The challenge that confronts South Africa 's emerging democracy is that an increasing percentage of its population is being infected with HIV/AIDS daily . The socio-political impact of the disease has resulted in the development of a variety of macro-level interventions. Despite these initiatives, there has been no decline in the spread of the epidemic. The increasing prevalence of HIV infection among young South Africans in particular, has necessitated an exploration into their risky sexual behaviour. A closer study of the social fields of practice, where knowledge is not only produced, but is constantly contested, negotiated, reproduced and embedded, is suggested. This study uses the principles of feminist theory to focus on gender roles and the related issues of power and risky behaviour. The central argument of this work is that the traditional construction of sexuality, which encourages sexual aggression and promiscuity among young men, alongside female sexual passivity and ignorance, are gendered factors which fuel the spread of HIV/AIDS . In order to examine young peoples' perceptions of the role of gender and risky behaviour, I engaged young people, who were already in the field, to conduct the research. An exploration into the processes of enabling young people to conduct research, while linking the production of meaning to the possibility of human agency and transformative social action, formed an evolving methodology in this work. The research was designed to provide young people with a space for active engagement, participation, immersion and reflection, en route to becoming researchers. Young researchers who conducted research in their youth communities served as deep insider researchers, who possessed an awareness of the slogan systems and semiotics which operated within the cultural norms of the community. The young researchers conducted the inquiry by using a multiplicity of methods, which included visual methodologies, individual interviews and questionnaires. They solicited most of the data from a wider group of 15 to 19 year old African and Indian learners . These learners, who were mainly from a lower socio-economic background, attended the co-educational school, in the province ofKwaZulu Natal in South Africa. The findings of this study reveal how young researchers become empowered by acquiring increased competence in doing research and achieving a greater understanding of the influences of gender and power on risky behaviour. The research report offers methodological insights into the training and enablement of young people as researchers. It reveals how catalytic validity enables a transformation in the young researchers, who, having achieved a heightened understanding of the purpose of the research , actively participated in the research process. The study is significant because it reveals the gradual effacement of the main researcher from the research process, as a natural consequence of engaging young researchers to solicit, generate and interpret data. These new insights evolved as a result of taking the risk of allowing oneself, as a main researcher, to "get off track" and to enter uneven social spaces by doing research differently. / Thesis (Ph.D.)-University of KwaZulu-Natal, 2006.

Multiple sexual partnerships play a very significant role in the spread of HN with epidemiologists suggesting that these partnerships possibly drive the epidemic. According to epidemiological evidence, a reduction of these partnerships would have a substantial impact on the epidemic. Like most countries in sub-Saharan Africa, Zambia is facing a crippling HIV epidemic with prevalence in the 15-20 percent range. In light of this, this study explored youth perceptions of multiple sexual partnerships in the contex,t of HIV/AIDS. The main aim of the study was to provide some insight on these partnerships with the hope that this will shed some light on why these partnerships exist and what barriers and opportunities for change exist given Zambia's high HIV prevalence. The findings of this study suggest that there are several social, cultural, economic and environmental factors that influence the existence of multiple sexual partnerships among the youth. In addition, the study also shows that while young people acknowledge the benefits of faithfulness in sexual relationships, there are several barriers that prevent the youth from being faithful. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2006.

In the global HIV/AIDS pandemic, men who have sex with men (MSM) have experienced high levels of infection. Consequently, this population is considered a crucial target for prevention, care, and treatment efforts. In sub-Saharan Africa, however, most HIV transmission occurs via heterosexual intercourse, and 60% of HIV cases are women. African HIV epidemics are thus classified as “heterosexual” phenomena, and MSM are rarely targeted by public health programming. Epidemiological studies now show that African MSM often have greater HIV prevalence than the general population. Behavioral research further indicates elevated sexual risk and low prevention-related knowledge levels among these men. Moreover, denial, stigmatization, and criminalization of male homosexual conduct across Africa have created social climates in which MSM remain “hidden,” fearing rejection or arrest. This has heightened their vulnerability to HIV infection. To counteract this trend, public health advocates call for prevention interventions adapted to the needs of African MSM. In a few countries, local NGOs have begun mobilizing around the “MSM issue.” However, little information exists about HIV prevention among MSM in sub-Saharan Africa and the associations undertaking it. Using a case study of one such association – Alternatives-Cameroun – this project aimed to explore the factors affecting design and implementation of HIV prevention interventions for MSM in Cameroon. Homosexual conduct is illegal in Cameroon, and MSM are frequently harassed and arrested. Nonetheless, Alternatives-Cameroun has launched prevention programming that reaches “hidden” MSM and addresses their unique characteristics. Through qualitative research involving stakeholder interviews and personal observation, this project found that local, national, and international factors all influence choices of intervention content and delivery formats. Interventions are designed by Cameroonian MSM, for Cameroonian MSM, but are also informed by empirical research and outreach principles drawn from other contexts. Implementation is a challenge in Cameroon’s hostile and resource-poor environment: stakeholders bear physical, emotional, and financial burdens during outreach. However, internal dynamics and foreign support help Alternatives-Cameroun mitigate these obstacles. This project reveals that understanding local realities and reinforcing multi-sectoral mobilization around MSM issues are important first steps towards launching HIV prevention interventions for MSM in sub-Saharan Africa. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

In this mini-dissertation the aim was to explore and describe the safety of infant feeding practices. It is argued that safe infant feeding practices can have a positive and long term effect on the health status and growth development of all infants. World wide, countries but more specific developing countries, are faced with the growing dilemma of high mortality and morbidity rates among infants. The need to find a way to eliminate and prevent the causing factors of life-threatening infectious diseases like diarrhoea and HIV/AIDS is now more important than ever before. A sound nutritional foundation together with safe infant feeding methods play a predominant role in ensuring the very survival of the infant. A cross-sectional, descriptive research design was used in this study. Non-probability sampling was used to identify the sample who complied with the set selection criteria. The research took place in a semi-urban community as the community serves a large group of mothers and infants as well as being accessible to the researcher. The semi-urban community was also identified as an area with health care needs that could be addressed in the research project. A questionnaire was adapted from an existing WHO assessment tool. A pilot study was conducted after which the questionnaire was finalised and the questionnaires were completed with the aid of three fieldworkers. Data collection took place until the sample size (n=155) was achieved according to the calculation of the statistician. The data analysis was done by means of descriptive statistics such as frequency, percentage, mean and standard deviation by using the STATISTICA data analysis software system programme. The results of the research study indicated that the majority of participants practice mixed feeding methods which do not comply with safe infant feeding standards. Infant feeding methods are not changed during illness or disease experienced by either the mother or infant, which again may greatly compromise their health status. The uptake of HIV testing and disclosure were relatively high. Recommendations are made for nursing education, nursing research and nursing practice with special focus on establishing safe infant feeding practices. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2008.

In the era of intense pressures on water resources, the loss of groundwater by increased seawater intrusion (SWI), driven by climate, sea level and landscape changes, may be critical for many people living in commonly populous coastal regions. Analytical solutions have been derived here for interface flow in coastal aquifers, which allow for simple quantification of SWI under extended conditions from previously available such solutions and are suitable for first-order regional vulnerability assessment and mapping of the implications of climate- and landscape-driven change scenarios and related comparisons across various coastal world regions. Specifically, the derived solutions can account for the hydraulically significant aquifer bed slope in quantifying the toe location of a fresh-seawater sharp interface in the present assessments of vulnerability and safe exploitation of regional coastal groundwater.  Results show high nonlinearity of SWI responses to hydro-climatic and groundwater pumping changes on the landside and sea level rise on the marine side, implying thresholds, or tipping points, which, if crossed, may lead abruptly to major SWI of the aquifer. Critical limits of coastal groundwater change and exploitation have been identified and quantified in direct relation to prevailing local-regional conditions and stresses, defining a safe operating space for the human use of coastal groundwater. Generally, to control SWI, coastal aquifer management should focus on adequate fresh groundwater discharge to the sea, rather than on maintaining a certain hydraulic head at some aquifer location. First-order vulnerability assessments for regional Mediterranean aquifers of the Nile Delta Aquifer, the Israel Coastal Aquifer  and the Cyprus Akrotiri Aquifer show that in particular the first is seriously threatened by advancing seawater. Safe operating spaces determined for the latter two show that the current pumping schemes are not sustainable under declining recharge. / <p>The thesis was founded by two research programmes: NEO private-academic sector partnership and Ekoklim, a strategic governmental funding through Stockholm University</p><p>At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 3: Manuscript.</p><p> </p>

Health and safety is of the utmost importance for any company or institution to be successful. There is quite a negative perception regarding the health and safety of rural hospitals and clinics. Rural hospitals are most of the time overcrowded due the large amount of patients that has no medical aid, thus increases the risk for health and safety issues. Patients sit in long queues for hours to receive medical attention and their medication and are therefore exposed to all kinds of diseases, which is a high risk for these patients’s health. The employees working in these rural areas are also exposed to life-threatening diseases on a daily basis and have a good chance of being infected. Employees leave the public sector because of these unsafe working conditions and find themselves either working in the private sector or may even immigrate to foreign countries for better and safer working conditions. During this research done, there were a few shortcomings identified for the management to improvement on and to ensure a safe working environment. There are quite a lot of negativities surrounding the patients and employees in these rural hospitals, because patients get raped by nurses, babies get stolen from maternity wards, doctors are attacked by patients and much more horrific incidents happening in these hospitals. Cultural differences are also a main concern for management, because there are a lot of different races working together in the same department and not everyone has the same beliefs and ways in doing tasks. These cultural differences may lead to clashes amongst employees and result in a negative working environment. This quantitative research was done in selected rural hospitals, due to cost and time consumption. Only 80 employees (doctors, nurses and pharmacists) participated in the research done and the research was not an in-depth research, but enough evidence was compiled to make the necessary assumptions that all is not well in the public sector. With the new National Health Insurance (NHI) to be implemented from 2012, there may a lot of changes in the rural hospitals for the better. Hospitals all over the country are being upgraded and the working conditions are being attended to by the government which may attract more health professional to rural hospitals and clinics. / Thesis (MBA)--North-West University, Potchefstroom Campus, 2012

As we enter the third decade of a devastating worldwide epidemic, much has been done to stem the flow of HIV/AIDS, in particular within North American and Western European urban centres. Successful prevention campaigns in the 1980s had the immediate impact of lowering the rate of HIV infection among gay men, and anti-retroviral drug therapies in the mid-1990s have literally brought thousands of gay men back from the brink. However, by the middle to late 1990s, epidemiological and anecdotal evidence has strongly suggested that gay men have begun to move away from the safer sex orthodoxy of the 1980s. / Forty gay men ranging in age from 21 to 55 were interviewed for this study in order to determine if they have changed their approach to safer sex strategies implemented in the mid-1980s. In contrast to approaches to risk behaviour that emphasize the Health Belief Model, with its focus on the rational individual, this dissertation focused on the social contexts that shape gay men's decisions. / This study found a number of factors that influenced gay men's sexual choices, including age and the changing role of community. Younger gay men, those who have come of age during the 1990s, have taken a different approach to the AIDS epidemic. None of the younger participants in this study had lost anyone to HIV. Furthermore, they were now part of a group of men who no longer considers a HIV diagnosis to be immediately fatal. New medications have definitely shifted their approach to AIDS. Finally, this group of gay men no longer feels defined by a gay community like older gay men interviewed for this study. They believe they are coming of age in a time and place where they have more choices in how they will define themselves as gay men. For older gay men, those who lost many lovers, friends, and acquaintances during the HIV epidemic, changes in gay men's sexual risk-taking are both surprising and inevitable. These men are dealing with issues of ageism, loss and lack of visibility in a changing gay community. / Although there are different age-related arguments for abandoning safer sex strategies, this study helps to explain why there is a definite shift in risk-taking behavior underway as we enter the third decade of HIV/AIDS. It suggests new challenges and approaches for AIDS service organizations to deal with a substantive change in gay men's sexual behaviour.

The central concern of this study is the social, cultural and political position of traditional birth attendants (TBA), known as yiey maap (grandmother midwives) in Chup Commune (pseudonym). In particular, this study explores strategies yiey maap use to negotiate or bypass Western model health services in an attempt to maintain their personal integrity and cultural capital as birth attendants, and to ensure the physical, emotional, economic and cultural safety of the woman they care for. / This thesis explores traditional maternity knowledges and practices using ethnographic methods to investigate the central issues, concerns and barriers confronting rural woman as they make choices to adapt, resist or negotiate Western maternity care. It is vital to consider historical, political, cultural and economic factors that influence women's decisions in order to understand how and why women hold onto or surrender their traditional childbirth knowledges and practices, including the preservation of yiey maap, their favoured birth attendant. / Safe Motherhood initiatives were introduced into resource-poor countries by the World Health Organization in 1987 with the goal of reducing maternal mortality rates. They were based on the premise that pregnancy, childbirth and postpartum care were safer when provided by skilled birth attendants in a modern health facility. TBAs were not considered skilled birth attendants by Safe Motherhood partner agencies, as training and utilizing TBAs in Safe Motherhood initiatives did not have a measurable impact on maternal mortality rates. Instead, TBAs' roles have been recast, and TBAs are expected to be health promoters and educators, referral agents and information gatherers. / I argue that Khmer women do not engage with the modern health system because it is unfamiliar and expensive, and health personnel provide poor quality care. Instead, in times of obstetric emergencies, women attempt to negotiate their own and their family's safety through personal autonomy and agency. / I conclude by proposing alternative approaches and strategies, including the increased utilisation of yiey maap in Cambodian Safe Motherhood programs. A central question is whether the Ministry of Health, supported by bilateral and multilateral agencies, should train and utilize yiey maap or midwives in maternity care. I argue that both are of equal importance. Until yiey maap are valued for their contribution to, and enjoy equitable inclusion in midwifery care, initiatives that involve yiey maap as program "extras", who undertake peripheral tasks, will not reduce maternal mortality rates.

Thesis (M.P.H.M.)--Mahidol University, 1999.

Thesis (M.A. (Population and Reproductive Health Research))--Mahidol University, 2003.