<p> Biomedical and behavioral interventions can virtually eliminate the risk of vertical (i.e., mother-to-child) HIV transmission. Pregnant and breastfeeding women&rsquo;s adherence to prevention of mother-to-child transmission (PMTCT) interventions, however, remains a challenge across sub-Saharan Africa. Using a concurrent mixed methods approach, including a survey and semi-structured interviews, I test whether a relationship exists between women&rsquo;s low power within married couples (based on domains from the Theory of Gender and Power) and adherence across the PMTCT cascade of care, including drug adherence during and after pregnancy, safe infant feeding practices, and pediatric HIV testing. The results of this study indicate that intimate partner violence is particularly detrimental to PMTCT adherence. Certain PMTCT protocols are also affected by partner controlling behaviors, participation in household decisions, and economic dependence, but not to the same extent as violence. Women with low power cite a lack of partner support and an unwillingness to disclose their HIV status to the husband due to fear of violence or abandonment as reasons for low PMTCT adherence. Conversely, women with high power cite partner support and the ability to prioritize PMTCT, sometimes even over the marriage, as enabling adherence. Based on these results, augmented efforts to address gender power dynamics both in society and within the home are recommended to promote the health of HIV-positive women and their families.</p>

This thesis examines how gender influences the perceptions of men and women toward different social, economic and political issues in Liberia's post-conflict reconstruction process. While the focus of the thesis is women, a gender framework is utilized and considers the situation of men to have a more comprehensive perspective on sustainable peace and reconstruction in post-conflict Liberia. Previous research has demonstrated that the condition of women and gender inequality must be accurately understood and addressed to ensure sustainable and equitable reconstruction in post-conflict societies. This dissertation seeks to answer the following research questions: To what degree do women perceive the post-conflict reconstruction process differently than do men, and what is the nature of such differences? And, to what degree have women's issues been incorporated in public discourse and reconstruction policy? This study seeks an in-depth understanding of how ideas about women's and men's social participation and responsibilities may be evolving in a time of social reordering and how such changes may shape efforts to positively influence socio-political processes and ultimately, long-term peace. This dissertation examines the actions taken by the reconstruction government to consider the effects of gender on policy and design policy accordingly, in an effort to eliminate gender-based inequalities. Using a country case study methodology, focus groups and key informant interviews were conducted in rural and urban Liberia. Focus groups stratified by ethnicity, gender, urban/rural residence and age were used to help determine how women and men and differing groups of Liberians view and discuss the post-conflict reconstruction process and the different socio-economic issues associated with this process; and what the differences and similarities in these experiences indicate for the success of the reconstruction process as a whole. The findings of this dissertation suggest that this initial post-conflict period has been instrumental to the restructuring of gender roles. Participants perceived that women have entered the political spectrum with a gender-balanced agenda that attempts to correct gender inequalities, although women and men have differing perceptions of the benefit of such agenda. Both men and women perceived that education is being used as a tool for addressing gender inequality and that gender roles in Liberia are changing in part to violent conflict. The information generated by this study will make a useful contribution to the effectiveness of policies and strategies of sustainable peace and reconstruction of Liberia, the West African region and post-conflict societies as a whole / acase@tulane.edu

<p> The objectives of this explorative case study investigated a multistakeholder conflict in Tanzania Africa, using stakeholder theory as the theoretical foundation. While stakeholder theory has evolved and gained prominence as a method for reviewing conflict resolution processes it was important to conceptualize any discrepancies that could establish a framework for resolving conflicts in practice and in strategy. The research design analyzed five factors of framing, reframing, managing, power and trust with four different stakeholders involved in higher education loan conflicts. The results of the study showed distinct differences compared to previous research findings focused on multistakeholder conflicts. One primary distinction was characterization of the conflicts followed other studies however the lack of motivation to change was complex. There was a strong risk aversion which blocked a link for long-term solutions. Though like other studies competitive, collaboration and coalition for managing the conflicts were identified, risk aversion precipitated an unpredictable mixture of these management processes. Furthermore power imbalances and trust were identified as important aspects of multistakeholder conflicts; however this study linked the impact of results when risk aversion is included in the conflict. Finally, like other studies barriers to a strong conflict resolution process were related to normative values. However, this study enhanced the impact of a lack of societal values for motivating stakeholders to include normative values. It is recommended that further research be conducted to explore the implications of the multistakeholder conflict resolution model. </p>

<p> <b>Background:</b> HIV testing saves lives. It is fundamental to combating the global HIV epidemic. Key populations at higher risk for HIV in Mozambique, including Men who have Sex with Men (MSM), Female Sex Workers (FSW) and mineworkers, are in urgent need of effective HIV prevention strategies. This is the first analysis ever conducted in Mozambique to identify levels of HIV testing and associated factors that inform these strategies. </p><p> <b>Methods:</b> This analysis used data from seven cross-sectional surveys conducted between 2011-2012 among MSM, FSW and Mineworkers in Mozambique. Participants completed a questionnaire and provided blood samples for HIV testing. MSM and FSW were recruited used Respondent Driven Sampling in Maputo, Beira and Nampula. Mineworkers were recruited using Time Location Sampling in Ressano-Garcia. Participants with previous HIV-positive tests or missing HIV test histories were excluded (&lt;5% overall). Weighted logistic regression was used to measure associations with recent HIV testing (&lt;12 months). Theory-driven multivariate logistic regression was conducted in R v2.15 using the Health Behavior Model as a conceptual framework. </p><p> <b>Results:</b> The prevalence of recent testing for HIV ranged from 29.8-59.5%, yet 4.4-25.0% had HIV and did not know it. Between 11.9-57.4% had never been tested, and fear was given as the primary barrier. Recent HIV testing was positively associated with knowledge of ARV drugs, knowing the HIV status of a sexual partner, knowing where to go to get tested, and having had contact with a peer educator. It was negatively associated with having had a genital sore or ulcer and unprotected sex. Between 32.1-90.0% of HIV-positive undiagnosed, key population members had used a healthcare service in the previous 12 months and 23.4-47.5% had tested negative for HIV in that time period. </p><p> <b>Conclusion:</b> Routine testing with strengthened post-test counseling encouraging key populations to have annual HIV screenings need to be implemented in Mozambique.</p>

<p> Without exception, healthcare systems in the Sub-Saharan Africa, including Ghana, face many challenges. Difficulties in Ghana&rsquo;s healthcare system stem from many factors, but the most notable one is professional migration, which has crippled the former British colony since 1980. Statistical data demonstrate the yearly migration of healthcare workers from Ghana and its impact on healthcare services (the doctor/nurse population ratio). This study used a quantitative multiple regression research method to examine and empirically analyze the relationship between healthcare workers, technological innovations, and changes in healthcare services in Ghana from 1990 to 2010. The main result was that technological innovations had a significant impact on healthcare services in Ghana during the observed period. Also, regional disparities in the number of medical doctors and nurses were largely explained by the degree of urbanization and economic development. Therefore, the pooled regression analysis from the panel data consistently showed that technological innovations significantly impacted the healthcare system in Ghana during the observed period. However, the numerical impact of the technological innovation coefficients was relatively lower in Ghana during the observed period.</p>

<p> Among the multitude of interventions to address the worst forms of child labor (WFCL), one of the responses to the presence of WFCL has been the institution of child labor monitoring (CLM). While systems to systematically monitor children with respect to their exposure and risks have been implemented, the degree of their efficacy and ultimately their effect on the targeted populations begs academic scrutiny. This dissertation seeks to provide an empirical view of the community-level dynamics that emerge in response to a community-based CLM program and their effects, in turn, on the CLM itself. </p><p> An embedded multiple case study methodology, surveying longitudinally at two points in time using a mix of purposive and probability sampling techniques, was employed for this study. Two communities, Ahokwa in the Western Region, and Dwease in the Ashanti Region of Ghana, were selected as cases. </p><p> The study finds that between the two points of observation &ndash; before and after the introduction of CLM &ndash; a profound reduction of WFCL is observed in Dwease, whereas much less reduction was observed in Ahokwa. A point-by-point analysis within and between the two villages reveals that individual, social and institutional factors worked together to transform behavior in Dwease. The principal change catalysts in Dwease were (a) a heightened awareness of child work hazards and a deepened parental investment in child education working at the individual level, coupled with (b) new norms created by the town's opinion leaders and the emergence of peer accountability at the social level, and (c) monitoring carried out by the Community Data Collection (CDC) and enforcement carried out by the Community Child Protection Committee (CCPC) &ndash; the two new institutions constituting CLM at the community-level. The underlying social dynamic proved to be decisive: a tipping point was crossed in Dwease whereby progressive opinion leaders in the community, who, once sensitized to recognize the pejorative effects of CL/WFCL, created new social norms and spurred a critical mass of community members to rid their community of CL/WFCL. </p><p> This study shows that with sufficient local ownership, and if properly instituted, the tandem operation of child protection committees and child labor monitoring enables a community to effectively detect, police and mitigate the practice of child labor and WFCL.</p>

<p> Sub-Saharan Africa has the lowest rates of electrification and some of the worst education statistics worldwide. In the absence of strong infrastructure for a reliable grid system and quality universal primary schooling, the poor suffer significantly. Though substantial research has been done on both issues separately, the relationship between the two has yet to be explored. This thesis uses social justice theories to introduce the connections between energy poverty and an individual&rsquo;s education capabilities through a case study in Zambia. Case study research was carried out in the urban low-resource settlements of Lusaka, Zambia over a period of two months with Lifeline Energy, using methods of participant observation.</p><p> Drawing on trends discovered in survey responses, interviews and feedback from a distribution of renewable technologies, this study demonstrates that a lack of modern forms of energy detracts from education. By synthesizing the data with Martha Nussbaum's capabilities approach and Sendhil Mullainathan and Eldar Shafir&rsquo;s scarcity theory, the research reveals that energy poverty hinders an individual&rsquo;s ability to study and gain a quality education and diminishes their available cognitive capacity to learn by tunneling attention to the resource deficit. Furthermore, it supports the claim that energy poverty is not gender neutral. The research concludes that the scarcity caused by energy poverty can be lessened by the investment in and use of small-scale renewable technologies which alleviates some of the daily stress and grind of poverty. This thesis lays the groundwork to recognize energy poverty as an injustice.</p><p> <b>Keywords: Energy Poverty, Education, Gender, Sub-Saharan Africa, Scarcity, Capabilities Approach.</b></p>

<p> The purpose of this qualitative, grounded theory study was to explore and describe the perceptions and experiences of African-born and educated nurses (ABEN) in order to understand how the nurses influenced systems of professional practice in healthcare systems of Maricopa County of Arizona. The overarching research question for the study directly reflected the purpose statement. Four sub-questions were also used in the study. These centered on was how care experiences shaped ABEN perceptions of the healthcare delivery system, how ABEN informed and shaped their social interactions when caring for patients and residents, the barriers to providing care and to fulfilling work practices and processes that ABEN described and the components of a model to adjust or remove experienced barriers. The sample consisted of 17 registered nurses, 16 females and one male, from five African countries, who participated in individual interviews. Lee's push-pull theory formed the theoretical framework of the study. Responses from interviews and researcher field notes were coded and thematically analyzed to determine answers to research questions. Six categories emerged from conceptual data analysis: optimism, self-development, confronting barriers, discovering, assimilation drive, and adaptability. A four-stage model of acclimation was developed from these six components. Results have implications for healthcare policy changes such that ABEN become fully assimilated and accepted as contributors to healthcare delivery in Maricopa County.</p>

<p> Postconflict governments and counterparts have collaborated to provide skills training to communities as a critical postconflict development strategy. In these undertakings, the role of community members remains largely undefined. The purpose of this qualitative descriptive case study was to understand the perceptions held by rural community members regarding the role they played in influencing government's policy priority for technical and vocational education and training (TVET) as a local human development strategy in postconflict Liberia. The conceptual framework was based on human capital theory and concepts of motivation and achievement. Fourteen participants were purposefully selected for the study. Data were collected from interviews, focus group discussion, and documents and analyzed using constant comparison. Results indicated that increasing human capital, restoring self-esteem, encouraging civic participation, and building peace were among the community members' motivations for establishing a skills training institution. Leadership, advocacy, and ownership were major roles community stakeholders played in establishing their local skill training institution; voluntarism and collaboration were found to be strategies for support to the local TVET initiatives. Findings have positive social change implications for facilitating community-initiated TVET programs for youth employment as well as informing TVET policies in countries transitioning from conflict to development.</p>

<p> "Bantu" is a term used to describe lineages of people in around 600 different ethnic groups on the African continent ranging from modern-day Cameroon to South Africa. The migration of the Bantu people, which occurred around 3,000 years ago, was influential in spreading culture, language, and genetic traits and helped to shape human diversity on the continent. Research in the 1970s was completed to geographically divide the Bantu languages into 16 zones now known as "Guthrie zones" (Guthrie, 1971). </p><p> Researchers have postulated the migratory pattern of the Bantu people by examining cultural information, linguistic traits, or small genetic datasets. These studies offer differing results due to variations in the data type used. Here, an assessment of the Bantu migration is made using a large dataset of combined cultural data and genetic (Y-chromosomal and mitochondrial) data. </p><p> One working hypothesis is that the Bantu expansion can be characterized by a primary split in lineages, which occurred early on and prior to the population spreading south through what is now called the Congolese forest (i.e. "early split"). A competing hypothesis is that the split occurred south of the forest (i.e. "late split"). </p><p> Using the comprehensive dataset, a phylogenetic tree was developed on which to reconstruct the relationships of the Bantu lineages. With an understanding of these lineages in hand, the changes between Guthrie zones were traced geospatially. </p><p> Evidence supporting the "early split" hypothesis was found, however, evidence for several complex and convoluted paths across the continent were also shown. These findings were then analyzed using dimensionality reduction and machine learning techniques to further understand the confidence of the model.</p><p>