No abstract available. / Dissertation (LLM)--University of Pretoria, 2013. / gm2014 / Centre for Human Rights / unrestricted

Purpose and rationale: In 2012, an estimated 9,500 infants in Ethiopia were born with HIV. Mortality for these infants is high, and preventing infection offers the best hope for reducing the childhood death rates. Effective measures exist which can reduce the likelihood of a child acquiring HIV from its mother to less than 2%, and the necessary anti-retroviral medications are free and accessible to Ethiopian women. However, Prevention of Mother to Child Transmission of HIV (PMTCT) efforts in the country have not kept pace with the global reduction in infant infections over the last decade, and the Ethiopian MTCT rate was still 20% in 2012. Although a large number of women are getting tested for HIV during pregnancy, only 41% of eligible women in the country complete PMTCT therapy. The purpose of this exploratory study was to elicit the perspectives of HIV+ mothers on the unique socio-contextual factors which affect them during pregnancy, both positively and negatively, including the beliefs, attitudes, cultural norms and individuals who have influence over their reproductive health decisions. Methods: The mixed-methods study was done at a community level in Addis Ababa, Ethiopia. With the assistance of several large networks of people living with HIV (PLHIV), PLHIV mothers who have a child at least one year of age were recruited by mixed purposeful sampling; various socio-economic demographics were represented. In-depth interviews, focus groups and surveys were then completed in Amharic with a research assistant translating to English. Results: 98 women in total took part in the study: 23 completed interviews, 28 participated in focus groups, and 49 completed additional surveys. The greatest barriers to PMTCT completion identified were: feelings of hopelessness and carelessness, a general lack of understanding of the efficacy of ARVs, negative religious influences, stigma and poverty. The strongest facilitators to PMTCT use expressed by the women were: PLHIV peer support, faith, and gaining hope. It was recommended that PLHIV mothers be utilized in all PMTCT planning and interventions in the future. Implications: Program managers and health officials can build on these findings to modify existing PMTCT programs and to develop innovative and effective new PMTCT interventions. This will ultimately result in increased PMTCT uptake and adherence amongst HIV + pregnant women and a reduction in infant HIV transmission.

Magister Artium (Development Studies) - MA(DVS) / Clarifying the nexus between leadership and organisational effectiveness across the world remains a significant challenge that has raised robust scholarly debate. A wide range of conceptual models have been provided on effective leadership. But, at the global level few empirical studies have been done to examine transformational leadership in the context of Non-Government Organisations (NGOs). In line with the leadership theory and conceptual framework, this study sought to analyse members' perception of their leaders, using a case study NGO in Addis Ababa. The researcher employed both quantitative and qualitative research methods. Quantitative methodology used questionnaire surveys based on the Multifactor Leadership Questionnaire to assess the dominant leadership style within ANOPA+. Qualitative methodology was applied through semi-structured interviews, in order to deepen the understanding of the existing leadership style based on the members' perception of the organisation. The results of the study indicated that transformational leadership motivated followers to attain more than they thought possible, by appealing to followers self-esteem and inspiring them to go beyond self-centered interests. In addition, the research process identified five important gaps that impede the successful implementation of ANOPA+'s programme. First, this study revealed that ANOPA+ leaders failed to use, or lacked a proper understanding of, transformational leadership skills. Second, this empirical research, discovered that the dominant leadership style within ANOPA+ was transactional leadership. Third, this research confirmed that there was no statistically significant difference between the perception of staff and volunteers regarding the leadership style within ANOPA+. Fourth, the field data assessment showed that HIV/AIDS status is the crucial criterion for appointment as a leader in ANOPA+. However, ANOPA+ members believed that effective leaders should have a combination of the knowledge, skills and competencies that followers can use to perform their day-to-day work. Fifth, the study identified that the appointment of women in leadership positions within ANOPA+ is very low. Within the context of the above mentioned analysis, the study finally brings into focus general observations gained from the investigation and provides recommendations to policy makers and other stakeholders.

<p>This was a descriptive qualitative study. Eight people living with HIV, four of which had disclosed their status, were individually interviewed. Two focus group discussions (each comprising 6 participants) were also conducted with health workers. The study was based at an urban TB hospital which is currently providing a range of HIV-related services including HIV Voluntary Counselling and Testing, case management and treatment.</p>

<p>This was a descriptive qualitative study. Eight people living with HIV, four of which had disclosed their status, were individually interviewed. Two focus group discussions (each comprising 6 participants) were also conducted with health workers. The study was based at an urban TB hospital which is currently providing a range of HIV-related services including HIV Voluntary Counselling and Testing, case management and treatment.</p>

Magister Public Health - MPH / This was a descriptive qualitative study. Eight people living with HIV, four of which had disclosed their status, were individually interviewed. Two focus group discussions (each comprising 6 participants) were also conducted with health workers. The study was based at an urban TB hospital which is currently providing a range of HIV-related services including HIV Voluntary Counseling and Testing, case management and treatment. / South Africa

Objectif : Évaluer la « lourdeur » de la prise en charge clinique des personnes vivant avec le VIH/SIDA (PVVIH) afin d’ajuster l’allocation des ressources en GMF. Méthodologie : Analyse comparative entre le GMF de la Clinique médicale l’Actuel, les GMF montréalais et de l’ensemble du Québec, en identifiant les différences dans les profils de consommation de soins pour les années civiles 2006 à 2008 et les coûts d’utilisation des services pour l’année 2005. Résultats : En 2008, 78% de la clientèle inscrite au GMF de la Clinique médicale l’Actuel est vulnérable comparativement à 28% pour les autres GMF montréalais, une tendance observée pour l’ensemble du Québec. Le nombre moyen de visites par individu inscrit et vulnérable est de 7,57 au GMF l’Actuel alors que la moyenne montréalaise est de 3,37 et celle du Québec de 3,47. Enfin, le coût moyen des visites médicales au GMF l’Actuel en 2005 est de 203,93 $ comparativement à des coûts variant entre 132,14 et 149,53 $ pour les unités de comparaison. Conclusion : L’intensité de l’utilisation des ressources au GMF de la Clinique médicale l’Actuel (nombre d’individus vulnérables, nombre de visites et coûts) suggère que la prise en charge clinique des personnes vivant avec le VIH/SIDA est beaucoup plus lourde qu’un citoyen tout venant ou même de la majorité des autres catégories de vulnérabilité. Afin d’offrir un traitement juste et équitable aux GMF, l’inscription devrait être ajustée afin de tenir compte de la « lourdeur » de cette clientèle et valoriser la prise en charge des personnes qui présentent des tableaux cliniques complexes. / Objective: To evaluate the “burden” involved in the clinical management of people living with HIV/AIDS, in order to adjust the allocation of resources in terms of family medicine groups (FMG). Methodology: A comparative analysis of FMG Clinique médicale l’Actuel, FMGs in Montréal and throughout Québec, identifying differences in care consumption profiles for the years 2006 to 2008 and the costs of use of services for 2005. Results: In 2008, seventy eight percent (78%) of the clientele registered with the FMG at Clinique médicale l’Actuel was considered vulnerable, in comparison to twenty eight percent (28%) at other Montréal FMGs, a trend observed throughout Québec. The average number of visits per registered individuals was 7.57 at the Actuel FMG, while the average in Montréal was 3.37 and in Québec overall, 3.47. In 2005, the average cost of a visit at the Actuel FMG was $203.93 compared to costs that varied from $132.14 to $149.53 for comparative units. Conclusion: The intensity of use of FMG resources at the Clinique médicale l’Actuel (number of vulnerable individuals, number of visits and costs) suggests that the clinical management of people living with HIV/AIDS is a much heavier burden than that of an average citizen, or even from the majority of other categories of vulnerability. In order to ensure that all FMGs are treated fairly and equitably, registration should be adjusted to take into account the “burden” of this clientele and to place more value on the case management of people with complex clinical presentations.

Objectif : Évaluer la « lourdeur » de la prise en charge clinique des personnes vivant avec le VIH/SIDA (PVVIH) afin d’ajuster l’allocation des ressources en GMF. Méthodologie : Analyse comparative entre le GMF de la Clinique médicale l’Actuel, les GMF montréalais et de l’ensemble du Québec, en identifiant les différences dans les profils de consommation de soins pour les années civiles 2006 à 2008 et les coûts d’utilisation des services pour l’année 2005. Résultats : En 2008, 78% de la clientèle inscrite au GMF de la Clinique médicale l’Actuel est vulnérable comparativement à 28% pour les autres GMF montréalais, une tendance observée pour l’ensemble du Québec. Le nombre moyen de visites par individu inscrit et vulnérable est de 7,57 au GMF l’Actuel alors que la moyenne montréalaise est de 3,37 et celle du Québec de 3,47. Enfin, le coût moyen des visites médicales au GMF l’Actuel en 2005 est de 203,93 $ comparativement à des coûts variant entre 132,14 et 149,53 $ pour les unités de comparaison. Conclusion : L’intensité de l’utilisation des ressources au GMF de la Clinique médicale l’Actuel (nombre d’individus vulnérables, nombre de visites et coûts) suggère que la prise en charge clinique des personnes vivant avec le VIH/SIDA est beaucoup plus lourde qu’un citoyen tout venant ou même de la majorité des autres catégories de vulnérabilité. Afin d’offrir un traitement juste et équitable aux GMF, l’inscription devrait être ajustée afin de tenir compte de la « lourdeur » de cette clientèle et valoriser la prise en charge des personnes qui présentent des tableaux cliniques complexes. / Objective: To evaluate the “burden” involved in the clinical management of people living with HIV/AIDS, in order to adjust the allocation of resources in terms of family medicine groups (FMG). Methodology: A comparative analysis of FMG Clinique médicale l’Actuel, FMGs in Montréal and throughout Québec, identifying differences in care consumption profiles for the years 2006 to 2008 and the costs of use of services for 2005. Results: In 2008, seventy eight percent (78%) of the clientele registered with the FMG at Clinique médicale l’Actuel was considered vulnerable, in comparison to twenty eight percent (28%) at other Montréal FMGs, a trend observed throughout Québec. The average number of visits per registered individuals was 7.57 at the Actuel FMG, while the average in Montréal was 3.37 and in Québec overall, 3.47. In 2005, the average cost of a visit at the Actuel FMG was $203.93 compared to costs that varied from $132.14 to $149.53 for comparative units. Conclusion: The intensity of use of FMG resources at the Clinique médicale l’Actuel (number of vulnerable individuals, number of visits and costs) suggests that the clinical management of people living with HIV/AIDS is a much heavier burden than that of an average citizen, or even from the majority of other categories of vulnerability. In order to ensure that all FMGs are treated fairly and equitably, registration should be adjusted to take into account the “burden” of this clientele and to place more value on the case management of people with complex clinical presentations.

Magister Public Health - MPH / Human Immune-deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) is a major public health problem. Globally, the number of new HIV infections is decreasing but the total number of people living with the disease is increasing. An estimated 5.7 million South Africans are currently living with the disease. The life expectancy of people living with HIV (PLHIV) in South Africa has slowly increased due to the availability of Anti-Retroviral Therapy (ART). The progressive "chronicity" of HIV may be associated with a variety of impairments and disabilities for people living with HIV. This emphasising the increasingly important role that physiotherapists play to minimize the disabling impact of the disease and improve quality of life for PLHIV. The aim of study was to determine the HIV/AIDS knowledge, attitudes and the occupational risk perception of physiotherapists practicing in the Eastern Cape Province, South Africa. This study utilized a cross sectional descriptive quantitative survey to collect data. The data was collected via a structured self-administered postal questionnaire. The questionnaires were captured in Microsoft Excel and analysed statistically using CDC Epi-Info version 3.5.1. Data was analysed descriptively and the chi-square test, T-tests and ANOVA was used to identify any statistically significant relationship between variables. The results of the study identified that the physiotherapists in the study have "high" general HIV related knowledge, although major gaps regarding HIV prevention and transmission still exists. The physiotherapists expressed a positive attitude towards PLHIV, while they perceive themselves to be at low risk of HIV transmission risk when managing PLHIV. The physiotherapists with more than 10 years' experience had significantly better HIV related knowledge compared to those with less than 10 years' experience while the attitudes of married physiotherapists towards PLHIV were significantly less favourable than those who were not married. There is a need for intervention strategies to address the HIV knowledge gaps of physiotherapists. Intervention strategies need to address physiotherapists HIV prevention and transmission knowledge.

The mini-dissertation analyses the international law obligations of the government and nonstate actors regarding the protection of internally displaced children living with HIV in the Democratic Republic of the Congo. The war and armed conflicts in the Eastern DRC have exacerbated the vulnerability of children, causing them to be separated from their families, to experience sexual violence and forced conscription into armed groups, to experience the violent deaths of a parent or friend, resulting in insufficient adult care. They further are subject to a lack of safe drinking water and food, insufficient access to health care services, discrimination and stigmatisation, and so on. These factors increase their risk of contracting HIV and, if they are already living with HIV, they adversely affect their welfare. The mini-dissertation illustrates that international, regional and domestic human rights instruments protecting children can be applied in situations of armed conflicts to supplement humanitarian law instruments. It demonstrates that the government of the DRC has not implemented and fulfilled its international obligations to ensure these children adequate access to health services and to humanitarian assistance for displaced persons living with HIV; security and protection within displaced persons camps; and that children are protected from abuse and human rights violations. The dissertation recommends the prosecution of perpetrators of crimes tied to the conflicts which have targeted children, as well as the ratification by the DRC of regional instruments such as the African Union Convention on the Protection and Assistance of Internally Displaced Persons in Africa, and the African Charter on the Rights and the Welfare of the Child, as this may enhance the legal protection of displaced children in the DRC. / Dissertation (LLM)--University of Pretoria, 2013. / gm2014 / Centre for Human Rights / unrestricted