Thesis (MSc)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Clinical results have indicated that abuse of multiple drugs/substances has devastating health and social consequences. The combined abuse of alcohol and the highly addictive methamphetamine has worsened the drug epidemic in South Africa, especially in the Western Cape Province. Using non-linear ordinary differential equations, we formulate a deterministic mathematical model for alcohol-methamphetamine coabuse epidemic. We prove that the growth of the co-abuse epidemic is dependent on the threshold parameters of the individual substances of abuse. The substance with the maximum reproduction number dominates the epidemic. We also prove that the equilibria points of the co-abuse sub-models are locally and globally asymptotically stable when the sub-model threshold parameters are less than unity. Using parameters values derived from the sub-model fittings to data, a population estimate of co-users of alcohol and methamphetamine under treatment is estimated with a prevalence of about 1%. Although the results show of a small proportion of co-users of alcohol and methamphetamine in the province, the prevalence curve is indicative of a persistent problem. Numerical simulation results reveal that co-abuse epidemic would persists when both reproduction numbers are greater than one. Results from sensitivity analysis shows that the individual substance transmission rates between users of methamphetamine and/or alcohol and the general susceptible population are the most vital parameters in the co-abuse epidemic. This suggests the need to emphasise on preventive measures through educational campaigns and social programs that ensure minimal recruitment into alcohol or methamphetamine abuse. Model analysis using the time-dependent controls (policies) emphasizes the need to allocate even more resources on educational campaigns against substance abuse and on effective treatment services that minimizes or eliminates rampant cases of relapse into substance abuse. / AFRIKAANSE OPSOMMING: Kliniese resultate toon dat die misbruik van meer as een dwelmmiddel verwoestende gesondheids-en sosiale gevolge het. Die gekombineerde misbruik van alkohol en die hoogsverslawende methamphetamine het die dwelm-epidemie in Suid-Afrika vererger, veral in die Wes-Kaapse provinsie. Deur van nie-lineere gewone diffensiaalvergelykings gebruik te maak, formuleer ons ’n deterministiese wiskundige model vir epidemie van die gesamentlike misbruik van alkohol en methamphetamine. Ons toon aan dat die groei van die sogenaamde mede-misbruik epidemie afhanklik is van die drumpelparameters van die individuele middels wat misbruik word. Die middels met die grootste voortbringende syfer domineer die epidemie. Ons bewys ook dat die ekwilibriumpunte van die mede-misbruik submodelle plaaslik en globaal asimptoties stabiel is wanneer die sub-model drumpelparameters kleiner as een is. Deur die submodelle op werklike data te pas word waardes vir die drumpelparameters afgelei en word daar beraam dat daar ongeveer 1% van die populasie mede-misbruikers van alkohol en methamphetamine onder behandeling is. Alhoewel die data ’n klein persentasie van mede-misbruikers van alkohol en methamphetamine in die provinsie toon, dui die voorkomskurwe op ’n groeiende endemie en voortdurende probleem. Resultate uit numeriese simulasie toon dat die mede-misbruik epidemie sal voortduur indien beide reproduserende syfers groter as een sal wees. Resultate van sensitiwiteitsanalise toon dat die individuele middeloordragkoerse tussen gebruikers van methamphetamine en/of alkohol en die gewone vatbare populasie die mees noodsaaklike parameters in die mede-misbruik epidemie is. Dit stel voor dat daar meer klem gelê moet word op voorkomingsmaatreëls deur opvoedkundige veldtogte en sosiale programme om te verseker dat minder alkohol en/of methamphetamine misbruik sal word. Model-analise wat gebruik maak van tyd-afhanklike kontroles (beleide) lê verder klem op die feit dat selfs meer hulpbronne aan opvoedkundige veldtogte teen dwelmmisbruik toegewy moet word, asook die effektiewe behandeling wat gevalle van terugval in dwelmmisbruik sal minimeer of elimineer.

Thesis (MA(MW))--University of Stellenbosch,2004. / ENGLISH ABSTRACT: An exploratory study was done on prevention programmes of substance abuse by high school learners. This was done in order to: explore the factors leading to substance abuse by high school learners; explore the conditions for successful substance abuse programmes and compare it with existing programmes; and to determine how prevention programmes for high school learners can be used in South-African schools. The motivation for this study emerged as a result of the researcher’s involvement in prevention programmes for adolescents in schools and on farms at the South-African Council for Alcohol and Drug Dependency (SANCA) in the Paarl area. The objective of this study is to provide guidelines to social workers for the effective implementation of substance abuse prevention programmes for high school learners. The literature study confirmed the need for effective prevention programmes and highlighted the focus om the factors which leads to substance abuse. Emphasis is placed on risk and protection factors involved with substance abuse. SANCA in Paarl’s adolescent community’s risk and protective factors was investigated, because of the necessity to identify these factors before a prevention programme can be designed. The universum is the grade 10 learners of six schools in the Paarl area. One learner out of each class represented the sample of 48 respondents. The study was done trough a structured questionnaire. A combination of qualitative and quantitative information, through the use of open and close-ended questions, was gathered. The results of this study confirmed the results of the literature study, namely that the most important factor leading to substance abuse, is peer group influence. However, a combination of strategies and programmes are needed to develope a suitable programme for the specific community. The recommendations focus on four areas. Firstly the conditions are described for an effective prevention programme regarding the role of social workers, the use of assessment, evaluation, models, theories and approaches. Secondly, recommendations are made for techniques and general approaches. The third area gives directions for programme content. The last area recommends a possibility for future research: the process, roles and type of training needed to implement an effective and sustainable support group system in schools, must be tested. / AFRIKAANSE OPSOMMING: ’n Verkennende studie vir voorkomingsprogramme vir middelmisbruik deur ho¨erskoolleerders is gedoen ten einde: die faktore wat tot middele-misbruik deur ho¨erskoolleerders aanleiding gee, te ondersoek; die voorwaardes vir suksesvolle middele-misbruikvoorkomingsprogramme te verken en met bestaande programme in verband te bring; en te bepaal hoe voorkomingsprogramme aan ho¨erskoolleerders in Suid-Afrikaanse skole benut kan word. Die motivering vir die studie het gespruit uit die navorser se betrokkenheid by die Suid- Afrikaanse Raad vir Alkohol- en Dwelmafhanklikes (SANRA) met die aanbied van voorkomingsprogramme vir adolessente, op plase en in skole in die Paarl-omgwing. Die doel van hierdie studie is dus om riglyne vir maatskaplike werkers daar te stel vir die effektiewe implementering van voorkomingsprogramme vir middelmisbruik deur ho¨erskoolleerders. Die literatuurstudie het die behoefte aan effektiewe voorkomingsprogramme bevestig en die faktore wat lei tot middelmisbruik is ook uitgelig. Daar is veral gefokus op die risikoen beskermingsfaktore hierby betrokke. Die studie is ingelei deur ’n ondersoek na die risiko- en beskermingsfaktore wat ’n rol speel in die adolessente gemeenskap van SANRA (Paarl), aangesien dit noodsaaklik is om hierdie faktore te identifiseer voordat ’n voorkomingsprogram ontwerp word. Die universum is graad-10 leerders van ses skole in die gebied. Een leerder uit elke klas het die steekproef, van 48 respondente, verteenwoordig. Die ondersoek is aan die hand van ’n gestruktureerde vraelys gerig. Kwalitatiewe en kwantitatiewe inligting is deur middel van ’n kombinasie van oop en geslote vrae ingesamel. Die resultate van hierdie ondersoek het die literatuurstudie bevestig, naamlik dat die hoof faktor wat aanleiding gee tot middelmisbruik, portuurgroepinvloede is. ’n Kombinasie van verskeie strategie¨e is nodig om geskikte programme vir spesifieke gemeenskappe te ontwerp. Die aanbevelings fokus op vier areas, naamlik die voorwaardes vir ’n effektiewe voorkomingsprogram rakende die rol van die maatskaplike werker, die gebruik van assessering, evaluering, modelle, teorie¨e en/of benaderings en aanbevelings ten opsigte van tegnieke, programvoorstelle en programinhoud. Die vierde en laaste area maak ’n aanbeveling vir verdere navorsing: ’n Ondersoek na die proses, rol van en tipe opleiding nodig om ’n effektiewe en volhoubare ondersteuningsgroepstelsel in skole te implementeer.

Globalisation raises hopes that communities will become self reliant through development success and thus become an integrated whole (Offiong 2001). But the creation of global village leads to fragmentation of communities, a loss of norms and local values. This study focuses on communities of the Eastern Cape Province, exploring the nature of and extent to which children use alcohol as a consequence of cultural rituals. The researcher aims to develop a culturally sensitive psycho-social approach to address alcohol use among children. The purpose of the research was to investigate the extent to which certain cultural practices contribute towards alcohol use among children in the rural areas of the Eastern Cape Province. Thus exploring the nature and extent to which children use alcohol as a consequence of cultural rituals and to explore whether families and communities are aware of the impact of alcohol use by children in the community. The research was qualitative in nature and through semi-structured interview schedules the researcher was able to gain insight in the area of substance use amongst children in the rural areas of the Eastern Cape Province. Community members, learners from schools, educators and probation officers formed part of the research sample. The research findings suggest that community members are aware that the traditional rituals that are carried out in the rural areas have been contributing to the issue of children using alcohol. However, the community members feel challenged as they become conflicted by their traditional rituals and this impacts upon children using alcohol.

South Africa has been witnessing an escalation in drug use amongst adolescents in high school. Thus, the main question that motivated this research was: How can a psycho-educational programme, using a selected audio-visual media resource, assist teachers and parents in an effort to prevent adolescent students’ substance abuse problem behaviour? Social cognitive theory (SCT) and self-efficacy theory (SET) were used as a conceptual framework. The study explained these theories in-depth. Adolescent substance abuse was also studied as well as programmes to address this problem. This was followed by a perusal of numerous audio-visual resources for their possible incorporation into prevention programmes. The ‘Above The Influence’ (ATI) resource was selected for the psycho-educational programme which was designed for the study. The programme was put into action during seven sessions over a period of about two months, and implemented with a group of 26 Grade 10 and Grade 11 students in Pietermaritzburg, South Africa, to evaluate its relevance for adolescent substance abuse prevention. To evaluate the programme, a qualitative approach was used. The data were gathered during the programme implementation by means of in-person and online focus groups, individual interviews, written open-ended questions, observation notes and follow-up interviews some time after the programme had ended. Eleven principles were identified from the literature to evaluate the potential of the programme to be effective in preventing adolescent substance abuse. In particular the programme needed to increase adolescents’ skills related to studying, communication, peer relationships, self-efficacy, assertiveness, and drug resistance. The programme also had to employ interactive techniques and needed to address the type of drug abuse problem in the local community, for example, the ‘gateway’ substances of marijuana, alcohol and tobacco. In addition, the programme potential was evaluated in the light of SCT and SET. The findings indicated that the psycho-educational programme, using ATI as audiovisual medium, can be used very effectively by teachers to raise students’ awareness and develop particular skills that could contribute towards the prevention of adolescent substance abuse. It is recommended that the programme should be used in the long-term with repeated reinforcing sessions over time. / Psychology of Education / D. Ed. (Psychology of Education)

Department of Curriculum Studies and Education Management / MEDEM

MPH / Dpartment of Public Health

MPH / Department of Public Health / Globally, substance use is a significant public health problem around the world. Many schools encounter the challenge of learners using substances in and outside of the school premises. This problem affects the education system because learners who use substances display behaviours that negatively affect the quality of learning and teaching. The study aimed to determine the educators’ knowledge of the factors contributing to substance use among secondary school learners in Greater Giyani Municipality, Limpopo Province. A descriptive research design was employed, and the participants were selected using purposive sampling. Data was collected utilising a structured questionnaire and analysed using the Statistical Package for Social Sciences (SPSS) version 25 programme. The study findings show substance use as a significant public health problem in schools. Some of the factors identified that contributed to substance use among learners by most educators were low-self-esteem, poor self-control, depression, meagre finances, academic environment, background, peer pressure, accessibility and availability of substances. Based on the findings a number of recommendations were made such as capacitating parents on parenting skills and also on strategies to assist teachers to fight against substance use by students. Instead of the media only displaying lucrative advertisements of alcohol, it must also provide education and awareness about substance use/abuse and its consequences. Further research is necessary to investigate learners’ and parents’ knowledge of the factors contributing to substance use. / NRF

MPH / Department of Public Health / The abuse of substances among the youth is a global health problem which has a negative impact on their health and wellbeing, families, educational and professional life, as well as communities and limits their hopes and dreams. An estimated 246 million persons globally (about one out of twenty people) between 15 and 64 years have abused substances in the past three years. The global drug problem has increased to such an extent that more than 1 out of 10 drug abusers is affected by either disorder or drug dependence. The aim of the study was to explore the factors contributing to substance abuse among the youth in Atteridgeville, Tshwane Metropolitan Municipality. The study was conducted in Atteridgeville community. Atteridgeville is a portion of the City of Tshwane Metropolitan Municipality, west of Pretoria in South Africa. The design was qualitative in nature, using exploratory design. The researcher purposively chose the participants from the target population. The population and sampling method was on participants aged between 15 and 35 years, with substance abuse problem, who were referred to Atteridgeville Medical Health Centre for counselling. The researcher used a semi-structured interview guide for gathering data. In-depth interview was used to collect data. A proposed total of number of 20 participants was suggested, and it was guided by data saturation. Data was analysed by using thematic content analysis. A measure of trustworthiness was ensured. Ethical consideration was observed in this study. The findings states that substance abuse problem was identified and certainly noticed by everyone in the community. New drugs remain unchallenged, drug dealers are known, yet, not a single law enforcement institution attempt to raid their houses to search and arrest them. Community involvement is not enough to end the scourge of substance abuse problems in the community. Some police officers were identified and known to be part of drug dealings or have family relatives who are drug dealers. The researcher therefore recommends that parents should be involved in the community forums to deal with substance abuse problems. The community policing and law enforcement should be equipped by developing a tactical team specifically looking at the drug problems in the local communities. In conclusion, the research revealed that, South African citizens are people who see a problem happening but lacks to implement strategies to deal it immediately. / NRF

AIDS-related illnesses are the leading cause of deaths in South Africa. Alcohol misuse among male youths fuels the risk of Sexually Transmitted Infections (STIs), including HIV. Literature review was conducted on the association of alcohol misuse and the risk of contracting HIV among male youths. In this qualitative study fourteen male youths, all from Soshanguve in Gauteng province, participated in face-to-face interviews. The male youths who misuse alcohol show greater signs of indulging in risky sexual intercourse. In addition, the male youths who find their sexual partners at taverns were less likely to use condoms during sex. Other factors linked to alcohol misuse that hinder HIV-prevention include multiple sexual partners, transactional sex, men who have sex with men (MSM), young men’s dominance over young women and non-use of condoms. The findings of this research project indicate the need of deliberate focus on alcohol misuse during HIV-prevention education. HIV-prevention interventions should pay attention to reducing sexual risk behaviour associated with alcohol misuse among young men. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

AIDS-related illnesses are the leading cause of deaths in South Africa. Alcohol misuse among male youths fuels the risk of Sexually Transmitted Infections (STIs), including HIV. Literature review was conducted on the association of alcohol misuse and the risk of contracting HIV among male youths. In this qualitative study fourteen male youths, all from Soshanguve in Gauteng province, participated in face-to-face interviews. The male youths who misuse alcohol show greater signs of indulging in risky sexual intercourse. In addition, the male youths who find their sexual partners at taverns were less likely to use condoms during sex. Other factors linked to alcohol misuse that hinder HIV-prevention include multiple sexual partners, transactional sex, men who have sex with men (MSM), young men’s dominance over young women and non-use of condoms. The findings of this research project indicate the need of deliberate focus on alcohol misuse during HIV-prevention education. HIV-prevention interventions should pay attention to reducing sexual risk behaviour associated with alcohol misuse among young men. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)