In the following chapters, I will discuss the effectiveness of radio and audiotapes as appropriate tools for health communication particularly suited to reaching deprived and isolated communities. I will refer to the striking achievements in radio and audiotape projects by drawing on the experiences of more than sixty radio and cassette projects concerned with primary health care in developing countries. I will present a detailed description of my Argentinean and South African radio experiences, focussing on how the two programmes came into existence, the different stages they have gone through, the problems and constraints encountered as well as their strengths and successes. I will describe the audiotape project I am involved in, and demonstrate how audiotapes can be used alone or in conjunction with radio for primary health education.

This study applied the theory of reasoned action (TRA) and its extension, the theory of planned behaviour (TPB) to the design of a workplace HIV/AIDS health promotion programme. The purpose of the study was to determine if the variables of the TRA and TPB would predict intentions to change HIV/AIDS health behaviour, whether a theory-based intervention would result in health behaviour change over time and if there would be any significant health behaviour differences among participants who received a theory-based intervention and those who received an information-only intervention. In a longitudinal, quasi-experimental study, 170 government employees were divided into two groups. One group comprised 92 employees who participated in a HIV/AIDS health promotion workshop based on the theories of reasoned action and planned behaviour. The other group comprised 78 employees who took part in an educational information session about HIV and AIDS. An elicitation study was conducted with a sample of 38 employees from the research population two months prior to the commencement of the study. The findings of the elicitation study informed the design of research questionnaires and an intervention workshop. Both groups of participants (theory-based workshop and information-only workshop) were measured on HIV/AIDS health behaviour intentions and HIV/AIDS health behaviour (condom use, seeking HIV testing and monogamy) across three measurement periods over a six month period. The results of the study showed that the combined theoretical variables predicted intentions to use condoms and to seek HIV testing, with attitudes having the main effect on intentions. There was, however, no significant health behaviour change across the three measurement periods. There were also no health behaviour differences between the two intervention conditions at one month and six months post-intervention. The study concludes that the intervention based on the theories of reasoned action and planned behaviour did not produce health behaviour change. The study also identified barriers to AIDS health behaviour in the South African context that the theories of reasoned action and planned behaviour cannot explain. Ways in which the theories of reasoned action and planned behaviour can be adapted to HIV/AIDS education in collectivist cultures are proposed. / Psychology / Thesis (D. Phil. (Psychology))

The prevalence of Protein-Energy Malnutrition (PEM) in South Africa has been welldescribed in previous research studies and yet little is known about the nutritional status of toddlers in the Vosloorus Township. Using the research questions as the conceptual framework for the study, an exploratory descriptive survey was conducted to determine. • What factors give rise to malnutrition in the Vosloorus Township? • Why do toddlers on the PEM Programme fail to achieve their expected target weight? Data was collected by means of structured interviews from a sample of 50 mothers in the Vosloorus Township whose toddlers were on the PEM Programme. The fmdings indicated that the poor socio-economic conditions of the majority of households, especially unemployment, low levels of education and ignorance, contributed towards the development of malnutrition amongst toddlers and their failure to thrive on the PEM Programme. Recommendations to reduce levels of malnutrition and transform existing nutrition programmes were made. / Health Studies / M.A. (Nursing Science)

Understanding the sexual behaviour patterns that can place the adolescent at risk for the development of sexually transmitted diseases is crucial in the HIV I AIDS epidemic era. An explorative descriptive survey was conducted among adolescents in the age group 14 to 19 years attending sexually transmitted disease services in the Vaal Region clinics. The purpose of the study was to explore the sexual behaviours of the adolescents and the impact the life style health education programme had on their sexual practices. Of the 89 respondents who attended the sexually transmitted disease clinic more than half were found to be engaging in sexual intercourse on a weekly basis. The study further revealed that the adolescents lacked in-depth information on sex and sexuality and expressed the need for change in the implementation of the adolescent life style health education programme. / Health Studies / M.A. (Nursing Science)

This research study was initiated by the desire to identify the constraining and enabling factors experienced by environmental health officers (EH Os) and their management in the implementation of environmental health education and promotion programmes in the environmental health sector. The research contextualises the issues of health promotion, the role of education in health promotion, and community-based environmental health service provision with specific reference to the role of the EHO in relation to these issues. The foremost value ofthis study lies in the fact that it profiles the need for change in the delivery of community-based environmental health education and promotion programmes and identifies distinctive policy changes and skills development needs in the field of environmental health promotion which are central to improved and sustainable community-based environmental health education and promotion. / Educational Studies / M. Ed. (Environmental Education)

Dissertation submitted in fulfillment of the requirements for the Degree of Magister Technologiae: Consumer Science Food and Nutrition, Durban University of Technology, 2011. / Nutrition plays a fundamental role in the care and support of people living with the Human Immunodeficiency Virus (HIV) and children in particular are affected by HIV and the Acquired Immunodeficiency Syndrome (AIDS) epidemic in Africa in various ways. The epidemic puts children at risk physically, psychologically and economically. Children are indirectly affected by HIV and AIDS when the epidemic has a negative impact on their communities and the services these communities provide. Undernutrition is a major problem in HIV-positive children in South Africa with severe malnutrition as a common finding in HIV-positive children. HIV contributes to an increased incidence and severity of undernutrition and micronutrient deficiency. Low serum levels of vitamins A, E, B6, B12 and C, betacarotene, selenium, zinc, copper and iron deficiencies are frequently documented during all stages of HIV-infection. Malnutrition in turn further weakens the immune system which increases the susceptibility to infections and the duration and the severity of infections. Thus, the immune response is less effective and less vigorous when an individual is undernourished. Although guidelines exist for the treatment and management of HIV-infected children, it is clear from the literature that exceptional measures are needed to ensure the health and well-being of the children are met. Furthermore, residential care should not only be considered as a last resort for children’s care, but also as an intervention that requires more than merely addressing children’s basic physical needs. Nutrition education has been utilised globally and in South Africa to address nutrition related problems. The main purpose of nutrition education is to provide individuals with adequate and accurate information, skills and motivation to buy, produce and consume the correct foods to stay healthy and lead an active life. Aim The purpose of this study was to develop reliable and valid nutrition education material for the child care workers (CCWs) of Immune Compromised children vi resident in Children’s Homes in the Durban area in order to maintain the child’s immune system and to optimise their quality of life. Methodology The FAO framework used for planning, implementing and evaluating a nutrition education programme was followed to develop the nutrition education material in this study. Phase I included a situational analysis of the children homes involved. The residential care settings that participated in this study included three Children’s Homes in Durban. The total purposive sample included: boys (5–19 years) n = 112, girls (5–19 years) n = 38 and CCWs n = 40. The sample of HIV-positive children included boys (5–19 years) n = 3 and girls (5– 19 years) n = 6. The physical measurements obtained for this study to determine nutritional status were weight and height. The anthropometric measurements were captured and analysed by the researcher using the World Health Organisation’s AnthroPlus version 1.0.2. Statistical software. The following indices were included: height-for-age (stunting), weight-for-age (underweight) and BMI-for-age (overweight and wasting). The WHO growth standards for school-aged children and adolescents were used to compare the anthropometric indicators. Dietary intake measurements were done by analysing the cycle menus by means of the Food Finder® Version 3 computer software program and comparing the results with the Dietary Reference Intakes (DRIs), specifically the EAR and AI where the EAR were not available. The data were analysed to determine the adequacy of energy and nutrient intake. Average portion sizes were established by the plate waste studies method as well as observation of practices, interviews with the central buyer and focus group discussions with the CCWs. Nutrition knowledge of the CCWs was determined by a self-administered questionnaire developed and tested for reliability and validity. The problems identified in Phase I through the implementation of the questionnaires and other methods directed the design of messages in Phase II. Once suitable media was selected, nutrition education material was developed based on existing guidelines pertaining to HIV and AIDS. The material developed was then tested for reliability and validity before it was produced. vii Results The anthropometric measurements indicated that the majority of the HIV-negative boys and girls were of normal height-for-age and weight-for-age. The results also showed that possible risk of overweight and overweight were more prevalent in girls whereas underweight was more prevalent in boys. Furthermore, the results indicated that a third (33.0%) of the HIV-positive children were stunted and 16.7% was severely stunted. Findings of the menu analysis indicated that both girls and boys consumed three times more carbohydrates than the recommended intake. The DRIs for girls and boys were met for energy and protein in all the age groups except boys aged 14-18 years did not meet the DRI for energy. However, the comparison of the actual intake of the macro nutrients with the WHO guidelines indicated that the protein (10.78%) and carbohydrate (58.07%) is within the recommendations of 10- 15% and 55–75% respectively. This comparison also showed that the total fat intake of 31.15% was above the recommended intake of 15-30%. None of the age groups met the DRIs for fibre. The comparison of the intake with the WHO guidelines also indicated that the total dietary fibre intake was only 19.67g/day and not 27–40g/day. The actual fruit and vegetable intake was a mere 68.64g/day instead of 400g/day as recommended. None of the groups met the DRIs for calcium and iodine. The results clearly showed that micro nutrient inadequacies were more prevalent in the dietary intake of age groups 9-13 and 14-18 years in both girls and boys. Inadequate intake of magnesium, vitamin A, vitamin C, riboflavin, niacin, vitamin B6, pantothenate, biotin, vitamin E and vitamin K were evident in the age group 14-18 year. Overall, it is evident from the results on nutrition knowledge that although the respondents’ knowledge was fair on general nutrition guidelines, the results of the nutrition knowledge questionnaire indicated that knowledge on the importance of a variety in the diet is lacking. The CCWs displayed a very poor knowledge of the recommended number of fruit and vegetable portions per day as well as correct serving sizes of vegetable portions. A very poor knowledge also existed regarding the role of healthy eating in maintaining and supporting the immune system and a limited knowledge on correct hygiene practices was noted. The fridge magnets developed included five messages relating to nutrition and four messages relating to food safety and hygiene. viii Conclusion This study established that malnutrition is apparent in the children’s homes and that there were many gaps in the nutrition knowledge of the CCWs. These gaps included the role of good nutrition in the support and maintenance of the immune system and the importance of adequate intake of fruit and vegetables daily. The NEM developed in this study will address these gaps.

Thesis (MSc (Dietetics))--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: The aim of the study was to contribute to the nutritional well-being of 0 - 24 month old children who attend primary health care clinics (PHC) in Duncan Village, an urban slum. This was to be achieved by first formulating essential nutrition-related message topics and second by formulating recommendations for optimising the accessibility of services, including nutrition-related messages, aimed at mothers attending PHC clinics in Duncan Village. In order to formulate targeted and relevant nutrition-related messages for mothers attending the PHC clinics (Phase I of the research) the need for more information on the six focus areas for intervention that were identified in the previous Duncan Village Day Hospital (DVDH) study" was determined. This was done through key-informant interviews and studying other relevant published research. Eleven research questions related to the six focus areas were subsequently formulated to guide further research. Non-scheduled structured interviews were conducted with mothers with children in specific age groups until data saturation was achieved. A total of 31 interviews were thus conducted at the homes of participants and observation data was also collected at the same time. Three focus groups with corresponding participant categories were also conducted to check the information obtained through the interviews. Two focus groups were conducted with grandmothers to serve as a further form of checking research but also to obtain a different perspective on the research questions. The data available for the formulation of the message topics was analysed qualitatively by hand. The focus areas and the research questions gave a specific focus to the analysis process and the unprocessed data was available in these broad predetermined categories. All the information from all sources (DVDH study, the non-scheduled structured interviews with mothers, focus groups with mothers and grandmothers and observation data) was studied, interpreted and integrated for each identified category. During this process key-factors, which need to be addressed in nutrition-related messages essential for the well-being of infants attending PHC clinics in Duncan Village, were identified. The final step in the analysis process was the formulation of message topics based on these key-factors. During the analysis process it became clear that some of the identified key factors were not suitable for the formu lation of nutrition-related message topics but rather give insight into the total context of the mothers attending the clinics in Duncan Village. It was evident that the information contained in the key factors could be used by health workers to identify and assist vulnerable mothers. These key-factors led to the formulation of relevant help topics. Eighteen main message topics and 16 help topics were formulated. The message topics included topics on: self-development, household food security, breastfeeding, good feeding practices, mothers' health and nutrition and hygiene practices. in Phase 2 of the study the accessibility of services, including nutrition-related messages, to mothers attending PHC clinics in Duncan Village was determined. This was done by determining how mothers inDuncan Village experience the clinics where they could be exposed to nutrition-related messages and by determining the experiences of health care workers with mothers as clients as well as with service delivery. This information was obtained through focus group discussions with different participant categories. These categories included mothers with children in the same age groupings as in Phase I who had either attended clinic for all the child's immunisations or who had not attended clinic for all the child's immunisations or who had attended clinics outside Duncan Village for immunisation purposes. Pregnant women who had either attended antenatal clinics or had not attended antenatal clinics were also included. The last participant category involved health workers. This category included health workers from the obstetric unit where mothers from Duncan Village give birth, the primary health care clinics and community health care workers. The data obtained was analysed with ATLAS/ti, computer software specifically designed for qualitative data analysis. Twelve code families were created during the analysis process, each family referring to a specific aspect of accessibility of services provided at the PHC clinics. A detailed description of each code family is presented after which six networks were compiled. The data and networks were used to create a framework for data interpretation. According to the framework it is proposed that the final elements in the process of providing accessible nutrition-related messages to clients at clinics are (1) that the clients must attend the clinic and (2) that appropriate nutrition-related messages must be available. Problems with interpersonal and organisational aspects of service delivery were found to be two of the most important aspects that influence accessibility of clinic services and therefore nutrition-related messages at the clinics. The last phase of the study (Phase 3) involved the formulation of recommendations to the relevant authorities about targeted and relevant nutrition-related message topics to be included in the education of mothers and pregnant women as well as recommendations to optimise accessibility of nutrition-related messages at the three PHC clinics in Duncan Village and the obstetric unit where mothers of Duncan Village give birth. A total of fifteen recommendations were formulated based on the frndings and recommendations of Phase I and Phase 2. These recommendations focus especially on the necessity for the municipality to create a health empowering environment at the clinics, on the provision of appropriate nutrition-related messages at the clinics and on the need to reach vulnerable mothers. The importance of involving the community in these processes was also emphasised in the recommendations. It is concluded that the implementation of the recommendations will contribute to the nutritional well-being of all young children in Duncan Village and could play an important role in realising the rights of children living in the area. / AFRIKAANSE OPSOMMING: Die doel van die studie was om 'n bydrae te maak tot die voedingswelstand van 0-24 maandoue kinders wat prirnere gesondheidsorg (PGS) klinieke in Duncan Village, 'n verarmde stedelike gebied, besoek. am die doel te bereik is daar eerstens beplan om essensiele voedingsverwante boodskappe te formuleer. Tweedens is daar beplan om aanbevelings vir die optimalisering van die toeganklikheid van gesondheidsorgdienste vir rna's wat die klinieke bywoon, insluitend die toeganklikheid van voedinsgverwante boodskappe, te maak. Voordat relevante voedingsverwante boodskappe vir rna's wat die klinieke in Duncan Village besoek, geformuleer kon word, was meer inligting nodig oor die ses fokusareas vir intervensie wat in die vorige Duncan Village Daghospitaal studie bepaal is. Die bepaling van watter inligting nodig was, is gedoen deur sleutelinformantonderhoude en die bestudering van ander relevante gepubliseerde navorsing. Na aanleiding hiervan is elf navorsingsvrae wat verband hou met die ses fokusareas geformuleer. Nie-geskeduleerde, gestruktureerde onderhoude is vervolgens met 111a's met kinders in spesifieke ouderdomsgroepe gehou totdat dataversadiging bereik is. 'n Totaal van 31 onderhoude is met respondente gehou by hul huise, waartydens die onderhoudvoerder ook sekere waamemingsdata ingesamel het. Drie fokusgroepe is ook met rna's met kinders in ooreenstemmende kategoriee gehou om die inligting na te gaan wat deur die onderhoude ingesamel is. Twee fokusgroepe is ook met oumas gehou om die data verder na te gaan maar ook om 'n ander perspektief op die navorsingsvrae te verkry. Die data wat verkry is, is kwalitatief met die hand geanaliseer. Die fokusareas en die navorsingsvrae het 'n spesifieke fokus aan die analiseproses gegee en die ongeprossesseerde data was beskikbaar in hierdie bree vooraf gedetermineerde kategoriee. Die inligting van aile bronne (DVDH-studie, die nie-geskeduleerde gestruktureerde onderhoude met die rna's, die fokusgroepe met die rna's en oumas asook die observasie data) is bestudeer, geinterpreteer en geintegreer vir elke geidentifiseerde kategorie. Gedurende hierdie proses is sleutelfaktore geidentifiseer wat aangespreek moet word in essensiele voedingsverbandhoudende boodskappe wat gemik is om die voedingswelstand van klein kinders wat die PGS-klinieke in Duncan Village besoek te verbeter. Die finale stap in die analiseproses was die formulering van boodskaponderwerpe. Die onderwerpe is gebaseer op die geidentifiseerde sleutelfaktore Dit het duidelik geword tydens die analiseproses dat sommige van die sleutelfaktore nie geskik was vir die formulering van voedingsverbandhoudende boodskaponderwerpe nie, maar dat dit eerder insig verskaf in die totale lewenskonteks van die rna's. Die inligting in hierdie sleutelfaktore kan wei gebruik word deur gesondheidswerkers om kwesbare ma's te identifiseer en by te staan. Hierdie sleutelfaktore het dus tot die formulering van relevante hulpboodskappe gelei. Agtien voedingsverbandhoudende en 16 hulpboodskappe is geformu leer. Die boodskaponderwerpe sluit in onderwerpe oor selfontwikkeling, huishoudelike voedselsekuriteit, borsvoeding, goeie voedingspraktyke, gesondheid van die rna en voeding- en higienepraktyke. Tydens Fase 2 van die studie is die toeganklikheid van PGS dienste, insluitend voedingsverbandhoudende boodskappe vir rna's, bepaal. Dit is gedoen deur te bepaal hoe mas in Duncan Village die kliniekdienste ondervind, waar hulle aan hierdie boodskappe blootgestel kan word asook die ondervindinge van die gesondheidswerkers met die rna's en die diensleweringsproses. Hierdie inligting is deur middel van fokusgroepbesprekings met verskillende deelnemerskategoriee ingesamel. Hierdie kategoriee het rna's ingesluit wat die klinieke in Duncan Village besoek het vir a.l die spesifieke kinders se immunisasies maar ook ma's wat nie kinders geneem het vir al hul immunisasies nie of wat hul kinders na klinieke buite Duncan Village geneem het. Swanger vroue wat die voorgeboortelike klinieke besoek het asook die wat nie die klinieke besoek het nie, is ook ingesluit. Die laaste kategorie wat betrek is, was gesondheidswerkers. Hierdie kategorie het werkers van die kraamafdeling van die nabygelee hospitaaI en die primere gesondheidsorgklinieke ingesluit. Beide professionele verpleegpersoneel en gemeenskapsgesondheids= werkers van die klinieke is betrek. Die data wat verkry is, is met ATLAS/ti, 'n rekenaarprogram spesifiek geskep vir die analise van kwalitatiewe data, ontleed. Twaalf kodefamilies is geskep tydens die analiseproses. Elke familie verwys na 'n spesifieke aspek van toeganklikheid van dienste by die klinieke. 'n Gedetailleerde beskrywing van elke kodefamilie is gegee asook ses netwerke. Die data en die netwerke is gebruik om 'n raamwerk vir data-intepretasie te skep. Die raamwerk postuleer dat die finale elemente in die proses van die verskaffing van toeganklike voedingsverbandhoudende boodskappe by klinieke die volgende is: (1) kliente moet die kliniek besoek en (2) toepaslike voedingsverbandhoudende boodskappe moet beskikbaar wees. Probleme met interpersoonlike en organisatoriese aspekte van dienslewering is geidentifiseer as die twee belangrikste aspekte wat toeganklikheid van kliniekdienste en daarom ook toeganklikheid van voedingsverbandhoudende boodskappe beinvloed. Die laaste fase van die studie (Fase 3) het die formulering van aanbevelings aan die relevante owerhede behels Die aa.nbevelings handel oor die insluiting van toepaslike voedingsverbandhoudende boodskappe by die gesondheidsonderrig van ma's en swanger vroue sowel as aanbevelings oor die optimalisering van toeganklikheid van dienste by die PGS klinieke en die kraamafdeling waar Duncan Village rna's geboorte gee. Vyftien aanbevelings gebaseer op die bevindinge van Fases I en 2 is geformuleer . Die aanbevelings fokus veral op die nocdsaaklikheid vir die plaaslike owerheid om 'n atmosfeer van gesondheidbemagtiging by die klinieke te skep, die nodigheid om toepaslike voedingsverbandhoudende boodskappe by die klinieke te verskaf en die belangrikheid daa.rvan om kwesbare rna's te bereik. Die noodsaaklikheid om die gemeenskap te betrek in hierdie prosesse is ook benadruk. Samevattend kan gese word dat die implementasie van die aanbevelings sal bydra tot die voedingswelstand van alle jong kinders in Duncan Village en dat dit 'n belangrike bydrae kan lewer tot die realisering van die regte van kinders in die area.

Thesis (MPhil)--Stellenbosch University, 2013. / Please refer to full text to view abstract.

This study applied the theory of reasoned action (TRA) and its extension, the theory of planned behaviour (TPB) to the design of a workplace HIV/AIDS health promotion programme. The purpose of the study was to determine if the variables of the TRA and TPB would predict intentions to change HIV/AIDS health behaviour, whether a theory-based intervention would result in health behaviour change over time and if there would be any significant health behaviour differences among participants who received a theory-based intervention and those who received an information-only intervention. In a longitudinal, quasi-experimental study, 170 government employees were divided into two groups. One group comprised 92 employees who participated in a HIV/AIDS health promotion workshop based on the theories of reasoned action and planned behaviour. The other group comprised 78 employees who took part in an educational information session about HIV and AIDS. An elicitation study was conducted with a sample of 38 employees from the research population two months prior to the commencement of the study. The findings of the elicitation study informed the design of research questionnaires and an intervention workshop. Both groups of participants (theory-based workshop and information-only workshop) were measured on HIV/AIDS health behaviour intentions and HIV/AIDS health behaviour (condom use, seeking HIV testing and monogamy) across three measurement periods over a six month period. The results of the study showed that the combined theoretical variables predicted intentions to use condoms and to seek HIV testing, with attitudes having the main effect on intentions. There was, however, no significant health behaviour change across the three measurement periods. There were also no health behaviour differences between the two intervention conditions at one month and six months post-intervention. The study concludes that the intervention based on the theories of reasoned action and planned behaviour did not produce health behaviour change. The study also identified barriers to AIDS health behaviour in the South African context that the theories of reasoned action and planned behaviour cannot explain. Ways in which the theories of reasoned action and planned behaviour can be adapted to HIV/AIDS education in collectivist cultures are proposed. / Psychology / Thesis (D. Phil. (Psychology))

The prevalence of Protein-Energy Malnutrition (PEM) in South Africa has been welldescribed in previous research studies and yet little is known about the nutritional status of toddlers in the Vosloorus Township. Using the research questions as the conceptual framework for the study, an exploratory descriptive survey was conducted to determine. • What factors give rise to malnutrition in the Vosloorus Township? • Why do toddlers on the PEM Programme fail to achieve their expected target weight? Data was collected by means of structured interviews from a sample of 50 mothers in the Vosloorus Township whose toddlers were on the PEM Programme. The fmdings indicated that the poor socio-economic conditions of the majority of households, especially unemployment, low levels of education and ignorance, contributed towards the development of malnutrition amongst toddlers and their failure to thrive on the PEM Programme. Recommendations to reduce levels of malnutrition and transform existing nutrition programmes were made. / Health Studies / M.A. (Nursing Science)