Academic literature on the topic 'AIDS (Disease) – Government policy – Botswana'

Purpose – This paper aims to explore the experiences of international volunteer tourists, or voluntourists, to Botswana. Wildlife conservation, health education and orphanage voluntourists are examined specifically. Design/methodology/approach – Qualitative data were collected through interviews with tourists who had completed or were in the midst of volunteer experiences. Findings – Findings revealed that international voluntourism opportunities in Botswana are challenging to locate and leave volunteers questioning their impact. Some of the difficulties associated with voluntourism in Botswana included the need for volunteers to pay to participate, the concern regarding whether volunteers were depriving locals of employment opportunities, hesitation about the authenticity of the experience and the lack of community ownership. Practical implications – This paper will be beneficial to industry practitioners as it details the challenges associated with international voluntourism and provides suggestions for ways to attract volunteers, engage them in the process and ensure both the organization and tourist have a positive and useful experience. Originality/value – The increased interest in international voluntourism is a trend which is unlikely to decelerate in the coming years. This paper advances the knowledge on voluntourism operations in Botswana which may be valuable to tourists, students, academicians, government policymakers and industry practitioners alike.

This paper traces the development of policies dealing with HIV/AIDS in Botswana from their beginning in the late 1980s to the current programme to provide population-wide anti-retroviral therapy (ARV). Using a variety of source material, including long-term ethnographic research, it seeks to account for the failure of Western-inspired approaches in dealing with the pandemic. It does this by looking at the cultural and institutional features that have created resistance to the message and inhibited effective implementation. The negative response to the first educational campaign stressing condom use is described and contextualized in terms of Tswana ideas of morality and illness. Nor, as was initially expected, did the introduction of free ARV therapy operate to break the silence and stigma that had developed around the disease. Take-up was very slow, and did not operate to encourage widespread testing. In 2003, key policymakers in Botswana began to argue for a break with the AIDS ‘exceptionalism’ position, with its emphasis on voluntarism, confidentiality and the human rights of patients. This resulted in routine testing being introduced in 2004. This links to a major argument running through the paper which is that the failure of policy cannot be attributed solely to the nature of local populations. Western cultural assumptions about ‘good practice’ also require critical examination.

The AIDS epidemic in Nicaragua is several years behind that in the United States and neighboring countries of Central and South America. A combination of events, including the isolation caused by the war of the U.S.-backed Contra army against the Sandinista government, the complete economic embargo imposed on Nicaragua by the United States in 1985, self-sufficiency for blood products, and a low rate of recreational injectable-drug use, have contributed to this situation. Since the Sandinistas were defeated in the general election of 1990, people have returned to Nicaragua from areas where HIV is more prevalent, such as Honduras and the United States. It is probable that many HIV-infected persons have now entered the country. Because of the high rates of sexually transmitted diseases and cultural factors such as “machismo,” HIV is likely to spread rapidly by heterosexual transmission, unless effective, culturally appropriate education and sexually transmitted disease prevention programs are implemented now.

This article examines the role of NGOs in complementing government efforts towards the achievement of millennium development goal of combating HIV and AIDS by 2015. Documentary research, key informant interviews, in-depth interviews and focus group discussions were used to investigate the extent to which government and NGOs coordinate their functions to avoid duplication of functions in their areas of operation as well as examining the net effect of NGO involvement in HIV/AIDS programmes. Evidence from researches points tovisible Government commitment to the eradication of the disease as evidenced by the formulation of the National Aids policy and the formation of the parliamentary portfolio committee on health. NGOs have also played a pivotal role in HIV and AIDS programmes by implementing government policies both in urban and rural areas of Zimbabwe. Notwithstanding this, lack of coordination of functions between NGOs and government has derailed the national response as studies highlight concentration of HIV/AIDS programmes in some areas whilst other areas have no programmes at all. Government’s requirement that NGOs must submit their work plans has not been adhered to by NGOs leading to mutual suspicion between the two. NGOs should comply with government demands to avoid cancellation of their contracts and the government must create a conducive working environment for NGOs for the attainment of MDG six.

One of the diseases that is now considered a problem that has received enough attention from the government is HIV and AIDS. Talking about HIV and AIDS means it discusses health issues that are currently quite sensitive to talk about. This relates to the unique nature of this disease. Besides the case which is like an iceberg phenomenon, namely the spread of HIV and AIDS cases that cannot be predicted at the initial phase and also has not found a cure to cure it. The purpose of this study is to obtain in-depth data on the implementation of HIV/AIDS policies in the Model Health Center, whether the policies made by the government run well or not in the field. This research uses a qualitative research method with descriptive research type on June 28, 2019, by interviewing informants and distributing questionnaires. As for the total overall value of the Government Policy Implementation is 235. The value of the implementation of government policies, amounting to 78.33% of the 100% expected results. The overall total value of HIV and AIDS is 83. HIV/AIDS counts in the working area of the Exemplary Health Center, which is 92.22% of the 100% expected results. Conclusions policy implementation has been going well and has been socialized to the community and health services, people at risk and sufferers of HIV/AIDS in the work area of the Community Health Center already has its own organization where this organization is expected to help achieve the goals of this HIV/AIDS program, and to achieve this goal the Community Health Center conducts activities in the form of mobile clinics where the exemplary Community Health Center goes directly to conduct examinations to the community, and in terms of treatment for patients so far it can be said to be in good category and runs smoothly but there are obstacles where sufferers continue to do things that can trigger the development of the HIV virus although in addition patients continue to take drugs to inhibit and minimize the development of the HIV virus.

Introduction: The Ebola epidemic in West Africa sparked many ethical and polarizing public health questions on how to adequately control transmission of the virus. These deliberations had and will continue to influence patients, healthcare workers, public perceptions of disease, and governmental responses. Such extensive and potential ramifications warranted an analysis of prior epidemics to sufficiently inform policy makers and prepare them and other authorities for future epidemics. We analyzed how the general public, medical institutions, federal government, and patients themselves responded during the early stages of the AIDS pandemic in two different countries and cultures, the United States and India.Discussion: Our analysis identified four key findings pertaining to the human rights of patients and healthcare workers and to the crucial roles of the government and medical community. The first demands that authoritative officials acknowledge the presence of high-risk behaviors and properly educate the public without stigmatizing groups of individuals. For this task, the medical community and federal government must form and display to the public a respectful and collaborative partnership towards battling the epidemic. These two synergistic endeavors will then allow appropriate officials to implement effective, yet civil, interventions for limiting transmission. Finally, the same officials must ensure that their interventions maintain the human rights of high-risk populations and of healthcare workers.Conclusions: Applying these findings to future epidemics of infectious diseases can aid policy makers in navigating complicated ethical and public health questions, and help prevent them from repeating past mistakes in handling epidemics.

In 2003, the George W. Bush administration passed the President’s Emergency Plan for AIDS Relief (PEPFAR), a US government initiative to address the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) epidemic primarily in Africa. PEPFAR’s US$18 billion budget remains the largest commitment from any nation towards a single disease and has saved countless lives. Given the historical and current political resistance to foreign aid, PEPFAR’s drastic spike in spending on HIV/AIDS raises questions over how the policy process resulted in bipartisan support. Using two policy process theories, punctuated equilibrium theory (PET) and the Narrative Policy Framework (NPF), this analysis helps explain the framing of the global HIV/AIDS epidemic and the factors that resulted in the creation of PEPFAR. The analysis of the PEPFAR policy process reveals a ‘tipping point’ in the early 2000s, when political actors, the media and advocacy coalitions benefitted from issue framing, narrative change and measures of political attention to elevate the global HIV/AIDS crisis to the public agenda. The findings highlight an increase in presidential attention, the evolution of the HIV/AIDS narrative away from stigma and the formation of powerful coalitions. Looking back on the combination of policy process factors that led to PEPFAR’s bipartisan success might lead to insights for dismantling the grand public health challenges of the present and future. This study’s findings have implications for currently stigmatised public health crises, such as the opioid epidemic.

Globalization and its associated international migrations facilitate the spread of infectious diseases. This article reports trends in and discusses the relation between international migration and HIV infection in Japan. The authors analyze relevant literature, drawing on government and other sources. Among foreigners in Japan, there were 27.0 reported HIV and 9.3 reported AIDS cases per million in 1990, and 52.9 HIV and 38.8 AIDS cases per million in 2000. These rates were initially 45 to 90 times the population prevalence of HIV and AIDS among Japanese, but are now only 10 to 20 times the prevalence among Japanese, as HIV becomes an increasing problem for the Japanese population. HIV-infected foreigners who are uninsured are at a disadvantage for diagnosis, counseling, and treatment compared with insured persons, and at a significantly higher risk for low CD4 counts. For all sections of Japan's population, counseling and testing are inadequate, and surveillance of behavioral risk, infection, and disease is limited. International migrants are at increased risk for HIV transmission and at a disadvantage for care and treatment. Japan needs both to develop policies that assist migrants and to respond to the growing threat among its nonmigrant population.

Thousands of people are infected with HIV/AIDS in Nepal and most of them are adults of working age. Therefore, HIV/AIDS is a big burden in Nepal. This review was conducted to find the existing knowledge gap about the economic burden of HIV/AIDS at the household level in Nepal, the extent of economic burden exerted by the disease, and to provide policy recommendations. It is concluded that there was a considerable knowledge gap about the issue, and the economic burden exerted by HIV/AIDS was big enough to push the affected households into poverty. It is suggested that more studies need to be conducted to fill the knowledge gap. Similarly, Government of Nepal and other organisations working in the field of HIV/AIDS need to provide economic supports (e.g.- support for travel costs) to the HIV positive people and need to increase the awareness level among general population for reducing stigma and discrimination, and reducing economic burden on them.

Context Conflicts between wildlife and humans have occurred for millennia, and are major drivers of wildlife decline. To promote coexistence, Botswana established buffer zones called wildlife-management areas (WMAs) adjacent to National Parks and Reserves where communities assume stewardship of wildlife and derive financial benefits from it. In contrast, communities outside WMAs are generally excluded from these benefits despite incurring ‘coexistence costs’, including crop damage and livestock depredation, although they may receive compensation for these losses. Aims To investigate the perceptions and actions of a livestock farming community outside (but surrounded by) WMAs in northern Botswana, especially in relation to predator management. Methods We conducted standard-format interviews with 62 heads of households (cattleposts), and evaluated responses using descriptive and multivariate statistics. Key results Almost half (46%) of respondents expressed negative perceptions of predators, with 67% reporting losses to predation. After disease, predation was the most commonly reported source of livestock losses. Increased age of the head of household was the strongest predictor of reported predation. Few households employed husbandry beyond kraaling at night, but some (21%) reported conducting lethal control of predators. Reported use of lethal control was independent of the household experience with predation and whether they derived financial benefits from wildlife. Instead, households with larger herds were more likely to report using lethal control, despite the most educated farmers tending to have larger herds. Lethal control was almost twice as likely in households previously denied government compensation for losses (42%) than in those granted compensation (23%). Perhaps as a result of perceived failures of the government compensation scheme, most households (91%) supported the development of an independent insurance program, with 67% expressing willingness to pay a premium. Conclusions Our results challenge the assumption that deriving financial benefit from wildlife increases tolerance. A measurable disconnect also exists between the willingness of a household to employ lethal control and their experience with predation, suggesting that lethal control was used pre-emptively rather than reactively. Implications Efforts must be made to connect the financial costs incurred during farming alongside wildlife with the financial benefits derived from wildlife. Where compensation schemes exist, timely payments may reduce retaliatory killing.

Thesis (PhD)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: This study aims to understand the processes and factors that explain the framing of HIV and AIDS policy in Botswana, South Africa and Swaziland. Africa remains the global epicentre of the HIV and AIDS epidemic with Southern Africa remaining the most affected region in the world. The investigation centres on the HIV and AIDS policymaking discourses and dynamics leading to the securitisation of the epidemic in the three countries. The central focus of the study covers the timeframe of the leadership of President Mogae in Botswana, President Mbeki in South Africa and King Mswati III in Swaziland. This period is important as it characterises the HIV and AIDS epidemic being elevated onto the political agenda of the respective countries. This dissertation relies on two strands of theoretical literature namely, public policy theory and securitisation theory to help explain the framing of policy decision-making that leads to the process of securitisation of the HIV and AIDS epidemic in the three countries. This study is a multiple case study within the qualitative research paradigm. This research is based on three case studies: Botswana, South Africa and Swaziland. As far as data collection is concerned, this study drew on primary sources of data, which consisted of documents obtained during the fieldwork from various stakeholders such as such as official government documents, as well as official documents from international and domestic HIV and AIDS organisations. Twenty semi-structured interviews were also conducted between 2007 and 2008 with various stakeholders including government officials, representatives of domestic and international HIV and AIDS organisations operating in the respective countries, researchers from think tanks and academics. In addition, eleven exploratory interviews were also conducted as part of the fieldwork process. Furthermore this study also relied on various secondary sources of data such as scholarly articles and books, official documents and legislation and newspaper articles. The preliminary results collected and analysed in this study suggest that Botswana, South Africa and Swaziland have all demonstrated a degree of formal commitment to adopting international guidelines to combat the epidemic. The thesis shows that while all three countries may share the burden of the epidemic, each presents a different political, social and cultural identity with different institutional architects (both foreign and domestic) that determined the nature of the response policy to the epidemic. The study shows that each of the three case studies presents an example of differing degrees of securitisation attempts: i) Botswana - successful securitisation; ii) South Africa - unsuccessful securitisation; and iii) Swaziland - partial securitisation because different actors and audiences are positioned at varying points along a spectrum of securitisation. This degree of securitisation can be linked to the acceptance of international ideas and the prevailing global discourse regarding the HIV and AIDS epidemic and the openness to forming collaborative agreements between state and non-state actors in each of the three countries.
AFRIKAANSE OPSOMMING: Hierdie studie poog om ’n begrip te ontwikkel van die prosesse en faktore wat verklaar hoe beleid rondom MIV en VIGS in Botswana, Suid-Afrika en Swaziland geraam word. Die Afrikavasteland is nog steeds die wêreld se MIV en VIGS-episentrum en die Suider-Afrika-streek loop die mees gebuk onder die epidemie. Die ontleding sentreer op die MIV en VIGS beleidsdiskoerse en die dinamieke wat aanleiding gee tot die beveiliging van die epidemie in die drie lande. Die kollig val op die tyd toe President Mogae van Botswana, President Mbeki van Suid-Afrika en Koning Mswati III van Swaziland aan bewind was. Hierdie periode is van belang omdat dit die tyd was toe MIV en VIGS op die drie lande se politieke agendas geplaas is. Die proefskrif gebruik literatuur uit twee teoretiese velde, naamlik openbare beleidsteorie en sekuriteitsteorie, om te verklaar hoe daar op bepaalde beleide besluit word, hoe dit geraam word, en die proses waarvolgens MIV en VIGS gevolglik in die drie lande beveilig word. Die studie is ’n meervuldige gevallestudie binne die kwalitatiewe navorsingsparadigma. Die navorsing is op drie gevallestudies gebaseer, te wete Botswana, Suid-Afrika en Swaziland. Ten opsigte van data-insameling, het die studie van primêre databronne gebruik gemaak bestaande uit bewysstukke wat van verskeie belangegroepe verkry is. Hierdie stukke beslaan amptelike regeringsdokumente en amptelike dokumentasie van internasionale sowel as nasionale MIV en VIGS-organisasies. Daar is ook met verskeie belangegroepe onderhoude gevoer. Die belangegroepe het bestaan uit regeringsamptenare, die verteenwoordigers van nasionale en internasionale MIV en VIGS-organisasies betrokke in die drie lande, akademici, en kundiges by navorsingsinstansies. Twintig semi-gestruktureerde onderhoude is in 2007 en 2008 gevoer. Boonop is daar as deel van die empiriese navorsing 11 verkenningsonderhoude gevoer. Die studie het ook van verskeie sekondêre databronne soos vakwetenskaplike artikels en boeke, amptelike dokumentasie, wetaktes en koerantartikels gebruik gemaak. Die voorlopige bevindinge dui dat Botswana, Suid-Afrika en Swaziland elkeen hulself tot ’n mate formeel tot internasionale riglyne verbind het om die epidemie te beveg. Die proefskrif bewys dat ofskoon al drie lande swaar aan die las van die epidemie dra, daar by elkeen verskillende politieke, maatskaplike en kulturele identiteite, asook institusionele argitekte (plaaslik sowel as buitelands) bestaan wat die aard van die beleidsrespons bepaal het. Die studie dui verskillende grade van beveiliging by elkeen van die gevallestudies: i) Botswana – suksesvolle beveiliging; ii) Suid-Afrika – onsuksesvolle beveiliging; en iii) Swaziland – gedeeltelike beveiliging. Hierdie grade van beveiliging kan verklaar word aan die hand van die mate waartoe daar by elkeen van die lande aanvaarding was van internasionale denke en diskoers oor die MIV en VIGS-epidemie en of samewerking tussen staats- en nie-staatsakteurs bewerkstellig is.

Despite the profound impacts of HIV and AIDS on all sectors of South African society, governmental responses to the AIDS epidemic have been inundated with contradiction, conflict and contestation. Though governmental leaders have justified not funding HIV treatment programs because they believe that poverty needs to be dealt with first, social spending has been slashed as part of an adherence to a neo-liberal economic model. Though it would seem that the government would seem to have everything to gain by establishing a cooperative relationship with non-governmental actors regarding the epidemic, the relationship between the government and non-governmental actors has instead been described as nothing short of hostile. Though the government enthusiastically backed Virodene, a supposed treatment for AIDS that turned out to be no more than an industrial solvent, other ‘scientifically backed’ AIDS treatments have been treated with caution and skepticism – to the point where the government even refused to provide funding for programs to prevent mother to child transmission of the virus. And perhaps the most perplexing is that although widely respected for his intellect and cool demeanor, former President Mbeki chose to risk his political career on the AIDS issue by shunning away from the mainstream consensus on the biomedical causes of the epidemic and instead surrounded himself and sought advice from AIDS ‘dissidents’ This thesis will seek explanations for these apparent contradictions. Using Bourdieu’s (1986) typology of capitals, it will build on an argument put forward by Helen Schneider (2002): from the South African government’s perspective, the contestation regarding HIV and AIDS policy and implementation is over symbolic capital, or the right to legitimately hold and exercise political power regarding the epidemic. Though this argument helps explain the conflictual relationship between the government and non-governmental actors regarding the AIDS crisis, in order to understand the perplexing contradictions within the governmental policy response, the political context of policy formation must first be taken into consideration.

The HIV/AIDS pandemic poses the greatest threat to Africa's efforts to achieve its full potential in the social, economical and political spheres. Cognizant of its devastating consequences, various mechanisms have been designed to address the issue of HIV/AIDS in Africa. This thesis addressed the question: 'Are the legislations and policies of Ethiopia, Botswana and Uganda providing for various modalities of HIV testing consistent with human rights as enshrined under African Human Rights system?' The author of this dissertation critically analyzed the African human rights instruments and the relevant domestic legislation and policies of the three countries.

This study was concerned with the social construction of HIV/AIDS at the policy level in contemporary South Africa, and how such constructions shape the manner in which the epidemic is understood in popular discourse.

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Bachelors
Arts and Sciences
Political Science

HIV/AIDS is a deadly disease that needs to be addressed with immediate effect before serious damage can occur. Because the government has a responsibility over the health of its citizens, everybody expects the government to take a lead in the fight against this epidemic and from the look of things the government's strategies are not making the desired impact on the epidemic. The author attempted to highlight that the South African government has not played a satisfactory role in the fight against this pandemic, which threatens to alter history to a degree not seen in the world.

Thesis (MPA)--University of Stellenbosch, 2003.
ENGLISH ABSTRACT: The implementation of national policies is a key function of government through its various departments. This is very crucial in the health sector where lives of individuals are involved. The implementation of the national HIV/AIDS policy is very important in dealing with the epidemic. This study combined both quantitative and qualitative methods to analyse the implementation of the South African government’s national HIV/AIDS policy in the Vhembe District of the Limpopo Province. The quantitative phase involved the stratified sampling process, resulting in identifying 2 health workers from each of the 25 health units in the district comprising of 22 community clinics, the infection control unit, the counselling unit at the hospital and 2 from among the doctors. A total of fifty respondents were selected from a workforce of about 500. The staff profile indicates that 76 % of the health workers interviewed were below 40 years of age and 28% of them were chief professional nurses. Of the health workers, 78 % had been in the current position for between 1 and 5 years, 6 % for 6 to 10 years, 6 % for 16 or more years and 10 % for less than one year. All of them had a diploma as a minimum qualification, 8 % had 2 diplomas, 2 % had 3 or more diplomas, 2% had degrees and 2 % had a degree plus diplomas. In terms of HIV/AIDS policy implementation, 100% of all the facilities provided HIV prevention information to clients, 60% of these facilities worked with other organisations in HIV prevention, but only 4% had voluntary counselling and testing (VCT) services. In these health units only 28% had had staff trained regarding HIV/AIDS issues. In addition 96 % of the health units had the male condom stocked at any one time and only 12 % stocked the female condom. In terms of sexually transmitted diseases (STD) control, all clinics were using the syndromic approach in management of STDs and also claimed to have youth-friendly services. On the other hand only 80 % of the facilities had had staff trained in STD management using the syndromic approach. In the area of prevention of mother-to-child transmission of HIV, (PMTCT) none of the clinics had VCT services for pregnant women and only 8% of them had PMTCT counsellors. Because of the lack of VCT services only 4% of the clinics had known HIV positive mothers attending the antenatal care services. On the issue of post-exposure prophylaxis (P.E.P.) all clinics had protocols for this and 88% of them had antiretroviral drugs (ARVs) stocked for post-exposure treatment for health workers. However, only 8% of these clinics had a betadine douche as the only post-exposure intervention for raped women. In the area of treatment care and support for patients none of these clinics offered ARVs, 24 % had protocols for prevention and management of opportunistic infections, 4% were involved in any form of home-based care, 4% had HIV/AIDS dedicated services and 24% collaborated with community non-governmental organisations (NGOs) in HIV/AIDS care. The qualitative phase of the study highlighted what health workers perceived as prominent features of the national HIV/AIDS policy and these included prevention of HIV by use of condoms, faithfulness and pre-test counselling. The respondents also interpreted the social response by government to include provision of home-based care, care of orphans, food provision and safe guarding rights of victims. Other issues that were perceived to be part of the national HIV/AIDS policy were STD management, health education, provision of training to health workers in HIV/AIDS issues, provision of home-based care and occupational health and safety for health workers. The government was also perceived to have a negative attitude towards AIDS NGOs, not providing adequate numbers of the female condom and denying patients antiretroviral drugs (ARVs). The recommendations made on the basis of the study therefore include strengthening the training of health workers in HIV/AIDS care and management, improved provision of VCT services, wider distribution of the female condom, provision of prevention of mother-to-child transmission of HIV (PMTCT) services and the linking of research and care to provide evidence-based practice. Other recommendations are that there should be support programmes for health workers with HIV, addressing gender issues in implementation and provision of ARVs especially where it is already known that they help.
AFRIKAANSE OPSOMMING: Die implementering van nasionale beleid is ‘n sleutelfunksie van die regering, verrig deur sy onderskeie departemente. Dit is veral deurslaggewend in die gesondheidsektor waar die lewens van individue op die spel is en die implementering van die nasionale MIV/VIGS- beleid is baie belangrik in die hantering van die epidemie. In hierdie studie is beide kwalitatiewe en kwantitatiewe metodes gekombineer om implementering van die Suid-Afrikaanse regering se nasionale MIV/VIGS -beleid in die Vhembe-distrik van die Limpopo-provinsie te analiseer. Die kwantitatiewe fase het ‘n gestratifiseerde steekproefproses behels, wat gelei het tot die identifisering van 2 gesondheidswerkers uit elk van die 25 gesondheidseenhede in die distrik, bestaande uit 22 gemeenskapsklinieke, die infeksie-beheereenheid, die beradingseenheid by die hospitaal en die geledere van die dokters. So is ‘n totaal van 50 respondente geselekteer uit ‘n arbeidmag van ongeveer 500. Die personeelprofiel dui aan dat 76% van die gesondheidswerkers wat ondervra is jonger as 40 jaar was en dat 28% van hulle hoof professionele verpleegsters was. Van die gesondheidswerkers was 78% vir 1 tot 5 jaar in hul bestaande posisie , 6% vir 6 tot 10 jaar, 6% vir 16 of meer jare en 10% vir minder as 1 jaar. Almal van hulle het ‘n diploma as ‘n minimum kwalifikasie gehad, 8% het 2 diplomas, 2% het 3 of meer diplomas, 2% het grade en 2% het ‘n graad plus diplomas gehad. In terme van die MIV/VIGS beleidsimplementering het 100% van die fasiliteite MIV- voorkomingsinligting aan kliënte verskaf, 60% van hierdie fasiliteite in samewerking met ander organisasies , terwyl slegs 4% vrywillige berading en toetsdienste verskaf het. Slegs 28% van die gesondheidseenhede het oor personeel beskik met opleiding in MIV/VIGSkwessies. Verder het 96% van die gesondheidseenhede die manlike kondoom in voorraad gehad teenoor slegs 12% eenhede die vroulike kondoom. In terme van die seksueel-oordraagbare siektebeheer, het al die klinieke die sindroom-benadering in die bestuur van seksueel- oordraagbare siektes toegepas en het beweer dat hulle dienste jeugvriendelik is. Daarteenoor het slegs 80% van die fasiliteite beskik oor personeel wat opgelei was in seksueel- oordraagbare siektebestuur met toepassing van die sindroombenadering. Op die terrein van voorkoming van moeder- na- kind- oordraging van HIV het geen van die klinieke oor vrywillige berading en toetsdienste vir swanger vroue beskik nie en slegs 8% van hulle het wel moeder-na-kind– oordragingsberaders gehad. As gevolg van die gebrek aan vrywillige berading en toetsdienste het slegs 4% van die klinieke kennis gedra van HIV- positiewe moeders wat voorgeboortelike sorgdienste bygewoon het. Wat na-blootstellingsvoorbehoeding aanbetref, het alle klinieke protokolle gehad en 88% het antiretrovirale medisyne in voorraad gehad vir nablootstellingsbehandeling van gesondheidswerkers. Slegs 8% van hierdie klinieke het egter ‘n betadine-spoeling(“douche”) as die enigste nablootstelling intervensie vir verkragte vroue gehad. Op die gebied van die behandeling van en ondersteuning aan pasiënte het geen van hierdie klinieke die antiretrovirale medisyne aangebied nie, 24% het protokolle vir die voorkoming en bestuur van geleentheidsinfeksies gehad, 4% was betrokke in enige vorm van tuisgebaseerde sorg, 4% het oor MIV/VIGS -gerigte dienste beskik en 24% het met gemeenskapsvrywilligerorganisasies saamgewerk in die voorsiening van MIV/VIGS-sorg. Die kwalitatiewe fase van die studie fokus op wat gesondheidswerkers beskou as prominente kenmerke van die nasionale MIV/VIGS- beleid en wat insluit die voorkoming van HIV deur die gebruik van kondome, getrouheid en voortoets- berading. Die respondente vertolk die regering se sosiale reaksie as insluitend die verskaffing van tuisgebaseerde sorg, die versorging van weeskinders, voedselvoorsiening en die beveiliging van slagoffers se regte. Ander kwessies wat ook gesien word as deel van die nasionale MIV/VIGS beleid is seksueel- oordraagbare siektebeheer, gesondheidopvoeding, die verskaffing van opleiding aan gesondheidswerkers in MIV/VIGS-probleme, die voorsiening van tuisgebaseerde sorg en beroepsgesondheid en veiligheid vir gesondheids werkers. Die regering se houding teenoor VIGS vrywilligerorganisasies is ook as negatief vertolk deur onvoldoende hoeveelhede van die vroulike kondoom te verskaf en antiretrovirale medisyne te weerhou van pasiënte. Die aanbevelings wat op grond van die studie gemaak is, sluit in die verbeterde opleiding van gesonheidswerkers in MIV/VIGS-sorg en -bestuur, verbeterde verskaffing van vrywillige berading en toetsdienste, wyer verspreiding van die vroulike kondoom, verskaffing van MIV-dienste vir die voorkoming van moeder-na-kind-oordraging en die konnektering van navorsing en sorg om ‘n inligtingsbaseerde praktyk te skep. Ander aanbevelings is dat daar ondersteuningsprogramme vir gesondheidswerkers met MIV behoort te wees wat geslagskwessies aanspreek in die implementering en verskaffing van antiretrovirale medisyne waar dit reeds bekend is dat dit wel help.

The aim of this research was to provide a preliminary investigation of how the HIV and AIDS epidemic will impact on management of municipalities, specifically George Municipality. Municipalities provide a large proportion of essential basic services and also represent one of the primary opportunities for public participation and decision-making at a community level. This paper takes George Municipality in the Western Cape as a case study of the current and potential impact of HIV and AIDS on public demand for services and on the municipality's capacity to govern and provide services. It also reviews the responses of the municipality to HIV and AIDS.The research was conducted using a questionnaire which was distributed to municipal officials in the different departments but also included a review of relevant literature and analysis of quantitative data. The study focused on a single case: An investigation into the impact of HIV and AIDS on municipal management of George Municipality. The study identified strategies utilised by the municipality to reduce the impact of HIV and AIDS. The study drew on people's experiences, perceptions and interpretations of the impact of HIV and AIDS on municipal management, responses and any other related factors that may have impeded the realisation of the reduction of the impact of HIV and AIDS on municipal management in the George Municipality.Fifty questionnaires were distributed, 40 copies by hand delivery and ten copies via e-mail to employees ranging from general worker to senior management. Employees participated in the study through interviews and answering of the questionnaires. An internet search was also conducted using Wed Crawler and by visiting the official website of the George Municipality for all policies, minutes, reports and all other relevant documents regarding HIV and AIDS. The researcher also drew on personal observations because she has been in George for almost six years and is also employed by George Municipality. Participants who were selected by the researcher for interviews purposes were five councillors and five ward committee members because councillors are decision makers in the municipality. The rest were given questionnaires to complete. Data was analysed by using interpretation analysis, namely codes to explain data collected. Results were presented in the form of tables and conclusions warranted by the data are presented. Statistical analysis was done to check correlation between the different aspects in the questionnaire. According to the research findings it can be confirmed that more of the budget needs to be allocated for employment of suitably qualified persons like occupational nurses, who will drive HIV and AIDS education and awareness campaigns. HIV and AIDS mainstreaming should be regarded as a priority in order make people aware about the realities of HIV and AIDS in communities. Leadership and management buy-in should be obtained to win the fight against the epidemic. A comprehensive strategy should be compiled and implemented to reduce the spread and stigma of HIV and AIDS. Proper planning should be done for compiling the strategy. This strategy should specify the budget for HIV and AIDS and how HIV and AIDS is going to be integrated into an IDP. Prevention and management strategies used by the organisation should be explained.

Although South Africa has the largest AIDS treatment program in the world, the ANC’s mishandling of the epidemic post-apartheid nevertheless contributed significantly to the spread of the disease. Unlike in Thailand or Brazil – where in many instances professional movements partnered with the state to respond to citizen needs and expand access to antiretroviral therapy – legal movements in South Africa however confronted a remarkably different dynamic: an intransigent government that, by virtue of unrivaled electoral majority, enjoyed the luxury of entertaining dissident AIDS science and experimenting with charlatan AIDS policy. While the strategic actions of the AIDS Law Project and the Treatment Action Campaign would eventually compel government action, initial government intransigence and the long and drawn-out nature of the legal process would prove to have horrific consequences, measured in hundreds of thousands of lost lives.