Background: The HIV epidemic has greatly affected sub-Saharan Africa, with the highest prevalence in the world found in Swaziland. One in three pregnant women in Swaziland has HIV. One of the PMTCT strategies is primary prevention of HIV among women who are uninfected. Understanding the reasons why pregnant women continue to seroconvert is the key in meeting this strategy. Purpose: The purpose of this study is to determine the factors associated with seroconversion among pregnant women utilizing Raleigh Fitkin Memorial Hospital in 2012. Objectives: The objectives of this study are to: determine the proportion of HIV non-infected pregnant women who are retested for HIV during pregnancy; determine the gestational age at which pregnant women are retested for HIV; establish the proportion of women who were initially HIV non-infected and seroconverted during pregnancy; and establish the factors associated with seroconversion during pregnancy. Methods: An observational cross-sectional study design with both descriptive and analytic components was carried out at Raleigh Fitkin Memorial Hospital. Systematic sampling was used for the recruitment of 381 pregnant women who were initially HIV non-infected. An interviewer-administered questionnaire and chart review were used to collect demographic and clinical data. The data was analyzed using descriptive and analytic statistics. Results: The results of the study show that demographic factors such as age and educational level are associated with HIV seroconversion during pregnancy. The findings also highlight how partner factors play a role in HIV seroconversion. The results indicate that sexual behaviours 333of the pregnant women contribute greatly to HIV seroconversion. Conclusion: Pregnant women continue to engage in risky sexual behaviours during pregnancy and there is need to strengthen counseling on preventive measures throughout the antenatal care period. There is also need for programs to explore possibility of providing antiretroviral drugs for pre-exposure prophylaxis to all HIV negative women during pregnancy. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2013.

descriptive correlational study aiming at describing the knowledge, attitude and risk behavior of adolescents in relation to HIV/AIDS in one “girls only” Catholic school of Manzini. Structured self-administered questionnaires were used to collect data from 260 respondents aged 12 to 19 years. Although only 22.31% respondents indicated been tested for HIV, (83.08%) would like to take an HIV test. Hospital and clinic are mostly known by respondents for providing HIV testing. Most respondents expressed lack of confidence in getting partners wear condoms. 16 (6.15%) have engaged in sex and 5 (6.10 %) were raped. No statistically significant difference was noted between condom use during sexual intercourse for both participants who were raped and those who consented to sex (P value = 0.6538). Future youth health programs should focus on building confidence of youth in accessing condom, discussing condom issues with their partners and make their partners wear condoms / Health Studies

descriptive correlational study aiming at describing the knowledge, attitude and risk behavior of adolescents in relation to HIV/AIDS in one “girls only” Catholic school of Manzini. Structured self-administered questionnaires were used to collect data from 260 respondents aged 12 to 19 years. Although only 22.31% respondents indicated been tested for HIV, (83.08%) would like to take an HIV test. Hospital and clinic are mostly known by respondents for providing HIV testing. Most respondents expressed lack of confidence in getting partners wear condoms. 16 (6.15%) have engaged in sex and 5 (6.10 %) were raped. No statistically significant difference was noted between condom use during sexual intercourse for both participants who were raped and those who consented to sex (P value = 0.6538). Future youth health programs should focus on building confidence of youth in accessing condom, discussing condom issues with their partners and make their partners wear condoms / Health Studies / M.A. (Public Health)

The purpose of the study was to explore and describe young people’s perceptions of access to sexual and reproductive health (SRH) services in Swaziland. The study provided insights into the SRH services currently available to the young people of Swaziland and reveals the opportunities that can be used to improve accessibility and utilisation of the current reproductive health services. The findings will inform policy-making and appropriate future interventions for young people’s sexual and reproductive needs and services. Data were collected through a descriptive exploratory study design. Colaizzi’s seven steps of data analysis were used. The study provides ample evidence that young people face sexual health risks that justify their need to access and utilise SRH services. The findings revealed that access to service is an important but complex element of quality care, as it determines whether a client gets to the service provider. / Health Studies / M.A. (Health Studies)

Text in English / The purpose of the study was to explore and describe the perceptions of the HIV positive pregnant mothers regarding the PMTCT Option B+ programme in order to identify and describe gaps; and also help the Swaziland government address these gaps. The study was conducted in one of the public health units in the Manzini Region of Swaziland. The qualitative, exploratory and descriptive research design was used and data collection was done using individual interviews and field notes. Permission was also requested from the participants in order to record the interviews. Population of the study were all cases of HIV positive pregnant mothers enrolled on PMTCT Option B+ programme, and were aged between 18 and 40 years. Number of participants sampled was 20 and only 17 participants were interviewed. Themes of the study were: perceptions of being enrolled on the PMTCT Option B+ programme, understanding about PMTCT Option B+ programme and information needed with regard to PMTCT Option B+ programme, perceptions with the care received from the nurses and their assistance on PMTCT Option B+ programme, effectiveness of the PMTCT Option B+ programme and challenges of taking ARVs. The findings revealed that Option B+ programme was perceived as preventing HIV from mother-to-child. It boosts the mother’s immune system, prevents opportunistic infections and prolongs life. Knowledge and understanding of the programme was displayed by the participants even though challenges such as discrimination and no support by families and partners were mentioned. Improvement of the programme on how to prevent the spread of HIV to babies and strategies to assist participants on how to disclose were recommended. This was found to be having a huge effect on treatment adherence. / Health Studies / M.A. (Health Studies)

The aim of this study was to investigate the implementation and sustainability of Free Primary Education (FPE) in Swaziland in terms of the interplay between policy and practice. The study was undertaken in four schools in the Manzini region of Swaziland. The schools were purposively sampled on the basis of their location. The participants consisted of the head teacher, a teacher and a parent, and six learners from each of the schools. Two Ministry of Education and Training (MoET) officials were also included; a regional inspector for primary schools stationed at the Manzini Regional Education Offices (REOs) and a senior official stationed at MoET headquarters. A qualitative approach and a case study design were used. The participants were interviewed using semi-structured interview schedules, while the learners were engaged in focus group interviews at each school which were conducted according to a focus group interview schedule. Documents were also used as data sources. Data was analysed using a thematic and document analysis approach. The findings revealed a disconnection between policy and practice. FPE implementers are not well versed on the policies they are supposed to implement as they were not included in the policy-making process. Moreover, no consideration had been given to the legal framework underpinning FPE. It was found that the sustainability of FPE is threatened by certain indirect costs of schooling as well as the top-up fees that are being charged illegally by some schools, resulting in some learners dropping out of school – defeating the purpose of FPE and violating their right to access education. It would appear that the most contentious issue for FPE in Swaziland is the top-fee, although the head teachers were of the view that the FPE grant paid by government is inadequate for running schools and therefore top-up fees are necessary. Problems were also identified with the embezzling of school funds by head teachers. These issues have led to tension between schools and the MoET. / Educational Leadership and Management / D. Ed. (Education Management)

The purpose of the study was to develop practice guidelines to promote adherence to infection control standards in a specific hospital in Manzini, Swaziland. It was a qualitative, descriptive and explanatory design which utilised an in-depth unstructured face to face interview data collection method done to nine (9) registered nurse participants. A qualitative content analysis was conducted to identify prominent themes and patterns, smaller units of data were named and coded according to the contents they represented. Four themes emerged from data analysis, they were; working environment for nurses, nurse’s descriptions of infection control standards, nurse’s challenges regarding adherence to infection control standards and nurses expressed needs. The findings revealed possible contributing factors to non-adherence to infection control standards by participants and therefore denoted to a serious need for development of general guidelines to promote adherence to infection control standards, these guidelines were presented. / Health Studies / M. A. (Health Studies)

Philosophiae Doctor - PhD / Food security is the ability to secure an adequate daily supply of food that is affordable, hygienic and nutritious and it has become a chronic development problem in most urban areas of the global South. This thesis contributes to the urban food security debate by exploring the connection between drought and food security in urban Swaziland. Specifically, the study examines the effects of the 2015/16 drought on access to food in the informal settlement of kaKhoza in the city of Manzini. The study used climate change and food security conceptual framework to interrogate the connection between drought and food security in the urban context. The framework shows how climate change variables like extreme weather events (e.g. drought) impact food security drivers such as agricultural management, demographic, cultural and socio-economic variables, and how these drivers impact the four components of food security (food availability, access, utilization and stability of access). The study drew from both the positivistic and interpretivistic paradigms and adopted a case study approach based on the mixed methods research design. Data was collected from the informal settlement of kaKhoza using a three step procedure involving a questionnaire survey, in-depth interviews, key informant interviews and focus group discussions. A questionnaire was administered to 145 heads of households using systematic sampling technique. Purposive sampling was employed to select 30 and 8 respondents for in-depth and key informant interviews, respectively. The researcher also engaged the observation method approach to capture additional information about effects of drought as observed in the study site. The researcher adhered to all legal and ethical procedures during the data collection and research writing processes. As such, participation in the research was strictly voluntary without any form of coercion, whatsoever. The results reveal that drought contributes to food insecurity in low income urban spaces by reducing the quantity and frequency of free or low priced rural-urban food transfers. As a result, low income households have had to rely more on food purchases, thereby making them increasingly food insecure. The problem is compounded by reverse food flows from urban to rural areas. The drought induced food price hike, compelled many low-income households to be less dependent on the supermarket as the main source of their food, and to buy increased amounts of food from the vegetable markets and tuck shops. Residents employ different coping mechanisms to deal with drought induced food shortage, some of which are too risky and further expose them to food insecurity. These coping strategies include: skipping meals, begging, use of informal credit, over reliance on informal markets and selling of sexual favours, which expose respondents to HIV and AIDS infection.

The purpose of the study was to develop practice guidelines to promote adherence to infection control standards in a specific hospital in Manzini, Swaziland. It was a qualitative, descriptive and explanatory design which utilised an in-depth unstructured face to face interview data collection method done to nine (9) registered nurse participants. A qualitative content analysis was conducted to identify prominent themes and patterns, smaller units of data were named and coded according to the contents they represented. Four themes emerged from data analysis, they were; working environment for nurses, nurse’s descriptions of infection control standards, nurse’s challenges regarding adherence to infection control standards and nurses expressed needs. The findings revealed possible contributing factors to non-adherence to infection control standards by participants and therefore denoted to a serious need for development of general guidelines to promote adherence to infection control standards, these guidelines were presented. / Health Studies / M. A. (Health Studies)

This exploratory study sought to determine how the current science education curriculum at Nazarene Teachers College contributes to the final (third) year’s students’ career readiness from their own perspectives. A self-administered questionnaire was used for data collection. The target population was 150 third year students; 110 responded to the questionnaire which had a response rate of 79%. To describe the biographical information of the respondents, frequencies and percentages were used. Tables of frequency distribution were then used to deduce the respondents’ responses to the group of questionnaire questions that probe the various career readiness concepts. Scale reliability testing was also used to determine the reliability of career readiness concepts. An overall measure of career readiness was calculated for each respondent and the effect of biographical properties as part of evaluation of respondents. The empirical (quantitative survey)showed that the science education course at the Nazarene Teachers College indeed prepares the students for their career readiness with specific reference to the teaching profession although some aspects can be improved. Therefore, it was recommended that there should be increased time allocated to science education and its teaching approaches; that a suitable science laboratory with all the required equipment for experiential learning should be constructed; the current curriculum content with regards to the relevance for primary school science should be reviewed; and the lecturers should be workshopped on the use of interactive methods of teaching science to facilitate active engagement with students. This study reveals that the science education course at the Nazarene Teachers College strengthened the students’ attitudes towards teaching science; improved their skills and confidence to teach science and enabled them to focus on a learner-centred approach. Students indicated that the use of specific teaching methods and the use of teaching aids contributed in a significant way to their preparation as teachers in the classroom. However, the students rated the contribution science makes to society as of minor importance / Curriculum and Instructional Studies / M. Ed. (Natural Science Education)