Health education is critical to the success of a community health program. Yet the majority of research on health education is conducted from the point of view of programme designers or evaluators. Where health educators themselves are the focus, data is often generated through surveys, questionnaires, field notes, or quantitative measures. Narrative accounts by health educators describing their activities and their perceptions of programme efficacy are thus a neglected line of inquiry. My thesis examines one group of health educators who trained and worked with Sidney and Emily Kark at the Institute of Family and Community Health in Durban during the 1940s and 1950s. The importance of health educators in the Institute's project has often been acknowledged by key figures like the Kark, but few scholars have highlighted the contributions of these paraprofessionals. As catalysts of change and disseminators of knowledge, their role was encapsulated by health educator Neela Govender: "So many things people can do to [become] aware of health problems, and how much they themselves could be responsible for their own health ... that's not something they can forget. They will pass it on to another generation, or influence each other. We sow the seed, and it must grow, and spread". In focusing on the health educators' role, I seek to integrate perspectives of "history from below" to enhance previous analyses that concentrated on doctors and government administrators as the main architects of the Institute of Family and Community Health. To this end, I have collected testimony of health educators as a valuable source of historical evidence, which not only uncovers a foot soldier's view of what the Karks called a "practice of social medicine" but also illuminates various social, political, and economic contexts underpinning health education in South Africa. This study used oral history techniques to explore how retired health educators perceived their experiences at the Institute. It thematically analysed their narratives to gain a sense of their training, goals, methods and working conditions in segregationist and apartheid-era South Africa. My interview subjects were predominantly women whose work reflected the centrality of maternal, child, and family health to the Institute. As intermediaries between the clinic and the community, they were integral to the Institute of Family and Community Health's investigation of the links between health and culture. The themes of race, gender and culture were as pertinent in the mid-twentieth century as they are today in the delivery of health services; health educators' narratives might provide insights into how such conceptual factors influence the operation of community health programs in contemporary South Africa. The ways in which the Institute's health educators became active agents in the face of oppressive circumstances also contain potential lessons for their counterparts currently struggling to address an HIV/AIDS epidemic with inadequate resources and governmental support. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, 2004.

The rapid increase in HIV-infections is changing the face of modern society. The number of HIV/AIDS orphans for sub-Saharan Africa is expected to increase to 18, 67 million in 2010. Education has a pivotal role to play in effectively dealing with the effects of the pandemic, as well as creating awareness among learners. The focus of this study is to explore educators’ perceptions of teaching learners about HIV/AIDS and of schools as care-giving centres for orphans and vulnerable children. The HIV/AIDS education curriculum has been introduced in a milieu of change and restructuring in South African education, presenting particular challenges for educators. This study set out to uncover how educators are engaging with their new roles and responsibilities when teaching HIV/AIDS education. / Sociology / MA (Social and Behaviour Studies in HIV/ Aids)

The rapid increase in HIV-infections is changing the face of modern society. The number of HIV/AIDS orphans for sub-Saharan Africa is expected to increase to 18, 67 million in 2010. Education has a pivotal role to play in effectively dealing with the effects of the pandemic, as well as creating awareness among learners. The focus of this study is to explore educators’ perceptions of teaching learners about HIV/AIDS and of schools as care-giving centres for orphans and vulnerable children. The HIV/AIDS education curriculum has been introduced in a milieu of change and restructuring in South African education, presenting particular challenges for educators. This study set out to uncover how educators are engaging with their new roles and responsibilities when teaching HIV/AIDS education. / Sociology / MA (Social and Behaviour Studies in HIV/ Aids)

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.