupted medicine supplies and inadequate procedure for complaints management. In conclusion, the following recommendations were proffered: deploy and train additional health care workers, integrate ART into regular health services, improve supply chain management of health commodities, and reduce end user overload in clinics. Finally, a best practice guideline for the provision of end user focused ART service provision was developed. / Health Studies / D.Litt. et Phil. (Health Studies)

The thesis explored the story of the healing of the ten lepers by Jesus in Luke 17:11-19 for its potential to facilitate a conversation between the Jesus context and the Yoruba context, to bring about a new praxis in the attitude of Yoruba Christian to people living with HIV and AIDS. In view of the fact that the context is a major determinant in the interpretations that ecumenical theologians make with the Bible, it calls on the interpreter to re-read the text in the culture of the people. And in a bid for African biblical scholarship to locate itself within the social, political and ecclesiastical context of Africa in the age of globalization and the scourge of HIV and AIDS crisis, a contextual reading of Jesus’ attitude and compassionate response to the wish of the ten lepers as presented in Luke for healing and restoration is not only desirable in this research but an opportunity to reflect on the contribution of contextual exposition of the miracle story to the contemporary attitude of Christians in an HIV and AIDS era. HIV and AIDS is a disease which not only plunders human bodies but also invades the attitude and behaviour of societies generating a kind of social pathology. Hence the definition of social phenomena is culturally determined and therefore the explanation and the attitudes of health and illness is a function of culture. As a result this has great implications for the attitude and behaviour of people towards sick people especially people living with HIV and AIDS in this era. Drawing insights from the model of the body as social map by Mary Douglas in which the concern and fight around social boundaries are linked with purity rules and taboo; and the labeling/deviancy theory of Becker, this research reads the Gospel of Luke with a social-scientific lens selected texts in Luke’s Gospel depicting the attitude of Jesus to outcasts (lepers). It also raises the question, whether being a Christian, having the Bible as a resource in the Yoruba context does or can make a difference to the way Yoruba people respond to sick people in an HIV and AIDS era. The empirical study was carried out in the Yoruba community of Ijebu Remo, Ogun State, Nigeria employed research methods which include the Tripolar exegetical method, an ethnographic study through focus group discussions, non-participatory observation and the contextual Bible study method. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2011.

Thesis (MPhil)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: The research focused on the knowledge of occupational safety by hospital managers towards HIV and other blood borne pathogens transmission in Abakaliki region in eastern Nigeria. These pathogens are easily transmissible by needle sticks and other occupational accidents. It is important to identify factors that pre-expose hospital cleaners to occupational risk exposure that can lead to the transmission of HIV, HBV and HCV. The research was conducted in 10 different hospitals. A total of 90 questionnaires were administered to the hospital cleaners that volunteered to participate in the research and 68 questionnaires were returned representing 75.6% of the total questionnaires. The mean age and standard deviation of the respondents in this study was 38.6 + or – 5.4 years. The researcher conducted a semi-structured interview with all the 10 hospital managers involved with the study and the interviews showed there was a need for an organised training on hospital work and occupational hazards, risk exposures and precautions. The questionnaires showed the knowledge of hospital cleaners on occupational safety and it was observed the majority of the hospital cleaners were not aware of post exposure prophylaxis for HIV. The workers relatively had good practices put in place to prevent HIV, HBV and HCV transmission but majority of them had not received HBV vaccine due to lack of awareness and availability. There was a significant positive correlation between the knowledge of the health workers and HIV transmission and the practice put in place by health workers to prevent HIV transmission (P<0.05). This implies as the knowledge of the health workers about HIV transmission increases, the practice put in place by health workers to prevent HIV transmission and Hepatitis B&C increases. Therefore there is need for continuous training on blood borne pathogens transmission such as HIV transmission in the hospitals and its routes of transmission. There is need for awareness creation for HBV vaccine and Post exposure prophylaxis for HIV exposure. / AFRIKAANSE OPSOMMING: Nie beskikbaar / jfl201601

This thesis seeks to outline the HIV epidemic in Nigeria and understand the response of the Church of Nigeria (Anglican Communion) to the epidemic. In evaluating the Church of Nigeria's policy document, it also seeks to understand how the response needs to be strengthened. The thesis looks at the history of HIV and AIDS in Nigeria and the impact of the epidemic on the Nigerian society. It further identifies some of the factors that contribute to the spread of HIV in Nigeria and the government's response to the epidemic. For the Church to respond appropriately to the epidemic there is a great need to start by theologizing the epidemic in a more helpful way. It is based on this that this thesis further attempts to theologize the epidemic by discussing sexuality, the notion of imago dei and shalom as well-being. The thesis examines the six thematic areas of the policy document and presents a critical analysis in which it discovers that though there are good things in the policy document, it however, needed a more solid theological foundation and employment of an educative tool that is more inclusive. Central to the argument of the thesis is that no one factor drives the epidemic, but rather a complex interaction between several factors. Therefore, to strengthen the policy document the thesis suggests a number of things to do which include a more solid theological foundation and employing of the 'SAVE' approach as an educative tool in response to the epidemic. / Thesis (M.Th.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.