Masters Degrees (Health Promotion).

Permanent URI for this collectionhttps://hdl.handle.net/10413/12724

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Experiences of home-based care organizations in the context of the global financial crisis.
(2014) Gwelo, Netsai Bianca.; Akintola, Olagoke.
Background: The global economic crisis has posed major threats to the fight against HIV and AIDS especially in developing countries. The crisis which originated in well-developed economies such as the US in 2007/2008 (Kin & Penn, 2008) has impacted key drivers of growth in trade, investment, mining and manufacturing at a global level. However, it is unclear how this crisis is affecting small, non-profit organizations providing care and associated services to people living with and affected by HIV/AIDS. Aim: The aim of this study was to explore the experiences of home-based care organizations in the context of the global financial crisis and its implications on the provision of services offered by home-based care organizations through the perspective of the managers. Methods: In-depth qualitative interviews were conducted with 10 managers who work in care organizations that provide care services to people living with HIV/AIDS using an interview schedule containing open-ended questions. Findings: The findings of the study show that the global financial crisis at the macro level has affected government and donors/funders’ grants to non-profit organizations. This has resulted in a reduction of funds allocated to care organizations. Funding cuts have severely affected care organizations at the exo-level. Care organizations were forced to employ different strategies such as organizational restructuring in order to survive in the new funding environment. This led to downscaling of services and the number of communities served, retrenchment of paid staff and reduced incentives for volunteer caregivers. Organizational restructuring had profoundly implications on recruited workers at the meso-level. Paid staff were confronted with retrenchment while volunteer caregivers were confronted with rationalization of incentives. At the micro level, there were severe implications for beneficiaries of care services. People who depended on these services are at a high risk of becoming more vulnerable to diseases and poverty. Recommendations: These findings highlight the need for the government to play a bigger role in the provision of funds and support to home-based care organizations. The government needs to incorporate home-based care into its social and economic policies to create a reliable source of funds for care organizations.
'Just a snip?' : Lemba circumcisers' perspectives on medical male circumcision for HIV prevention in Mberengwa district of rural Zimbabwe.
(2014) Shumba, Kemist.; Akintola, Olagoke.
Medical Male Circumcision (MMC) is an HIV ‘prevention technology’ hailed for holding the promise to containing the epidemic. MMC augments the vision of the Joint United Nations Programme on HIV/AIDS (UNAIDS) that pins hope on the possibility of zero new infections through the adoption of a comprehensive prevention approach. This study’s impetus stems from the view that the success of MMC is anchored not only on the premise that its wide-scale implementation subsequently lowers HIV incidence in heterosexual men practicing vaginal penetrative sex, but is also dependent on the readiness of the target population to undergo circumcision. From a culture-centred approach which holds that health promotion programmes should be planned, implemented and evaluated within the context of the relevant socio-cultural beliefs and value systems prevalent in a particular community, the study is a qualitative exploration of perceptions on MMC for HIV prevention among the Lemba people of Mberengwa. The Lemba are a traditionally circumcising cultural group. In light of the culture-centred approach, how they perceive MMC is worth investigation if success has to be achieved in its implementation among this cultural group. The objective of the study is to identify factors influencing collaboration of Lemba traditional circumcisers and medical institutions rolling out voluntary MMC. Purposively selected Lemba surgeons and elders participated in this study. Findings suggest that the Lemba practise male circumcision not as a mere surgical operation but as a symbolic cultural ritual that is value laden. However, they are ready to embrace MMC provided that it is done in a way that does not compromise the cultural values they attach to male circumcision. A deeper insight into Lemba perspectives generated in this study has been used to suggest ways in which the Ministry of Health and Child Care in Zimbabwe can scale-up roll out of voluntary MMC in Mberengwa through creating synergies between cultural and medical perspectives. For example, the majority of participants suggested that making use of Lemba initiates with medical training to conduct circumcisions in Murundu camps can help increase uptake of VMMC.
Male partner support among young unmarried pregnant women in Durban.
(2015) Phiri, Thandiwe Msipu.; Akintola, Olagoke.
The improvement of maternal and child health (MCH) outcomes has been an important part of the millennium development goals (MDGs). Although the world is at end of the MDG era, MCH remains an important issue globally as the MDGs have not been achieved in most countries. Maternal physical and psychological wellbeing is crucial because poor health during pregnancy does not only affect mothers but their unborn infants as well hence the integration of maternal, newborn and child health (MNCH). Young women in universities are likely to experience pregnancy due to the risky sexual behavior in tertiary institutions which is characterized by lack of condom and/or contraceptive use and coercion. Therefore, most of these pregnancies are unintended. Unintended pregnancy can be a traumatic experience for students and has been associated with negative maternal and child health outcomes. In addition, pregnant young women in an academic environment are susceptible to stressors such as meeting academic demands, lack of financial resources, unstable relationships with their partners and social stigma. This is a problem because stress in pregnancy has been associated with anxiety, depressive symptoms and is a risk factor for postpartum depression. Therefore, it has potential negative effects on MNCH outcomes. One way to cope with stress in pregnancy is receiving social support because of its role in mediating psychological wellbeing in stressful situations. The role of male partners in giving social support was the main area of interest in this study. Therefore, this study explores the support needs of pregnant students at the University of KwaZulu Natal in Durban, South Africa. Participants were purposively selected among pregnant students at the university. The findings show that pregnant students experience challenges in their environment which is a source of stress in pregnancy. To cope with these challenges, they seek different types of support such as emotional, instrumental, informational and financial support. Male partners are considered to be an important source of support in mediating stress and fostering physical and psychological wellbeing. The types of support received from male partners are mainly emotional and instrumental support. There is need for greater social support at different levels ranging from interpersonal, community and policy and male partner support should be encouraged by the health system for better MNCH outcomes.
Water, sanitation and hygiene in community and home-based care for people living with HIV/AIDS/TB in Durban, South Africa.
(2015) Mulopo, Chanelle.; Akintola, Olagoke.
The majority of HIV/AIDS patients in South Africa receive health care services at home. However, few studies have examined water; sanitation and hygiene (WASH) in home and community-based care. The main objective of this study was to explore community health workers’ (CHWs) perceptions of WASH in home-based care and the implications for people living with HIV/AIDS/TB, their family members and the health workers themselves. The participants in this qualitative study were drawn from four community home-based care organizations that provide care to HIV/AIDS/TB clients. These organizations are located in four marginalized communities in Durban. Data was collected using participant observation of care-giving activities; semi-structured interviews with five home-based care project managers from the organizations and five focus group discussions with a total of 49 CHWs. Some AIDS patients are incontinent. It is typical for CHWs to find patients in closed areas with bedding soiled by urine and feces. It was found that CHWs had limited access to protective materials such as gloves and aprons and therefore tended to avoid carrying out activities that could help maintain proper hygiene in the home for fear of infection. Furthermore, limited access to water and an unreliable water supply meant that CHWs had to fetch water from immediate neighbors or surrounding areas and this limited the time spent with their patients. The unavailability of water had ramifications for the number of times patients could bath. Insufficient water also presented a challenge to CHWS and families in maintaining proper sanitation. There is a great need for adequate water, proper sanitation and hygiene in community-based care. Inadequate access to water influences sanitation and hygiene, and this affects the work of CHWs. The government needs to respond promptly to the water and sanitation needs of marginalized communities with limited resources. The study’s findings have implications for policy on WASH and community-based care in low-income communities.

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Browsing Masters Degrees (Health Promotion). by Author "Akintola, Olagoke."