Fifteen million children have been orphaned by AIDS. A growing body of evidence documents impacts of parental deaths on orphans, but little is known about impacts faced by AIDS-orphan carers. This study set out to: (a) investigate physical and mental health outcomes of adults caring for children in Umlazi, a high HIV prevalence township in South Africa; (b) assess whether AIDS-orphan carers face worse outcomes compared to other carers; and, (c) identify risk and protective factors for health. Using a cross-sectional survey, data was gathered from a representative community sample from August 2008 to March 2009 resulting in the largest known study conducted on AIDS-orphan carers to date (n=1599). The majority of carers looked after non-orphaned children (66.85%) followed by AIDS-orphan (22.45%) and other-orphan children (10.69%). Orphan carers had significantly worse general health and functioning, depression, and post-traumatic stress than non-orphan carers but patterns were less clear when orphan carers were disaggregated into AIDS-orphan and other-orphan carers for comparison. This suggests that health interventions might target orphan carers, rather than singling out AIDS-orphan carers. Differences in age, gender, education, economic assets, and source of household income fully accounted for the association between being an orphan carer and poor health. Social policy grants reduced negative health disparities between orphan carers and non-orphan carers. Social support, education, economic assets, food, access to water, and housing were iii also identified as risk and protective co-factors that might reduce orphan carer disparities in health. By highlighting health as a serious issue for orphan carers and identifying risk and protective factors for health, this study offers policy and program insights into how to mitigate negative impacts faced by carers in high HIV prevalence communities facing escalating numbers of orphans.

The basis of my study is the belief that governance of the local delivery of health could usefully include full and wide community representation and participation by the stakeholders and the larger community. The study was initially carried out in 2003 and now the same clinic has been targeted to carry out an update to see whether the perceptions have changed; if so why and if not what the status is. This study investigates the proposition that if communities do not participate in policy formulation processes, implementation is crippled. The case study is of free health-care policy in a small area of Pietermaritzburg, the Mpumuza area. This area is chosen because it has a local clinic that is being used by the local people to get free primary health care services, covered by the national policy. My interest in the study is influenced by the role I played as a public servant within the district Department of Health one and a half years ago. I dealt, on a daily basis, with service delivery (with a focus on facilitation of the process of service delivery). My interest is to know how the processes of policy development unfold in practice. The study will be examining what the different writers allude to in relation to policy formulation and implementation, the legislative framework pertaining to health policy, the actual case study and finally the conclusions drawn and recommendations, which are open for further exploration in other studies. The study looks at the impact of lack of involvement of the community members (who are at the receiving end) and the role of service providers (who for the purposes of this study will be confined to the nurses that offer the health services at the specific local clinic). Basically the study found that the subject of involving communities in policy formulation is a crucial one if the policy is to be successfully implemented and these are detailed later in the document. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.

No abstract available.

No abstract available.

This study looks at two community mental health facilities. The one setting is that of a state aided organisation, while the other is a non-government organisation (NGO). These two settings are contrasted in terms of how they conceptualise the concept 'community', their physical settings and facilities, and the activities and processes at each setting. The differences in the day-to-day operational processes, and activities according to their respective philosophies - psychiatric medical model and ecological model - are explored and captured from the participants through utilising qualitative data gathering methods such as interviews, observations and the personal experiences of the researcher. The information obtained from each participant in both settings reflect how they think, feel and behave towards their work. This information contributes to an understanding of how community mental health clinics operate. Finally the recommendations are of how work could be done differently, making them both more community orientated. / M. A.(Clinical Psychology)

This study looks at two community mental health facilities. The one setting is that of a state aided organisation, while the other is a non-government organisation (NGO). These two settings are contrasted in terms of how they conceptualise the concept 'community', their physical settings and facilities, and the activities and processes at each setting. The differences in the day-to-day operational processes, and activities according to their respective philosophies - psychiatric medical model and ecological model - are explored and captured from the participants through utilising qualitative data gathering methods such as interviews, observations and the personal experiences of the researcher. The information obtained from each participant in both settings reflect how they think, feel and behave towards their work. This information contributes to an understanding of how community mental health clinics operate. Finally the recommendations are of how work could be done differently, making them both more community orientated. / M. A.(Clinical Psychology)