Magister Scientiae (Physiotherapy) - MSc(Physio) / The purpose of the study was to explore the need for physiotherapy support for teachers in selected inclusive schools in Zambia. The study aimed to determine teachers skills and teachers attitudes as they included learners with physical disabilities in their classrooms. / South Africa

Philosophiae Doctor - PhD / This study explores Mobility, Identity and Localization of Language in Multilingual Contexts of Urban Lusaka. By examining data from different sites of language practices of Lusaka urbanites, that include, casual and formal conversations, Zambian popular music, computer mediated discourses and advertisements; the study shows how interlocutors creatively draw on their extended communicative repertoire to make meaning, transform social structures/roles and stylize modern identities. Accordingly, the study consolidates the recent sociolinguistic theoretical position that views language as social practice and privileges speakers as social actors in shaping and recreating language. In this regard, the study foregrounds language as localized social practice and argues against the idea that language is homogenous and a bounded system. In doing so, the study adds to recent sociolinguistic theorizing calling for a paradigm shift to language studies. Therefore, the main research question that the study addresses, relates to how Lusaka urban dwellers achieve their mediated agency, voice and actorhood through linguistic choices during interactions in various social contexts of modern Lusaka. In turn, the question relates to how urbanites use language as localized social practice to maintain, transform and reproduce social structures/roles and identities in modern Lusaka. Owing to the type of data the study collected, a multifaceted methodological and analytical approach was employed for both data collection and analysis. Informed by a descriptive research design, the study used focus group discussions and individual key-informant interviews to collect data from casual and formal conversations. Data from Zambian popular music were purposively sampled from Youtube.com and music CDs. In addition, group/individual interviews with musicians were conducted in order to supplement data collected from music CDs and video sources. Data from online discourses were collected from the Facebook platform and from two Zambian based online news blogs, while data from print advertisements were collected through the capturing of images on billboards around Lusaka city as well as advertisements from newspapers and internet sites. Television and radio advertisements were recorded from the Zambia National Broadcasting Corporation TV and radio channels. All the data collected from these sources were generally analyzed using Conversational Analysis, Facework Negotiation Theory, Multimodal Discourse Analysis and its cognate analytical tools such as Resemiotisation, Semiotic Remediation, Intertextuality, Multivocality and Dialogism. The study shows that message consumption is not a function of isolated semiotic resource but a combination of semiotic material drawn from semiotics that people are familiar with. The study thus argues that social meaning is steeped into social and cultural experiences of the speakers and that any study of language practices in such contexts should take into account the multifaceted nature of human communication. Furthermore, the study demonstrates that given the advancements in communication technology and mobility of semiotic resources across modes which have largely contributed to a reconceptualization of the nature of human language, any study of language in social contexts ought to account for other meaning making semiosis in both methodological and approaches to data collection and analysis, respectively. The study further shows how interactants in late modern settings of Lusaka stylize their multiple identities by dissolving the traditional linguistic boundaries through use of the extended linguistic repertoire. In this vein, the study demonstrates that social identity is a dynamic aspect of social life which is actively negotiated and performed through speakers' linguistic choices. In this respect, the study finds that speakers simultaneously stylize translocal hybrid identities which include urban versus rural, modern versus traditional, African versus Christian (Western fused) as well as gendered ones, through their use of different linguistic choices. Furthermore, the study finds that language borders and domains of language use are permeable. In this regard, the study demonstrates how Lusaka urban speakers use localized language forms to colonize the formal spaces thereby challenging the dominant ideologies about language as a fixed, impermeable and a bounded system. In the process of colonizing formal spaces using localized language forms, the study shows how speakers perform acts of humour, role play, face saving, identity and meaning enhancement. In turn these localized repertoires are drawn upon as resources to accomplish different tasks which would not be accomplished if only a 'single' language were to be used. In this regard, the study views language as a resource that transcends the role of meaning making. In addition, the study shows how, through the use of localized repertoires in formal spaces, speakers transform traditions and modernity into a hybrid space which identifies them as having multiple identities. This demonstrates that speakers in such modern settings use language as a resource to accomplish several things at once. It also highlights speakers’ agency in recreating language as well as transforming their social spaces. The findings of the study entail contributions to recent arguments on language that view it not as an autonomous system but rather as embedded in people’s social interactions. It demonstrates that languages have no clear-cut borders.The study also contributes to methodological and analytical approaches to the study of language in recent times. In addition, the study adds new knowledge to our understanding of identity as a performative act which is actively negotiated for as people interact in different social contexts. This implies that identity is not a fixed thing as traditionally conceived. Ultimately, the study calls for a rethinking of our conception of language and identity considering modernity practices.

Magister Scientiae - MSc / The aim of the study was to determine the prevalence of and risk factors contributing to work-related musculoskeletal injuries amongst underground mine workers in Kitwe, Zambia.

Magister Artium (Development Studies) - MA(DVS) / The Constituency Development Fund (CDF) is a type of decentralised government funding that is supposed to deliver goods and services directly to constituents by providing additional funds for local community development, outside line ministries. It is predominantly a developing country policy that is intended to meet the immediate social needs of local communities. In countries where it is operational, CDF is appropriated by Parliament within a country’s national budget. CDF in Zambia was introduced in 1995 for the implementation of community based projects which would in the long term improve the socio-economic wellbeing of the constituents. The stated objective of the CDF in Zambia is to provide Members of Parliament and their constituent communities with the opportunity to make choices and implement (MPs) projects that maximise their welfare in line with their needs and preferences. However, questions have been raised over whether CDF actually represents efforts to spur local development and consequently national development, or whether it is primarily a political project aimed at benefitting MPs by providing them with the resources to help them gain popularity with the electorate. The study aims to assess the effectiveness of CDF as a tool for community development. This has been done through a case study of Katuba Constituency in the Central Province of Zambia, using qualitative research methods. The study seeks to gain insight into of the impact of CDF projects in relation to the goals espoused by the CDF as laid down in Zambia’s Guidelines for the Utilisation and Management of the Constituency Development Fund.

Masters in Public Administration - MPA / Agenda setting is about how some issues get onto the policy agenda for discussion and action why others do not. Drawing critically on the ―policy windows‖ approach of J.W Kingdon (2003) this dissertation will describe and explain the shifting of policy agendas in health with reference to human resources in Zambia between 2000 and 2006. This research explores how and why the issue of human resource shortages in health became prominent on the state‘s agenda in 2005.The research is a qualitative study and data was collected using both primary and secondary sources of data across various stakeholders in the country. It tested the applicability of Kingdon‘s conceptual framework to a case study of Zambian health policy by analysing the degree to which agenda-formation is influenced by such factors as issue definition, the presence of policy alternatives, presidential support, interest group advocacy, media attention, political cycles, and public opinion. The general elections scheduled for the following year, coupled with media attention and strong public action contributed to the selection of the human resource crisis as an issue on the state‘s agenda for serious action. Furthermore, the slow progress on the attainment of the health related Millennium Development Goals and the poor performance of some donor funded programmes necessitated the state to act. Despite some weaknesses, Kingdon‘s multiple streams approach was found to be useful in explaining the agenda-setting of the Human Resources for Health Strategic Plan (2006-2010) in Zambia.

Masters of Public Health - see Magister Public Health / With a prevalence of 14.3% among the 15-49 years age group, HIV/AIDS still constitutes a significant challenge in Zambia. In order to respond to the impact of HIV/AIDS within the workplace, government ministries have developed HIV-focused workplace policies and programmes that provide HIV/AIDS services. However, despite their availability, the number of employees accessing the services, especially those targetting HIV positive workers remains low. The fear (either perceived or real) of disclosing an HIV positive status is one likely reason for the low uptake of services. HIV-positive status disclosure is an important public health goal as it can create opportunities for an individual to access information and social and medical support, and this will affect career and workload related decisions. This exploratory, qualitative study aims to identify and describe the HIV-disclosure experiences of 12 openly HIV-positive Zambian public sector workers living in Lusaka and working in four Zambian Ministries. Both male and female public sector workers were interviewed. The participants’ experiences of disclosing their HIV positive status in the workplace were explored in depth in this study. With the aim of providing those responsible for overseeing and managing the Zambian public sector HIV workplace initiatives with some practical recommendations regarding the disclosure support needed by HIV-positive public sector workers. The study found that whilst participants had an initial fear of disclosing their HIVpositive status in the workplace, their HIV disclosure actually proved to be very beneficial. Not only did it allow their health-related needs (such as accessing medication and visiting a doctor) to be met, but their disclosure also encouraged others to also disclose their status. The recommendations are are aimed at creating a supportive working environment for people living with HIV within the Zambian public service, and offering suggestions to their managers on how best to support the process of disclosure amongst their staff.

Magister Educationis (Adult Learning and Global Change) - MEd(AL) / The study explored the efficacy of radio programs as a strategy for adult education for HIV/AIDS awareness intervention in the Livingstone District Zambia. Data was collected through a review of policies, including the HIV/AIDS/STI/TB Policy Guidelines (2008), National HIV and AIDS Strategic Framework (NASF2006-2010), PMTCT guidelines on HIV Prevention (2008), Zambia Information and Communication Policy (2007) and the Communication and Advocacy Strategy (NACAS, 2004). In addition semi-structured interviews were conducted with adults and young adults aged 23 to 58 years in Maramba catchment area. The research revealed that overall, there is a mixed picture of effectiveness of the use of radio for educating adults on HIV/AIDS prevention. Some of the most important factors that enable the effective use of radio in education of adults include sharing of experiences which result in increased understanding of issues among community members, community participation in radio listening groups also results in further sharing of information and active engagement with other community members on the topic of discussion and the use of local languages with the use of simple words and visual aids to take account of low literacy levels. In addition, there were important set of factors related to economic, social and cultural issues including gender inequalities, poverty and unemployment to mention a few. My research has identified the need to give greater consideration to adult education theory and adult learning principles in the design and delivery of the radio education programs. The research suggests that HIV/AIDS awareness and prevention strategies need an approach which takes account of adult education theory – to promote active involvement of learners in developing the curriculum of the radio programs and involvement of a range of stakeholders in designing and delivering the radio programs. My research also suggests that there is a need to adopt a critical perspective on the social, cultural and religious practices which influence the participation of both women and men in radio education programmes for HIV/AIDS prevention.

Magister Public Health - MPH / Background: One study on estimating rates of mother to child transmission of HIV (MTCT) in program settings in Zambia showed significant reduction in the MTCT rate with some specific prevention of mother to child transmission of HIV (PMTCT) interventions. Prolonged breastfeeding and mixed feeding practices by HIV positive mothers increased the MTCT rate by more than double by the time the infant reached 6 to12 months of age. Although the study did not assess the quality of PMTCT counselling in antenatal care settings, literature shows that poor quality of counselling on PMTCT reduces the effectiveness of PMTCT interventions. Study aim: To evaluate the quality of PMTCT counselling offered to pregnant women attending antenatal care (ANC) services in four public health facilities in Kitwe, Copperbelt province of Zambia. Study design and data collection: This was a cross sectional descriptive study. Data was generated using qualitative research methods including document analysis and individual interviews with 22 participants using non-participant observations, client exit interviews and focus group discussions (FGDs) to collect data. The study participants were ANC attendees and PMTCT providers. Two FGDs were conducted with a total of 98 counselling observations done and 16 ANC client exit interviews. Client exit interviews were done immediately after the mothers had undergone PMTCT counselling. Results: Content for group health education (GHE) varied across the facilities. Individual pre-test, post-test and follow up counselling sessions were very short and lacked depth. A total of 41 (83.7%) pre-test observations took between 1 and 5 minutes to be conducted. In addition, several key topics including major modes of HIV transmission, MTCT and the "window period" were omitted. The counsellors' interpersonal skills were generally good but they did not consistently summarize the main issues. The 16 mothers interviewed had limited knowledge of PMTCT with only one client knowing all the MTCT modes correctly. Discussion: Quality of PMTCT counselling did not meet expectations. With a lot of key topics omitted, outcomes of PMTCT interventions may not be as good as expected. Facilities are faced with serious staff shortages and limitations with space. The few members of staff available are overworked and are not able to provide quality PMTCT counselling. Conclusion: While the PMTCT uptake was good and clients felt satisfied, the quality of PMTCT counselling is compromised. There is need to improve it and ensure optimal effectiveness of PMTCT services.

Philosophiae Doctor - PhD / This study is an investigation of the informal trans-border Chewa ethnic movement of Malawi, Mozambique and Zambia and its relationship to the formal state boundaries defined by the Westphalian model. The Chewa refer themselves as belonging to a Kingdom (formerly the Maravi Kingdom) which currently cuts across the three modern African states of Malawi, Mozambique and Zambia and its paramount, King Gawa Undi, is based in Zambia. The secretariat of the kingdom is Chewa Heritage Foundation (CHEFO), which is headquartered in Malawi. The fundamental quest of this study is to investigate how the Chewa understand, experience, manage and interpret the overlap between formal states (as defined by the Westphalian model) and informal trans-border ethnic identity without raising cross-border conflicts in the process. Indeed, it is this paradoxical co-existence of contradictory features of Westphalian political boundaries and trans-border ethnic identity that initially inspired this study. The main research aim is to interrogate whether the Chewa Kingdom (of Malawi, Mozambique and Zambia) is challenging or confirming state boundaries, and to reflect on what this means for the contemporary Westphalian model. In International Relations (IR), the Westphalian model provides the assumption that states are independent actors with a political authority based on territory and autonomy. Despite a large number of criticisms of the model, it has not completely been dismissed in explaining some elements of the international system. This is evident by the underlying assumptions and perspectives that still persist in IR literature as well as the growing contemporary debates on the model, especially on its related elements of state sovereignty and citizenship. In Africa, the literature focuses on the formal structures and ignores the role of informal trans-border traditional entities - specifically, how trans-border traditional entities affect the re-definition of state and sovereignty in Africa. Such ignorance has led to a vacuum in African IR of the potentiality of the informal to complement the formal intra-regional state entities. Within a historical and socio-cultural framework, the study utilises [social] constructivism and cultural nationalism theories to critically investigate and understand the unfolding relationship between the Westphalian state and Chewa trans-border community. Another supporting debate explored is the relevance of traditional authorities under the ambit of politics of representation. In this case, the study fits in the emerging debate on the meaning, experience and relevance of state sovereignty and national identity (citizenship) in Africa. Drawing on a wide range of sources (informant interviews, focus group discussions, Afrobarometer survey data sets, newspaper articles and comparative literature surveys in Malawi, Mozambique and Zambia), the study finds that although the upsurge of Chewa transborder ethnic identity is theoretically contradictory to the Westphalian model, in practice it is actually complementary. Within the framework of [social] constructivism, the state has with some variations demonstrated flexibility and innovation to remain legitimate by co-opting the Chewa movement. In this case, the study finds that the co-existence of Westphalian model and trans-border Chewa ethnic identity is mainly due to the flexibility of the state to accommodate informal ethnic expressions in ways that ultimately reinforces the mutual dependence of the states and the ethnic group. For instance, during the Chewa Kulamba ceremony held in Zambia, the state borders are „relaxed‟ to allow unhindered crossing for the participants to the ceremony. This does not entail weakness of the state but its immediate relevance by allowing communal cultural expressions. Another finding is that the Chewa expression of ethnic identity could not be complete if it did not take a trans-border perspective. This set-up ensures that each nation-state plays a role in the expression of Chewa ethnic identity - missing one nation-state means that the historical and contemporary relevance of this identity would be lost. It is also this same set-up that limits the movement's possibility to challenge the formal state. This argument reinforces the social constructivist perspective that sovereignty is not static but dynamic because it fulfils different uses in a particular context. The overall argument of this study is that the revival of the informal Chewa trans-border traditional entity offers a new, exciting and unexplored debate on the Westphalian model that is possibly unique to the African set-up. One theoretical/methodological contribution of this study is that it buttresses some suggestions that when studying African IR, we have to move beyond the strict disciplinary boundaries that have defined the field and search for other related African state experiences. The study also strengthens one of the new approaches in understanding IR as social relations - in this approach, individuals and their activities or their social systems play a prominent role.

Master of Public Health - MPH / Introduction: Despite the progress that Zambia has made in reducing its maternal mortality ratio from 649 to 398 per 100,000 live births between 1996 and 2013/14, the country did not meet the Millennium Development Goal 5a target, of reducing the maternal mortality ratio by 75% (i.e. to a ratio of 162 per 100,000 live births) by the end of 2015. Thus, as is the case with many other countries, considerable challenges still remain in relation to reducing maternal mortality in Zambia. According to Zambia's Roadmap for Accelerating Reduction of Maternal, Newborn and Child Mortality (2013-2016), the continuum of care for reproductive and maternal, newborn, and child health includes integrated service delivery for mothers and children across these various time periods, and also across place: within the home, the community, and in health facilities. In this regard, a referral system plays a key role in linking the various levels at which care is provided, and the different types of services offered at these levels. In the urban district of Lusaka, Zambia, all complicated pregnancy-related cases received by health centres or clinics are referred to either Levy Mwanawasa General Hospital, or the University Teaching Hospital. However, it appears that at present those working at the primary level of care, who make such referrals up to these higher levels of care, receive no feedback on the outcome of their referrals; there are also few counter-referrals to the respective clinics in the district. With limited communication to the primary level of care, and with no formal handover of patients back to the clinics by the tertiary level institutions, it is difficult to ensure that the required continuum of care for the referred mothers and their children, post-delivery, has been established within the district. This explorative study aimed therefore to identify the strengths and weaknesses of the maternity-related referral system currently operating between primary and tertiary levels of health care in the district, and to consider how the system might be strengthened so as to support a stronger continuum of care with respect to maternal and neonatal health. Methods: Using a descriptive qualitative research approach, stakeholders involved in the planning, delivery and/or oversight of maternal and neonatal health services in the district were purposively sampled and asked to voluntarily participate in the study. Prior to all the interviews, after being informed about the study, and receiving information sheets to read through, participants were required to give informed consent. Their experiences and opinions regarding referrals and counter-referrals were collected through a series of 23 individual, semi-structured interviews. A Thematic Analysis approach was used to analyse data in this study. Ethics approval was first obtained from the Senate Research Committee, University of the Western Cape and thereafter from the Excellence in Research Ethics and Science Converge Ethical Review Board in Zambia, before proceeding with the study. Clearance was also obtained from the Ministry of Health, the Lusaka District Health Management Team and the University Teaching Hospital to facilitate entry into the health facilities. Findings: The study found that, in practice, the referral system for maternity and neonatal health does exist and is generally – but not optimally - functional in the Lusaka District. However, challenges were noted that included the fact that the district’s maternity referral system has not been revised since it was first developed in the 1980s and is not available in a comprehensive set of guidelines or standard operational procedures which explicitly outline the reasons for referral and the related referral steps and mechanisms. In addition, the referral forms currently in use in the district have not been standardised and appear to be inconsistently used by the different facilities. Interviewees reported that there were limitations in terms of the number of, and availability of ambulances, and that there was also an inadequate number of trained midwives. Limitations on the health service's infrastructure, namely, the physical space that is available, the number of delivery beds, and the limited supply of equipment place an additional burden on the staff working at both the primary and tertiary level. Conclusion: Overall, the study recommends that further research – possibly in the form of a baseline audit – be conducted so as to develop a more detailed and/or operational assessment of the actual rather than the reported level of functionality of the district's maternity referral system. Specific recommendations are also proposed for the various stakeholders who are critical role players in the referral system, namely, the clinics, the University Teaching Hospital, the Lusaka District Health Management Team, the Provincial Health Office, the Ministry of Health and Cooperating Partners.