Background: Children make up more than 50% of the population affected by humanitarian crisis. Although it has been shown that a stable, nurturing and safe home environment can help mitigate the negative effects of ambient violence and instability, with deteriorating family relationships and poor psychosocial wellbeing of caregivers in humanitarian crisis, children may face an additional source of harm from within their home. This scoping review was conducted to a) examine the extent to which caregiver psychosocial wellbeing and family violence affect the wellbeing of children and b) understand if interventions and programming can improve wellbeing of children through changes in caregiver psychosocial wellbeing or family violence. Methodology: Using the Arksey and O’Malley framework, we searched three electronic databases and various grey literature sources for literature that discussed the associations between caregiver psychosocial wellbeing and/or family violence, and the wellbeing of children. A quantitative and thematic analysis was conducted to examine the extent, range and scope of literature. Results: The findings from 22 identified observational studies indicated that caregiver psychosocial wellbeing and family violence are both associated with various dimensions of child wellbeing. Although the three interventional studies suggest that targeting caregiver wellbeing and family violence may be promising, the search revealed very limited evidence in the form of evaluated programs that reliably measure caregiver and family dimensions, while also measuring child outcomes. Conclusion: Focusing on improving the wellbeing of caregivers and reducing family violence may provide an important venue through which we can improve the lives of children. However, further research must be conducted to expand our understanding of the relationships between relevant factors, and to create robust program evaluations to determine the efficacy and value of interventions. Such research can contribute to the evidence base that is crucial to helping us protect and promote the wellbeing of children in these challenging contexts. / Thesis / Master of Science (MSc)

The provider-role continues to be strongly linked to ideas of manhood even in the era where family and work roles have changed. This is mainly because society continues to esteem notions of hegemonic masculinities that reduce men to a single role of providing. Such a discourse is problematic however, especially during the quandary of unemployment that South Africa finds itself. With this in mind, men find themselves battling not only with the stigma arising from their inability to perform manhood (providing) but also with the harsh labour market that refuses them the means to perform this role. As a consequence, men suffer often undiagnosed depression leading to suicide, harmful behaviour and loss of hope for a better future. Through the qualitative research approach, this study adopted the Social Identity Theory, the Eco-systems Approach as well as the Functionalism Theory towards exploring the effects of strong identification with the idea of man as provider on the psychosocial wellbeing of black men during unemployment. Individual interviews were conducted with twenty-two young men aged between 18 and 35 from Soweto as well as three social workers who were previously placed as student social workers with the Ipelegeng Youth Leadership and Development Programme. Through the use of the thematic content analysis, this study found that young men identified with the provider role and therefore participated in informal work under hazardous conditions in order to fulfil this role. Where the men failed to fulfil the provider role, communities often ridiculed and shamed them leading them to feeling stressed and depressed. The study also found that the young men were not utilising psychosocial services; owing to the notions of traditional masculinities; general lack of services and perceived ineffectiveness of programs. This report thus concludes that interventions that are tailored to tackle men’s problems should be developed and be made widely available, being stringently cognisant of contextual cultural dynamics however.

The purpose of this study was threefold; to examine the unique challenges faced among young breast cancer survivors’ self-concepts; to explore the identity reformulation process as they adjust to a new lifestyle after completing medical treatment; and to identify women’s creative problem solving solution used to mitigate any long-term distress and discontinuity between past, current and ideal selves. In-person semi-structured interviews were conducted with 10 young breast cancer survivors (aged 32-45). The results indicated that exploring women’s narratives through the identity reformulation process created an alternative approach to the four prescribed quality of life domains used to understand survivors’ overall wellbeing. The results also identified three shared domains of social location (gender, youth and health status) that intersected in women’s identity reformulation process. These findings have implications for psychosocial oncology literature, as well as clinical practice for mental health practitioners. Limitations and recommendations for areas of future research were discussed.

The purpose of this study was threefold; to examine the unique challenges faced among young breast cancer survivors’ self-concepts; to explore the identity reformulation process as they adjust to a new lifestyle after completing medical treatment; and to identify women’s creative problem solving solution used to mitigate any long-term distress and discontinuity between past, current and ideal selves. In-person semi-structured interviews were conducted with 10 young breast cancer survivors (aged 32-45). The results indicated that exploring women’s narratives through the identity reformulation process created an alternative approach to the four prescribed quality of life domains used to understand survivors’ overall wellbeing. The results also identified three shared domains of social location (gender, youth and health status) that intersected in women’s identity reformulation process. These findings have implications for psychosocial oncology literature, as well as clinical practice for mental health practitioners. Limitations and recommendations for areas of future research were discussed.

Introduction A group of 317 HIV-1 infected pregnant women and 53 postpartum HIV-negative women were recruited for a two-year prospective descriptive study of psychosocial and other determinants of antenatally planned and actual postnatal feeding, associations between maternal status and infant feeding practices, and health outcomes. Methods The subjects were interviewed periodically for 2 years using structured research instruments. Anthropometric measurements, biomarkers of nutritional status and measurements of pysychosocial wellbeing were obtained from the mothers. Data was collected on infant feeding and outcomes for the babies. Results At recruitment, 74% of mothers planned to formula-feed. Significant differences between these women and those who planned to breastfeed emerged. After delivery, 25% of the women who antenatally planned to formula-feed changed their minds and actually breastfed. Conversely, half of the women who antenatally planned to breastfeed actually formula-fed. Some significant reasons emerged for these feeding changes. Most mothers were well-nourished or overweight. Breastfeeding mothers lost little weight between six weeks and six months after delivery. At the end of follow-up, 65% were obese. While there were differences between HIV-infected and uninfected women in respect of micronutrients, no deficiencies were observed. Vitamin A and selenium concentrations were higher in the HIV-infected women than uninfected women at six weeks. There were no significant micronutrient changes over time. Most mothers maintained an adequate immune status with only slow deterioration of CD4 counts. At two years postpartum, 60% had a CD4 cell count greater than 500cells/mm³, and only about 8% less than 200/mm3. HIV transmission was 15% by 24 months of follow-up. Among the 65 ever breastfed children, 16 (24.6%) were HIV-infected compared to 12.8% of never breastfed children. Most children were growing normally, suggesting that, overall, maternal HIV status did not interfere with feeding ability. Eight mothers (3%) and 33 children (11%) died. Only 12 of 33 children who had died had a positive HIV-PCR. By 2 years, 78% surviving HIV-infected children had been initiated onto ARV therapy. Maternal adherence to HAART was poor. Conclusion HIV and infant feeding counselling is inadequate in the routine PMTCT programme, with stigma and lack of disclosure continuing as major barriers to appropriate care. Whilst maternal obesity was common, most children were growing normally. Weaknesses in routine PMTCT services were identified, and compliance with HAART was poor. / Thesis (PhD)--University of Pretoria, 2010. / Paediatrics and Child Health / unrestricted