The purpose of the study was to analyze the process of facilitating collaboration between traditional healers and western trained health care workers in the management of chronic illnesses, hypertension and diabetes. This process was facilitated through qualitative participatory action research which utilized the principles of Action Science Enquiry. This was a qualitative research. Two phases were as followed: phase one was the analysis of the problem of collaboration while phase two was the implementation of strategy one and two. Strategy one was the development of the constitution of traditional healers towards the establishment of the Swaziland traditional Healers' Council and a traditional healers' department within the Ministry of Health and Social Welfare. Strategy two was a small comparative survey into the safety and efficacy of traditional medicine. The survey compared clients who utilized only traditional medicines and those who utilized only western medicines to control their hypertension. Data was collected through interviews, meetings, observations and clinical measurements. Audio-taped and field notes were transcribed, carefully studied and analyzed. The editing analysis described by Crabtree and Williams (1992) was utilized in the analysis of data. The results of phase one was a descriptive profile of traditional healers and the way hypertension and diabetes were managed by the traditional healers and the western trained health care workers, with the aim of finding out how they could collaborate. A number of barriers for collaboration were identified such as the lack of a legal body of traditional healers, negative attitudes of western trained health care workers towards clients and traditional healers, ethical issues, perceptions of illnesses and payments as well as the lack of transparency. Enhancers for collaboration were also identified. Consequences of a successful collaborative process were established by the participants. Strategies to solving the problems of collaboration were identified and two of the strategies were implemented. A traditional collaborative model was identified and compared to an existing modem collaborative model. Phase two, strategy one, the legalizing of traditional healers in Swaziland, was decided upon during one of the meetings held between traditional healers, clients and western trained health care workers. Barriers to successfully organize this strategy were also identified, such as organization and exclusion, leadership style, traditional and cultural structures, lack of resources, poor communication and different traditional healers' categories. Action plans to solve those problems were developed and progress was made. The end result was that a draft of the traditional healers' constitution content was developed. Stakeholders who would be part of the development of the constitution were contacted. The stakeholders included the Ministry of Health and Social Welfare, the Ministry of Natural Resources and Agriculture, the Swaziland World Health Organization, the Ministry of Justice and the University of Swaziland. The traditional healers managed to form an interim committee called the Traditional Healers' Constitution Development Committee. This committee was still in a process of involving all traditional healers in Swaziland to furnish their views and opinions to the committee concerning the constitution. The target date for the constitution to be completed was set to be around April, 2001. The researcher will still be working with the committee until the legalizing process is completed. This would take another one year to complete. Phase two : strategy two, establishing the efficacy of traditional healers' medicines to control hypertension was established to enhance trust between the traditional healers and the western trained health care personnel. From the small sample, it would seem that fluctuations of blood pressure levels were similar between the two groups. This showed that traditional healers medicines to control hypertension in Swaziland is effective. Though it was difficult to establish the safety of those clients who utilized only the traditional medicines, there were no abnormalities discovered to be associated with the use of the traditional medicines. / Thesis (Ph.D.)-University of Natal, Durban, 2001.

Introduction. The use of Highly Active Antiretroviral Therapy (HAART) has shown to reduce the morbidity and mortality and prolongs survival, improving quality of life restoring and preserving immunologic function, maximizing antiretroviral activity and durably suppressing viral load and further preventing vertical HIV transmission. However, their use in Critical Care Units CCU is still controversial as there are still no set standards for how HAART should be applied in these settings (Anderson, 2009). This study was aimed at exploring the perceptions of critical care nurses towards their educational preparedness in managing HIV/AIDS patients admitted to CCU in KwaZulu-Natal. Methodology. Quantitative descriptive research design was used and data collection included a structured questionnaire and open ended questions. Results. The findings of this study indicate that of the critical care nurses who were sampled for this study and had undergone training in HIV/AIDS management, 45% and 25% respectively perceived that they were not educationally prepared to provide services for people living with HIV/AIDS admitted to CCUs. Almost all N=50 (94%) critical care nurses reported that HIV/AIDS management should be incorporated into the critical care nursing programme. Their universal perception N=42 (75%) is that this will improve the standards of nursing care in the critical care field. Over and above lack of training and updated information reported by the respondents, they are still challenged by factors such as advanced level of HIV disease, confidentiality about the disease, knowledge about a HIV/AIDS treatment regimen and emotional challenges. However, there are guiding policies within critical care settings for nurses to utilise in the management of HIV/AIDS and in the care of people who have already been infected. Conclusion and recommendations. In conclusion, more research with a larger scale sample is required to provide appropriate generalisation of the findings of the study. Alternatively a qualitative research study which may provide richer data on the lived experiences of the critical care nurses regarding care of people living with HIV/AIDS is suggested. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2012.

The reduction of the maternal mortality rate is part of the priority agenda of governments in Africa, including South Africa. Research shows that a large portion of maternal deaths are preventable because they are largely due to lack of inappropriately prepared staff. In South Africa, outcome studies on the quality of comprehensive prepared nursing graduates reflect some concerns regarding their levels of competence. These studies, however, are general; they did not directly target the competence of these graduates in their midwifery practice, therefore, the purpose of this study was to explore and describe the perceived level of competence of newly qualified-midwives functioning in midwifery units. Based on the positivist paradigm, an exploratory descriptive design, using a quantitative approach, was adopted in this study. Two structured questionnaires were used to collect data: one for the newly-qualified midwives and one for the supervisors. A total of 48 newly-qualified midwives and 26 supervisors from five hospitals at eThekwini District participated in this study. Ethics principles and other considerations were observed throughout the study. Data were analyzed statistically using a computer Software Package (SPSS, version 15.0) and a variety of statistical tests were carried out. . From the findings there was a positive congruence between graduates and their supervisors' ratings of the newly-qualified midwives clinical competencies. There were, however, significant differences in a few skills with graduates tending to rate themselves higher than did their supervisors. On the whole though one can conclude that although VI the findings in this study are not conclusive, compared to the previous studies in this area, there is an improvement in the level of competence of newly-qualified midwives. The improvement was noted in their level of competence in midwifery clinical practice, clinical teaching, management and research. The findine;s, however, revealed some areas that need special attention in the theory and clinical preparation of midwives. Recommendations included reviewing the curriculum and strengthening the research component. In midwifery clinical practice there needs to be more attention paid to neonatal care skills, problem solving and record keeping. Further research is also recommended. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

Purpose: To explore sexual practices of married women, which make them vulnerable to HIV infection in a rural setting, and the implications such practices have for the HIV/AIDS epidemic. Methodology: An ethnographic approach was used to explore the phenomenon of, which was sexual practices of married women, both ancient and contemporary. Unstructured interviews and focus group discussions were undertaken. The researcher applied the principle of theoretical saturation and a total of fifty participants were included in the study. All the interviews were taped and transcribed. Data analysis was done manually by the researcher, using themes and sub-themes. Findings: Married women engage in short term sexual relationships with secret lovers which are either concurrent or frequent while their husbands are away on migrant labour. A number of factors that cause women to engage in such risky sexual practices were identified. Some of these factors included scarcity of men due to migration and economical resources, the fact that women cannot negotiate safe sex due to gender and cultural factors; limited knowledge of infections particularly HIV/AIDS, life skills including their sexual rights and how to exercises these rights, and economic skills. Recommendations included the designing of an intervention program to sensitise and empower women on factors that make them vulnerable to HIV infection. Conclusions: Married women in the rural KwaZulu-Natal indulge in multiple concurrent or successive extramarital partnerships in the absence of their migrant men. These sexual practices place them in a vulnerable position to get HIV infection as they engage in risky sexual behavior without condom use. They also have fear of being rejected by their secret lovers and their own husbands because of women's economic dependency on men. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Introduction Youth is a group of people which has been greatly affected by HIV epidemic in Malawi. They are vulnerable to HIV infection because they are at a stage where they are beginning sexual exploration. Youth therefore, need a lot of information and support on HIV preventions, and voluntary counseling and testing. They should be encouraged and assisted to disclose their HIV status whether positive or negative for them to access necessary support system. Purpose: The purpose of the study was to explore youth's experiences in disclosing their HIV positive status Methodology: This is an exploratory study that adopted a qualitative approach utilizing the phenomenological design to explore the experiences of HIV positive participants in disclosing their HIV positive status. The study was conducted in Likuni urban and Nambuma areas in Lilongwe district, Malawi. Ten HIV positive participants five males and five females between the ages 19-25 years were purposively sampled half from each area. A qualitative approach to data collection was done through face to face individual in-depth interviews. All the interviews were audio taped and transcribed verbatim using qualitative content analysis. Findings: The following are the four major themes that emerged from the findings of the study: factors leading to and hindering HIV positive status disclosure, disclosure of HIV status, experiences of disclosing HIV positive status, consequences of HIV positive status disclosure. These themes are in line with the objectives and the conceptual framework of the study. The findings of the study have shown that disclosure of HIV positive status among HIV positive youth is difficult and still remains a challenge. The study established that the majority of participants disclosed their HIV positive status due to their deteriorating health status. Stigma and discrimination was found to be the major barrier to HIV positive status while the positive consequences which include: psychosocial care, accessing medical services, safer sex practices and positive living with HIV seemed to be more rewarding because it brought some relief in their lives. Conclusion: Stigma and other hindering factors were found to be the major barriers to disclosure. This therefore, necessitates the need for dealing with barriers to disclosure because the benefits of disclosing HIV positive status are rewarding and outweighs the negative consequences. This study has made some recommendations to promote disclosure of HIV positive status among youth through Ministry of Health, Ministry of Education, National Youth Council, National AIDS Commissions, the Community and further research. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Despite the availability, accessibility and affordability of cervical cancer screening (CCS) in Malawi, many women do not utilize the CCS services. This research was conducted in Blantyre district, Malawi. The main objective of the study was to identify factors that act as barriers to the uptake of cervical cancer screening programs among urban and rural women in the Blantyre district of Malawi. A quantitative design was used and convenience sampling was applied in selecting a sample of 196 women from the population of women aged 18 and over in two Reproductive Health clinics, one urban clinic at Queen Elizabeth Central Hospital and one rural clinic at Mlambe hospital in Blantyre district, Malawi. A structured questionnaire was used to collect data. The questionnaire was translated from English into the local Chichewa language so that respondents were interviewed and responded in a language that they were able to comprehend. Analysis and discussion of findings are presented in five sections. Data were processed into numeric values using SPSS version 15.0 and Microsoft Excel to give meaning to the findings of the study. In order to test for statistically significant associations between variables, the Pearson correlation was applied. The study revealed that the main barrier to CCS was that women lack knowledge and information about cervical cancer and there is a lack of publicity about CCS services. Lack of knowledge was found in relation to - risk factors, prevention of, detection of and benefits of cervical cancer screening with a greater knowledge deficit being found in the rural women. Higher levels of education in both the urban and rural groups did not have a positive influence on the screening behaviours of the women. Commencing sexual intercourse at ages 15 to 19 years and having multiple sexual partners were the main risk factors to cervical cancer among the women in the study. It was also found that although rural women perceived themselves being very likely to be at risk of cervical cancer, this perception did not translate into CCS behaviour. v / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Background: Literature on postgraduate student throughput and success suggests a mismatch between registration, throughput and success rates among postgraduate students. Purpose of the Study: This study aimed at exploring and describing mechanisms used to increase throughput and success rates in Postgraduate Nursing Programmes at the University of KwaZulu-Natal. Conceptual Framework: The theoretical framework used in this study was derived from Tinto's proposed Theory ofInstitutional Action (2005). This theory is based on the assumption that learners' behaviour which is manifested in persistence or departure is never fully understood because only the act of leaving or staying is observed, not the underlying intentions behind the action. Research Methodology: Using a mixed methods paradigm, the whole target population of 83 participants was sampled for the quantitative aspect and 2 focus groups each consisting about 12 participants for the qualitative aspect were used. Data were collected using a questionnaire and an interview guide. Descriptive statistics and were used for quantitative data, while thematic content analysis was used for qualitative data. Results: This study revealed that the support mechanisms for increasing student throughput and success rates are structured in three phases: the pre-enrolment phase, the integration phase, and the engagement phase. During the pre-enrolment phase, support is offered in form of information to help students understand what is expected of them, inform students about the programmes offered, the cost of the programmes, duration of the programs and the available support services. During the integration phase, the support provided includes guidance about the registration process, information about programmes and disciplines offered, counselling regarding curriculum design, modules to select and required credits for completion, orientation, and helping international students with visa extension with repatriation issues. During the engagement phase, the support provided includes academic, psychosocial and financial services. Facilitating factors reported include: student interaction with academic staff to monitor and provide feedback, a responsive curriculum to learning needs through the teaching and assessments methods utilised, active student involvement, personal effort, prior learning and working experience, and enough learning resources. Barriers reported were inadequate information, insufficiency of student-lecturer interaction time, unsuitable psychosocial support for adult learners, lack of mentorship and academic advising services, lack of time to participate in co-curricular activities, limited time for studying, ineffective use of learning resources, and language barrier. Recommendations: The study revealed a need to provide a balance mixture the available support mechanisms because academic support dominated the support services offered. Findings also showed the necessity to adapt the psychosocial support to the needs of all categories of students including adult postgraduate students. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2010.

Background: 'The literature reveals that a large percentage of teachers ask questions aimed at lower cognitive levels irrespective of the underpinning philosophy. They fail to set challenging questions at higher order levels when setting examination papers. Purpose of the Study: This study is aimed at describing and analysing the examination questions set over a four year academic period, at the University of KwaZulu-Natal School of Nursing, in terms of Bloom's levels of cognitive domains. Research Methodology: A quantitative approach and content analysis was used. A total of 1319 questions were examined, SOUTCed from 39 examination papers, from 2003-2007. These questions were independently reviewed by two coders according to Bloom's taxonomy's template. Research Results: The findings revealed that all six categories of the cognitive domains in Bloom's taxonomy were used across the four levels in the Bachelor of Nursing (BN) programme. Overall about 57 % of the questions were aimed at lower level (knowledge, recall and comprehension) whilst only 43.4% were aimed at higher levels (application, analysis, synthesis and evaluation). In the first year lower order questions averaged at 62% with higher order questions at 51 %. In second year the lower order questions took up 51% of the paper \\~th higher order questions at 49%. During third year there was an equal (50/50) split between higher order and lower order questions. In fourth year there was the highest percentage of lower level questions (66%) was seen, with only 34% of questions being of the higher order. Regarding the increase in the complexity of questions within the programme, a change of 13% was seen between first and second year. Whilst there was an increase of 1% reported between second and third year. However, there was a significant drop (16%) in the complexity ofquestions in the fourth year, with lower order questions clearly dominating. Recommendations: The nursing education curriculum, and staff development progranune, should pay special attention towards developing educators in the setting of questions ensuring appropriate examination criteria are met. Exercises during the capacity building initiatives should cover aspects such as how to plan an assessment for the whole programme ensuring the appropriate increases in complexity as the programme progresses, as well as setting, or critiquing, of examination papers and coming up with recommendations to improve the quality of questions. Special attention should be given to how to align teaching and assessment in such a way that the level ofcomplexity increases as the students' progress through the programme. Lastly, further research should be conducted, using mixed methods, to explore the assessment of learning and in order to address certain questions which could not be answered quantitatively; for example questions regarding the construction of questions, because it impacts the nature of the question Also it should be noted that there was a disjuncture between the scenario and the questions in some cases. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2010.

The study aimed to explore adolescents knowledge, perceptions and behaviors regarding sexual reproduction and sexual reproductive health services in community junior school in Tutume Botswana. A descriptive exploratory design using both the qualitative and quantitative approach was used to guide the research process. Data was collected by means of a self administered questionnaire and two focus group discussions. A total of 76 participants answered the questionnaire and 2 focus group discussions one consisting of the 15 to 17 year olds and the other one consisting of 12 to 15 year olds were conducted. The results of the survey highlighted adequate levels of knowledge regarding sexual matters among adolescents in the school with the bulk of the information being provided by the teacher. Parents, nurses, siblings, peers and the media played a low key role in providing adolescents with information regarding sexual reproduction and sexual reproductive health services. The results of the focus group discussion showed marked underutilization of the local clinic for curative, preventive and promotive services by adolescents. The poor utilization resulting mainly from perceived barriers such as provider attitudes, subjective norms, cultural taboos, inadequacy of the clinic, judgmental attitudes from provider and parents as well as lack of encouragement from authority figures like parents and teachers. Adolescents in the focus group discussion perceive themselves as being susceptible to HIV but did not appreciate the benefits of using preventive measures even though the survey group showed sound knowledge on contraception. Improving the services to align them to adolescent friendly services, improving the delivery of information through other means apart from the teacher and reducing the barriers that discourage adolescents from reaching the reproductive health services will go a long way in improving the utilization of the services by adolescents. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2009.

This study was aimed at evaluating effects of psycho education on medication compliance and symptom management for clients with bipolar affective disorder attending community psychiatric clinics in the Ethekwini Health District of KwaZulu-Natal Province. A quantitative study was done using a quasi-experimental design. A one group pre-test and post-test design was used to assess the effects of psycho education. The population of the study were all clients with bipolar affective disorder attending Escoval House community psychiatric clinic and its satellite clinic (Austerville). Systematic sampling was used to select clients to participate in the study and a total of forty clients were selected. Two self-administered questionnaires were used to collect data. Clients were assessed in areas of their knowledge, medication compliance and symptom management (Pre-test). The group was then exposed to six sessions of psycho education, and they were assessed again a week after the psycho education (post-test) using the same instruments. The data was analyzed using the Statistical Package for Social Sciences (SPSS). Descriptive statistics were used to analyse participants' characteristics and some selected variables. Cross tabulations, chi-squares and paired t-tests were used on dependent variables and on social variables of interest to compare the changes in scores and means respectively and lastly to determine the relationship of social variables and the dependent variables. The findings of this study revealed that psycho education improved respondents' knowledge about their illness and symptom management techniques (with P-values ranging from 0.0001- 0.03), psycho education also improved medication compliance with P-value =0.000, but it did not affect the respondents' ability to use new techniques in managing their symptoms (with P-values ranging from 0.125- 0.75). / Thesis (M.A.)-University of KwaZulu-Natal, 2005.