In the developing world, child care institutions often involve more complexity than is typically reflected by the word “orphanage.” In many instances, children do not fit the widespread definition of an orphan as one with with deceased parents. Oftentimes, institutions play a partial role in a child’s development by contributing towards childcare in collaboration with a relative, an ill parent, or nearby kin. In South Africa, the need and complexity surrounding the role of child care institutions is further amplified by the region’s longstanding HIV/AIDS epidemic. Through a primarily ethnographic study, I sought to understand and relay the nuances of a child care center in Hillbrow, an urban neighborhood in central Johannesburg known for its crime and gang proliferation. Through the developmental stages of intake and early childhood, middle childhood, and late adolesence and outward transition, I explored how children overcome traumatic pasts with the help of the center, how the center struggles with the material burdens of providing to children with a wide array of needs, and how the process of transitioning into adulthood is handled by the children and their caretakers. In conclusion, I explore the non-negotiable elements of the center’s approach to child care and make further recommendations for other institutions in a similar context as well as future academic research.

<p>In sub-Saharan Africa, poverty and its consequences hit orphan and vulnerable children (OVC) the hardest. As the once protective safety net dissipates, many OVC are forced to live in overcrowded and understaffed orphanages. In the attempt to meet survival needs, psychological health is pushed into the background. The aim of this study is to increase the understanding of psychological well-being among institutionalized OVC in Maputo, Mozambique. Qualitative interviews (N=12) and field observations in orphanages (N=6) were analyzed through the hierarchy of needs model. Institutionalized OVC were found living under poor general care with few opportunities for ludic, educational, and social growth. Also among the finding were neglect and abuse, attachment difficulties and traumatic stress symptoms. Nonetheless, this study opposes the disuse of orphanages and suggests interventions to improve the children’s psychological well-being.</p>

In sub-Saharan Africa, poverty and its consequences hit orphan and vulnerable children (OVC) the hardest. As the once protective safety net dissipates, many OVC are forced to live in overcrowded and understaffed orphanages. In the attempt to meet survival needs, psychological health is pushed into the background. The aim of this study is to increase the understanding of psychological well-being among institutionalized OVC in Maputo, Mozambique. Qualitative interviews (N=12) and field observations in orphanages (N=6) were analyzed through the hierarchy of needs model. Institutionalized OVC were found living under poor general care with few opportunities for ludic, educational, and social growth. Also among the finding were neglect and abuse, attachment difficulties and traumatic stress symptoms. Nonetheless, this study opposes the disuse of orphanages and suggests interventions to improve the children’s psychological well-being.

OBJECTIVE: It is already known from earlier research studies that block grant support can provide educational benefit to students that are orphaned and vulnerable in secondary schools in East Africa. This thesis examines the impact of block grant support given to secondary schools in Southwest Uganda to see whether or not block grant support benefits the entire student population. STUDY POPULATION: The Republic of Uganda is located in East Africa. Block grant support was given to secondary schools starting in 2006 in the districts of Isingiro, Mbarara, and Ntungamo, all located in Southwest Uganda. The NGOs that provided block grants were Africare and Integrated Community Based Initiatives (ICOBI). MEASUREMENT: School-wide indicators, such as the number of secondary schools, the number of students who took the Year IV National Exam, and the proportion of students that failed the exam, were analyzed retrospectively. The main variable of interest was the percent failure rate of students who took the national exam in schools with and without block grant support (intervention vs control schools). The average failure rates for all students who took the exams, male students, and female students were also calculated. Graphs showing the exam failure rate for each year from 2001 to 2010, excluding 2009, for both intervention and control schools were produced to assess patterns and trends. Data for 2009 was unavailable. STATISTICAL ANALYSIS: Excel Data Analysis RESULTS: No statistically significant difference was found in the percent failure rates between control and intervention schools before and after implementation of the block grant support in 2006. However, for male students in 2001 and 2010, there was a statistically significant difference between the percent failure rates at control (6.9% in 2001; 3.3% in 2010) and intervention (11.2% in 2001; 2.2% in 2010) schools. Between genders in intervention schools, a statistically significant difference was found from 2002 to 2006, and 2010. In other words, the percent failure rates of female students were significantly higher than those of male students for those years. Unlike the quantitative analysis, qualitative analysis shows that the majority of stakeholders believe that the block grants benefited the school as a whole. CONCLUSION: As there was no statistically significant difference in percent failure rates between control and intervention schools prior to when block grant support began in 2006, schools targeted by NGOs in 2006 seem to not have been &ldquo;poor performing&rdquo; schools. As there was no statistically significant difference in percent failure rates between control and intervention schools after 2006, block grant support seems to have made no significant impact at the school level. According to the qualitative data, the majority of stakeholders interviewed expressed approval of block grants and believed that they benefited the school as a whole.

Master of Public Health - MPH / Background: The repercussions of being HIV positive coupled by the complications of antiretroviral therapy are likely to cause distress, emotional and psychological problems particularly among children infected by the virus. The limited support services for children experiencing distress intensify the urgency to address this challenge. Despite the availability of social workers and nurses' interventions currently in place, the number of children in need of psychological care continues to increase. This is particularly true at Deborah Retief Memorial (DRM) hospital, one of the main antiretroviral therapy facilities in Kgatleng district, Botswana. Method: The purpose of this study was to explore and describe the perceptions of social workers, nurses and caregivers on key factors contributing to psychological distress of HIV positive children. A descriptive, exploratory qualitative study design that employed the use of in-depth interviews was used to conduct this study. Participants included four caregivers of HIV positive children who seek antiretroviral therapy at DRM hospital Infectious Diseases Control Clinic, together with five nurses and two social workers who worked in the same clinic. Conventional content analysis was used to analyse the in-depth interview transcripts. Results: Perceived psychological stressors for HIV positive children included disclosure of HIV status, orphanhood, social problems, lifelong treatment, stigma, poor caregiver-child relationship and lack of caregiver‟s love, care and support. However the caregivers did not fully understand the psychological distress the HIV positive children were experiencing, hence were unable to recognize it in these children. The study highlighted that major challenges faced by the health-workers included lack of qualified personnel, lack of adequate knowledge and skills, and a non-conducive working environment required to effectively assist children with psychological distress. The findings also indicated the need for education and support of caregivers and HIV positive children by the educators, family and health-worker systems. Conclusion: The profile of key stressors of psychological distress, the challenges and support needs suggested by the participants in this study can provide a framework for improving the existing services for HIV positive children with psychosocial problems. This information is important for use in training nurses and social workers involved with children with psychological behaviours.

NRH quinone oxidoreductase 2 (NQO2) is regarded as a mammalian Phase I detoxifying enzyme responsible for reducing quinones to hydroquinones. NQO2 is highly expressed in different types of cancer such as breast and prostate cancer suggesting its participatory role in the progression of these diseases. A potential reason for this is that NQO2 has the ability to modulate the stability of cyclin D1 and activity of NF-ÃŽÂoB and it has been shown that inhibition of NQO2, either genetically or pharmacologically, can alter the pattern of proliferation of cancer cells. However, the biological roles of NQO2 in cancer progression are still ambiguous and need further investigation. A panel of seven ovarian cancer cell lines (OVCs) were screened for the presence and functionality of NQO2. SKOV-3 and TOV-112D cells expressing comparatively the highest and lowest levels of NQO2 were stably transduced to silence and overexpress NQO2 respectively. Pharmacological inhibition was achieved using resveratrol or a series of novel 4-aminoquinolines synthesised in-house. Cell proliferation was monitored by cell counting and clonogenic assays. Flow cytometric analysis was used to determine cell cycle distribution and levels of ROS following modulation of NQO2 function. The expression of cell cycle regulatory markers was determined by Western blot. The contributory roles of NQO2 in determining the cytotoxicity of Adriamycin (ADR) towards OVCs was investigated using MTT assay together with evaluation of P-gp expression and basal ROS levels. In the OVCs panel, NQO2 protein levels and enzymatic activity showed an excellent correlation; with activity varying 36-fold between the cell lines. The sensitivity of OVCs to CB1954 was significantly increased when combined with the NRH-like co-factor, EP0152R. This supports the notion that NQO2 mediates the toxicity of CB1954, which is further confirmed by the strong correlation between cellular NQO2 activity and the responsiveness of the OVC cell lines to CB1954. Hydrazone quinolines showed the highest inhibitiory potency against NQO2 in SKOV-3 when compared to the typical and in-house synthesised quinolines inhibitors. NQO2-overexpressing TOV-112D cells showed more aggressive growth pattern and higher capacity to form colonies than wild-type cells. This was consistently associated with an enhancement in the progression of cells through cell cycle phases and significant reduction in Rb expression. A reduction in ROS levels in NQO2-OE cells may also explain this enhancement in cell growth. Overexpressing NQO2 also resulted in destabilisation of CDK4 and cyclin D1 with significant reduction in their expression levels, and concomitant increase in p-cyclin D1 (Thr286). The involvement of NQO2 in controlling cyclin D1 turnover is also confirmed in SKOV-3 cells when genetic silencing of NQO2 was accompanied by significant reduction in p-cyclin D1 and subsequent stabilisation of cyclin D1 levels. In spite of this, no alterations in the growth pattern of SKOV-3 cells were observed highlighting the impact of cell type on the variations in cellular responses. The role of NQO2 in determining the toxicity of ADR treatment was not proved in OVC cells. This was despite that modulation of NQO2 levels caused significant changes in P-gp expression. The intracellular basal levels of ROS was found to affect the responsiveness of OVCs to ADR as demonstrated when treating SKOV-3 with resveratrol was accompanied by significant increase in ROS levels and concomitant enhancement in the cells’ response to ADR. In conclusion, NQO2 can profoundly alter the proliferation characteristics of OVCs and is a potential therapeutic target for the treatment of this disease. However, the biological functions of NQO2 and its contributory roles in particular pathways are varied among different types of cancer -in other words- are highly dependent on cancer type.

Section A: Article 1.Due to the increasing number of people being infected with or affected by HIV or AIDS, the need for home-based care services has increased. The psycho-social needs of families have also increased due to HIV infection resulting in a need for more extensive service rendering by relevant service providers. By exploring the role of Hospice T.L.C. caregivers in meeting these needs, recommendations could be made for service rendering to families infected with or affected by HIV or AIDS. Main focus areas for service rendering to these families were identified. / Section B, Article 1: In Kokstad, Kwazulu-Natal Hospice caregivers have been rendering services to families infected with and affected by HIV and AIDS. The role of these caregivers was explored by means of a qualitative study making use of focus groups. The focus of this article is the role that Hospice caregivers fulfil in meeting the needs of these families. Through their training and knowledge they obtain access to families infected with and affected by HIV and AIDS. From the study, certain recommendations could be made that could improve future service rendering, and assist the caregivers in meeting the needs of their patients more effectively. / Section B, Article 2: Literature indicates that people are widely affected by the presence of HIV or AIDS in their lives. The effects are of a physical, psychological, as well as a social nature. This has several implications for the affected families. In this study the bio-psychosocial needs, as identified by families themselves, receive attention. This qualitative study was conducted with the help of caregivers of Hospice T.L.C. operating in the Kokstad area, Kwazulu-Natal and involved home visits to affected families where an interview schedule guided the process of data collection. Material needs, as well as a need for emotional support were the most prevalent. The relationship between the caregivers and affected families are very positive, allowing an open door for further service rendering. / Section B, Article 3: Hospice T.L.C. is a non-profit organization (NPO) operating since 2006. They are rendering holistic, palliative and frail care services to ail patients in the Kokstad area, southern. KwaZulu-Natal. This qualitative study was aimed at exploring the extent of involvement of welfare organisations in meeting the bio-psychosocial needs of families infected with and affected by HIV or AIDS. This article deals with the stakeholders rendering services to these families and possible ways in which service rendering could be improved. Data was obtained during a focus group session with the caregivers and their supervisor. Interviews were conducted with members of the relevant resources that could meet the bio-psychosocial needs of families infected with or affected by HIV and AIDS. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2010.

Section A: Article 1.Due to the increasing number of people being infected with or affected by HIV or AIDS, the need for home-based care services has increased. The psycho-social needs of families have also increased due to HIV infection resulting in a need for more extensive service rendering by relevant service providers. By exploring the role of Hospice T.L.C. caregivers in meeting these needs, recommendations could be made for service rendering to families infected with or affected by HIV or AIDS. Main focus areas for service rendering to these families were identified. / Section B, Article 1: In Kokstad, Kwazulu-Natal Hospice caregivers have been rendering services to families infected with and affected by HIV and AIDS. The role of these caregivers was explored by means of a qualitative study making use of focus groups. The focus of this article is the role that Hospice caregivers fulfil in meeting the needs of these families. Through their training and knowledge they obtain access to families infected with and affected by HIV and AIDS. From the study, certain recommendations could be made that could improve future service rendering, and assist the caregivers in meeting the needs of their patients more effectively. / Section B, Article 2: Literature indicates that people are widely affected by the presence of HIV or AIDS in their lives. The effects are of a physical, psychological, as well as a social nature. This has several implications for the affected families. In this study the bio-psychosocial needs, as identified by families themselves, receive attention. This qualitative study was conducted with the help of caregivers of Hospice T.L.C. operating in the Kokstad area, Kwazulu-Natal and involved home visits to affected families where an interview schedule guided the process of data collection. Material needs, as well as a need for emotional support were the most prevalent. The relationship between the caregivers and affected families are very positive, allowing an open door for further service rendering. / Section B, Article 3: Hospice T.L.C. is a non-profit organization (NPO) operating since 2006. They are rendering holistic, palliative and frail care services to ail patients in the Kokstad area, southern. KwaZulu-Natal. This qualitative study was aimed at exploring the extent of involvement of welfare organisations in meeting the bio-psychosocial needs of families infected with and affected by HIV or AIDS. This article deals with the stakeholders rendering services to these families and possible ways in which service rendering could be improved. Data was obtained during a focus group session with the caregivers and their supervisor. Interviews were conducted with members of the relevant resources that could meet the bio-psychosocial needs of families infected with or affected by HIV and AIDS. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2010.

In 2011 there were an estimated 3.9 million orphaned children in South Africa, many of them orphaned by HIV/AIDS. These children are at high risk for developing psychosocial and mental health problems. The National Strategy for the care of orphans and other vulnerable children (OVCs) recognizes the importance of psychosocial support but there are few specific guidelines on best practice and little research on the effectiveness of psychosocial support programs. There is even less research capturing the perspectives of front-line staff and caregivers. This master’s thesis project conducted a case study of an NGO that provides foster care for OVCs in the Western Cape of South Africa. Semi-structured interviews were carried out with 14 foster mothers, four social workers and one administrator of the HomeFromHome organization. Interviews explored the experiences, opinions and concerns of participants regarding psychosocial support and the respondents’ views on the (1) main challenges they face in providing psychosocial support (2) what they see as the most effective forms of support and (3) their recommendations for policy changes. Responses highlighted the psychosocial challenges faced by OVCs, those caring for children, and program staff. The research findings support the existing literature, which promotes psychosocial support as essential for orphaned, and vulnerable children. This case study found that HomeFromHome social workers, foster mothers and administration want increased levels of psychosocial support for both children and caregivers. Respondents identified foster mothers and a primary loving caregiver as the most significant form and source of psychosocial support for the children. An analysis of the participant responses identified several areas that warrant further investigation for future policy and program development. These include: the different forms of alternative childcare, the role of the community and the church, the gap between policy and implementation, gendered issues, the aging out process, and issues concerning biological families.

Abstract in English, Sepedi and Zulu / The people with the greatest stake in Orphan and Vulnerable Children (OVC) interventions are the children and their parents/guardians. Unfortunately, most OVC programmes are predesigned and implemented without considering beneficiaries’ perceptions when developing solutions (ALI 2007:15). The purpose of this study was to explore and describe the perceptions of orphans and vulnerable children’s parents/guardians about the effectiveness of Future Families’ children programme in Olievenhoutbosch. This study used a qualitative, explorative and descriptive design. Thirteen parents/guardians of children registered with the Future Families were interviewed on the effectiveness of the Future Families programme using a semi-structure interview guide. The study results suggested that parents/guardians were happy with Future Families’ services and believed the programme is effective in responding to their families’ needs / Abantu abathinteka kakhulu ekungeneleni kokuphathelene nezintandane kanye nabantwana abasengcupheni (ama-OVC) ngabantwana kanye nabazali noma abaqaphi. Ngeshwa, izinhlelo eziningi zama-OVC zenziwe futhi ziqala ukusetshenziswa ngaphandle kokucabangela imibono yalabo okumele bahlomule kwizisombululo zokuthuthukisa (ALI 2007: 15). Inhloso yalolu cwaningo kwakuwukuhlola nokuchaza imibono yabazali nabaqaphi bama-OVC mayelana nokusebenza kohlelo lwabantwana olunikezwa yiFuture Families e-Olievenhoutbosch. Kwasetshenziswa uhlelo oluhlolayo noluchazayo kulolu cwaningo. Abazali abayishumi nesishiyagalolunye noma abaqaphi babantwana ababhalisiwe kwaFuture Families, okuyinhlangano engenzi nzuzo ehlinzeka izinsizakalo kuma-OVC nakubantu abaneHIV/AIDS noma abahlukumezekayo ngenxa yalokho, babuzwa imibuzo kusetshenziwa umhlahlandela wemibuzo ehlelekile kwezinye izindawo ukuze baveze imibono yabo maqondana nokusebenza ngempumelelo kohlelo lweFuture Families. Imiphumela yalolu cwaningo iphakamise ukuthi abazali nabaqaphi bagculisekile ngemisebenzi ehlinzekwa yiFuture Families, futhi bakholwa ukuthi lolu hlelo lusebenza ngempumelelo ukubhekana nezidingo zemindeni yabo. / Batho ba ba nago le setseka se segolo go ditseno ka bogare tša Bana ba Ditšhiwana le bao ba lego Kotsing (OVC) ke bana le batswadi/bahlokomedi ba bona. Ka bomadimabe, mananeo a mantši a OVC a akanyetšwa pele le go phethagatšwa ntle le go tšeela šedi maikutlo a batho ba ba tlago holega ge go naganišišwa ditharollo (ALI 2007:15). Morero wa thuto ye e be e le go hlohlomiša le go hlaloša maikutlo a ditšhiwana le batswadi/bahlokomedi ba bana ba ba lego kotsing mabapi le go šoma gabotse ga lenaneo la bana la Malapa a ka Moso (FF) kua Olievenhoutbosch. Thuto ye e šomišitše moakanyetšo wa khwalitheithifi, wa go hlohlomiša le wa go hlaloša. Batswadi/bahlokomedi ba 13 ba bana ba ba ingwadišitšego le Malapa a ka Moso ba ile ba botšišwa dipotšišo mabapi le go šoma gabotse ga lenaneo la Malapa a ka Moso ka go šomiša mokgwa wa dinyakišišo wa go botšiša dipotšišo. Dipoelo tša thuto di šišintše gore batswadi/bahlokomedi ba be ba thabile ka ditirelo tša FF le go dumela gore lenaneo le šoma gabotse ka go iphetolela go dinyakwa tša malapa a bona. / Health Studies / M.P.H.