"Zimbabwe and South Africa are facing an HIV/AIDS epidemic of such proportions that the populations of these countries will markedly decline in the next ten years despite the existence of effective drugs to treat the symptoms of AIDS and dramatically lower the communicability of the virus. These drugs are under patent protection by companies in the developed world and the patents raise the prices above the level of affordability for HIV infected persons in South Africa and Zimbabwe. Zimbabwe has declared a national emergency on HIV/AIDS, apparently in conformance with TRIPS and has issued compulsory licenses to a local company that has started to manufacture and sell cheap anti-retroviral drugs. South Africa has not declared a national emergency and has not invoked the TRIPS flexibilities or utilized flexibilities inherent in its own legislation. However, while thousands of people die every week in the two countries, neither government has yet provided an effective HIV/AIDS policy. Extensive litigation and public pressure in South Africa has led the government to announce a policy of supplying free HIV drugs in public hospitals while the Zimbabwean government has announced the provision of the same drugs, also in public hospitals, apparently utilising the state of emergency. The TRIPS agreement under which the two governments undertook to protect international patents allows compulsory licensing under certain circumstances (not limited to a national emergency) and the Doha Declaration on TRIPS and Public Health, and subsequent agreements by the Ministerial Council of the WTO allow the manufacture and, in limited circumstances, the parallel importation of generic drugs. These provisions provide a theoretical mechanism for poor countries to ensure their citizens' rights of access to health (care). The research is aimed at identifying the extent of the effectiveness of the legal norms created by Articles 20 and 31 of TRIPS, the Doha Declaration and subsequent Council of Ministers' decisions, which together ostensibly provide a framework to allow provision of generic drugs. It is further aimed at investigating how the state of emergency in Zimbabwe has been utilised to provide cheap generic drugs to Zimbabweans and whether this would be an option for South Africa. A comparison of the legal provisions governing the provision of drugs in the two countries will also be undertaken to examine the extent to which international and national constitutional and legal provisions may be utilised to give effect to the right to health." -- Introduction. / Thesis (LLM (Human Rights and Democratisation in Africa)) -- University of Pretoria, 2004. / Prepared under the supervision of Dr. Enid Hill at the American University in Cairo. / http://www.chr.up.ac.za/academic_pro/llm1/dissertations.html / Centre for Human Rights / LLM

MPH / Department of Public Health / The high maternal mortality ratio is caused by various factors, including avoidable complications which can be reduced by attendance to antenatal care visits. The utilisation of antenatal care has been low in rural areas, especially in Africa. The purpose of this study was to explore the utilisation of antenatal care in Mutasa District of Zimbabwe. This study used a qualitative study approach, adopting the descriptive, explorative design that presented an active image of the research participants’ reality and capture live experiences. Participants of the study were pregnant women and women with children under the age of one. The participant were sampled using purposive and snow-ball sampling techniques. In-depth interviews were conducted. The participants were interviewed in their native language, Shona. The main question was: Can you explain in your own words how you use antenatal care services from the primary health care facility? The researcher clarified questions which the participant failed to understand. The researcher wrote down all responses and used a tape recorder to capture the responses. The researcher analysed data using thematic content analysis where themes and sub-themes were discussed. The main theme was low uptake of antenatal care in rural primary health care facilities. From the main theme there were factors influencing and perceptions of women on uptake of antenatal care services in primary health care facilities. Trustworthiness was ensured through credibility, dependability, transferability and conformability. Permission from the relevant authorities, such as the University of Venda Higher Degrees Committee, the Provincial Medical Director and the District Administrator was sought before conducting this study. Informed consent was also sought before interviewing the participants. The study concluded that socio-demography of participants affected antenatal care attendance. These are age, level of education, low income, high parity and distance to facility. Other hindering factors to utilization of antenatal care were lack of knowledge, religion and acceptability of antenatal care by the women in rural primary health care facilities. Findings will be disseminated through a research report and published in relevant accredited journals with the help of the supervisors. The study recommended that the Ministry of Health and Child Care of Zimbabwe review Antenatal Care policies to ensure friendliness and to increase awareness through health education and continuous dissemination of antenatal care information. / NRF

Community participation has been hailed as the panacea for most community programmes. Community participation at high levels empowers communities, increases self-reliance, selfawareness and confidence in self-examination of problems and seeking solutions for them Behavioural changes are promoted and utilisation and support of services is facilitated, which is of great importance in antenatal care and generally in this present day of HIV/AIDS. The purpose of this study was to determine the extent to which women were participating in the provision of antenatal care. Secondly, the study sought the pregnant women's perceptions and expectations regarding their participation in the provision of antenatal care and to find out at what level if any, the women wanted to be involved in the provision of antenatal care. The theoretical model guiding this study was Rifkin' s model for evaluating community participation. A guided interview was conducted with 30 conveniently selected pregnant mothers residing in the area of the Chinamhora clinic. The results indicated limited participation in the five process indicators of community participation. However, all the women regarded community participation as being important. The majority of the women wished to be involved at high levels of participation. The results of this study should be valuable to health care professionais in formulating strategies and modifying existing programmes to enhance community participation, with the decentralisation of health services in Zimbabwe. / Health Studies / M.A. (Advanced Nursing Sciences)

Community participation has been hailed as the panacea for most community programmes. Community participation at high levels empowers communities, increases self-reliance, selfawareness and confidence in self-examination of problems and seeking solutions for them Behavioural changes are promoted and utilisation and support of services is facilitated, which is of great importance in antenatal care and generally in this present day of HIV/AIDS. The purpose of this study was to determine the extent to which women were participating in the provision of antenatal care. Secondly, the study sought the pregnant women's perceptions and expectations regarding their participation in the provision of antenatal care and to find out at what level if any, the women wanted to be involved in the provision of antenatal care. The theoretical model guiding this study was Rifkin' s model for evaluating community participation. A guided interview was conducted with 30 conveniently selected pregnant mothers residing in the area of the Chinamhora clinic. The results indicated limited participation in the five process indicators of community participation. However, all the women regarded community participation as being important. The majority of the women wished to be involved at high levels of participation. The results of this study should be valuable to health care professionais in formulating strategies and modifying existing programmes to enhance community participation, with the decentralisation of health services in Zimbabwe. / Health Studies / M.A. (Advanced Nursing Sciences)