政府自民國七十六年起，即以土地重劃方式試辦農村社區土地重劃，且陸續針對農村社區相關民生公共建設制訂相關法規，於民國八十九年公佈實施【農村社區土地重劃條例】，使農村辦理整體建設配合地籍重整及交換分合有法源的依據。不過，農村社區土地重劃業務實施至民國九十六年底，已進行農村社區土地重劃建設之社區僅有四十八個，所佔比例甚低，且農村社區土地重劃實施之內容，僅偏重在公共設施之硬體建設，以應居住生活之需，然其與農地重劃之配合，及其對生態環境之維護卻顯得十分不足，理當進一步檢討與改進。再者，放眼國際，知悉國外農村土地重劃制度之演化值得我國省思，尤其是德國之農村土地重劃實施百年之經驗別具特色，該國不僅著眼在調整坵塊型態及耕地結構等方面，同時也配合農村發展策略與自然景觀維護，以發揮農村地區生態與景觀維護之功能。由此知悉現代化土地重劃已不再僅是改善農業生產結構之手段，而是被視為一種多目標的農村發展工具。 因此，本研究主要運用文獻分析法、案例研究法及深度訪談法，對欲擬列探討之課題作深入的研究。收集國內外農村社區土地重劃相關文獻，包括：農村規劃的理論和方法，及相關法律規定與案例等，從中探悉如德國等先進國家藉由推動農村土地重劃以促進農村發展的經驗；另針對目前台灣農村社區土地重劃的功能及實施過程所遭遇之問題等項目加以探討，並透過深度訪談之方式，以瞭解地方居民的想法與意見，並觀察重劃後之發展是否達到其原先設定規劃之目標與效益，再藉由德國實施農村土地重劃之規劃原則，加以檢討我國重劃制度之方向與問題，最後研提未來的改進方案，以供有關當局之參酌。 / The government has been trying to readjust the rural community by land consolidation, and formulate relevant laws and regulations one after another on public construction, which is related to people's livelihood of the rural community. In the 89th year, the government published the “Regulations on Land consolidation in Rural Communities”, serving as the source of law in the steady implementation of the cooperation between the overall construction and the re-construction of rural communities, as well as the exchange of cadastral division. However, in the end of the 96th year of R.O.C., the implementation of re-zoning the land of rural communities has only covered 48 communities, which have been readjusted and re-constructed. The proportion is very low. What’s more, as to the content of the implementation, it focused on hardware construction of public facilities to meet the needs of living. Speaking of its relationship between agriculture and land consolidation and its impact on the maintenance of the ecological environment, it is insufficient. We should further review and improve it. Furthermore, if we look into the international situation, we will figure out the evolution of foreign systems of rural land consolidation. Especially in Germany's rural land consolidation, the experience of implementing the consolidation of the rural land for a hundred years is unique. It focuses not only on Hill block patterns and adjusting the structure of arable land aspects, but also on trying to be in line with the rural development strategy and the maintenance of the natural landscape, so as to play the ecological function and the function of landscape maintenance in rural areas. From this, it is known that the modernization of land consolidation is no longer a means which is only to improve the structure of agricultural production, but seen as a rural development instrument with plural goals. Accordingly, the present study will makes use of literature analysis, case studies and depth interviews so as to make an in-depth research on those tasks which are planned to be discussed. The collection of relevant literature on domestic and rural community land consolidation includes: theories and methods on rural planning and relevant legal provisions and precedents, from which we can try to pry into the experience of promoting the development of rural areas by initiating the consolidation of rural land provided by developed countries like Germany. Moreover, after dabbling into the present functions of the land consolidation in rural communities of Taiwan and the problems encountered in the implementation process, we should also try to understand the ideas and views of local residents through the way of depth interviews and observe if the original goal and benefits are attained after the readjusted. Still, we should check the direction and problems of our consolidation systems by comparing with the regulations and principles adopted by Germany when it carried out the implementation of land consolidation and finally make a proposal for programs of future improvement for the light of relevant authorities.

To mitigate the loss of experienced administrators, community college leaders create internal grow-your-own (GYO) leadership development programs. Although the purpose of these programs is to ensure institutional efficacy by developing a pipeline of administrative and faculty leaders, little attention has been given to learning about the participants' post-program career advancement over time. Consequently, the value of GYO leadership training for participants is not well known. The purpose of this qualitative case study was to explore the post-program professional development of a group of participants 2 years after completing a rural community college GYO leadership program. The conceptual framework was guided by both the American Association of Community Colleges' Leadership competency model and situated learning theory. Research questions examined the leadership knowledge, skills, and behaviors the participants acquired from their training and how these knowledge, skills, and abilities were being used. Data sources included interviews of a cohort of 10 GYO leadership participants, leadership institute artifacts, and human resources documents, which were used for triangulation of the data. A constant comparative analysis methodology was used to identify themes. Research findings indicated that the participants most often applied their communication, collaboration, and advocacy knowledge and skills in their respective jobs, interests, and professional development over time. Academic and other leaders can use the research results to create positive social change by offering GYO leadership training programs to promote the advancement of the institution's mission, thereby improving the lives of the students and the health of the community.

During the past decade, the environmental issue has been an important concern of public affairs because the problems generating from the physical environment are the main focus of local development. Generally, the most effective work of community development is to encourage people to participate in environmental improvement actions. For example, the literature has indicated that individual is the most important factor for environmental improvement actions. Thus, people who highly participate in the community affairs often have better performances on community improvement actions. Base on an efficient society and the budget of government downsizing, promoting community residents to actively participate in environmental improvement actions would help the community environment management to be more sustainable and indirectly leading the local development. Concerning community environment, the responsibility for the community, knowledge of environmental action, and the ability of self-control might be correlated with the community residents¡¦ participation behavior in environmental improvement actions. The purpose of study is to explore the relationships among sense of community, the knowledge of environmental action, environmental moral obligation, and participating environmental improvement actions. Four objectives are mainly specified: first, to develop a sense of community scale of Taiwanese population; second, to integrate theories to test a community participation behavior model in environmental improvement actions; third, to understand the influential factors of community residents participation in environmental improvement actions; finally, to compare and interpret community residents participation in environmental improvement behavior model and ¡§Theory of Planned Behavior¡¨. This study surveyed community residents who ever participated in ¡§urban community landscape renaissance project¡¨ supported by Construction and Planning Agency, and ¡§rural community landscape renaissance project¡¨ founded by Soil and Water Conservation Bureau. A total of 616 community residents were administrated a self-report questionnaire. Further analysis of the data based on comparing respondent¡¦s residence, respondents were grouped into to urban planning district group and non-urban planning district group. Structural Equation Modeling (SEM) method was then employed to test a conceptual model. There were nine domains proposed in the conceptual model. Five of nine domains adopted from planning behavioral theory included ¡§attitude¡¨, ¡§subjective norm¡¨, ¡§perceived behavioral control¡¨, ¡§behavioral intention¡¨ and ¡§behavior¡¨. One of nine domains, ¡§self-efficacy¡¨, was chosen from social cognition theory. Two of nine domains from environmental citizen behavioral model were ¡§knowledge of environmental action¡¨, ¡§environmental moral obligation¡¨. ¡§Sense of community¡¨ was referenced to the last domain. The findings provided support for eight hypotheses and two hypotheses were partial supported. The detailed descriptions of hypothesis-testing results were as below. Eight hypotheses supported, they included: (1) After residents reflected on the ¡§subjective norm¡¨, the ¡§attitude¡¨ toward participating environmental reform behaviors was remarkably promoted. (2) Resident¡¦s ¡§attitude¡¨ significantly influenced their ¡§behavioral intention¡¨ of participating environmental improvement behaviors. (3) Resident¡¦s ¡§perceived behavioral control¡¨ significantly impacted their ¡§behavioral intention¡¨ of participate in environmental improvement behaviors. (4) Resident¡¦s ¡§sense of community¡¨ significantly impacted their ¡§behavioral intention¡¨ of participating environmental improvement behaviors. (5) Resident¡¦s ¡§knowledge of environmental action¡¨ significantly impacted their ¡§self-efficacy¡¨. (6) Resident¡¦s ¡§self-efficacy¡¨ significantly effected their ¡§perceived behavioral control¡¨. (7) Resident¡¦s ¡§environmental moral obligation¡¨ significantly impacted their ¡§attitude¡¨ of participating environmental improvement behaviors. (8) Resident¡¦s ¡§behavioral intention¡¨ significantly impacted their participating environmental improvement ¡§behaviors¡¨. Two hypotheses were partial supported: (1) Only in non-urban planning district resident¡¦s ¡§subjective norm¡¨ significantly impacted their ¡§behavioral intention¡¨ of participating environmental improvement behaviors. (2) Only in urban planning district and all districts resident¡¦s ¡§perceived behavioral control¡¨ significantly impacted their ¡§attitude¡¨ of participating environmental improvement behaviors. Additionally, the findings confirmed that Italian Sense of Community Scale (ISCS) was an appropriate scale to measure Taiwanese population¡¦s sense of community. These findings provide researchers and practitioners for insight of resident¡¦s participation in environmental improvement, which is better than ¡§Theory of Planned Behavior¡¨.

More than 16 years post-apartheid, South Africa is still regarded as the most unequal society in the world. The government is facing various obstacles and challenges in improving the standard of living and quality of life for all its citizens, for example in facilitating the access to clean drinking water and sanitation, building houses and providing basic education. In addition, the country is facing the world’s largest HIV/AIDS epidemic with a national prevalence rate of 18.1 %, equalling approximately 5.7 million people who are currently infected. (Pressly, 2009; UNAIDS, 2008c) Against this background, the aim of this thesis was to study the Madwaleni community, situated in a deeply rural area of the former apartheid homeland Transkei. Applying the Community Oriented Primary Care approach, a strategy of ‘community assessment and diagnosis’ was used to obtain a holistic community profile and to determine the perceptions of its community members regarding their health and social problems and needs, intending to make recommendations to health care providers working at Madwaleni Hospital regarding future health education and disease prevention programmes. (Brown and Fee, 2002) This research used a cross-sectional design. In a preliminary survey, qualitative data was collected in short interviews with health care providers working at Madwaleni Hospital (N=46). The information served as a basis to develop and design parts of the Madwaleni community survey questionnaire. The questionnaire consisted of 36 questions, complying with the aim and objectives of this thesis. It was used for the structured interviews with the main study population, all of whom were members of the Madwaleni community (N=200), whereas half of the main study population were men and half were women, then again, half were unaware of their HIV status and half were HIV+ and had joined the Madwaleni HIV/AIDS programme. Key findings 1) Madwaleni community profile and characteristics Thoughtful sexual behaviour: Particularly interesting in light of the HIV/AIDS epidemic, more than 90 % of the sexually active community members were monogamous at the time of the survey. While only 36.4 % of the men and women unaware of their HIV status used condoms, 76.5 % of the HIV+ community members claimed to do so, indicating that the Madwaleni HIV wellness programme and especially its counselling and health education components are adequate and valuable in serving their purpose. High rates of illiteracy and insufficient education: Only 56.5 % of the interviewed community members were ‘functionally literate’ at the time of the survey. Of those, only 8 % had received a matriculation and not one of the community members had received any higher degree. In addition, 19.5 % of the sampled men and women were not able to read at all. High rates of unemployment, poverty and dependency on welfare grants: Only 20 % of the Madwaleni community members were employed at the time of the survey. Taking the daily income per capita as a reference, one third of the community members suffered from ‘moderate poverty’, defined as an income of 1 to 2 US $ per day, while the other two thirds suffered from ‘extreme poverty’, defined as an income of less than 1 US $ per day, although more than 90 % of the corresponding households received at least one type of welfare grant already. Large household sizes and predominance of traditional dwellings: In the Madwaleni community, an average of eight people lived together per household at the time of the survey, whereas 95 % of the community members lived in traditional dwellings, constructed from freely occurring natural resources. In need of safe drinking water, sanitary systems and access to electricity: More than 80 % of the Madwaleni community members obtained their drinking water from rivers or stagnant dams, while only 6.5 % used rain water and 9.5 % had access to piped water. In addition, almost 70 % of the community members had no access to any sanitary systems, using nearby bushes instead. Furthermore, more than 90 % had no access to electricity. The majority used paraffin for cooking, candles for lighting and wood for heating their homes. Small-scale cultivation to provide an extra source of food: In the Madwaleni area, 90 % of the families owned a small garden patch attached to their houses, used for small-scale cultivation. In addition, almost 90 % owned livestock, mainly poultry, cattle and goats. Crops and animals were used to provide an extra source of food; however, not one of the households could solely live on subsistence farming. Difficulties in accessing health care facilities: On average, each of the community members needed three-quarters of an hour to access their closest clinic and almost one and a half hours to reach Madwaleni Hospital, with 40 % and 60 % respectively depending on public taxi transport to get there. No substantial improvement of the living circumstances since apartheid: Comparing the Madwaleni community characteristics with corresponding data from apartheid-times, no substantial improvement of the living circumstances and conditions could be noticed, proving that governmental and non-governmental actions, programmes and services have not yet reached all remote communities. Similar community characteristics in the neighbouring communities: Comparing these characteristics with corresponding features of communities in the immediate or surrounding areas, namely Cwebe, Ntubeni, Mboya, Shixini and Zithulele, various similarities could be detected, indicating that the living circumstances and conditions might be generalisable to a certain degree, at least to deeply rural communities in the former Transkei area. More disadvantaged than the general South African population: The Madwaleni community differed significantly from the general South African population in 75 % of the compared characteristics. For example, amongst the community members the illiteracy rate (21.7 % vs. 13.6 %, p = 0.002) and unemployment rate (80.5 % vs. 25.5 %, p < 0.001) were significantly higher. In addition, the ‘poverty headcount ratio of 2 US $ per day’ showed that significantly more people were suffering from poverty in the Madwaleni area (92.2 % vs. 34 %, p < 0.001). The Madwaleni community members were less likely to have access to clean drinking water, along with significantly higher proportions of them using river water as their main source of drinking water (75.5 % vs. 5.1 %, p < 0.001). Also, they were less likely to have access to any sanitation or toilet facilities (31.3 % vs. 91.8 %, p < 0.001) or to electricity (8.5 % vs. 80.2 %, p < 0.001). 2) Weightiest health and social problems as experienced by the Madwaleni community In the Madwaleni area, the three health problems with the highest impact on the community were TB, HIV/AIDS and hypertension. On the basis of the applied 3-to-0-point rating matrix, they were rated by more than 95 % of the community members as being relevant problems, with mean values of 2.33, 2.30 and 2.14 respectively. Interestingly, women rated HIV/AIDS higher than men. Musculoskeletal problems and headache were additional health problems with relevant impact on the Madwaleni community, rated by more than 90 %, with mean values above 1.80. While pain and discomfort experienced by PLWHA have been recognised and researched before, there are no corresponding studies on rural communities and further research is necessary to identify the contributing factors. Additional relevant health problems: Interestingly, six health problems were rated higher by HIV untested than by HIV+ community members, namely bilharzia/ schistosomiasis, epilepsy, Herpes Zoster, HIV/AIDS, lung infections and stroke. Since the HIV+ men and women were educated about and screened for all of those diseases within the Madwaleni HIV/AIDS programme, this might explain the deviating rating patterns between the different sub-samples. Moreover, these results demonstrate that health education and disease prevention programmes are able to reduce the perceived burden of health problems and might therefore serve as a substantial argument in their favour. Interestingly, for the Madwaleni community, social matters had a higher impact on their lives than health problems, whereas the three social problems with the highest impact on the community were alcohol abuse, dependency on social grants and smoking. They were rated by more than 98 % of the community members as being relevant problems, with mean values of 2.75, 2.73 and 2.72 respectively. In accordance with these findings, employment & lack of work opportunities, education & illiteracy, food supply and poverty were additional social problems with relevant impact in the Madwaleni area, rated by more than 90 %, with mean values above 2.00. 3) Recommendations for future health education and disease prevention programmes At the time of the survey, the three most relevant health education and disease prevention topics for the Madwaleni community were HIV/AIDS, TB and healthy nutrition. They were rated by more than 95 % of the community members as being relevant health education problems, with mean values of 2.65, 2.51 and 2.36 respectively. In addition, STIs, alcohol & drug-related problems, water & sanitation and body & muscle pain were rated as the subsequent issues of relevance, with mean values above 2.00, supporting the identified community characteristics as well as the listing of the weightiest health and social problems. In addition, valuable new insight could be gained. For instance, HIV untested men rated the topic HIV/AIDS lower than all other community members, which is particularly interesting since men only constitute a minority of 20 % of the people testing for HIV in the Madwaleni area. Besides, topics not previously considered, such as injury prevention and basic first aid, were in-fact relevant for more than 85 % of the community members and require further attention. Furthermore, deviating rating patterns between men and women and the corresponding need for gender-specific educational workshops became evident, for example, for men about prostate & testicular cancer check-up or erectile dysfunction and for women about breast & cervical cancer check-up & papsmears or nutrition & growth. In addition, HIV+ community members rated depression & stress and psychiatric diseases higher than HIV untested men and women, with further studies required to identify the underlying reasons for these deviating rating patterns. Taking all findings from this Madwaleni community survey into consideration, health care providers working at the hospital and its peripheral clinics should first and foremost concentrate their efforts on maintaining the existing programmes, particularly, the Madwaleni HIV/ARV programme and the workshops on hypertension and diabetes mellitus. In addition, if qualified and motivated personnel can be recruited and the necessary funding can be raised, future health education and disease prevention programmes should focus on TB, alcohol & substance abuse-related problems as well as water & sanitation.

SUMMARY Renata GAIŠAITĖ ORGANIZATION OF YOUTH SOCIO-CULTURAL ACTIVITY IN RURAL COMMUNITIES Final project of Master’s studies written in Lithuanian language consists of 69 pages, 23 pictures, 13 tables, 56 sources of literature and 5 enclosures. KEYWORDS: youth, organization of socio-cultural activity, rural community, social problem, social assistance, social integration. Object of research – youth socio-cultural activity in rural communities. Objective of study – to analyze the organization of youth socio-cultural activity in rural communities and to present a model of youth’ socio-cultural activity organization in rural communities. The main tasks are: 1. To traverse theoretical aspects of youth socio-cultural activity organization in rural communities. 2. To present youth’, as a social group, characteristics that has its peculiar problematic aspects. 3. To analyze the survey data results of experts’ and youth’ sociological research. 4. To do a comparable analysis of survey results of experts and rural youth. 5. To present a model of youth socio-cultural activity organization in rural communities. Methods of research are: logical analysis and synthesis, comparable analysis, data analysis of nonfiction and statistics, half standardized interview of experts, youth’ questionnaire survey data analysis, graphic presentment and generalization. While studying the scientific works of Lithuanian and foreign authors, Laws of Lithuanian Republic, the theoretical aspects of youth... [to full text]

This study examines the association between collective identification with a rural communityfrom the northern coast of Peru, and the subjective, psychological and social expressions of well-being. These variables were analyzed in a sample of 80 community residents. Resultsshow significant associations between some components of collective identification and some expressions of well-being. A path analysis suggest that the general positive self-stereotype has a positive effect on collective self-esteem, while the self-stereotype of low efficacy reduces it. Meanwhile, collective self-esteem increases the degree of identification. Self-stereotype components influence different expressions of well-being. Thus, self-stereotype of low efficacy negatively affects social well-being, and self-stereotype of corruption negatively affects psychological well-being. Finally, social well-being influences psychological well-being, which in turn influences subjective well-being. / Este estudio examina las relaciones entre la identificación colectiva con una comunidad rural y las expresiones subjetiva, psicológica y social del bienestar. Estas variables fueron analizadas en 80 pobladores de la comunidad. A través de un modelo estructural se observa que el autoestereotipo positivo general incide positivamente sobre la autoestima colectiva, mientras que el autoestereotipo de baja eficacia, atenúa la misma. Por su parte la autoestima colectiva incrementa el grado de identificación. Los componentes autoestereotípicos presentan relaciones de influencia con distintas expresiones del bienestar. Así, el autoestereotipo de baja eficacia incide negativamente en el bienestar social y el autoestereotipo de corrupción influye negativamente en el bienestar psicológico. Finalmente, se observa que el bienestar social influye en el bienestar psicológico, y este en el bienestar subjetivo. / Este estudo examinou a relação entre a identificação coletiva em uma comunidade rural e asexpressões do bem-estar subjetivo, psicológico e social. Estas variáveis foram analisadas em 80 moradores da comunidade. Através de um modelo estrutural mostra-se que o auto-este- reótipo positivo geral aumenta a autoestima coletiva, enquanto o auto-estereótipo de baixa eficácia, diminui a mesma. Enquanto isso, a autoestima coletiva aumenta o grau de iden- tificação com a comunidade. As dimensões do auto-estereótipo tem relações de influência com as diferentes expressões do bem-estar. Assim, o auto-estereótipo de baixa eficácia afeta negativamente o bem-estar social e o auto-estereótipo de corrupção afeta negativamente o bem-estar psicológico. Finalmente, observa-se que o bem-estar social influencia o bem-estarpsicológico, e este influencia o bem-estar subjetivo.

The inter-related social and ecological facets of global sustainability imply that the way society develops will impact the environment. Development presents complex, multifaceted challenges. Interventions in the developing world in the form of projects created by the agencies, organizations and agents of the international development community increasingly appreciate and seek to address these challenges. Yet, to do so effectively, interventions need to shift from fragmented, sector-specific approaches based on formal data reports to approaches that anticipate, adapt, transform, and learn. This research aims to complement and support the practical and theoretical knowledge of rural development agents with insights from practitioners using approaches that consider complexity in other fields, in order to explore how development interventions could play a role in moving society toward sustainability. A prototype guide for rural development interventions synthesizes results gathered from interviews with rural development agents within Latin America and learning experience designers into three levels: system, interaction, and personal. The Framework for Strategic Sustainable Development (FSSD) provides a systems perspective and unifying definition of sustainability. The interaction level presents key recommendations, rationale, and methods for action, and the personal level presents reflection questions. This research hopes to inspire mutual learning between development actors and communities.

Esta investigación se centra en evidenciar el uso de los elementos de comunicación como humor, efectos multimedia y acciones persuasivas en los videos de experiencias turísticas y cómo estas influyen en la decisión de compra del turismo rural comunitario del turista de Lima Metropolitana. Respecto a este tema, la hipótesis planteada es que el uso de estos elementos expuestos en los medios digitales son lo suficientemente influyentes en la decisión de compra de turismo rural sostenible. La investigación describe cada etapa del proceso de proceso de compra de este servicio y el nivel de influencia que tienen cada elemento utilizado mediante el relato de experiencias. La investigación es de tipo descriptivo y menciona las herramientas de marketing digital como Facebook, Instagram, Youtube. Además de influencers, youtubers que son parte de esta comunicación y proceso de compra / This research focuses on evidencing the use of testimonial experiences and videos as E-wom actions and how they influence each stage of the process of buying rural community tourism for tourists from Metropolitan Lima. Regarding this issue, the hypothesis raised is that the testimonies of travelers exposed in digital media are sufficiently influential in the process of buying sustainable rural tourism. The research describes each stage of the process of purchasing this service and the level of influence that each digital action has used through the experience report. The research is descriptive and mentions the tools of digital marketing such as Facebook, Instagram, YouTube. In addition to influencers, youtubers that are part of this communication and purchase process. / Trabajo de investigación

MCur / Department of Advanced Nursing Science / See the attached abstract below

More than 16 years post-apartheid, South Africa is still regarded as the most unequal society in the world. The government is facing various obstacles and challenges in improving the standard of living and quality of life for all its citizens, for example in facilitating the access to clean drinking water and sanitation, building houses and providing basic education. In addition, the country is facing the world’s largest HIV/AIDS epidemic with a national prevalence rate of 18.1 %, equalling approximately 5.7 million people who are currently infected. (Pressly, 2009; UNAIDS, 2008c) Against this background, the aim of this thesis was to study the Madwaleni community, situated in a deeply rural area of the former apartheid homeland Transkei. Applying the Community Oriented Primary Care approach, a strategy of ‘community assessment and diagnosis’ was used to obtain a holistic community profile and to determine the perceptions of its community members regarding their health and social problems and needs, intending to make recommendations to health care providers working at Madwaleni Hospital regarding future health education and disease prevention programmes. (Brown and Fee, 2002) This research used a cross-sectional design. In a preliminary survey, qualitative data was collected in short interviews with health care providers working at Madwaleni Hospital (N=46). The information served as a basis to develop and design parts of the Madwaleni community survey questionnaire. The questionnaire consisted of 36 questions, complying with the aim and objectives of this thesis. It was used for the structured interviews with the main study population, all of whom were members of the Madwaleni community (N=200), whereas half of the main study population were men and half were women, then again, half were unaware of their HIV status and half were HIV+ and had joined the Madwaleni HIV/AIDS programme. Key findings 1) Madwaleni community profile and characteristics Thoughtful sexual behaviour: Particularly interesting in light of the HIV/AIDS epidemic, more than 90 % of the sexually active community members were monogamous at the time of the survey. While only 36.4 % of the men and women unaware of their HIV status used condoms, 76.5 % of the HIV+ community members claimed to do so, indicating that the Madwaleni HIV wellness programme and especially its counselling and health education components are adequate and valuable in serving their purpose. High rates of illiteracy and insufficient education: Only 56.5 % of the interviewed community members were ‘functionally literate’ at the time of the survey. Of those, only 8 % had received a matriculation and not one of the community members had received any higher degree. In addition, 19.5 % of the sampled men and women were not able to read at all. High rates of unemployment, poverty and dependency on welfare grants: Only 20 % of the Madwaleni community members were employed at the time of the survey. Taking the daily income per capita as a reference, one third of the community members suffered from ‘moderate poverty’, defined as an income of 1 to 2 US $ per day, while the other two thirds suffered from ‘extreme poverty’, defined as an income of less than 1 US $ per day, although more than 90 % of the corresponding households received at least one type of welfare grant already. Large household sizes and predominance of traditional dwellings: In the Madwaleni community, an average of eight people lived together per household at the time of the survey, whereas 95 % of the community members lived in traditional dwellings, constructed from freely occurring natural resources. In need of safe drinking water, sanitary systems and access to electricity: More than 80 % of the Madwaleni community members obtained their drinking water from rivers or stagnant dams, while only 6.5 % used rain water and 9.5 % had access to piped water. In addition, almost 70 % of the community members had no access to any sanitary systems, using nearby bushes instead. Furthermore, more than 90 % had no access to electricity. The majority used paraffin for cooking, candles for lighting and wood for heating their homes. Small-scale cultivation to provide an extra source of food: In the Madwaleni area, 90 % of the families owned a small garden patch attached to their houses, used for small-scale cultivation. In addition, almost 90 % owned livestock, mainly poultry, cattle and goats. Crops and animals were used to provide an extra source of food; however, not one of the households could solely live on subsistence farming. Difficulties in accessing health care facilities: On average, each of the community members needed three-quarters of an hour to access their closest clinic and almost one and a half hours to reach Madwaleni Hospital, with 40 % and 60 % respectively depending on public taxi transport to get there. No substantial improvement of the living circumstances since apartheid: Comparing the Madwaleni community characteristics with corresponding data from apartheid-times, no substantial improvement of the living circumstances and conditions could be noticed, proving that governmental and non-governmental actions, programmes and services have not yet reached all remote communities. Similar community characteristics in the neighbouring communities: Comparing these characteristics with corresponding features of communities in the immediate or surrounding areas, namely Cwebe, Ntubeni, Mboya, Shixini and Zithulele, various similarities could be detected, indicating that the living circumstances and conditions might be generalisable to a certain degree, at least to deeply rural communities in the former Transkei area. More disadvantaged than the general South African population: The Madwaleni community differed significantly from the general South African population in 75 % of the compared characteristics. For example, amongst the community members the illiteracy rate (21.7 % vs. 13.6 %, p = 0.002) and unemployment rate (80.5 % vs. 25.5 %, p < 0.001) were significantly higher. In addition, the ‘poverty headcount ratio of 2 US $ per day’ showed that significantly more people were suffering from poverty in the Madwaleni area (92.2 % vs. 34 %, p < 0.001). The Madwaleni community members were less likely to have access to clean drinking water, along with significantly higher proportions of them using river water as their main source of drinking water (75.5 % vs. 5.1 %, p < 0.001). Also, they were less likely to have access to any sanitation or toilet facilities (31.3 % vs. 91.8 %, p < 0.001) or to electricity (8.5 % vs. 80.2 %, p < 0.001). 2) Weightiest health and social problems as experienced by the Madwaleni community In the Madwaleni area, the three health problems with the highest impact on the community were TB, HIV/AIDS and hypertension. On the basis of the applied 3-to-0-point rating matrix, they were rated by more than 95 % of the community members as being relevant problems, with mean values of 2.33, 2.30 and 2.14 respectively. Interestingly, women rated HIV/AIDS higher than men. Musculoskeletal problems and headache were additional health problems with relevant impact on the Madwaleni community, rated by more than 90 %, with mean values above 1.80. While pain and discomfort experienced by PLWHA have been recognised and researched before, there are no corresponding studies on rural communities and further research is necessary to identify the contributing factors. Additional relevant health problems: Interestingly, six health problems were rated higher by HIV untested than by HIV+ community members, namely bilharzia/ schistosomiasis, epilepsy, Herpes Zoster, HIV/AIDS, lung infections and stroke. Since the HIV+ men and women were educated about and screened for all of those diseases within the Madwaleni HIV/AIDS programme, this might explain the deviating rating patterns between the different sub-samples. Moreover, these results demonstrate that health education and disease prevention programmes are able to reduce the perceived burden of health problems and might therefore serve as a substantial argument in their favour. Interestingly, for the Madwaleni community, social matters had a higher impact on their lives than health problems, whereas the three social problems with the highest impact on the community were alcohol abuse, dependency on social grants and smoking. They were rated by more than 98 % of the community members as being relevant problems, with mean values of 2.75, 2.73 and 2.72 respectively. In accordance with these findings, employment & lack of work opportunities, education & illiteracy, food supply and poverty were additional social problems with relevant impact in the Madwaleni area, rated by more than 90 %, with mean values above 2.00. 3) Recommendations for future health education and disease prevention programmes At the time of the survey, the three most relevant health education and disease prevention topics for the Madwaleni community were HIV/AIDS, TB and healthy nutrition. They were rated by more than 95 % of the community members as being relevant health education problems, with mean values of 2.65, 2.51 and 2.36 respectively. In addition, STIs, alcohol & drug-related problems, water & sanitation and body & muscle pain were rated as the subsequent issues of relevance, with mean values above 2.00, supporting the identified community characteristics as well as the listing of the weightiest health and social problems. In addition, valuable new insight could be gained. For instance, HIV untested men rated the topic HIV/AIDS lower than all other community members, which is particularly interesting since men only constitute a minority of 20 % of the people testing for HIV in the Madwaleni area. Besides, topics not previously considered, such as injury prevention and basic first aid, were in-fact relevant for more than 85 % of the community members and require further attention. Furthermore, deviating rating patterns between men and women and the corresponding need for gender-specific educational workshops became evident, for example, for men about prostate & testicular cancer check-up or erectile dysfunction and for women about breast & cervical cancer check-up & papsmears or nutrition & growth. In addition, HIV+ community members rated depression & stress and psychiatric diseases higher than HIV untested men and women, with further studies required to identify the underlying reasons for these deviating rating patterns. Taking all findings from this Madwaleni community survey into consideration, health care providers working at the hospital and its peripheral clinics should first and foremost concentrate their efforts on maintaining the existing programmes, particularly, the Madwaleni HIV/ARV programme and the workshops on hypertension and diabetes mellitus. In addition, if qualified and motivated personnel can be recruited and the necessary funding can be raised, future health education and disease prevention programmes should focus on TB, alcohol & substance abuse-related problems as well as water & sanitation.