The study aimed at assessing the factors influencing the low involvement of men in prevention of mother-to-child transmission (PMTCT) of HIV programmes in the Mambwe district, Zambia. The factors studied were grouped as knowledge and awareness, socio-cultural, programmatic and demographic characteristics. A quantitative, exploratory study was used and 127 men were interviewed. The major findings were: Knowledge of PMTCT was the strongest factor which was positively associated with the level of men's involvement in PMTCT. Socio-cultural and programmatic factors were found to negatively influence men's involvement (although weakly); and among the demographic characteristics, age and level of education were positively associated with an increase in the level of involvement, while the duration of the relationship with the female partner was negatively associated with the level of men involvement. / Health Studies / M.A. (Public Health)

This study is a collective case study. It assesses the various aspects of distance teacher education in the five institutions. These are the University of Zambia, the Zambian Open University, the National In-Service Teachers’ College, the Nkrumah College of Education and the Copperbelt Secondary Teachers’ College. Distance education practitioners‟ and distance students‟ views on the management of distance teacher education in Zambia were elicited. The researcher collected data using semi-structured individual and focused group interviews, and observations. In addition, relevant documents such as reports, policy documents and statistics were used. Also, the researcher analysed instructional study materials (modules) to establish whether they were suitable for distance students. The researcher employed qualitative methods in the collection and analysis of data. Triangulation was used in order to verify the information given during this study. In terms of theory, a comprehensive literature review was carried out to determine the works other researchers had done in the area of open and distance education, especially in the field of the management of distance teacher education. The Literature review revealed that good management of distance teacher education depends on how the various aspects of distance education are managed. Furthermore, the evidence from the literature review indicates that good management of distance teacher education improves the quality of distance teacher education. Apart from ZAOU, the other four institutions are dual-mode institutions. They offer distance education programmes and full-time programmes. The same lecturers teach both distance and full-time students. The findings concerning the strengths of the management of distance teacher education in Zambia were: a recognition by providers and clients of the importance of distance teacher vi education, an awareness of the challenges of distance teacher education as displayed in their guidelines and a positive attitude towards distance teacher education. The findings concerning the weaknesses were: inadequate student support services, inadequate channels of communication, inadequate training and professional development, problems relating to integrating Information and Communication Technology (ICT) in distance education delivery, problems concerning assignments and examinations, inadequate records management, inadequacy regarding interactive instructional materials, problems relating to staffing, and a lack of national policy on distance education in Zambia. The overall conclusion is that the management of distance teacher education in Zambia is reasonably effective. However, the areas of concern highlighted above should be given attention if institutions that offer distance teacher education programmes are to provide quality distance teacher education. / Educational Studies / D.Ed. (Education Management)

The most important part of the research or the central part of this work is the inculturation which may be understood as the emergence of a local church in a place (Bate 1994, 100). By a local church I mean the manifestation of the one church of Christ as the community of faith in a particular context. Essential for this emergence are two apparently opposed forces whose dialectical resolution motivates the inculturation process. The first of these forces is the unifying, creative and redemptive power of God seeking the oneness of creation and salvation, so that God may be all in all. The second is the incarnational locus of all creation and salvation which moves the Word to take on flesh in a time, place and culture and the Spirit to take the church to the ends of the earth. The resolution of this dialectic may be expressed as the emergence of unity in diversity or as a communion of communities. The papal document emerging from the African Synod, Ecclesia in Africa, describes the resolution of this dialectic as showing respect for two criteria in the inculturation process, namely ‘compatibility with the Christian message and communion with the Universal Church’ (EA62; cf RM 54). These two criteria highlight the importance of unity in the inculturation process. They affirm the relatedness of all Christian consciousness, ethos and mission which is expressed so well by Paul: ‘There is one Lord, one faith, one baptism and one God and the father of all, over all, through all and with all’ (Eph 4: 6). / Christian Spirituality, Church History and Missiology / D. Th. (Missiology)

Aflatoxins are cancer-causing, immuno-suppressive mycotoxins that frequently contaminate important staples in Zambia including maize and groundnut. Managing aflatoxins begins with understanding the distribution of aflatoxins across the target region. Seventeen percent of crops from markets contained aflatoxin concentrations above allowable levels in Zambia, with the frequency of contamination in groundnut and maize highest in warmest regions of the country. Proper management of aflatoxin contamination requires a clear understanding of the etiologic agents of the observed contamination. Several species within Aspergillus section Flavi have been implicated as causal agents of aflatoxin contamination in Africa. In Zambia, A. parasiticus was the main etiologic agent of aflatoxin contamination of maize and groundnut, although fungi with S morphology also caused contamination. Aspergillus flavus L morphotype fungi were associated with reduced aflatoxins, suggesting natural biological control by atoxigenic strains may reduce aflatoxin contamination in Zambia. In addition to maize and groundnut, wild insects, fruits and fish are important sources of food and incomes in Zambia. Unfortunately, both insects and wild plants are susceptible to aflatoxin contamination. To evaluate the safety of wild insects and fruit, concentrations of aflatoxins and presence of aflatoxin-producers were assessed. Some species of wild fruits and insects were found to have unsafe levels of aflatoxins suggesting mitigation efforts should target these important foods of Zambia in addition to crops such as groundnut and maize. New lineages of aflatoxin-producing fungi have been described, and found associated with cases of aflatoxicoses in Kenya and elsewhere. Although A. parasiticus is highly frequent and an important etiologic agent of aflatoxin contamination, it is not known how this fungus is related to similar fungi elsewhere. A multigene phylogenetic analysis revealed at least two new groups divergent from known fungal species whose frequencies need to be modified if aflatoxin contamination of crops is to be reduced.

M.A. (Politics) / Please refer to full text to view abstract

Magister Curationis / Research has shown that there is a problem in the delivery of quality care in maternal and child health services in Zambia. The 1996 Zambia demographic and health survey estimated maternal mortality rate as high as 649 per 100,000 live birth, with this reason among others, human resource constraints and low number of supervised antenatal clinics, deliveries and postnatal clinics by skilled personnel as some of the reasons for the high maternal mortality. Selected studies identify the role of a clinical nurse specialist in advanced midwifery and neonatology who has acquired the knowledge and practical skills to bring about the desired impact of quality care in safe mother hood in order to bring down the high maternal mortality rates. In order to achieve this, the government needs to integrate the advanced midwifery and neonatology clinical nurse specialist in the health system. It was the purpose of the study to inquire into the feasibility of integration of the advanced midwifery and neonatology clinical nurse specialist in the Ndola District Health system . / South Africa

Magister Public Health - MPH / Introduction: Zambia is among the countries in the sub-Saharan African region most severely affected with HIV/AIDS. Approximately 1.2 million (14%) Zambians were living with HIV in 2010. Zambia introduced antiretroviral therapy (ART) in the public sector in 2002, starting with two pilot sites, and rolling it out throughout the country in 2004 and 2005. To date,approximately 350,000 people have accessed HIV treatment. The long-term success of ART programs depends on optimal adherence to ART by patients.In 2010 Livingstone General Hospital (LGH), the setting for the current research had over 7,000 enrolled for HIV care of whom 3,880 patients were on ART. By the end of June 2011, it was reported that 343 patients in this hospital were between 2 to 30 days late for their medication refill appointments. This meant that these patients had missed more than one dose, and thus not meeting the required 95% of medication for viral suppression. This study explored the barriers to medication adherence experienced by ART patients at Livingstone General Hospital (LGH). Methodology: An exploratory qualitative study was conducted. Six focus group discussions(FGD) were conducted with 42 patients on ART, and follow up semi-structured interviews with 7 patients identified during the FGDs. FGDs and semi-structured interviews were audio-tape recorded and transcribed verbatim. Thematic and content analysis of transcribed data was done. Results: The study found that the barriers to ART adherence included socio-economic factors such as poverty, use of traditional complementary and alternative medicines (TCAM) and religious beliefs. Patient related factors reported to negatively affect adherence were HIV related-stigma and discrimination, alcohol use, low literacy and education levels, busy daily schedules and forgetfulness. Regimen related factors included experiencing side effects to medication and complexity of treatment regimen. Negative staff attitudes, traveling long distances to health facility, long waiting times, lack of confidentiality, poor health information and poor patient-health provider relationships were the health system factors that negatively impacted on ART adherence. Conclusion: The combination and complexity of factors affecting adherence identified in this study have posed a challenge to adherence to ART. People have been forced to make adjustments to their routine lives in order to accommodate ART. The most problematic factor identified was the use of TCAM in combination with ART or as replacement of ART.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Zambia is undergoing epidemiological changes from communicable diseases to NCDs as a result of demographic transition and hence Stroke is an emerging NCD in the country. The process of care of stroke in Zambia as country is unknown. Exploring the process of care of stroke in Zambia, could help understand the gaps in service delivery thereby helping to create interventions to improve stroke service delivery. The purpose of this study was to determine and explore the process of care of stroke in Zambia. As there is no information regarding stroke care in Zambia, the study aimed to explore and determine the process of care and explore the conditions under which diagnosis and management of stroke is done in Zambia and are the factors influencing stroke diagnosis and management in Zambia. The study was conducted in Zambia’s five general hospitals which were selected conveniently. The study consisted of both quantitative and qualitative methods. The quantitative part consisted of stroke patients’ medical records reviews, who were admitted to general hospitals between 1st January to 3oth October 2014. A sample of 80 medical records was selected randomly from each general hospital, making the total of 400 medical records from all the hospitals. Data was collected using a checklist which was specifically design for the study after literature review and contained stroke care processes including diagnosis, medical management, rehabilitation, lifestyle management and community linkage. Analysis of quantitative data was done using Statistical Package for Social Science (SPSS) version 22. The qualitative part consisted of individual in-depth interviews with a purposefully selected sample of three health workers from each hospital making 15 health workers. The in-depth interviews were based on predetermined themes including staffing levels, multidisciplinary team action, treatment guidelines, clinical capacity, planning and budgeting and technical environment. All the interviews were audio-taped, transcribed verbatim and the predetermined themes were analysed using content analysis. Ethical clearance to conduct the study was obtained from the University of the Western Cape Faculty Board Research and Ethics Committees and Senate Research Committee and ERES Converge in Zambia. Permission to conduct the study in Zambia was obtained from the Ministry of Health, Zambia. Informed consent was obtained from the health workers who took part in the study. The study found that the stroke process of care in Zambia ranged from diagnosis through to physical rehabilitation and lifestyle management. The stroke process of care was challenged in the area of diagnosis using biochemistry, haematology, CT scan, MRI and Angiography etc. The process of care in rehabilitation was challenged by lack of gadgets and space to use in rehabilitation. Community linkage, speech therapy and social welfares services were not part of the stroke process of care in Zambia as the study as established. Staff shortages, busy schedules, no treatment guidelines, poor clinical capacity, lack of resources and poor technical environment impacted negatively on the stroke process of care according to this study. Diagnosis and management of stroke was made with no treatment guidelines, poor clinical capacity and poor technical environment. The same were the factors which were influencing diagnosis and management namely staff shortages, no multidisciplinary teams due to busy schedules of health workers, lack of treatment guidelines, poor clinical capacity by health workers, lack of resources for stroke and poor technical environment. Using the Chi-square association of variables, the study showed that CT scan was associated with definitive diagnosis with the p-value of 0.000. Equally, Chi-Square test showed that Diagnosis was not associated with medical management (p value=0.058).

Magister Artium - MA / Background: Spina Bifida (SB) is one of the leading causes of disability in children globally. Its management in Sub-Saharan countries is quite challenging and has shown to be an expensive public health problem. A recent study on SB has shown that physiotherapy is poorly utilised in Zambia. Although it is very cardinal in the rehabilitation of children right from birth, very little is known on the role of physiotherapy in the management of children with SB. Aim: To investigate the role of physiotherapy in the management of SB patients both at the University Teaching Hospital (UTH) and Beit Cure International Hospital (BCIH) during the period: January 2010 to December 2014. Study design: A sequential explanatory mixed study design was used for this study. An adapted validated data extraction form was used to capture quantitative data from hospital records, while an interview guide was used in in-depth interviews and Focus Group Discussion (FGDs) with specialist physiotherapists. Data analysis: Quantitative data was analysed using SPSS version 23 and descriptive statistics represented on graphs, charts and tables in form of percentages and frequency distributions. Qualitative data was audiotaped during the focus group discussion and in-depth interviews, transcribed verbatim and thematic analysis was used. Results: A total number of 207 children with SB were managed during the period under review at the two hospitals with the most prevalent type of SB being myelomeningocele and hydrocephalus at 69.4%, commonly located in the lumbar region 53.3%, prone in female patients 55.6%. A total of 38% had an increased tone while 2% had low tone indicating the need for physiotherapy. Through purposive sampling, a total of eight physiotherapists took part in the qualitative study. Results showed that there are poor referral systems for physiotherapy at the two hospitals making follow up quite difficult at times. Information on physiotherapy sessions was not included in patient files but only indicated in the physiotherapy departmental registers. Some physiotherapists felt that their role in the rehabilitation process was not known amongst team members such as surgeons. However, the availability of assistive devices at the hospitals helped provide better services which in turn promoted improvement in patients and also contributed to motivation. Conclusion: Having undergone some training as rehabilitation team members, all the physiotherapists noted that training helped to empower them, gain experience and changed attitudes of some rehabilitation team towards them. It is therefore recommended that the referral system and documentation be improved upon in order to effectively work together as a rehabilitation team with common goals.

African mole-rats (Bathyergidae) are subterranean hystricomorph rodents offering an excellent system with which to test theories relating to the evolution and maintenance of sociality in mammals. The aridity food distribution hypothesis (AFDH) suggests that, within the bathyergids, sociality has evolved in response to patterns of rainfall, its effects on food distribution, and the subsequent costs and risks of foraging and dispersal. Here, in the first detailed study of burrow architecture in a social mole-rat species, with data from 32 burrows, we show that in the giant mole-rat Fukomys mechowii, burrow fractal dimension increases with colony size and is higher during the rainy season than during the dry season. The mass of food in the burrow increases with fractal dimension and is higher during the rainy season than during the dry season. These results link for the first time colony size, burrow architecture, rainfall and foraging success and provide support for two assumptions of the AFDH, namely that (1) in arid conditions burrowing may be severely constrained by the high costs of digging; and (2) the potential risks of failing to locate food may be mitigated by increases in colony size. It was also fundamental in this study to assess whether the Fukomys mechowii is (1) An aseasonal or seasonal breeder (2) To investigate whether non-reproductive female giant mole-rats exhibit induced or spontaneous ovulation and finally (3) To estimate the age variation and sexual dimorphism of this little studied giant mole-rat species. Thus in a field study that involved the complete excavation of 32 burrow systems with a mean colony size of 9.9 individuals (range 7-16), it was evident that Fukomys mechowii is a cooperatively breeding mole-rat exhibiting a reproductive division of labour in which usually one, or occasionally two, females are responsible for procreation. Pregnant reproductive females were found throughout the study period (September 2005 until June 2006), supporting preliminary evidence that reproduction occurs throughout the year. Of the 32 colonies sampled, 14 of 18 (87.5%) in which the reproductive female could be identified as pregnant contained a single reproductive female, while four (12.5%) had two females breeding simultaneously (plural breeding). The population sex ratio was skewed towards females at 1:1.46. Autopsy of pregnant reproductive females (n=18) revealed that the production of two (10/18 pregnancies) or three (7/18) offspring was the norm, with one case of four embryos being present. These new data increase our fragmentary knowledge of the natural history of this little studied species. Six non-reproductive females were removed from their natal colonies and housed individually without a male for a period of 12 weeks as a control group. They were then subsequently housed for a further 6 weeks as experiment 1, on their own before being allowed non-physical contact in experiment 2, with a mature adult male for a further 6 weeks. The non-reproductive females were given a further period of isolation for a month prior to being physically paired with vasectomized males, in experiment 3. Urine was collected every second day for all three experiments and urinary progesterone profiles were generated. The progesterone values measured during the first part of Experiment 2 and 3 were markedly higher than those measured during the first part of Experiment 1 (Z= -2.201, p=0.028 for both comparisons), however, this was not significant after Bonferroni correction. Similarly progesterone values tended to be elevated during the second phase of Experiment 2 and 3 but not significantly so (Experiment 1 vs. 2: Z=-1.782, p=0.075, Experiment 1 vs. 3: Z=-2.201, p=0.028). Thus, chemical or physical stimulation by a male does not appear to be necessary for ovulation in female giant mole-rats. The giant mole-rat is a spontaneous ovulator. Due to difficulties in estimating absolute age in mammals, different methods for its estimation have been proposed, and among these, the degree of molar eruption and wear are considered to be one of the most reliable indicators of relative age. Consequently, maxillary molar tooth-row eruption and wear were used to assign individuals of the giant mole-rat, Fukomys mechowii (Peters, 1881) from two geographically proximal and ecologically similar localities in the Copper-belt Province of Zambia to 9 relative age classes. These were in turn used to assess the nature and extent of sexual dimorphism and age variation in this little-studied social mole-rat based on cranial morphometric data, reference to body mass and a series of both univariate and multivariate statistical analyses. Both univariate and multivariate analyses showed morphological differences between individuals of age classes 1–3 and those of age classes 5–9, while individuals of age class 4 were intermediate between these age class groupings, suggesting that this age class lies at a point on a hypothetical growth curve where it begins to stabilize. The analysis of the nature and extent of sexual dimorphism revealed its absence in the younger individuals of age classes 1–4 and its presence in older age classes 5–9. These results may allow an insight into our understanding of the population social structure, and reproductive strategies in the giant mole-rat. In conclusion, it is worth mentioning that; (1) A number of studies have examined burrow architecture, although not necessarily fractal dimensions in the Bathyergidae but the majority of these have concentrated on solitary species in which when there is plural occupancy it is during the breeding season or when the mother has a litter. This study is thus the first to examine in detail the dynamic nature of social mole-rat burrows, with respect to seasonal changes. The burrow fractal dimension is a good indication of the mole-rats ability to burrow to find food and thus results support the critical assumption which underlies the aridity food distribution hypothesis. The results accord well with previous data in social mole-rats indicating that larger colonies have greater survival and link colony size, burrow architecture and foraging success for the first time; (2) the giant mole-rat is an aseasonal breeder which in a few instances can have two queens per colony; (3) the giant mole-rat is a spontaneous ovulator and finally (4) the giant mole-rat Fukomys mechowii exhibits a sexual dimorphism amongst its older age classes 5-9. Suggesting that there are different growth curves in males versus females, whereby males attain much larger size (skull size and body mass) than females after puberty and finally intimating that opportunistic mating competition among males is very high. / Thesis (PhD)--University of Pretoria, 2011. / Zoology and Entomology / Unrestricted