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The psycho-educational needs of children orphaned by AIDS as perceived by their caregivers / Marieke Cornelia van RooyenVan Rooyen, Marieke Cornelia January 2011 (has links)
During the past decade, South Africa has become the country with the highest number of
HIV/AIDS infections in the world. In the wake of the widely spread HIV/AIDS epidemic in
South Africa, hundreds of thousands of children are left parentless. Since limited research exists
on the psycho-educational needs of children orphaned by AIDS in South Africa, the focus of this
study was on their psycho-educational development.
A literature study was conducted to investigate the HIV/AIDS epidemic in South Africa and its
consequences for the psycho-educational development of AIDS orphans.
A qualitative investigation was undertaken and interviews were conducted with caregivers of
AIDS orphans at two care centres in rural KwaZulu-Natal. The aim of the investigation was to
identify the psycho-educational needs of AIDS orphans as perceived by their caregivers.
Moreover, the investigation also aimed at identifying factors that impede the psycho-educational
development of AIDS orphans, and to determine the extent to which these day care centres meet
the psycho-educational needs of these orphans.
The following psycho-educational needs of AIDS orphans emerged from the investigation:
- the need to socialise and communicate
- the need to cope with parental death
- the need for acceptance
- the need for security and care
- the need for love and belonging
- the need to deal with negative emotions
Physical and material needs were added to the above needs, since these were frequently
mentioned during the course of the interviews.
Factors that seriously impeded the psycho-educational development of AIDS orphans were abuse
and neglect. The investigation also revealed that the care centres were to a large extent able to
meet a broad spectrum of these orphans’ psycho-educational needs, especially at the care centre
where the AIDS orphans were able to sleep over and received the full-time attention caregivers.
Since the extended family system can no longer fully carry the burden of hundreds of thousands
of AIDS orphans in South Africa, care centres situated in the affected communities can offer a viable alternative to traditional models of care. The study emphasised the need for further
research on the needs of AIDS orphans as well as increased support of AIDS orphans on local,
provincial and national levels. / MEd (Learner support), North-West University, Potchefstroom Campus, 2012
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A review of antiretroviral medicine cost in primary health care clinics in Lesotho / M.V. RamathebaneRamathebane, Maseabata Venus January 2010 (has links)
HIV/AIDS treatment is costly. Lesotho as a resource–limited country depends mostly on donor funding for HIV/AIDS treatment and care. Knowledge of how much was spent on treatment of HIV/AIDS was lacking. This leads to overstocking of some ART medicines resulting in expiry. Sufficient funds need to be secured for the treatment programme. The main objective of the study is to assess the cost of antiretroviral medication treatments, by specifically assessing the cost of antiretroviral regimens, antiretroviral side effects, and the cost of medicines used for prophylaxis and treatment of opportunistic infections as well as the cost of monitoring laboratory tests and dietary supplements.
The study engaged both public and private ART clinics in the Maseru District in Lesotho. The study population consisted of 1 424 patients and study period was between 12 and 56 months from January 2004 to August 2008. Retrospective observational method was used. The cost for HIV/AIDS treatment comprised the cost of antiretroviral medicines and those used for their side effects, opportunistic infections (OI) prophylaxis and treatment, dietary supplements as well as monitoring laboratory tests. Prescribed daily dose (PDD) was used to calculate the cost of all the medicines used. To determine significant differences in average costs for various regimens d– values were used, while a cost/prevalence index was used to determine whether the cost was worth spending on the population or not. Cost–effectiveness ratio was also utilized in order to assess whether the cost born was worth the benefit.
The main findings revealed that regimens 1a (stavudine/lamivudine/nevirapine) and 1c (zidovudine/lamivudine/nevirapine) were the least expensive (cost/prevalence index of 0.6 and 0.7 respectively). Regimens containing efavirenz were found to be more expensive than those containing nevirapine (cost/prevalence index of 1.2 and 1.7 respectively). When using d–values, there was a significant difference between the cost of regimens 1a and 1b, 1a and 1d, 1c and 1d and the information could be used for regimen switching decisions. Increase in CD4 cell count was more in stavudine–based regimens than in zidovudine–based regimens, which cost less per treatment. Cost effectiveness ratio was lower in 1a with R9.42/1cell/mm3 of CD4 cell count increase, and the highest was 1d with R31.77/1cell/mm3 of CD4 cell count increase. Therefore it was concluded that stavudine–based regimens are less costly as they have the lowest cost– effectiveness ratio in the Lesotho clinic environment. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.
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A review of antiretroviral medicine cost in primary health care clinics in Lesotho / M.V. RamathebaneRamathebane, Maseabata Venus January 2010 (has links)
HIV/AIDS treatment is costly. Lesotho as a resource–limited country depends mostly on donor funding for HIV/AIDS treatment and care. Knowledge of how much was spent on treatment of HIV/AIDS was lacking. This leads to overstocking of some ART medicines resulting in expiry. Sufficient funds need to be secured for the treatment programme. The main objective of the study is to assess the cost of antiretroviral medication treatments, by specifically assessing the cost of antiretroviral regimens, antiretroviral side effects, and the cost of medicines used for prophylaxis and treatment of opportunistic infections as well as the cost of monitoring laboratory tests and dietary supplements.
The study engaged both public and private ART clinics in the Maseru District in Lesotho. The study population consisted of 1 424 patients and study period was between 12 and 56 months from January 2004 to August 2008. Retrospective observational method was used. The cost for HIV/AIDS treatment comprised the cost of antiretroviral medicines and those used for their side effects, opportunistic infections (OI) prophylaxis and treatment, dietary supplements as well as monitoring laboratory tests. Prescribed daily dose (PDD) was used to calculate the cost of all the medicines used. To determine significant differences in average costs for various regimens d– values were used, while a cost/prevalence index was used to determine whether the cost was worth spending on the population or not. Cost–effectiveness ratio was also utilized in order to assess whether the cost born was worth the benefit.
The main findings revealed that regimens 1a (stavudine/lamivudine/nevirapine) and 1c (zidovudine/lamivudine/nevirapine) were the least expensive (cost/prevalence index of 0.6 and 0.7 respectively). Regimens containing efavirenz were found to be more expensive than those containing nevirapine (cost/prevalence index of 1.2 and 1.7 respectively). When using d–values, there was a significant difference between the cost of regimens 1a and 1b, 1a and 1d, 1c and 1d and the information could be used for regimen switching decisions. Increase in CD4 cell count was more in stavudine–based regimens than in zidovudine–based regimens, which cost less per treatment. Cost effectiveness ratio was lower in 1a with R9.42/1cell/mm3 of CD4 cell count increase, and the highest was 1d with R31.77/1cell/mm3 of CD4 cell count increase. Therefore it was concluded that stavudine–based regimens are less costly as they have the lowest cost– effectiveness ratio in the Lesotho clinic environment. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.
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'n Verkenning van die rol van vrees vir MIV/VIGS in adolessente se seksuele keuses (Afrikaans)Taljaard, Annette 18 May 2009 (has links)
ENGLISH : The purpose of this study was to determine the role of fear for HIV/AIDs in adolescents’ sexual choices. Theories which informed the study included developmental theory, decisionmaking theory, as well as emotion theory. In this survey study a mixed-method questionnaire was designed, piloted and then implemented with 252 purposefully selected Grade 11, Afrikaans learners (127 boys and 125 girls), aged 16 to 17 years in one high school in Gauteng. Data was analysed quantitatively and qualitatively. It was found that adolescents link several emotions with HIV&AIDS: fear, concern and caution. Another finding was that adolescents reportedly made safe sexual choices. Therefore, it was concluded that adolescents fear for HIV&AIDS positively impacted on their safe sexual choices. AFRIKAANS : Die doel van hierdie studie was om te bepaal welke rol vrees vir MIV&VIGS speel in adolessente se seksuele keuses. Teorieë wat die studie ingelig het was ontwikkelingsteorie, besluitnemingsteorie en emosie-begronde teorieë. Die navorsingsontwerp van hierdie studie was ‘n opname studie. ‘n Gemengde metode vraelys is ontwerp, geloods, aangepas en geïmplementeer met. 252 graad 11, Afrikaanse leerders (127 seuns en 125 dogters), tussen die ouderdom van 16 en 17 jaar, wat doelgerig geselekteer is vanuit een hoërskool in Gauteng. Vraelysdata is kwantitatiewe en kwalitatiewe geanaliseer. Daar is bevind dat adolessente MIV/VIGS verbind met die emosies: vrees, bekommernis en versigtigheid. Verder blyk dit dat adolessente veilige seksuele keuses maak. Die gevolgtrekking is gemaak dat adolessente se vrees vir MIV&VIGS positief korreleer met hul veilige seksuele keuses. / Dissertation (MEd)--University of Pretoria, 2009. / Educational Psychology / unrestricted
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Die impak van die MIV/VIGS-pandemie op sekere aspekte van die Suid-Afrikaanse kinderregLüneburg, Liezel 31 March 2008 (has links)
Text in Afrikaans / Die MIV/vigs-pandemie in Suid-Afiika- van die ergste in die wereld- toon geen tekens van
afname nie. Miljoene kinders is reeds of wees gelaat of hewig geaffekteer deur die magdom
impakte daarvan op gesinne en gemeenskappe. Die epidemie het voortdurend stygende
sterftesyfers tot gevolg en die hewige las van die siekte rus swaar op MIV-positiewe sowel as
MIV-negatiewe individue. Verder word tradisionele ondersteuningsnetwerke oorbelaai en/of
gaan hulle tot niet. Gesinne en gemeenskappe verloor hul ekonomiese, sosiale en kulturele
lewensvatbaarheid. Die pandemie hou, veral onder die armes, 'n geweldige bedreiging vir die
gesondheid, welstand en regte van babas, kinders en jongmense in. 'n Groot gedeelte van die
impak van MIV/vigs hou verband met die feit dat sommige kinders en hul gesinne beperkte
toegang tot die elemente van 'n gesonde omgewing en goeie gesondheid het. Regerings,
gemeenskappe en gesinne wat deur MIV/vigs geraak word, het minder tyd, energie en
finansiële hulpbronne beskikbaar om op voorkomende gesondheidsorg te fokus. Benewens die
impak op gesondheidstatus, word kinders se omstandighede ook as gevolg van MIV/vigsverwante
probleme bemoeilik. Dit sluit verhoogde gesinsarmoede, 'n hoer risiko van verlating
en weeslating, geforseerde migrasie, onterwing, sielkundige trauma, uitsluiting en
diskriminasie, en fisiese en seksuele mishandeling in. Die derde vlaag van die epidemie, welke
vlaag nou betree word, word gekenmerk deur 'n ontsettende hoe sterftesyfer, 'n ontploffing in
die getal sorgbehoewende en weeskinders en 'n verhoging in menslike pyn en lyding. Die reg
speel 'n baie belangrike rol in die beperking van hierdie impak van die MIV/vigs-pandemie op
die lewens van alle kinders. MIV/vigs-reg is in die proses van evolusie of vorming en reeds
bestaande teorieë kan aangewend word ten einde sekere vrae te beantwoord en probleme
daaromtrent aan te spreek. Tog is daar 'n dringende behoefte aan MIV/vigs-spesifieke
wetgewing en teorieë ten einde die impak van die pandemie op alle vlakke suksesvol te
beheer. Verder het die Kinderreg so 'n mate van ontwikkeling bereik dat daar algemeen
aanvaar word dat kinders 'n spesiale belangegroep binne die gemeenskap vorm. Die regsreëls
met betrekking tot kinders verander gedurig en is ook nie geskik om volgens die tradisionele
wyse, as privaat- of publiekreg, geklassifiseer te word nie. In die hieropvolgende proefskrif
word die impak van MIV/vigs op sekere publiekregtelike, maar oorwegend privaatregtelike
aspekte van die Suid-Afiikaanse kinderreg ondersoek, sowel as enkele metodes waarop die
reg moontlik hierdie impak kan absorbeer en hanteer. Daar word ook in aparte hoofstukke na
die impak van MIV/vigs op die lewens van kinders. sorgbehoewende kinders, egskeiding en
die ouer-kind-verhouding verwys
The HIV/aids pandemic in South Africa - one of the worst in the world - does not seem to be decreasing. Millions of children have already been either orphaned or heavily affected by the numerous impacts on families and communities associated with it. The epidemic brings on an ever-increasing mortality rate and the extreme burden thereof weighs down heavily on HIV-positive as well as HIV-negative individuals. Traditional support networks are further being heavily burdened or perish entirely. Families and communities lose their economical, social and cultural viability. The pandemic threatens, especially among the poorest, the health, wellbeing and rights of infants, children and young people. The impact of HIV/aids is to a great extent the result of the fact that some children and their families do not have sufficient access to a healthy environment and good health. Governments, communities and families affected by HIV/aids have less time, energy and financial resources available in order to enable them to focus on preventive healthcare. In addition to the impact on health status, children's circumstances are also being encumbered by HIV/aids-related problems, including family poverty, a higher risk of being abandoned or orphaned, forced migration, disinheritance, psychological trauma, ostracism and discrimination and physical and sexual abuse. The third wave of the epidemic, which wave is presently being experienced, is characterised by a high mortality rate, an increasing amount of children in need of care and orphaned children and an increase in human pain and suffering. The law plays an important role in the limitation of the impact of the HIV/aids pandemic on the lives of children. HIV/aids law is in the process of evolution or forming and existing theories can be used in order to answer certain questions and address certain issues relating to it. However, there is an urgent need for HIV/aids-specific legislation and theories in order to successfully manage the impact of the pandemic on all levels. Child law has also reached such an extent of development that children is now viewed as a special interest group within the community. The legal principles regarding children change constantly and cannot be classified in the traditional way, which is either as private or public law. In this thesis the impact of HIV/aids on certain aspects of the public and private law pertaining to children is examined. Ways in which the impact can be absorbed and managed by the law is also examined. The impact of HIV/aids on divorce, the parent-child relationship, children in need of care, and the impact of HIV/aids on the lives of children is examined in separate chapters. / Jurisprudence / LL. D.
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Die impak van die MIV/VIGS-pandemie op sekere aspekte van die Suid-Afrikaanse kinderregLüneburg, Liezel 31 March 2008 (has links)
Text in Afrikaans / Die MIV/vigs-pandemie in Suid-Afiika- van die ergste in die wereld- toon geen tekens van
afname nie. Miljoene kinders is reeds of wees gelaat of hewig geaffekteer deur die magdom
impakte daarvan op gesinne en gemeenskappe. Die epidemie het voortdurend stygende
sterftesyfers tot gevolg en die hewige las van die siekte rus swaar op MIV-positiewe sowel as
MIV-negatiewe individue. Verder word tradisionele ondersteuningsnetwerke oorbelaai en/of
gaan hulle tot niet. Gesinne en gemeenskappe verloor hul ekonomiese, sosiale en kulturele
lewensvatbaarheid. Die pandemie hou, veral onder die armes, 'n geweldige bedreiging vir die
gesondheid, welstand en regte van babas, kinders en jongmense in. 'n Groot gedeelte van die
impak van MIV/vigs hou verband met die feit dat sommige kinders en hul gesinne beperkte
toegang tot die elemente van 'n gesonde omgewing en goeie gesondheid het. Regerings,
gemeenskappe en gesinne wat deur MIV/vigs geraak word, het minder tyd, energie en
finansiële hulpbronne beskikbaar om op voorkomende gesondheidsorg te fokus. Benewens die
impak op gesondheidstatus, word kinders se omstandighede ook as gevolg van MIV/vigsverwante
probleme bemoeilik. Dit sluit verhoogde gesinsarmoede, 'n hoer risiko van verlating
en weeslating, geforseerde migrasie, onterwing, sielkundige trauma, uitsluiting en
diskriminasie, en fisiese en seksuele mishandeling in. Die derde vlaag van die epidemie, welke
vlaag nou betree word, word gekenmerk deur 'n ontsettende hoe sterftesyfer, 'n ontploffing in
die getal sorgbehoewende en weeskinders en 'n verhoging in menslike pyn en lyding. Die reg
speel 'n baie belangrike rol in die beperking van hierdie impak van die MIV/vigs-pandemie op
die lewens van alle kinders. MIV/vigs-reg is in die proses van evolusie of vorming en reeds
bestaande teorieë kan aangewend word ten einde sekere vrae te beantwoord en probleme
daaromtrent aan te spreek. Tog is daar 'n dringende behoefte aan MIV/vigs-spesifieke
wetgewing en teorieë ten einde die impak van die pandemie op alle vlakke suksesvol te
beheer. Verder het die Kinderreg so 'n mate van ontwikkeling bereik dat daar algemeen
aanvaar word dat kinders 'n spesiale belangegroep binne die gemeenskap vorm. Die regsreëls
met betrekking tot kinders verander gedurig en is ook nie geskik om volgens die tradisionele
wyse, as privaat- of publiekreg, geklassifiseer te word nie. In die hieropvolgende proefskrif
word die impak van MIV/vigs op sekere publiekregtelike, maar oorwegend privaatregtelike
aspekte van die Suid-Afiikaanse kinderreg ondersoek, sowel as enkele metodes waarop die
reg moontlik hierdie impak kan absorbeer en hanteer. Daar word ook in aparte hoofstukke na
die impak van MIV/vigs op die lewens van kinders. sorgbehoewende kinders, egskeiding en
die ouer-kind-verhouding verwys
The HIV/aids pandemic in South Africa - one of the worst in the world - does not seem to be decreasing. Millions of children have already been either orphaned or heavily affected by the numerous impacts on families and communities associated with it. The epidemic brings on an ever-increasing mortality rate and the extreme burden thereof weighs down heavily on HIV-positive as well as HIV-negative individuals. Traditional support networks are further being heavily burdened or perish entirely. Families and communities lose their economical, social and cultural viability. The pandemic threatens, especially among the poorest, the health, wellbeing and rights of infants, children and young people. The impact of HIV/aids is to a great extent the result of the fact that some children and their families do not have sufficient access to a healthy environment and good health. Governments, communities and families affected by HIV/aids have less time, energy and financial resources available in order to enable them to focus on preventive healthcare. In addition to the impact on health status, children's circumstances are also being encumbered by HIV/aids-related problems, including family poverty, a higher risk of being abandoned or orphaned, forced migration, disinheritance, psychological trauma, ostracism and discrimination and physical and sexual abuse. The third wave of the epidemic, which wave is presently being experienced, is characterised by a high mortality rate, an increasing amount of children in need of care and orphaned children and an increase in human pain and suffering. The law plays an important role in the limitation of the impact of the HIV/aids pandemic on the lives of children. HIV/aids law is in the process of evolution or forming and existing theories can be used in order to answer certain questions and address certain issues relating to it. However, there is an urgent need for HIV/aids-specific legislation and theories in order to successfully manage the impact of the pandemic on all levels. Child law has also reached such an extent of development that children is now viewed as a special interest group within the community. The legal principles regarding children change constantly and cannot be classified in the traditional way, which is either as private or public law. In this thesis the impact of HIV/aids on certain aspects of the public and private law pertaining to children is examined. Ways in which the impact can be absorbed and managed by the law is also examined. The impact of HIV/aids on divorce, the parent-child relationship, children in need of care, and the impact of HIV/aids on the lives of children is examined in separate chapters. / Jurisprudence / LL. D.
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'n Verkenning van opvoeders se mobilisering van bates ter ondersteuning van gemeenskapshantering van MIV/VIGS (Afrikaans)Loots, Mathilda Christina 05 September 2005 (has links)
The purpose of this study was to empower educators to mobilise assets and resources within their community in order to enable the community to cope better with the daily difficulties associated with HIV/AIDS. The study was conducted to explore and describe the process of mobilising assets in a HIV/AIDS infected and affected rural community. The working assumption was that the mobilisation of community assets could support and enhance community-based coping with the HIV/AIDS pandemic. A qualitative approach was followed. Purposeful sampling was applied to select an information-rich case for in-depth study (instrumental case study design). The case was a primary school in the Nelson Mandela Metropole. Ten educators participated in the study. The study was theoretically founded on an asset-based approach, with the focus on community-based coping. An interpretavist approach was used to describe and interpret the process of asset mobilisation in coping with HIV/AIDS. A number of data selection strategies were implemented: focus groups in combination with workshops, visual data, observation and a reflective field journal. The ten educators who participated in the study were empowered to identify and mobilise assets and resources within their community and to continue with the facilitation process on their own. The educators identified three priority areas and succeeded in establishing a vegetable garden on the school premises, a support group and an information centre at school, for HIV/AIDS infected and affected members of the community. These initiatives resulted in the wider community being better equipped and empowered to cope with the daily difficulties associated with HIV/AIDS that are being experienced on emotional, spiritual, materialistic, social and knowledge levels. It is concluded that the community, the school and individuals were empowered with regard to effective coping strategies, more specifically in dealing with the challenges associated with HIV/AIDS. / Dissertation (MEd (Educational Psychology))--University of Pretoria, 2006. / Educational Psychology / unrestricted
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Riglyne vir pleegouers by die bekendmaking van pediatriese MIVDavin, Reda J. (Reda Johanna) 05 October 2011 (has links)
Afrikaans text / Die studie ondersoek die leemte aan teoreties gefundeerde riglyne om pleegouers in die bekendmakingsproses van hulle kind se MIV-positiewe status te ondersteun Die studie geskied binne die teoretiese raamwerk van ʼn intervensienavorsingsmodel. In die empiriese navorsing is die vrese en probleme van pleegouers by die bekendmakingsproses ondersoek. Daar is bevind dat hierdie vrese en probleme in ag geneem moet word in die beoogde riglyne. Die kognitiewe ontwikkeling van die kind is deur middel van ʼn literatuurstudie ondersoek om vas te stel watter kennis, denke en inligting die kind op verskillende ouderdomme begryp. Daar is bevind dat kinders wat MIV-positief is, moontlike agterstande ondervind en dat die riglyne gevolglik gebaseer moet word op die toenemende ontwikkeling van die kind, met begrip vir individuele ontwikkelingsverskille. Voorts is bevind dat pleegouers se eie gereedheid ʼn belangrike rol speel. Alhoewel die pleegouer die bekendmakingsproses self moet aanvoer en hanteer is dit belangrik dat die pleegouers deur ʼn interdissiplinêre span ondersteun en begelei sal word. / This study investigates the absence of theoretical grounded guidelines to support foster parents when disclosing paediatric HIV. The study was done within the theoretical framework of an intervention research model. The empirical research investigated the fears and problems experienced by foster parents during the disclosure process. It was found that these fears and problems should be taken into account when compiling guidelines. The child‟s cognitive development was researched by way of a literary study in order to determine what knowledge, thoughts and information the child is able to grasp at different ages. It was found that children who are HIV positive could possibly lag behind and that the guidelines should therefore be based on the accumulative development of the child, with consideration given to individual developmental differences. Furthermore, it was established that foster parents‟ own readiness plays an important role. For this reason the foster parents should be supported and guided by an interdisciplinary team, but that they themselves should take care and execute the process of disclosure. / Social Work / M. Diac. (Spelterapie)
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Die rol wat die reg op toegang tot gesondheidsorgdienste speel in armoedevermindering in Suid–Afrika / Z. Strauss (Kruger)Strauss, Zannelize January 2010 (has links)
Section 27(1)(a) of the Constitution of the Republic of South Africa, 1996, entrenches everyone's right of access to health care services. The purpose of this dissertation is to determine the manner in which this right must be interpreted and implemented in order to alleviate poverty to the optimal extent possible, in South Africa. As a point of departure, the relationship between poverty and health, as well as the theoretical basis of poverty, is addressed in terms of soft law. Thereafter, the theoretical basis of the right of access to health care service is analysed and explained from both an international and a South African perspective. This is followed by an investigation into international law. The manner in which the United Nations International Covenant on Economic, Social and Cultural Rights is interpreted and implemented and whether or not this contributes to poverty alleviation, is investigated. This is followed by an analysis of the right in terms of the Constitution and case law. Particular attention is paid to the manner in which the courts interpret the right of access to health care services. It is then determined whether the state is implementing the right in such a manner as to contribute to the optimal alleviation of poverty, in South Africa. Finally, a conclusion is reached and recommendations are made as to ways in which the right can be interpreted and implemented to reduce poverty to the optimal extent possible, in South Africa. / Thesis (LL.M.)--North-West University, Potchefstroom Campus, 2010.
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Medicine prescribing patterns in HIV/AIDS and non HIV/AIDS children : a comparative study in the private health care sector of South Africa / Mocke, M.Mocke, Martlie January 2010 (has links)
Background: According to the United Nations AIDS Reference Group (2010) and World Health Organization (2010:2), approximately 33 million people in the world had HIV/AIDS in 2009 of which 2.6 million were children. More than 30 million of these individuals resided in low– and middle–income countries. South–Africa had the highest prevalence of HIV/AIDS in the world with an estimated 5.2 million patients in 2009 (Statistics South Africa, 2010:2). Although the prevalence of human immunodeficiency virus (HIV) infection among children is reported to be high, little is known about other medication administrated concomitantly with their antiretroviral drugs.
Objective: The general objective of this study was to investigate possible changes in the medicine prescribing patterns of HIV/AIDS and non–HIV/AIDS children.
Methods: A quantitative, retrospective drug utilisation review was performed utilising medicine claims data of a South African pharmacy benefit management company. Data for a four–year period (Jan 1, 2005 to Dec 31, 2008) were analysed. The study population consisted of all children <=12 years divided into those receiving ARVs (designated HIV positive) and those without (designated HIV negative).
Descriptive statistics such as average mean, standard deviation, t–test, d–values, and two way frequency tables were used to describe the results. Data were analysed using the Statistical Analysis System ® SAS 9.1 ® programme.
Results: The study population (children <= 12 years) represented 16.2% (n = 197 323) of the total population in 2005, 15.4% (n = 193 346) in 2006, 15.6% (n = 142 049) in 2007 and 13.3% (n = 98 939) in 2008. Children with HIV/AIDS represented 0.2% (n = 197 323) of the study population in 2005 and increased to 0.4% (n = 98 939) in 2008, whereas the percentage of children without HIV/AIDS decreased from 99.8% (n = 197 323) in 2005 to 99.6% (n = 98 939) in 2008. The total number of HIV/AIDS children that also received other medication concomitantly with their ARVs increased from 96.5% (n = 402) in 2005 to 97.2% (n = 427) in 2008. Males with HIV/AIDS who used other medication represented 52.6% (n = 388) in 2005 and increased to 53.3% in 2008 while female HIV/AIDS patients represented 47.4% in 2005 and decreased to 46.7% in 2008.
Prescriptions containing three ARV items represented 69.5% (n = 2 969) of the total number of prescriptions received by HIV/AIDS patients in 2005 and decreased to 67.7% in 2008. The combination of lamivudine, nevirapine and stavudine were the three products that appeared most frequently on prescriptions for HIV/AIDS children in the age group 0 <= 1 years and 1 <= 5 years from 2005 to 2008. In the age group 5 <= 12 years the combination most frequently prescribed was lamivudine, nevirapine and zidovudine.
HIV positive children received 6.2 ± 4.62 prescriptions for other medication (non–ARVs) per year during 2005 compared to HIV negative children with 3.9 ± 3.71 (p < 0.0001, d = 0.5). In 2008 HIV positive children received 6.4 ± 5.02 prescriptions per year compared to HIV negative patients who received 4.36 ± 4.05 prescriptions (p < 0.0001, d = 0.5) in 2008.
HIV negative children received more central nervous system items, endocrine items and autacoids than HIV positive children, whereas HIV positive children received more respiratory system agents, dermatological, ear, nose throat and antimicrobials items.
Conclusion: The study showed that HIV positive children received significantly more prescriptions for other medication per year compared to their HIV negative counterparts. The top pharmacological groups mostly prescribed to both groups were respiratory agents, antimicrobials, analgesics, dermatological and ear, nose and throat items. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2012.
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