Magister Public Health - MPH / Being healthy (‘feeling fine’) and health deterioration (‘getting sick’) were key health concerns among PLHIV prior to ART initiation. PLHIV often referred living with HIV as ‘being sick’ and experiencing poor health when already infected with HIV as ‘very sick’ and this perception about sickness and wellness partly determined the need and value placed on accessing HIV services. Motivations for starting treatment included needing to maintain or regain health, encouragement from HCWs, relatives and friends and believing in the effectiveness of ART to improve health. Prevention of HIV transmission to others was not cited to influence uptake. The majority of PLHIV reported stringent adherence to ART; even a half-hour delay in taking treatment was sometimes defined by participants as ‘non-adherence’. Initial reminders for taking ART (setting alarm, placing pills where visible) fell away as daily medication became routine. However, daily uptake of treatment had its own psychosocial and economic consequences which PLHIV had to navigate. With few exceptions, when taking the first line regimen, most PLHIV experienced both temporal (hallucinations, vomiting) and long-term (dizziness and irregular heartbeat) side-effects attributed to ART, which although not considered life threatening, could undermine ART adherence. HIV status disclosure was both limited and selective (mainly to spouses, close relatives, friends and co-workers) and deemed as promoting adherence to treatment and access to HIV services. HIV/AIDS stigma persisted even among relatively healthy PLHIV due to links with ‘promiscuity’, hampering disclosure and access to HIV services. Competing demands on participants’ time, especially livelihood activities, also disrupted accessing services. Good relationships between HCWs and PLHIV promoted access to services.

This thesis examines Northern and Southern Rhodesia's history through the formation and development of their police and military units from the time Rhodesia was created in 1890 until the end of the Second World War. Southern Rhodesia, founded after a series of short and bloody frontier wars, was a self-governing British colony under a white minority and centered its peace-time security efforts around keeping an eye on potential uprisings from the African majority. White Northern Rhodesians viewed the African majority with similar suspicion although they were never able to exclude Africans from territorial defense. Northern Rhodesia was governed from London and ultimate power did not lie with the settler community. The importance of the Second World War for Southern Rhodesia is that, because of British strategic policies, Rhodesians received perhaps the widest possible military exposure of any allied nation of the War. Because of a lingering hostility and suspicion by the Union of South Africa, Britain's prewar plans for defending their African empire were centered on making use of the skilled white manpower of Rhodesia and Kenya. Added to this was the willingness and apparent positive reception by white Rhodesians of black units in the Southern Rhodesian army, a break with the exclusively all-white tradition that prevailed up until then. The political capital accrued to Southern Rhodesia because of its close cooperation with Britain was perhaps the significant factor in the establishment of the Federation of Rhodesia and Nyasaland in 1953 which included Northern Rhodesia and Nyasaland. The Federation was Southern Rhodesia's supreme political achievement and the closest it came to legal independence and international respectability.

The high infant mortality in Zambia is largely attributable to malnutrition. It is exacerbated by the inability of mothers to recognise threats to nutritional status and take corrective action. Advice in ‘Health Centres’ is often inaccessible to mothers. The Traditional Birth Attendants (TBAs) work with pregnant women in local communities, and the purpose of this study was to develop and implement an educationprogram in growth monitoring and nutrition for the TBAs and then to evaluate its effects. Twenty five TBAs from two peri-urban areas of Kitwe were enrolled in this pilot study and eighteen completed the program. The researcher developed and taught a program to the TBAs over ten days. A pretest was given before the teaching program to enable the researcher to obtain information about the knowledge and skills of the TBAs. Following the teaching program the TBAs were re-tested, with the same questionnaire. Focus groups were conducted to enable the TBA to provide information on the teaching materials and the education program. The TBAs then returned to their communities and put into practice the skills and knowledge they had learned for six months. Their practice was monitored by a trained Public Health Nurse. The researcher also surveyed 38 pregnant women about their knowledge of growth monitoring and nutrition before the TBAs went into the field to work with their local communities. The same questionnaire used with the pregnant women was administered to 38 new mothers with children aged 0 to 6 months to gain information of their knowledge and skills following the work of the TBAs. The program was evaluated by assessing the extent to which TBAs knowledge and skills were increased, the knowledge and understanding of a selection of their clients and the rates of malnutrition of infants in the area under study. The results from the research clearly indicated that the teaching program on growth monitoring and nutrition given to the selected group of TBAs had a positive effect on their knowledge and skills. It was found that the teaching developed their knowledge, practical skills, evaluative skills. That they were able to give infants’ mothers sound advice regarding their children’s nutrition was revealed by the mother’s increased knowledge and the decrease in numbers of malnourished children in the study areas at the conclusion of the research. The major outcomes from the study are: that Zambian TBAs can be taught to carry out an expanded role; field experience is a key factor in the teaching program; making advice available in local communities is important; and preliminary data on the Zambian experience were generated. Recommendations are: The pilot program should be expanded with continuing support from the Health Department. Similar educational programs should be introduced into other areas of Zambia with support from the Ministry of Health. That in administering a teaching program: Sufficient time must be allocated to practical work to allow poorly educated women to attain the basic skills needed to master the complex skills required to competently reduce faltering in their communities. The teaching materials to illustrate nutritional principles for feeding programs must be developed to suite locally available foods and conditions. Methods of teaching should suit the local area, for example, using what facilities are locally available. The timing of the teaching program should be suitable for the TBAs to attend. This may vary from area to area, for example it may be necessary to avoid times traditionally given to fetching water or working in the fields. For similar reasons, the venue for the teaching program should be suitable to the TBAs. The teachers should go into the TBAs’ community rather than causing disruption of the TBAs’ day by expecting them to go to the teacher. Data should be collected from a larger group of TBAs and clients to enable sophisticated statistical analysis to complement data from this pilot program. The TBAs should be given recognition for their work and achievement. This is something which they asked for. They do not ask for payment, rather acknowledgment through regular follow up and approbation.

Thesis (M.A. (Pastoral Studies)--North-West University, Potchefstroom Campus, 2008.

The Rural Aquaculture Promotion (RAP) project is a vital development initiative by the Peace Corps in Zambia with the goal of increasing the nutritional and caloric intake of rural Zambian farmers in addition to augmenting income (Peace Corps Zambia rural aquaculture promotion, n.d.). Peace Corps Volunteer (PCV) success in achieving the goals of the RAP project is vital, and because PCVs are on site working on projects in the aquaculture assignment area for only 24 months, and as only three generations of PCVs are placed at a given site, it is imperative that they be able to contribute to these projects very promptly after arrival on site. The overriding issue concerning the effectiveness of the Peace Corps development effort is the job performance of the individual PCV which primarily depends on the PCV's ability to transfer learned knowledge and skills to the workplace. Many PCVs are routinely hampered by an inability to achieve significant and continuous contributions to projects within their assignment area. The Peace Corps' fundamental approach to the diffusion of aquaculture in Zambia is centered on the exchange of information between PCVs and rural farmers. Achieving sustainability with the RAP project is essentially based upon the consistency and longevity of this information exchange. PCVs are instructed in very specific technical procedures concerning all aspects of fish farming during pre-service training in order to ensure that they are equipped to diffuse a standardized technical curriculum to project beneficiaries. In addition, volunteers are trained in language and cross-cultural skills, and throughout the pre-service training period are assessed by the training staff for competence in the behavioral areas of motivation, productive competence, and adaptability/social sensitivity. Deficiencies in language and cross-cultural skills, the detrimental psychological effects of culture and role shock, and a lack of agency planning and support were key factors that affected the PCVs' ability to transfer successfully learned skills to the workplace. The lack of language ability was identified as the most substantial factor affecting the Volunteer's on-site job performance. Given the social nature of rural extension efforts, this has serious implications for Volunteer effectiveness.

No description available.

Background: The Human immunodeficiency virus infection (HIV) and Acquired immunodeficiency syndrome (AIDS) epidemic peaked in 1999, which led to an increase in funding by donors and Global Health Initiatives (GHI) to combat the epidemic. This literature review examined how the substantial influx of funding for GHI’s and HIV and AIDS since early 2000 has impacted the health system in Zambia. Method: The method used for the study was a systematic literature review.  Results: There is conflicting views and mixed evidence about whether GHIs and HIV and AIDS initiatives have benefitted the general health system. It is clear that GHIs and HIV and AIDS initiatives have added substantially to the increase in funding for health in Zambia. Furthermore, it seems likely that the special attention put on HIV and AIDS created an exclusive and skewed environment with increased capacity to tackle HIV and AIDS, but with less capacity built for health services in general. In-coming support from Global Health Initiatives and funding for HIV and AIDS in Zambia has to some extent been controlled by and led by the contributing donor, giving the Zambian authorities limited oversight of the resources. Conclusions: The influx of funding for HIV and AIDS has led to increased support for a specific disease, but it has not generated support to the health sector in general. It has also led to a fragmented approach, where HIV and AIDS have fallen outside of the regular coordination of the health sector.   Keywords: Zambia, HIV and AIDS, Health systems, vertical initiatives, strengthening, impact. / Bakgrund: The Human Immunodeficiency Virus Infection (HIV) och Acquired Immunodeficiency Syndrome (AIDS) epidemin var på sin högsta nivå 1999, vilket ledde till en kraftig ökning av resurser från givare och globala hälsoinitiativ för att bekämpa epidemin. Denna genomgång av litteraturen undersökte hur denna tillväxt av resurser sedan början av 2000-talet påverkade hälsosystemet i Zambia. Metod: Den metod som användes för studien var en systematisk litteraturgenomgång. Det finns olika slutsatser och bevis för om insatser för HIV och AIDS och globala hälsoinsatser har gynnat hälsosystemet. Resultat: Det är klart att insatser för HIV och AIDS och globala hälsoinsatser har bidragit substantiellt till finansiering av hälsosektorn i Zambia. Studien visade att det är troligt att det särskilda fokus som HIV och AIDS fick skapade en exklusiv och snedvriden miljö, med ökad kapacitet för att hantera HIV och AIDS, men med mindre kapacitet för hälsosektorn generellt. Det stöd och resurser från globala hälsoinitiativ och för HIV och AIDS som Zambia fick del av, har till en del varit kontrollerat av och letts av bidragsgivaren, vilket ledde till att Zambiska myndigheter hade begränsad kontroll över dessa resurser. Slutsats: De ökade resurser som tillkom för att bekämpa HIV och AIDS innebar en ökad satsning på dessa sjukdomar men det har bevisats att detta inte genererade tillräckligt stöd till hälsosystemet. Detta ledde också till en fragmenterad satsning, där HIV och AIDS har hanterats utanför den vanliga samordningen av hälsosektorn.   Nyckelord: Zambia, HIV och AIDS, Hälsosystem, vertikala initiativ, stärkande, effekt.

This dissertation examines how Zambia’s international relations, particularly with China, affected its political and economic development in the first decade after independence. Zambian development issues in the 1960s were directly tied to the volatile situation in Southern Africa, and its methods of negotiating this situation were deeply influenced by the Cold War. Regional issues placed land-locked Zambia in a difficult situation politically, economically, and socially. Yet, despite major hurdles to peace and stability, Zambia was an anomaly among newly independent Africa nations. Postcolonial African history is riddled with violent decolonization struggles, civil war, and oppressive dictatorship. The history of these newly independent nations was dramatic and bloody and has garnered much attention from scholars of Africa, identifying causes ranging from inept colonial governance to neo-colonialism, global resource competition, and poor leadership. More recently, scholars have begun to include the Cold War in this postcolonial narrative; however, they have almost exclusively focused on instances of resistance. It is true that violent conflict unfortunately represents a majority of decolonization struggles, not just in Africa, but in Asia as well. It is also true that these narratives are more dramatic than their peaceful counterparts. It is not true however, that decolonization struggles influenced by the Cold War only manifested in bloodshed. Relatively speaking, the Zambian independence process was deliberate and peaceful. Yet Zambia’s political and economic development following independence was directly influenced by the bi-polar political situation of the Cold War. The Zambian government’s most important communist ally was the People’s Republic of China. The reaction of the West to this “mutually beneficial friendship” between Zambia and China was, unsurprisingly, not a positive one. Yet Zambia’s staunch commitment to non-alignment was both a reaction to its political and economic situation, as well as the best way of ensuring development. Through trade agreements, pledges of aid, and, most importantly, the negotiation of the TAZARA railway, the Zambian government showed deft political skills at negotiating between the West and China for its continued economic development.

The aim of the study was to investigate the sense of coherence among students in Zambia. Sense of coherence was assessed with the questionnaire SOC-29. The respondents were 102 students, aged 15 to 20 years, in three schools in Livingstone. A secondary aim was to examine the relationship between sense of coherence, gender and age. The mean score on SOC-29 was 131 for the Zambian students, which is lower than SOC measured for Swedish adolescents (m=138,5) as well as the Swedish population (m=146). There were no significant correlations between sense of coherence and gender, nor between sense of coherence and age.

<p>The aim of the study was to investigate the sense of coherence among students in Zambia. Sense of coherence was assessed with the questionnaire SOC-29. The respondents were 102 students, aged 15 to 20 years, in three schools in Livingstone. A secondary aim was to examine the relationship between sense of coherence, gender and age. The mean score on SOC-29 was 131 for the Zambian students, which is lower than SOC measured for Swedish adolescents (m=138,5) as well as the Swedish population (m=146). There were no significant correlations between sense of coherence and gender, nor between sense of coherence and age.</p>