Doctoral Degrees (Psychology)

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Acholi indigenous methods for healing and re-integrating survivors of violent conflict into the community: a case of Gulu and Kitgum, Northern Uganda.
(2017) Adibo, Josephine.; Mkhize, Nhlanhla Jerome.
This study explored Acholi indigenous methods for healing and re-integrating survivors of violent conflict into the community in Gulu and Kitgum, Northern Uganda. The healing mechanisms of Acholi indigenous healing and reintegration methods have not previously been documented. This study sought to describe how survivors of violent conflict in northern Uganda experienced these methods. The study also sought to identify the specific problems for which these methods were prescribed, the ritual processes as experienced by the participants, and their perceived healing mechanisms. A qualitative research paradigm was used. Fifty (50) participants were selected using purposive sampling. Male and female survivors of violent conflict comprised the sample. Elders, who officiated in these rituals, were also interviewed. Data, in the form of interview narratives, was analysed using Voice-Centered Relational (VCR) method. The findings indicated that the healing rituals were performed in various specific sequences dependent on the nature of the atrocities committed. The most commonly used rituals were nyonotongweno, culukwor and matoput, in that order. The rituals were performed for a range of reasons, incorporating cleansing and protection of the survivors, their families, as well as the communities into which they were returning, from the bad spirits of the deceased that were never appeased. The rituals healed through spirituality— an appeal to a force greater than humanity — the presence and participation of the community, compensation of the aggrieved clan, and open forgiveness. The place of healing, as well as the healing of the spaces where the violence took place, attest to the holistic, as opposed to the individualistic, orientation of western versus indigenous methods. The contaminating effects of the violence extend beyond individuals and the community to the environment itself, hence the need to heal spaces where violence occurred. Most participants perceived the rituals in positive terms. Influences of religion and globalisation were noted amongst those that perceived the rituals in negative terms. The fact that women who were sexually violated during the conflict were unable to resume a conjugal relationship with their spouses, even after the rituals, points to the profound influence of gender. This calls for further investigation into the effectiveness of healing rituals in cases where sexual violence against women is involved.
Addiction and recovery from whoonga : an interpretative phenomenological analysis of the lifeworld of youth from INK townships "in recovery” = Ukubhenywa noku simama ekubhemeni iwunga : kuhlungwa ngokuhlolisisa nge-phenomenology ehumushayo umhlaba wezimpilo zentsha yasemalokishini ase-INK “esimamayo”.
(2020) Khumalo, Richard Thabane.; Mkhize, Nhlanhla Jerome.; Mayaba, Phindile Lungile.
In dealing with a rampant increase in addiction to whoonga or nyaope, a heroin variant drug that has taken hold amongst Black youth in South African townships, the employment of addiction treatment that includes harm reduction measures is advanced. Complementary to these approaches, this study speaks to addictions to whoonga from an ecological perspective, a macro level approach concerned with eliminating addictions by identifying their root causes. In seeking solutions and intervention from the environment that begets addictions, recovery draws empirical evidence from overcoming addiction, a science of factors prompting, sustaining, and supporting abstinence and long-term recovery. This is a person-centred approach that begins with an understanding of recovery from experiences of those “in recovery”, people who are in the process of resolving their addiction issues, to advance interventions that people would identify and be familiar with. To make sense of addiction and recovery from whoonga from the perspective of those who were involved, six young Black African males between the ages of 20 and 33, who had desisted from whoonga use for an average of 3.3 years, were recruited from the communities of Inanda, Ntuzuma, and KwaMashu (INK) townships, north-west of Durban. Participants were recruited through snowballing, and by using advertisements. Participants were interviewed indepth, and one-on-one at their original homes, using semi-structured interviews. These interviews were guided by an interview schedule derived from literature on addiction treatment, self-change models, as well as recovery frameworks. Interviews were recorded and transcribed. Transcripts were subjected to interpretative phenomenological analysis (IPA), a qualitative methodology derived from hermeneutic phenomenology that was developed within psychology to add an idiographic component. To understand what addiction and recovery from whoonga meant for participants, four superordinate themes: becoming iphara, being iphara, curative confrontations (becoming human) and nurturing potentials (approximating citizenship), guided discussions. Results show that addiction to whoonga transformed participants in profound and deleterious ways. Addiction was characterised by a state of being iphara, a term that describes the embodiment of dedicated whoonga use. While whoonga addiction was initiated in pursuit of pleasure, escaping difficult life situations, and boredom, and where the influence of friends and peers dominated, it soon became a burden that began with the body becoming the site for pain. The state of being a whoonga addict is described as a preoccupation with the drug and the now, in which there is a deficiency of care for oneself, others, and other life concerns. Largely because of crime committed in the pursuit of the next fix, whoonga addicts are marginalized and ostracised by the community and family members. Other than isolation, to be an iphara is a perilous and precarious lifestyle, in which vigilante attacks from the community retaliating would put addicts’ lives and the lives of those close to them in danger. Arrests presented criminal records with huge implications for future employability. Recovery from whoonga was founded on survival instincts and a sense of self-preservation when difficult conditions as an addict were presented to participants’ lives. The crossroads within whoonga addiction lives jolted participants to the correct orientation to the truth, demanding reorientation to the present, that involved the evaluation of the past and concerns with the future. Although desistance can be coerced, an inner resolve to end addiction lives was deemed necessary; and such bolstered courage to attempt desistance. Desistance involved the use of Methadone: this was difficult particularly for participants who desisted from whoonga use without recourse to medication and professional help. Recovery marks a sense of growing and maturing; taking responsibility for oneself and others, which are efforts of becoming umuntu/human; making amends with peers, family members, and the community. Participants in this study present evidence of overcoming whoonga addiction. They offer an opportunity for the emergence of recovery support in the creation of peer recovery-support groups. Participants would model recovery, presenting hope to those addicted and the community, that overcoming whoonga addiction is a reality. Such should alleviate stigma and create pressure on the unwilling. Peer-recovery groups provide communities of former whoonga addicts with a place to go to. Such communities are best positioned to support early recovery experiments in empathic and non-judgemental ways. To filter preventative measures, reorientation of youth to traditional African ways that support and bolster a sense of pride in who they are, is necessary. Instilling mechanisms of earning membership to the community, and guidance on navigating transition to adulthood, for example, rites of passage amongst youth, would be necessary. The message is that actions and behaviours reverberate, affecting their communities. For youth to understand the plight of own communities, teaching individual responsibility to the health and welfare of communities, is important for prevention. Iqoqa locwaningo Ekuhlahleni indlela iNingizimu Afrika ezobhekana ngayo nokubhebhetheka kokusetshenziswa kwesidakamizwa esibizwa ngewunga noma i-nyaope, nokuyisidakwamizwa se-heroin exutshiwe esesithathe isizinda kwintsha eMnyama ehlala emalokishini, kuhlongozwa ukulandelwa kwezinhlelo eziphakamisa ukusetshenziswa kokulashwa kwezidakamizwa umhlabawonke nezifaka izinhlelo ezehlisa umonakalo odalwa izidakamizwa. Ekuhlangabezeni ngokulekelela lezizindlela, lolucwaningo lubheka ukubhenywa kwalesisidakamizwa ngokusibheka ngokwesimo semvelo, nokuyindlela ebanzana efaka ukuqedwa kokubhenywa kwezidakamizwa ngokuthola izimbangela eziyizinzika edala ukubhenywa kwezidakamizwa. Ukuthola izixazululo nendlela okungangenelelwa ngayo ngokwezendawo edala ukuhuqwa kwalezizidakamizwa, ukusimama ezidakamizweni kuhlongoza ukuqhakambiswa kwezindlela abantu abasimama ngayo ekubhemeni izidakamizwa, nokuyisayensi yokusimama efaka ukuthi yini eyenza abantu baqalise ukusimama, bakulondoloze futhi balekeleleke ukuthi baziyeke futhi baqhubeke bengazibhemi izidakamizwa. Lokhu kubeka phambili umuntu ombandakenyayo, okuqala ngokuthi siqondisise kahle ukuthi abantu abasimamayo, nabaziyekile izidakamizwa benzenjani, ukuze sikwazi ukuthola izisombululo ezizojwayeleka kubantu ngoba zisuselwa kulokho abakwaziyo nokwenzekayo ezimpilweni zabo. Ukuqondisisa kahle ukubhuqabhuqwa nokusimama ekubhuqwabhuqweni ukubhema iwunga kususelwa kwizindlela abayibona ngayo labo abambandakanyekileyo, izinsizwa eziMnyama eziyisithupha ebezineminyaka esukela kwamashumi amababili kuya kumashumi amathathu nantathu, nababesebeyiyekile ukuyibhema iwunga isikhathi esingangeminyaka emithathu nezinyanga ezintathu sebebonke, batholakale kumphakathi wamalokishi aseNanda, eNtuzuma naKwaMashu, kwinyakatho ntshonalanga yeTheku. Ababambe iqhaza kulolucwaningo batholakala ngokuthi bamemane, kwasetshenziswa nezikhangiso. Kwaxoxwa nabo kabanzi kwizinkulumo ubuso nobuso besemakubo. Lezizingxoxo zazingakhululekile ngokuphelele ngoba zazilandela imibuzo eyayihleliwe. Lemibuzo ehleliwe yasuselwa kwimibhalo nezingcwaningo ezidlule kwizifundo zokulashwa kokubhuqabhuqwa izidakamizwa, ukuziguqula kwabantu ngokwabo kanye nakwizinhlaka zokusimama ezidakamizweni. Lezizingxoxo zaqoshwa zabhalwa phansi umcwaningi. Lemibhalo yabe isihunyushwa kusetshenziswa i-interpretative phenomenological analysis (IPA), nokuyindlela yokucwaninga e-qualitative, esuselwa kuhlobo lwe-phenomenology ehumushayo eyabe isifakwa ukuhluza iidiography ngaphansi kwazo izimfundiso zoMoya. Ukuthi ingenziwa njani lendaba yewunga izosuselwa kwizinhlaka zokusimama. Ukuqondisisa ukubhenywa nokusimama ekubhemeni ADDICTION AND RECOVERY FROM WHOONGA: AN IPA vi iwunga, kuzosetshenziwa lezizingqikithi ezikhuluma ngo: Ukuqala ube iphara; Uma usuyiphara, Ukunqwamana nezimo ezinzima kodwa ezilulamisayo (Usuqala uba umuntu), bese kuba ukwenza izinto eziqhubekisela phambili impilo uzokwazi ukubuyela usebenze njengomuntu ojwayelekile (okungukwenza izinto ezisimamisayo neziwubuntu). Imiphumela yalolucwaningo itshengisa ukuthi ukubhuqwabhuqwa iwunga kwabashintsha ngendlela egxilayo nenemiphumela emibi kubona siqu sabo, nokuchazwa njengokuba iphara nokungukuba isimo sobuhambuma. Nakuba ukuqala ukubhema iwunga kwakungukuhubha intokozo nokuthanda izinto, kubalekelwa izimo ezinzima emakhaya nesimo sokungenzi lutho, lapho kudlange ukushomana nokuthokozisa abangani, iwunga yabe isisuka iba umthwalo, okwaqala ngomzimba usugqamisa ukuba sezinhlungwini. Ukuba iphara kuchazwa njengokunaka iwunga kuphela nentokozo yamanje, lapho umuntu akasenandaba naye, abanye abantu kanye nokwenza ezinye izinto ezibalulekile empilweni. Ngenxa yobugebengu, ukuba iphara kusho ukunyongozwa umphakathi nemindeni, bakukhiphela ngaphandle. Ngaphandle kokunyongozeka, ukuba iphara impilo enobungozi lapho intukuthelo yomphakathi ongahlasela ubeke impilo yakho kanye neyomndeni wakho encupheni kungenzeka. Uma beboshwa babuya benamarekhodi obugebengu okwenza kubenzima ukuqasheka. Ukusimama ukubhema iwunga kutholakala lapho impilo isikubhincisela nxanye sekusele ukuzisindisa wena sekufike izimo ezinzima ezihambisana nokuphila impilo yokubhema iwunga. Lesisimo sokukhetha sihlokolozwa ukuzibuzisisa nokubheka impilo ngendlela eyiqiniso ephoqa ukuthi umuntu abuke isimo lapho ekhona, abuke emuva bese ecabanga ngekusasa. Nakuba ukushiya iwunga kungaphoqwa, uma kusuka ngaphakathi kuyaye kumthwale umuntu ukuthi amelane nezinhlungu zokuyeka. Kwasetshenziswa i-Methadone ukuyeka iwunga, kunzima kakhulu ukuyiyeka, ikakhulukazi kulabo abavele bayeka bengasebenzisanga muthi bangaya nakwabezempilo. Ukusimama kunokufana nokukhula, uyimele impilo ubenendaba nokuzinakekela unakekele nalabo abaseduze kwakho, okuyimizamo yokuba umuntu, uphinde uzwane nabantu, imindeni, abangani kanye nomphakathi Ababambiqhaza basivezela ubufakazi bokuyekeka kwewunga. Basinika ithuba lokuqala izindlela zokulekelela labo abafuna ukuyiyeka, kanye nalabo esebeyiyekile, bengabuyeli. Bangahlahla indlela etshengisa abanye ukuthi iwunga iyayekeka. Bangahlanganyela ndawonye basize laba abasandakuyiyeka ngendlela engezobanyongoza bezozwelana nabo ngosizi abalwaziyo bonke. Ukubhenywa kwewunga emalokishini kuqeda isithunzi, lapho uma ubuntu bufundiswa kwintsha kungaveza izindlela zokuziphatha, nokubaluleke ekuqhubekezeleni umphakathi phambili. Lokhu kungasiza ukuthi balulame nokuthi bengayiqali nokuyiqala iwunga.
Addressing the treatment gap for perinatal depression within an integrated primary health care model: development and feasibility study in the Dr Kenneth Kaunda District, North West Province.
(2020) Kathree, Tasneem.; Petersen, Inge.
Background: Perinatal depression (PND) is a common mental disorder (CMD) with onset either during pregnancy or in the postnatal period, with potentially harmful inter-generational impacts on families, and by extension on communities. In South Africa a combination of high prevalence rates for PND, an estimated treatment gap of 75 percent for CMDs, and a large medically uninsured population poses a public health and social burden. Compounding the issue, there is a lack of awareness of and minimal attention paid to PND in scarce-resourced primary health care (PHC) settings in South Africa. Consequently, screening, referral and treatment for PND is low to absent, as are targeted pharmacological and psychosocial therapies for PND. Internationally, evidence supports the concepts of both collaborative care and task-sharing to address PND in low-and middle-income countries (LMIC). In South Africa however, despite support for the integration of mental health services into general health care, promotion of perinatal mental health care, and endorsement of task-sharing in mental health care, promoted by a national mental health policy framework, there is an absence of clear strategies to address PND in the mandated maternity care guidelines in PHC. In response to this service and evidence gap, the aim of this study was to co-develop and evaluate the feasibility of a culturally and contextually appropriate integrated model of care for PND with PHC service users and service providers. The research aimed to contribute towards the body of evidence towards the development of integrated, PHC-based, task-shared collaborative care for PND in South Africa and other LMIC. The study was guided by explanatory models of illness and the UK Medical Research Council framework for complex interventions. Methods: Set in an urban 24-hour service community health centre in the Dr Kenneth Kaunda District, North West province, and nested within the larger PRogramme for Improving Mental health CarE (PRIME) project, the study was undertaken using a phased approach. The first step was an in-depth review of the literature on task-shared care, integrated or collaborative care for PND, particularly in LMIC, and the platforms, models and cadres used in task-shared care for PND. These essential components for task-shared PND care in LMIC were identified and guided the development of the interview schedules for both service users and service providers. In-depth semi-structured interviews were conducted with 20 service users to understand their perceptions, attitudes to task-shared care and recommendations to address PND, using thematic analysis to analyse the data. This work comprised the first phase of the study. In the second phase, nurses (n=10), HIV counsellors (n=20) and operational managers (n=4) were interviewed to gauge their clinical understanding of PND, attitudes to task-shared mental health care and recommendations to address PND. This was followed by a participatory workshop which included nurses, managers and specialists to co-develop a model of care for PND. An additional six key informants were interviewed for institutional perspectives and guidance on the model. Framework analysis was used to analyse the data in this phase. In the third phase, a quasi- experimental cohort design was used to recruit perinatal care attendees (n=54) to evaluate depression outcomes, feasibility and acceptability of the model. Primary care nurses consulting women attending antenatal and postnatal services were trained to identify women with depressive symptoms using a short maternal depression screening tool, and clinical assessment. Pregnant and postnatal women (6-48 weeks postpartum) who had mild/moderate depressive symptoms were referred to an existing 9-session manualized counselling intervention addressing common triggers of depressive symptoms, based on cognitive behavioural approaches, provided by a co-located non-specialist counsellor. Women with moderate/severe depressive symptoms were referred to both the counsellor and upwards for specialist assessment and treatment. Participants were administered a questionnaire including the Patient Health Questionnaire 9 (PHQ9). Service users (n=31) identified by nurse clinicians and referred for counselling and/or further treatment were assigned to the intervention arm, and service users (n=23) not identified with PND by the nurse, but who screened positive on the PHQ-9 were assigned to the control arm. Participants were interviewed at baseline and four months after baseline to assess change in PHQ-9 scores. Qualitative process evaluations were also conducted with five service user participants and eight health workers after the four-month assessment to identify evidence of feasibility and acceptability, challenges and recommendations. Results: The qualitative results from the first phase indicated support for task-shared care and produced service-user recommendations to address the need for psychoeducation, support groups and counselling, either at community or facility-levels for PND. The second phase service provider engagement (participatory workshop) culminated in the co- development of a task-shared, collaborative care model for PND, with strengthened referral pathways, based on the nurse clinician screening, diagnosing, and referring onward to either a facility-based non-specialist counsellor, a doctor or a mental health specialist. In the third phase, an evaluation of the task-shared, collaborative care model with strengthened referral pathways to a co-located psychosocial intervention delivered by non-professional mental health workers at PHC level, indicated a clinically significant decline in depression scores (10- point reduction) in the intervention arm from baseline (M=14.3, SD 2.9), and at four- month follow-up (M=4.3, SD 4.5). Qualitative data indicated that participants experienced the counselling intervention as beneficial and acceptable. The non-specialist, co-located counselling was viewed by most nurses as beneficial although there were recommendations to streamline the screening and diagnosis process. Process indicators suggest that the model is feasible and acceptable. Conclusion and recommendations: This study has contributed new applied knowledge regarding the development and evaluation of a task-shared, integrated, collaborative care model for PND at PHC level in South Africa, providing evidence of feasibility and acceptability of the model of care. The favourable results suggest the potential for a larger effectiveness study, based on the recommendations and lessons garnered from this study. At the time of this report, the policy developments within the mental health landscape demonstrate a level of awareness among a minority of policy-makers, researchers and health care providers of the need to promote perinatal mental health. However, the lessons from this study suggest that key policy level changes are required which include but are not confined to the adoption and reporting of mental health data elements and indicators for PND, and adaptations to the maternity guidelines to include detection in the form of brief screening, assessment, diagnosis and referral for PND. With reference to task-shared mental health care, the inclusion of social workers in counselling treatment plans, and the identification of appropriate cadres, trainers, training, and supervision for non-specialist mental health counsellors are critical factors that require concerted political will and effort.
Adolescent boys living with HIV.
(2011) Blackbeard, David Roy.; Lindegger, Graham Charles.
This qualitative research identified constructions of masculinity among seven adolescent boys who were HIV positive, purposively sampled from the age range of 13 to 16 years and were members of a clinic-based HIV support groups. Central to this research was the critical use of the concept of ‘hegemonic masculinity’, defined as the legitmation of gendered power through masculinity ideals, embodied practices and imperatives. The framework of dialogical self theory was used for exploring the dynamics of individual and group positioning around hegemonic masculinity and this theory was compared with other approaches such as discursive theory. Using multiple research methods within a qualitative design, this research identified individual and group ideals and practices held by the adolescent boys, with a key focus on how young men maintained ‘positions’ in relation to hegemonic masculinity, be these forms of masculinity that retained complete or partial identification with hegemonic masculinity or versions of masculinity that were alternative to the hegemonic form. The study was situated at the intersection of masculinity with the experience of living with a chronic medical condition, and the relatively homogenous and small sample provided an indepth basis for understanding the instantiation of masculine identity in a situation of fairly unique challenges and complexity. A combination of semi-structured interviews, focus groups, autophotography, reflective writing, biographical drawings and biographical interviews were used to match an interpretive, inductive research process, with reflexivity and research ethics as key considerations. Interviews were carried out by the researcher and two of the support group facilitators, creating an opportunity for reflexivity around the complexities of qualitative interviewing. Multiple methods of data analysis were used to analyse and ‘dialogue’ multi-sourced verbal and visual data. Thse methods consisted of thematic analysis, an adaptation of critical narrative analysis for selected texts and content analysis of visual data. The findings suggested that there were active processes of positioning masculine identity at individual and group levels and that positions in relation to hegemonic ideals were emotionally invested. Two hegemonic versions of young masculinity were identified as sets of ideal standards and embodied practices. ‘Township young masculinity’ was a peer-approved version identified with physical invulnerability, risk-taking and an ideal of attaining ‘influence and affluence’ through exceptional performances. ‘Aspirant young masculinity’ was a future orientation towards attaining a commodity masculinity, identified with an independent provider roles and signified through visible displays of ownership both material and symbolic. Interpreting findings from dialogical self theory, it appeared that some of the boys, at some times, established a distance from hegemonic imperatives by taking personally agentive, independent I-positions. This carried the risk of impulsively reacting to hegemonic imperatives without the support of collective identities and social relationships. Some boys developed Ipositions that were contradictory to produce new and more tenable I-positions. This process appeared to be more sustainable when it was connected with a group or collective identity such as being a member of the support group or being a person living with HIV. Some of the boys maintained alternatives through ‘metapositions’ that were made available through contexts or resources which offered alternative perspectives and possibilities. Dilemmas faced included managing the hegemonic imperative of being sexually active as an HIV positive young man or prioritising health where the hegemonic standard promoted physical risk-taking. It was apparent that despite interviewer expectations, the participants did not foreground an HIV positive identity but instead defined themselves foremostly as young men. One of the solutions to these dilemmas was to modify but maintain some alignment or identification with masculinity ideals. Here, the constraints of being HIV positive meant that maintaining health was more important than conforming to masculinity ideals or a reframing of masculinity within the physical, social and symbolic barriers of having a potentially life-threatening illness. The challenge of this solution was that its sustainability relied to a large extent on the availability of safe ‘dialogical’ spaces such as the HIV support group. Some of the boys found ‘principled’ alternatives to hegemonic masculinity from community or cultural values. Some of the boys identified with hegemonic standards but had to constantly defend against the anxiety of not being able to embody these hegemonic standards.
An analysis of community based health approaches in the delivery of integrated sexual, reproductive health and HIV services for adolescents with disabilities in Siaya County, Kenya.
(2019) Mbanga, Paul James.; Govender, Kaymarlin.
There is evidence of widening health disparities among vulnerable groups and inadequacies in the public health care system in sub-Saharan Africa (SSA), including Kenya. In particular, adolescents with disabilities (AWDs) confront many challenges in accessing health services. Their increasing primary care needs and rights in terms of sexual and reproductive health (SRH) is beyond the capacity of the conventional health system. While the Community Based Health Care (CBHC) approach has improved basic health services for maternal and child health as well as HIV and AIDS interventions, its capacity and utility to address the SRH and HIV interventions required by AWDs is not adequately studied in Kenya. Furthermore, debates persist on the overall quality of services provided through such primary health care systems. This study therefore investigated the CBHC approach as an option for improving AWDs‘ access to and use of Kenya‗s state-run adolescent SRH and HIV services in Siaya County of rural Kenya. The descriptive qualitative case study design used systems theory that featured Urie Bronfenbrenner‗s bio-ecological (Person-Process-Contexts-Time) and the World Health Organisation‘s (WHO‘s) (building blocks) health systems assessment frameworks as the main models to conceptualize, design, collect, analyze and interpret the data. Qualitative methods of data collection were used to explore purposively selected CBHC programs, and included semi-structured interviews, focus group discussions, observations, case narrations and record reviews. The study exposed serious institutional level inadequacies of the existing CHBC approaches, which were largely mediated by the disabling operating environment in the county health system. These ranged from poor staffing, inadequate financing, inadequate family support and community care, and unresponsive policy and legislation frameworks that lack enforcement mechanisms. Furthermore, the study found challenges associated with personal attributes including age, gender, type of disability, schooling and awareness of risks and available community-based services. Sexual and xii gender- based violence against the backdrop of an irresponsive justice system dominated the plight of AWDs in the county. As a result of analysing these factors, the evidence suggests a need to address the unique challenges surrounding the multi-dimensional issues that mediate access to and use of healthcare for adolescents living with disabilities to achieve equitable access to SRH & HIV services. In particular, the government should foster positive mechanisms of supporting community- based programs through co- financing with donors to expand the resource base for effective health services delivery, including SRH and HIV services for AWDs. Moreover, responsive policies and legal frameworks that were inclusive in approach to community care for AWDs would need to be clearly enunciated and enforced by the government and its stakeholders. Lack of data related to AWDs should be addressed to facilitate effective programming.
Analysis of policy for protection of HIV positive adolescent girls against vulnerabilities faced in using contraception in Malawi.
(2022) Bulage, Patience.; Govender, Kaymarlin.
There are challenges faced in accessing and using contraception by adolescent girls, but the reality is worse for adolescent girls living with HIV. Thus, it is important to investigate the extent to which current policies in Malawi put into account the vulnerabilities faced by this sub-population. This study therefore sought to answer the following research questions: 1. What are the structural and socio-cultural issues affecting the use of contraception among AGLHIV in Malawi? 2. What policy provisions are in place in Malawi to address the issues/risks faced by AGLHIV during reach and use of contraception? 3. What implementation challenges affect the effectiveness of the available policy provisions? This study was guided by the healthy policy triangle (HPT) framework and it was qualitative in nature, using both secondary and primary data collection methods. The findings include; • Access to contraception by adolescent girls living with HIV is hampered by several structural and socio-cultural issues, mainly; the mode of service provision, supply chain and infrastructural challenges, age restrictions, conditioned access, as well as integration challenges. The socio-cultural issues include; the high momentum for children, male dominance, social labelling, non-disclosure of HIV serostatus to sexual partners, social sensitivity, perpetuation of harmful content, and a general lack of social support, and poor risk perception. • The available provisions include those addressing gender-based violence, discrimination and stigma, community engagement, confidentiality, and emphasis on adolescent girls and young women. However, most of the provisions are broadly stated and gaps exist too. • Effective implementation is affected largely by cascading challenges, lack of sufficient funding, limited political will, low comprehension of policy directives, limited participation of target population, coordination challenges, social resistance, effects of decentralization, low capacity of implementing partners and the slow pace of behaviour change among the targeted population and communities. While the policy environment in Malawi is seemingly favourable, undertones exist around harmonization, and representation of interest groups, mainly PLHIV groups. Policy makers ought not to continue ignoring the importance of formulating HIV-sensitive policies which can give way to social protection programs for the most vulnerable within the society, given the benefits of a healthy youthful population.
Analysis of race and racism discourse by academics in post-apartheid Higher Education.
(2019) Motloung, Siphiwe Maneano.; Durrheim, Kevin Locksley.
Despite being in the twenty-fourth year of a democratic South Africa with a constitutionally enacted goal of non-racialism, South Africa continues to be plagued by social explosions of race and racism incidents in various contexts including higher education. While there is abundant research on race and racism issues in South Africa there is still a need for more research in the multitude of specific and varied contexts that make up South African society. This research study explicitly focuses on the specific discursive positions of academics of the delineated racial categories of black, white, coloured and Indian, within the South African post-apartheid Higher education context. The research study uses a social constructionist theoretical orientation that speaks to the methodologically complex nature of the study of the socially constructed categories of race. It was conducted at the University of KwaZulu-Natal and was guided by a qualitative interpretive paradigm and employed a non-probability, purposive sampling method. Four academics from each of the four delineated racial groups were interviewed bringing the total to sixteen in-depth detailed interviews. Discourse analysis as delineated by Antaki (2009) was used to analyse the discursive way academics speak and position themselves with regard to race and racism in a postapartheid higher education context. Coupled with discourse analysis, the researcher employed a critical Africanist standpoint in the analysis. With the limitations of qualitative studies notwithstanding in terms of generalisability, there were some discursive elements identified that can add to the knowledge on the subject matter of race and racism in our higher education South African context: i. Despite South Africa being constitutionally non-racial, nuanced reproductions of apartheid divisions continue in the post-apartheid context. Regardless of having sampled the delineated four racial categories (black, white, coloured and Indian), racial bifurcation with either the white or the black identity was evident with some Indian, coloured and black academics exhibiting denial and internalised racism. ii. To straddle the racial division and the espoused norm of an integrated rainbow nation, a deracialized discourse was used by academics. Selected academics also used race as a social construction discourse to solve the dilemma of race as an unreality and a reality. iii. Academics marginalisation discourse included experiences of being side-lined where specific and personal examples were relayed by some academics, while others discussed marginalisation in a more distanced manner. iv. The battleground on which some academics fought racial division was through the Africanisation discourse where the inferiority of black academics as compared to the superiority of white academics was expressed, being couched in terminology such as African scholarship versus scholarship which was represented as neutral. The thinking of academics regarding race and racism would appear to be progressive and forward thinking overall; however, closer discursive scrutiny reveals thinking similar to academics who were the very architects of the racial categories and racism in an apartheid South Africa. To deal with the contentious subject matter of race and racism the academics used deracialized and racialized discourse to take recognisable racial positions on specific grounds. The ability of black academics and African scholarship was in doubt as compared to the capability of white academics within scholarship which is socially constructed as white and neutral. The study contributed to current post-apartheid scholarship from a critical Africanist standpoint.
An analysis of the experiences of children with cerebral palsy in therapeutic horse riding
(2009) Naidoo, Pravani.; Hayes, Grahame.
This study utilised a qualitative interpretive approach to investigate the subjective
An analysis of the experiences of children with cerebral palsy in therapeutic horse riding.
(2009) Naidoo, Pravani.; Hayes, Grahame.; Van den Berg, Henriette Suzanna.
This study utilised a qualitative interpretive approach to investigate the subjective experiences of six children with cerebral palsy who participated in a therapeutic horse riding intervention programme over a two-year period. Data was collected through a triangulation of methods and sources of data in the form of proxy reports from teachers, parents and therapists, and participant observations on my part. Research in the field of disability and rehabilitation remains largely ungrounded with respect to formalised theorising around concepts such as strengths, capabilities, and well-being. In attempting to address this gap, the nascent sub-discipline of positive psychology was identified as a field that holds significant research utility. Arguably, its keynote contribution entails directing researchers and practitioners in the field of disability and rehabilitation to the aim of building, reinforcing and extending disabled individuals' strengths in order to optimise their functioning. Consistent with existing work, this study found that the participants' lives were characterised by experiences of difference and marginalisation in relation to non-disabled individuals. More striking, however, was the finding that they were subject to experiences of difference and othering in relation to their disabled peers. This group dynamic seemed to be accounted for in terms of a hierarchy of similarities and differences with respect to their capabilities for communication and motor functioning. Further, the findings suggested that the participants tended to utilise their bodies, the site of their impairments, to engage with their environments and social others in their own idiosyncratic and agentic ways. By virtue of the tendency to negotiate and at times transcend their impaired physicalities, the participants were perceived as functionally autonomous, which worked to challenge prevailing stereotypes with regard to individuals with profound forms of physical disability. Importantly, such features impacted upon the degree and quality of their engagements with their physical and psychosocial environments in significant ways. In addition, in terms of the therapeutic riding activities engaged with during the course of this study, the participants came to experience their bodies as bodies that work. This seemed to have had positive implications for how they felt about their bodies and themselves. An enhanced sense of personal worth also tended to minimise their experiences of their bodies as impaired and dis-abled. In this way, their participation in therapeutic horse riding facilitated the children's experiences of themselves as more than disabled, thereby indicating the emancipatory potential of participating in this form of intervention. Moreover, it was noted that the limited body of existing, largely quantitatively oriented research in the field of therapeutic horse riding has often been methodologically wanting. As disconcerting was the noticeable absence of theorising around the mechanisms and processes by which therapeutic horse riding effected changes. It was therefore fitting to draw on theoretical frameworks within psychology to delineate possible mechanisms and processes by which participation in therapeutic horse riding could potentially effect subtle, meaningful shifts in the everyday functioning and psychological well-being of children with disabilities. This study contributed to existing research within the field of disability and rehabilitation through its efforts to yield "thick descriptions" and "thick interpretations" in combination with the theory-laden validation of findings around the everyday subjective experiences of children with disabilities.
“At home” at the University of KwaZulu-Natal?: a study of experiences of exclusion amongst academic staff.
(2021) Nzuza, Nompumelelo.; Durrheim, Kevin Locksley.
The study aimed to examine how academic staff feels excluded in the institution based on race and gender. The objectives were developed following the current scenario and existing studies conducted in this domain. Six in-depth interviews were conducted with the staff members of UKZN. The interviews were then analysed through the use of thematic analysis. The two main themes that emerged from the interviews were; 1) discontent with the institutional environment and 2) belonging to the university as mediated by race. The study set out to determine whether staff members felt a sense of belonging based on race and gender. However, the study's main conclusion was that academic staff do not feel excluded at the university based on race, but there were masculine spaces that were alienating to female academics. The dissatisfaction felt by the lecturers was directed at the university’s management and the adverse institutional environment that they were creating. The lecturers had 2 different responses; one group of lecturers withdrew from the university and felt that they could not change the status quo. They saw themselves as powerless and inferior to management. The other lecturers identified strongly as a unit and were vocal about their dissatisfaction with management, and they were engaged and resisted management’s dominance.
An autoethnographic study of my experience with breast cancer.
(2020) Johns, Lucinda Theresa.; Sliep, Yvonne.; Richards, Roselee.
My breast cancer experience facilitated the exploration of my intersectional identities within an autoethnographic framework. I contextually reflected on my personal and professional identities within the interactional lens of silence and vulnerability. The qualitative methodology of autoethnography allowed me to use autobiographical self-reflective data collection that included self-narrative, poetry, photographs, presentation, intersecting academic and community spaces. The data collection informed the analytical intersecting chapters that reflect the research question and the associated three objectives: (1) to explore the transformative nuances of my breast cancer in relation to my intersecting identities, (2) examine how my profession as an academic and psychologist had an influence on meaningmaking of my illness and healing and (3) investigate the contextual contributions of interconnectivity within communities. The concluding chapter reasserts the intersecting matrix of my identities as I navigated through my breast cancer experience. This elaborate autoethnographic process ultimately contributes to existing knowledge and the national narrative of breast cancer within the South African context.
The behaviour and development of infants with iron deficiency anaemia : systematic observation of 9-month-old Pemban caregiver-infant dyads.
(2009) Dellis, Andrew Mark.; Cowley, Stephen.; Spurrett, David.
Background: The Zanzibar Infant Nutrition Campaign is a large-scale randomised control trial investigating the effects of iron and zinc supplementation on the morbidity and mortality of infants and young children on Pemba Island, Zanzibar, Tanzania. The Child Development Study is a substudy of the larger ZINC control trial assessing the effects of 12 months of iron and zinc supplementation on motor and language development. The Caregiver-Infant Interaction Study is a substudy of the Child Development Study, assessing the effects of 1 to 3 months of iron and zinc supplementation on caregiver-infant interaction among 9-month-old dyads. This thesis reports on the dyads enrolled in the Caregiver-Infant Interaction Study. While not examining treatment effects1 • Formulate behavioural and developmental hypotheses specific to a population of 9-month-old caregiver-infant dyads affected by a history of IDA , hypothesised disturbances in the behaviour and development of infants affected by a history of iron deficiency anaemia (IDA) are examined. Objectives: • Develop a hypothesis-driven observational coding system and establish the psychometric properties of this measure • Test hypotheses about the relationship between a history of IDA and the behaviour and development of 9-month-old caregiver-infant dyads Rationale: Iron deficiency anaemia is the most common nutritional disorder in the world. Prevalence is especially high among women, young children and infants in developing countries. As a public health concern, the effects of IDA are various and insidious, however the relationship between IDA and infant behaviour and development is not known. The majority of studies concerned with the impact of IDA in infancy have relied on global developmental scales, such as the Bayley Scales of Infant Development (Bayley, 1969, 1993). While infants with IDA consistently score worse than non-anaemic comparisons on mental and motor subscales, the value of this form of assessment is known to be limited. Apart from being of questionable validity as indices of abilities or functions (e.g., Fagan & Singer, 1983), the scores and ratings produced by traditional developmental scales are not designed to assess the specific functions hypothesised to be affected by IDA (Lozoff, De Andraca, Castillo, Smith, Walter & Pino, 2003). Over-reliance on this kind of measure thus rules out meaningful hypothesis-driven research. Recently, malnutrition researchers have begun to made use of systematic behavioural observation as a means of assessment. While a promising approach, extant research is limited to only two studies (see Footnote 6), and both of these have been conducted by the same research group. Moreover, these studies have relied on fairly rudimentary behavioural coding to examine a version of the ‘Functional Isolation Hypothesis', originally proposed some time ago in the infrahuman literature (Levitsky & Barns, 1972, 1973). More sophisticated hypotheses are available, especially given the ready availability of insights from developmental psychobiology and cognitive science. Design: A correlational design was used to examine the behaviour and development of 9-month old caregiver-infant dyads with a history of IDA. Setting: Wete District, Pemba Island, Zanzibar, Tanzania. Participants: 160 Caregiver-infant dyads assessed observationally at 9-month of age. Main Outcome Measure: Systematic observational coding. Main Findings: Infants with a history of more severe IDA spent significantly less time in high energy states during free play, and their caregivers made less physically demanding requests. A history of IDA also correlated with developmental disturbances in postural control. Affectively, IDA infants were hypo-responsive, and caregivers showed more (overt) positive affect for healthy males, but not females. Caregivers coordinated actions and vocalizations less often during interaction with infants affected by a history of IDA. Conclusion: A history of IDA among 9-month old infants is related to behavioural and developmental disturbances in both motor and socio-cognitive domains. Note to reader: The present research was first submitted as a Masters dissertation in 2008. The author was subsequently offered the opportunity rather to upgrade to a Doctoral thesis and resubmit the work as PhD. Chronologically then, studies which did not inform the design and development of the coding system used for data collection, or which published findings after the first submission of the present work, are discussed in the final chapter.
Behaviour, biology and the social condition of Cercopithecus Aethiops, the Vervet Monkey.
(1984) Tollman, Shirley G.; Lucas, John.; Krige, Penelope Disa.; Murray, C. O.
Biotelemetry has been coupled with an ethological approach to investigate a postulate that the physiological, behavioural, and social functioning of individuals coact in order to maintain homeostasis in an everchanging environment. Attention was focussed upon body temperature, behaviour, and the social situation, as they occurred together in each of five 'undisturbed' adult vervet monkeys. One male and one female were housed alone in single cages, and the other three, all females, were part of a natural troop that live together in captivity in a 6.5 metre radius geodesic dome. Intensive studies, including in-depth and multiple repeated measures at each level of functioning permitted comparisons between and within subjects, so that the connections between body temperature, and individual and social behaviour, could be scrutinised. Techniques for observation, data processing, and factor analysis have been considered, and procedures to facilitate the organisation and interpretation of information are suggested. The results pointed to individual variations superimposed upon a rhythmic underpinning of all the functions monitored. A synthesis of the data of body temperature with individual and social behaviour supports the contention that the individual responds to the vagaries of the environment as an integrated system within which the different levels of functioning are linked. It was found that the oscillation in body temperature was greater in the vervets that lived alone than in the vervets that lived in a troop. These results were supported behaviourally since the isolated subjects could only complement autonomic thermoregulatory responses with individually based behavioural strategies, whereas their troop-living conspecifics could utilise both individual and socially directed behavioural mechanisms. Within the troop an inverse relationship between body temperature variation and social status was revealed that is, the lower the status of the subject, the more the body temperature fluctuated around the mean. Behaviourally, it was found that the lower the status of the subject, the more difficult it became to gain access to resources, and to manipulate interpersonal space. In addition, harassment by troop conspecifics increased and, consequently, the efficiency with which behavioural patterns could be executed, was decreased. An analysis of the data also led to the proposal that social grooming has evolved as a thermoregulatory mechanism; to the identification of three different facets of individual behaviour and of social behaviour; and to the idea that the rhythmic changes in the troop's spatial conformation reflected cyclical patterns in behavioural and social activity.
‘Being romantic’, agency and the (re)production and (re)negotiation of traditional gender roles.
(2018) Human, Nicola Glen.; Quayle, Michael Frank.
Romance is a ubiquitous, Western cultural context which is constructed as an important tool for relationship success. However, research by gender scholars on romance as a site for gender enactment has been limited. Therefore, this study investigated the way that romance and romantic gendered identities may be produced or resisted, and investigated how ‘being romantic’ may produce affordances for particular gendered identities and limit others. This study took an ethnographic discursive approach and five middleclass, heterosexual South African couples were recruited to take part. Each participant was asked to plan a ‘romantic event’ for their partner and was interviewed multiple times in different contexts. A total of 25 interviews were conducted over eight months in 2013. The transcribed interviews were analysed using a discursive approach to investigate how romance, masculinity and femininity were constructed and performed. The study’s theoretical model viewed the romantic context as providing a range of situated affordances and discursive scripts for identity production, and explored how romantic masculinity and femininity were co-constructed as different but complementary gender identities. The findings suggested that romance was differentiated according to time, effort, and flexibility in deviating from the discursive scripts that govern it. Three forms of romance emerged, and the more rigid the discursive boundaries, the more romantic it was produced as being and thus as offering the best access to emotional intimacy. This emotional intimacy was positioned as being central to relationship maintenance, especially within the context of marriage. It was found that romantic masculinity was characterised by chivalry and the active orchestration of romance. In contrast, participants struggled to operationalise romantic femininity, especially in ways that allowed for active romancing of the man. Some romantic feminine agency was presented in resistance to this gendered norm, but appeared to need more justificatory work and more effort in its execution in comparison to that of the men participants. 6 By studying the co-production of masculinity and femininity as a product of the romantic context, a key finding has emerged. It has been argued elsewhere that women are responsible for the emotional housekeeping of their relationships, and this was evident in the data as well. However, this analysis argues that the narrow, rigid scope of the situational discursive scripts of grand dates limit the ways that women can take the initiative to enact them in meaningful ways. Thus, our modern understanding of romance places women in a dilemmatical position: they are expected to do relationship-maintenance, but the greater comparative effort and the stigmatising effect on both the active romantic woman and her partner means that women must rely on men to produce it. While it is possible to re-imagine romance, until we can collectively reduce this normative pressure, we will be strong-armed into re-enacting romance in ways that support patriarchal, old-fashioned gender identities.
Beyond belonging? White settler entitlement and the dynamics of nativeness, autochthony and nostalgia in South Africa.
(2022) Maseko, Sibusiso.; Durrheim, Kevin Locksley.
White settlers continue to impose themselves as owners of contemporary settler colonies (Veracini, 1999; Moreton-Robinson, 2015). Their imposition not only translates into making settler colonies their permanent homelands, but also engenders deep sense of entitlement to them (Veracini, 1999; Moreton-Robinson, 2015). Despite the transition from an era of outright colonial rule to modern-day liberal democracies, colonial based asymmetries of power between White settlers and Indigenous groups remain resolute. Commonly, these asymmetries of power present as race-based hierarchies that shape the political, social and economic landscape of these societies. Hence, White settlers’ entitlement claims to contemporary settler colonies are central to the continuing problem of racial inequality because they rationalise, maintain and even reproduce their enjoyment of historical privileges. While Indigenous groups, who are the victims of settler colonial conquest, continue to exist on the margins of these societies (Veracini, 1999; 2008; Moreton-Robinson, 2015). The social psychology of intergroup relations has hardly paid attention to how White settlers continue to exercise dominance over contemporary settler colonies by advancing entitlement claims. In this thesis, I attempt to address this gap in literature by examining how White nativeness, White settler autochthony beliefs and White settler nostalgia, reinforce race-based hierarchies. Mainly, I argue that White settlers’ enduring sense of entitlement to settler colonies reinforces race-based hierarchies through the construction of a White native status and the mobilisation of White settler autochthony beliefs and nostalgia. My primary aim in this thesis is to show how White settlers’ psychological entitlement to settler colonial territory, reinforces preference for race-based hierarchies. To do this, I first undertake a theoretical examination of how White settlers construct and assert nativeness to settler colonies. Second, I undertake an empirical examination that investigates how psychological expressions of entitlement to settler colonies, through White settler autochthony and White settler nostalgia reinforce race-based hierarchies. In my theoretical examination, I argue that White settlers have constructed themselves as de facto natives by mobilising settler mythologies. And their assertion of a de facto White native status enables the mobilising of White settler autochthony and White settler nostalgia. This is because autochthony beliefs are a powerful set of ethical and moral ideals that award rightful ownership of a territory based on first arrival and investment of time and labour. While collective nostalgia is a deep yearning for a place and time in the history of the group (Wildschut et al., 2014). Autochthony beliefs and collective nostalgia are psychological orientations are typically used by native groups express entitlement to territory. Hence, in my empirical examination, I argue that autochthony beliefs and collective nostalgia are expressions of psychological entitlement to territory that White settlers use to reinforce racebased hierarchies, because they help them justify racial asymmetries and reflect their assertion of a de facto White native status.
Black managers and their work colleagues in selected industrial organizations in Natal : a study of perception, attitudes and experiences.
(1985) Watts, Jane Catherine.; Murray, C. O.
South African black Managers are experiencing numerous problems as pioneers in the white-dominated managerial world. Management and research studies have usually concentrated on the black managers' behaviour. The present investigation attempts to redress this by examining their work-related experiences. Phase I examined the attitudes, perceptions and experiences of 34 black managers, and of selected work colleagues (a boss, peer and subordinate,if available) in regard to the black manager and black job advancement issues. In-depth, focused interviews were conducted. Fundamental interpersonal perceptual discrepancies emerged between the black managers and their work associates. The black managers tended to attribute their work problems and behaviour to external, situational factors By contrast their work colleagues often ascribed them to personal dispositions of the black manager. Euclidean distance analyses revealed that the largest interpersonal perceptual differences were between the black manager-boss dyads. This was followed by the black manager-peer dyads, boss-peer dyads and black manager-subordinate dyads. The black managers' perceptions diverged significantly from those of their white bosses, whose perceptions were closer to those of the white peers. Finally, analyses of incomplete sentences filled in by the black managers identified two types of subjects. Type I informants possessed more positive self-concepts than Type II individuals. Phase II: Since the black managers appeared to be experiencing considerable work stress, this was followed up using focused interviews. The conceptual work of stress used involved models of personal environment fit, and role episode. The major work stressors the black managers reported were role-related, followed by interpersonal stressors. Role conflict, generated by their marginal, middleman position between white management and the black Workers, was particularly stress-provoking. Although several black managers coped with stressful work conditions by direct problem-solving action, many resort to emotional defensive mechanisms. Discriminant analyses revealed that: black managers with large boss-black manager interpersonal perceptual disparities, were under more stress than those with small disparities; more work stress was reported by Type II than Type I informants, by middle management than junior management blacks, and by black line managers than black staff managers. The thesis concludes with recommendations of an applied nature.
Body image and antiretroviral therapy adherence among adolescents and young people living with HIV in Durban, South Africa.
(2021) Nyamaruze, Patrick.; Govender, Kaymarlin.
Background: The benefits of antiretroviral therapy (ART) for treating HIV among adolescents and young people living HIV (AYPLHIV) may be undermined by non-adherence to ART. Several reasons for non-adherence to ART have been reported among young people including internalised HIV-related stigma, body image concerns, and depression. Research into how AYPLHIV experience and make sense of feared or actual body changes is limited, yet these changes have emotional and psychological implications which may curtail adherence to ART. This doctoral thesis investigated the relationship between body image and various psychosocial factors; and explored the perceptions and feelings about body appearance among AYPLHIV in Durban, South Africa. Method: A cross sectional, convergent parallel mixed method approach was adopted in which quantitative and qualitative data were concurrently collected in the same phase of the research process using non-probability sampling. For the quantitative part of the study, a total of 76 AYPLHIV (15-24 years) were conveniently sampled. Qualitative data were obtained through a series of semi-structured in-depth interviews with a sub-set of 18 AYPLHIV who were purposively and conveniently recruited from the quantitative sample. Descriptive statistics, Pearson Product Moment correlations, and mediational analyses were used to analyse the quantitative data whereas thematic analysis was used for the qualitative data analysis. Results: The converging quantitative and qualitative results from this study provide evidence that body image is a significant issue among AYPLHIV and is differentially associated with various psychosocial factors. Self-esteem and adherence to ART were indirectly associated through a two-step path of internalised HIV-related stigma and then body appreciation. Findings from the qualitative analysis showed physical and psychosocial effects of living with HIV among young people including weight loss, body dissatisfaction and social withdrawal. Coping mechanisms such as social support networks and physical exercises were highlighted as important in counteracting the physical and psychosocial effects of negative body image and living with HIV. Conclusion: The findings from this study suggest that body image concerns are central to the health and well-being of AYPLHIV as they are related to several psychosocial challenges. The findings underscore the need for development of multi-pronged interventions to boost body image.
Building critical reflexivity through life story work.
(2018) Norton, Lynn Margaret.; Sliep, Yvonne.
This thesis investigates what happens when space is facilitated in a number of settings for the development of critical reflexivity through narrative practices and other related reflexive and dialogical methodology. In a broad sense the research examines the transformative effects of life story work and reflexivity, to track outcomes and the conditions under which they are enabled. Although there is much existing literature on reflexivity, recent research suggests that there is little consistency across educational strategies and among health professions generally. There is also a paucity of evidence-based guidance for educators, which, combined with a lack of clarity across the literature on a clearly defined conceptualisation of the term ‘reflexivity’ makes it difficult for newcomers to the field or educators across disciplines to put reflexive strategies into place. In addition there is little translation of how reflexivity, once obtained, can be translated into practice; and also in regard to its facilitation in a community context. The research aims to deconstruct ways to facilitate critical reflexivity in order to promote accessibility, transferability and evaluation. The ongoing impact of South Africa’s colonial and apartheid history has resulted in continued inequality and social divisions making it crucial for these challenges to be urgently and critically addressed. In terms of education we need to look beyond Eurocentric content knowledge and towards a critical reflection of our assumptions and long held beliefs in terms of our history, current local complexities, and future possibilities. This can be aided through the use of life stories to link new knowledge to lived experience, and to work towards building an African centred identity that embraces diversity while taking into account the rich indigenous knowledge systems that are part of this landscape. The research design is qualitative in nature and grounded in social constructionist principles applied within a narrative theory and dialogical approach. This fits well with a transformative agenda with a focus on social justice to guide the research in light of the South African context in which it is embedded. The study follows a phased and reflexive research process that explores critical reflexivity on three levels: the self in terms of personal and professional development; in education; and in community practice. The process begins with an autoethnographic study of the researcher’s experience of working with her life story and reflexivity, which is followed in the educational phase with a focus on tertiary education and tracks the experience of a number of students involved in an educational module that uses life stories to develop critical reflexivity in health promotion. In the final phase, the researcher applies this work in community practice with refugee youth from the Democratic Republic of the Congo, living in Durban, South Africa. A Critical Reflexive Model is used and developed as a conceptual framework throughout the research, and is examined in the final chapter as a theory of change that guides the development of reflexivity and is assessed for its value in taking this work forward in an accessible way. The results of the research show not only the transformative benefits of developing critical reflexivity through life story work in terms of self, relational, and contextual development but also the complexity of, and shortcomings in, evaluating a reflexive programme or intervention. Using the results of the data and the Critical Reflexive Model the researcher develops a comprehensive guide to evaluating such programmes and also to assess the benefits for participants, using Blooms Revised Taxonomy as an educational foundation to guide the process. The researcher concludes that the Critical Reflexive Model, together with the evaluation guide and life story methodology examined in this research, offers an accessible and beneficial ‘reflexive package’ or guide to educators or professionals wanting to develop critical reflexivity, whether as educators with students across disciplines as an important aspect of developing reflexive practitioners, or as part of their community practice.
Career development narratives and experiences of post-matriculants in a disadvantaged community: a study of Douglas in the Northern Cape.
(2022) Hoorn, Caroline.; Mkhize, Nhlanhla Jerome.
Post-matriculants in disadvantaged communities such as Douglas encounter a number of career challenges. The transition to the democratic dispensation in 1994, coupled with the rapid changes in the information domain that are characteristic of post-industrial life, complicate the career development trajectories of black youth in the rural areas in particular. Legally, South Africa has moved from an apartheid to a democratic system. Although this democratic system is approximately 27 years old, the legacy of apartheid runs deep and more so in rural settings. The career development stories and experiences of black rural youth in provinces such as the Northern Cape have not been told, leading to their marginalisation. It is against this background that the current study explored the career development narratives and experiences of post-matriculants in the Douglas community in the Northern Cape. Using a qualitative, narrative approach, the researcher elicited career development stories from 23 participants in Douglas using semi-structured interviews. The study revealed that the career development narratives and experiences extracted are those filled with a mixture of a few positive experiences but mainly those of frustration, stagnation, and loss of hope resulting from the uncontrollable external environmental conditions in Douglas. Key pillars like family, teachers, some people in the community, as well as non-governmental organisations, played a critical role in enabling post-matriculants to choose and pursue careers amidst constant frustration with social, environmental, and socio-economic factors that posed serious obstacles. Another key factor that the study showed was that gender did not have any influence on the career choices of the post-matriculants. The perceptions around career choices and gender were being challenged partly by the urge to affirm equality and the constant reminder of the poverty-stricken conditions prevalent in the households. However, the constraints experienced by the post-matriculants outweighed the enablers’ needed for consistent career development. In addition, the study concluded that while the systems of influence like individual, society and environmental-societal are critical in shaping individual career pathways, individuals are pushed by a strong sense of self-concept, and self-efficacy propelled by constant resilience to emerge with successful careers even amid existing deeply entrenched structural systems designed to disadvantage black people. Lastly, the study concluded that the development of self as individuals is not done in the absence of the community or society. The study revealed a lot of attachment to society that was expressed in the future plans of Douglas’ post-matriculants should they succeed in their career pursuits. Therefore, the importance of stakeholder roles and integration within the planned strategies towards the effectiveness of career development processes and approaches would alter the career development narratives and experiences of post-matriculants and would enable them to have successful career pathways and growth.
Career management complexities in a developing economy: an autoethnographic exposition of one inxile’s.
(2017) Gama-Chawana, Thabile.; Meyer-Weitz, Anna.; Mkhize, Nonhlanhla.
This reflexive study was conceptualised from the lens of a South African whereby as a developing economy political, educational and socioeconomic strangleholds persistently impinge on individuals’ career management processes. Eventual negative consequences impact on individuals’ career successes and the country’s economic success even after the demise of apartheid. The study benefited from a hindsight perspective that rationalised a perceived gap in dominant career theories that had limited capacity to model and explain lived-career experiences within a sociocultural environment like SA. The lived-career management experiences of the researcher as the subject and thus the inxile in the autoethnographic design within the qualitative research paradigm provided the framework to investigate the stated gap from a constructivist philosophical perspective. Four broad research questions guided the study from which it was derived 23 interview sub-questions and seven focus group sub-questions. A total of 13 participants were criterion sampled to engage in conversational interviews, 11 individually, and a combined five participants for one focus group session. They comprised three family members, three recent graduates, two peers, three self-proclaimed inxiles and two additional focus group members. All played a corroborative role on idiosyncratic yet persistent complexities that constrain career management imperatives, thus rendering the study as multi-voiced in its approach. It was rationalised in the study that: SA’s current policy document does not emphasise the pivotal role of individuals in taking ownership of personal career imperatives against argued complexities, also that career education was consistently poor and perpetuated disadvantage for the majority of black learners. Through the objectives of the study it was investigated the perceived gap towards indigenous knowledge development and to evaluate changes in the country as contextual to the poor education system. All stated objectives embedded intentions to derive elements from combined lived-career experiences from which career knowledge could be enriched while also deriving insightful input to enhance career education policy reformulation. The Systems Theory Framework provided philosophical and theoretical alignment for analysis towards culturally embedded interpretations and discussions whereby the study’s rationalisations were positively supported through fully achieved objectives.

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