Dissertations / Theses on the topic 'AIDS (Disease) – Swaziland'

Thesis (MTh)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: This thesis critically analyses the appropriateness and effectiveness of the ABC model in the HIV/AIDS prevention within the context of Swaziland. According to Louw (2008:423), the ABC model stands for the following: A = Abstinence, B = Be faithful and C = use Condoms. According to Green and Herling (2007:1) the ABC model has gained the attention of many countries. The attempt of this model in HIV prevention was to “aim at empowering people through value-based programs to basically abstain from sex as long as possible, to be faithful to one intimate partner and to use condoms correctly and consistently” (De la Porte 2006:79). The assessment of the HIV/AIDS virus in 1983-1984 came as a shock. It was difficult for the church to know at that time how to respond. Some of the responses pointed to the virus as punishment of God. Gradually the church started to become involved in the pandemic. From a Christian spirituality perspective it was argued that the so called ABC model could be viewed as a means of remedy within a prevention approach. The cultural issues as well as human sexuality factors have been discovered to be an obstacle in the ABC model in playing a progressive role in Swaziland. The cultural factors that prevent the ABC model from accomplishing effective results are listed in the final report of (Whiteside et al. 2006: 18-19): bunganwa (having multiple sexual partners; a cultural practice of male married and unmarried to have many girlfriends); kungenwa (levirate or wife inheritance); a widow is given in marriage to marry the brother of her deceased husband without the consent of the women which exposes women to the HIV virus. This practice is done without the consent of the women. Kujuma (occasional overnight visits between unmarried lovers); kuhlanta (a young girl bearing the children of her infertile sister); kushenda (extramarital relationships); kulamuta (a man having a sexual relationship with a younger sister of his wife); and sitsembu (polygamy, one man with more than one wife); this is a common cultural practice found in many African countries due to gender inequality (Chitando 2009:26). This has led to Swaziland being seriously affected by the HIV/AIDS virus (Rupiya 2006:66). The high rate of infection is frightening in a small country with a population of 1 million. As Bishop M, Mabuza, the Anglican bishop indicated, the nation‟s existence is threatened. (Rosenow 2011: 32). Therefore the researcher proposed a pastoral model which gives dignity to human and adds the spiritual dimension of healing in the pastoral care and counselling. There is an urgent need for church leaders to be empowered to face the HIV/AIDS with knowledge that the pandemic is not a punishment for promiscuous people. The theology of sexuality emphasises the responsibility in every sexual engagement for people to be conscious to whatever decision they take.
AFRIKAANSE OPSOMMING: In hierdie navorsing word die toepaslikheid en effektiwiteit van die ABC model in die voorkoming van MIV/Vigs binne die konteks van Swaziland krities ontleed. Volgens Louw (2008:423) staan ABC (in Engels) vir: A = Onthouding, B = Getrouheid aan een maat en C = Die gebruik van kondome. Die navorser, ‟n geordende predikant van die Evangeliese Lutherse Kerk, bespreek die erns van die voorkoms van die MIV/Vigs-infeksie in Swaziland. Empiries is bewys dat Swaziland een van die lande in Sub-Sahara en die wêreld is met die hoogste infeksiekoers (Rupiya 2006:66). Dit is ernstig in ‟n klein landjie soos Swaziland met ‟n bevolking van slegs 1 129 000. Die pandemie het ‟n impak op alle gemeenskappe in die land en bied‟n groot uitdaging vir die Kerk in Swaziland. Die vraag is hoe die Kerk, in haar pastorale bediening, die ABC model kan gebruik om die globale poging te steun om te verhoed dat MIV/Vigs versprei. Hoe kan die konsep van die ABC model toegepas word sodat die Kerk, as hulpgewende gemeenskap, kan sorg vir die siele van die gemeentelede (cura animarum) en effektief inligting omtrent die ABC model kan versprei en uitreik na MIV-positiewe mense? Die navorser stel voor dat daar verandering moet kom in die gesindheid van die Kerk en dat daar ‟n herkonseptualisasie van die voorkomingstrategie en die Skrifverklaring van menslike seksualiteit moet wees. Die Kerke in Swaziland moet hulle houding verander. Daar moet baie meer openlikheid wees sodat sosio-kulturele kwessies openlik bespreek kan word. Daar moet ‟n kritiese herbepaling wees van die tradisies en die kerkbeleid rondom menslike seksualiteit en hoe dit betrekking het op die MIV/Vigs-pandemie.

This research focuses on vulnerable children in Swaziland, the country with the highest level of adult HIV prevalence in the world, where nearly 25 percent of children will be orphaned by 2010. It investigates the experiences of relatively poor urban children growing up in the epidemic and the coping strategies the children and their adult carers adopt. Through the lens of both children and adult carers, it explores the ways sexual knowledge is gained and used by older children in the context of HIV/AIDS as well as the experience of coping with widespread bereavement. In this way, it adds to the literature on childhoods in the 'South' and the increasing recognition of the heterogeneity of children's lived experiences. Rather than being seen as passive, the agency of both vulnerable children and their adult carers emerges as they seek to improve their livelihoods. The way this agency connects with government, NGO and community structures is revealed by showing the opportunities for and constraints on gaining access to education and health-care. The interwoven roles of government, international donors, NGOs and civil society is explored by assessing the relative merits of supporting vulnerable children by either welfare assistance to poor families or new forms of 'community' care structures or institutionalised residential care. The critical importance of relationships and power relations between key actors in different organisations and the effect this has on implementation of interventions for children is discussed as well as the relevance of these findings to vulnerable children in other settings.

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.

The aim of this study was to describe the knowledge and attitudes of college students of the Manzini Nazarene Teacher Training College with regard to HIV/AIDS. The aim was to identify risky sexual practices of the college students as well, which may require redress in order to enhance their effectiveness in combating the spread of HIV.

Swaziland is one of the countries most affected by HN and AIDS on the entire globe. The impact of the pandemic on the country is enormous with a prevalence of 42.6%. This has been so far the highest in Africa and possibly in the whole world. Due to this unbearable situation, a number of organizations, Church bodies, government and some individuals in the country are trying hard to counter the pandemic. This dissertation therefore seeks to outline the HIV epidemic in Swaziland and understand particularly the response of the Methodist Church to the epidemic. In dealing with the problem, the Methodist Church of Swaziland is using the Methodist Church of Southern Africa's (MCSA) HIV and AIDS policy document. In evaluating the MCSA HN and AIDS policy document, the thesis seeks to investigate the impact of the MCSA's response to HIV and AIDS. It also seeks to reflect theologically on the content of the policy document of the MCSA and to identify the strengths and weaknesses of the document and to establish whether it is relevant to the Swaziland context or not. In general the thesis looks at the HIV and AIDS situation in Swaziland, the Shalom concept as well-being, the document summary and also presents a critical analysis in which it discovers that there are good things in the policy document. However due to the theological gaps in the document, there is need for a solid theological foundation for it to be used as a necessary tool or a sine qua non instrument. Conclusively, to strengthen the policy document the thesis recommends a number of things which include also a more solid theological base.
Thesis (M.Th.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.

Theses (MPH.) -- University of Limpopo, 2017
INTRODUCTION: Since the introduction of Anti-retroviral therapy, People Living With HIV/AIDS (PLWHA) now live longer and present with various opportunistic neuro-musculoskeletal and cardio-pulmonary conditions among other complications. This has led to a surge in the number of patients that visit the physiotherapy department presenting with many complications which include mobility problems, neurological deficits, muscle weakness and developmental delay in children among others as experienced by the researcher in the work place. AIM: To determine the knowledge of physiotherapists with regard to HIV/AIDS and their attitude towards HIV/AIDS patients in the Kingdom of Swaziland. METHOD: In this study a quantitative, descriptive cross-sectional survey was used to determine the knowledge and attitudes of Physiotherapists in the management of HIV/AIDS in the Kingdom of Swaziland. RESULTS: The results of the study revealed that physiotherapists in the Kingdom of Swaziland have a good knowledge and a positive attitude towards people living with HIV/AIDS. Amongst other attributes that were looked at in the study it was reported that 100% of the participants were knowledgeable on the complications associated with HIV/AIDS and 94% of the physiotherapists reported that they are familiar with complications that will benefit from physiotherapy. On the attributes related to attitude of physiotherapist towards HIV/AIDS patients the study found that 100% of the physiotherapists reported that they would take precautions and continue seeing the patients. There was no statistical significant relationship between years of experience and attitude (Pearson chi-square =0.25, p-value =0.61), familiarity with commonly used ARVS (Pearson chi square =1.13, p-value =0.76) and familiarity with Universal Precautions (Pearson chi-square =2.55, p-value =0.46).There was no statistically significant relationship between knowledge and attitude (Pearson chi square =1.000, p-value =0.61). CONCLUSION: The study revealed that the physiotherapists have good knowledge on HIV/AIDS and they also have positive attitude towards managing People Living with HIV/AIDS at their respective departments. There is need for the physiotherapy training schools to include HIV/AIDS in their curricula since some of the schools of physiotherapy where the participants trained did not include it during their time of training and the practising physiotherapists need continuing health education on HIV/AIDS. There is a need for the work setting libraries where physiotherapists work to have current books and journals for the physiotherapists to update themselves on issues pertaining to HIV/AIDS and internet access in the departments. The physiotherapists are also encouraged to take the initiative to utilise the libraries in their work settings and get information on HIV/AIDS. Keywords: Knowledge; attitudes; Physiotherapists; HIV/AIDS; Patients

This study was done to assess the quality of life (QOL) of people living with HIV and AIDS (PLWHA) in Swaziland who are on antiretroviral therapy (ART). No study has been done on QOL of PLWHA in Swaziland who are on ART since it started to be administered in Swaziland in 2001. A qualitative, exploratory, descriptive, and contextual design was used to assess QOL of PLWHA in Swaziland who are on ART. Twenty-four PLWHA were purposely selected to participate in the study. Methods of data collection used were semi-structured individual in-depth interviews, focus group discussions, and observations. The data (tape-recorded interviews and discussions, and field notes) were transcribed verbatim for data analysis. Data analysed was done using Tesch’s framework of data analysis as described in Creswell (2002:256-283). The research findings are reflected, with the six domains of QOL identified through a literature review and validated by nurses’ expertise. These domains are the physiological, psychological, spiritual, socio-economic, cognitive, and environmental domains.The study revealed that PLWHA in Swaziland are faced with many challenges concerning ART, namely: inability to meet their nutrition needs, non-adherence to ART, experience of disfiguring side effects of ARVs, inconsistent condom use, experience of stigma and discrimination, depression, difficulty in accepting and coping with ARVs, lowered self-esteem, a negative influence of some religions on ART, a lack of financial support, poor support systems, poor understanding of ARVs, negative thoughts about HIV and AIDS and ART, an unsatisfactory health care delivery system, a negative influence of culture on ART, and violation of the rights of PLWHA. These challenges negatively influence the QOL of PLWHA and hence the study concluded that PLWHA in Swaziland who are on ART have a poor QOL. Conclusions drawn from the data analysis reveal that PLWHA in Swaziland are powerless to deal with the above challenges and improve their QOL. The researcher, therefore, developed guidelines to empower PLWHA to deal with these challenges and adhere to ART, thus improving their QOL. Recommendations were made with regard to nursing practice, nursing education, and further nursing research.
Health Studies
D. Litt. et Phil. (Health Studies)

A qualitative study following a phenomenological approach was undertaken to explore voluntary counselling and testing nurses' perception of educating HIV+ people about ARVs. Non-probability convenience sampling was used and in-depth semi-structured face-to-face interviews were conducted to collect data from 12 participants. The most important results were:  The need for extensive education on ARVs since it is a new technology used to curb the infection therefore clients need the information in order to use them effectively.  Stumbling blocks encountered when educating HIV+ people about the drugs. The problems are mainly due to the nurses lack of current knowledge about the drugs; patients' low economic status; severe side effects; difficulties in behaviour change; poor quality of life on ARVs and medical terminology.  Inability of clients to comply to the regimen because of severe side effects, complex regimen, lack of support from family and friends, lack of motivation, depression, cultural beliefs, lack of knowledge on how to use them and financial constraints.  Challenges for continuous education because of current nursing shortage, negative attitudes of some nurses, demotivation and inadequate funding for such activity. Recommendations include provision of continuing education and the incorporation of ARV therapy knowledge in the basic nursing curriculum in nursing education.
Health Studies
MA (HEALTH STUDIES)

The AIDS pandemic has generated a large number of orphaned and vulnerable children (OVC) in Swaziland, as it affects the reproductive age group. Most of the OVC are being cared for by their grandparents who are old, poor and suffer from degenerating diseases of old age. The purpose of this study was to explore and describe the needs and support available for OVC under the care of grandparents in the informal settlements of Mbabane, Swaziland in order to develop guidelines for their care and support. A qualitative, exploratory, descriptive and contextual study was conducted to identify the needs of the OVC and type of support provided by organizations for these children. Data was collected using unstructured and semi-structured interviews. The study was conducted in three phases each addressing a research objective. In the first phase which was to identify the needs of OVC, twelve grandparents who cared for OVC in the informal settlements participated. For the second phase seven managers of organizations that provide support to OVC in the informal settlements participated. The third phase was the development of guidelines by the researcher and validated by participants and experts. The study highlighted the needs of OVC, the nature of the existing support structure and type of support provided by organizations for these children. The findings revealed that the OVC have developmental support, protection support, psychosocial support and support for survival needs. The themes identified from the analysis of the type of support provided by organizations were developmental, partnership, protection, psychosocial and support for survival needs. The organizations' support was inconsistent and inadequate to meet these needs due to the large number of OVC. Some of the weaknesses of organizations were indicated as donor dependency and lack of coordination and collaboration among organizations. The study highlighted partnership as fundamental to the successful implementation of the guidelines.
Health Studies
D. Litt. et Phil. (Health Studies)

descriptive correlational study aiming at describing the knowledge, attitude and risk behavior of adolescents in relation to HIV/AIDS in one “girls only” Catholic school of Manzini. Structured self-administered questionnaires were used to collect data from 260 respondents aged 12 to 19 years. Although only 22.31% respondents indicated been tested for HIV, (83.08%) would like to take an HIV test. Hospital and clinic are mostly known by respondents for providing HIV testing. Most respondents expressed lack of confidence in getting partners wear condoms. 16 (6.15%) have engaged in sex and 5 (6.10 %) were raped. No statistically significant difference was noted between condom use during sexual intercourse for both participants who were raped and those who consented to sex (P value = 0.6538). Future youth health programs should focus on building confidence of youth in accessing condom, discussing condom issues with their partners and make their partners wear condoms
Health Studies
M.A. (Public Health)

descriptive correlational study aiming at describing the knowledge, attitude and risk behavior of adolescents in relation to HIV/AIDS in one “girls only” Catholic school of Manzini. Structured self-administered questionnaires were used to collect data from 260 respondents aged 12 to 19 years. Although only 22.31% respondents indicated been tested for HIV, (83.08%) would like to take an HIV test. Hospital and clinic are mostly known by respondents for providing HIV testing. Most respondents expressed lack of confidence in getting partners wear condoms. 16 (6.15%) have engaged in sex and 5 (6.10 %) were raped. No statistically significant difference was noted between condom use during sexual intercourse for both participants who were raped and those who consented to sex (P value = 0.6538). Future youth health programs should focus on building confidence of youth in accessing condom, discussing condom issues with their partners and make their partners wear condoms
Health Studies

The demand for circumcision in Swaziland has dramatically increased since it was reported that circumcision ensures 60% protection against HIV infection. The aim of this study was to explore the reasons for, and the motives behind, this increasing interest in undergoing circumcision. A generic qualitative research design was used, in which 17 circumcised men selected by convenience sampling at FLAS Clinic, Mbabane, participated. In-depth unstructured face-to-face interviews were used to collect data. The results showed that the main reasons for circumcision are perceived health, hygiene and sexual benefits, community influences, as well as medical reasons. It was concluded that the major motives underlying circumcision are personal and partner safety and satisfaction during sex. These motives were found to be both promotive and threatening to the interests of public health. After evaluating the risks and benefits, it was recommended that mass circumcision be promoted alongside reinforced and accurate health education on circumcision
Health Studies

The HIV/AIDS epidemic is described as a crisis by the Global Report (UNAIDS 2004:13). Swaziland¡¦s King Mswati III also declared the HIV/AIDS epidemic as a disaster when the HIV/AIDS prevalence rate increased from 3.9% in 1992 to 42.6% in 2004 (MOHSW 2004:3). In responding to the increasing numbers, the Government of Swaziland established various programmes; one of them being the Voluntary Counselling and Testing (VCT) services to meet societal needs. The MOHSW designed guidelines to be utilized when training nurses to be pre and post HIV test counselors (TASC 2003:2). The period of training ranges between 1 to 2 weeks, after which they are deployed to the VCT centres where nurses provide counseling and testing, treatment of opportunistic infections and distributing antiretroviral drugs. Much research has been done in Swaziland on HIV/AIDS however; there is insufficient knowledge on the impact of HIV/AIDS on nurses working at the VCT services. The objectives of the study were to: ,,« Explore and describe the experiences of nurses working in the VCT services. ,,« Explore and describe the experiences of clients receiving VCT services. ,,« Design and develop an empowerment programme for nurses working in the VCT services in Swaziland. ,,« Formulate and describe guidelines for the implementation of the programme. In this qualitative study, the exploratory descriptive and contextual methodology was utilized to look into lived experiences of nurses and clients. This was done within the adaptation of the intervention Design and Development genre proposed by Rothman and Thomas (1994). Data was collected through purposive sampling and analysed according to Tesch¡¦s methods (Tesch 1990:890) The study revealed one major theme; constant experience of stress that was related to psychological and physical factors (categories). Nurses identified the complexity of HIV/AIDS, shortage of staff, lack of social support, lack of a supportive working environment, and a need for staff development under psychological factors. Clients identified stigma and discrimination. Constant exhaustion and development of medical conditions were identified as physical factors that led to constant experience of stress. Conclusions drawn from the data analysis revealed that nurses were stressed and felt disempowered at working in the VCT services. An empowerment programme was designed and developed to enable these nurses to deal with issues and VCT services for rendering quality care and enjoy the work they do. Guidelines were formulated to implement the empowerment programme. The study concluded with the identification of limitations and recommendations for future endeavours.
Health Studies
D.Litt. et Phil.

Background: The HIV epidemic has greatly affected sub-Saharan Africa, with the highest prevalence in the world found in Swaziland. One in three pregnant women in Swaziland has HIV. One of the PMTCT strategies is primary prevention of HIV among women who are uninfected. Understanding the reasons why pregnant women continue to seroconvert is the key in meeting this strategy. Purpose: The purpose of this study is to determine the factors associated with seroconversion among pregnant women utilizing Raleigh Fitkin Memorial Hospital in 2012. Objectives: The objectives of this study are to: determine the proportion of HIV non-infected pregnant women who are retested for HIV during pregnancy; determine the gestational age at which pregnant women are retested for HIV; establish the proportion of women who were initially HIV non-infected and seroconverted during pregnancy; and establish the factors associated with seroconversion during pregnancy. Methods: An observational cross-sectional study design with both descriptive and analytic components was carried out at Raleigh Fitkin Memorial Hospital. Systematic sampling was used for the recruitment of 381 pregnant women who were initially HIV non-infected. An interviewer-administered questionnaire and chart review were used to collect demographic and clinical data. The data was analyzed using descriptive and analytic statistics. Results: The results of the study show that demographic factors such as age and educational level are associated with HIV seroconversion during pregnancy. The findings also highlight how partner factors play a role in HIV seroconversion. The results indicate that sexual behaviours 333of the pregnant women contribute greatly to HIV seroconversion. Conclusion: Pregnant women continue to engage in risky sexual behaviours during pregnancy and there is need to strengthen counseling on preventive measures throughout the antenatal care period. There is also need for programs to explore possibility of providing antiretroviral drugs for pre-exposure prophylaxis to all HIV negative women during pregnancy.
Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2013.

Text in English and siSwati
The purpose of this study was to develop support guidelines to assist with disclosure of HIV status to HIV infected children by their parents and caregivers in Swaziland. The study explored parents’ and caregivers’ experiences with disclosure, and described the pattern of disclosure for HIV status to infected children. A qualitative descriptive research was conducted. Data were collected through semi-structured with thirteen (13) parents and caregivers who were purposively selected to participate in the study. Data analysis was done using qualitative content analysis. Three themes emerged which were understanding the general concept of disclosure, the pattern followed by parents and caregivers on disclosure of HIV status to infected children and the experiences of parents and caregivers on HIV status disclosure to their children. Based on the findings, support guidelines were formulated to assist parents and caregivers with disclosure of HIV status to their infected children. The outcome of this study is the description of a clear pattern of when, how and what to be disclosed to HIV infected children; as described by the parents and caregivers of the HIV positive children.
Health Studies
M.A. (Nursing Science)

Thesis in English, Annexure E: Consent form (leaf 81) as well as KABP Survey Questionnaire (leaves 87-91) in English and SiSwati.
The purpose of the study was to assess knowledge, explore attitudes and determine practices of breastfeeding mothers living with HIV regarding post-natal PMTCT interventions and services. The study was quantitative and descriptive in nature, utilising a retrospective cohort design. The study sample included breastfeeding mothers living with HIV, who attended the King Sobhuza II public health unit in the Manzini region of Swaziland. A written questionnaire was administered to a non-random sample of 90 consecutively selected mothers living with HIV attending the above-cited public health unit for post-natal health purposes. The overall study results revealed that the majority of breastfeeding mothers living with HIV in the afore-mentioned region (77.8%) presented high levels of knowledge on PMTCT, and 90% demonstrated a positive attitude; while a further 90% also demonstrated positive behaviour towards PMTCT. However, stigma and discrimination among family members, non-disclosure of HIV status to sexual partners; as well as poverty and fear of future drug-resistance are the cause of non-adherence to ARV prophylaxis. Furthermore, inconsistent condom use, mixed-feeding methods and wet-nursing also emerged as other contributing factors to the increase of post-natal mother-to-child transmission of HIV among breastfeeding mothers living with HIV.
Health Studies
M.A. (Nursing Science)

This study used a qualitative, explorative, and descriptive design to understand the experiences of adolescents after HIV status disclosure in Hhohho region Swaziland. The data were collected through in-depth individual semi structured face-to-face interviews from 10 adolescents living with HIV between the ages 15-19 years. To analyse interviews, Tesch’s qualitative data analysis approach was used. Findings from the study revealed that participants experienced sadness, despair and anger after disclosure and also had fear of death because some had lost one or both parents. The participants reported recurrent episodes of poor health, which resulted in failure at school. In addition, they stressed that they could not disclose their HIV status because they feared discrimination and stigma. Recommendations were made to improve coping strategies of adolescents and revising the nursing curriculum to equip nursing students with appropriate skills that would enable them to care for adolescents living with HIV (ALHIV).
Health Studies
MA (Health Studies)

This quantitative study sought to identify and describe factors influencing HIV disclosure and sexual practices among 340 PLWHA on ART at Mbabane National Referral VCT/ART Centre, Swaziland. Data were collected using a structured questionnaire. A high general HIV disclosure rate (94.1%; f=320; N=340) was observed of which 57.5% (f=184; n=320) was to sexual partners. X2 procedures indicate an association with gender, residential region, religion, and period of being on ART. The majority (70.2%; f=179; n=255) of the respondents used condoms all the time to avoid infecting their sexual partners (99.2%; f=243; n=245) and to avoid contracting STIs (99.2%; f=243; n=245). X2 procedures indicate an association with gender, residential region, marital status, number of sexual partners, knowledge of the HIV status of sexual partners and period of being on ART. The single leading reason for not using the condom was sexual partners’ refusal to use condoms (85.7%; f=54; n=63).
Health Studies
M.A.(Health Studies)

The aim of the study was to gain in-depth understanding of teachers ’experiences with regard to the provision of care and support to school children on antiretroviral therapy in Swaziland in order to recommend approaches for enhancing support and care offered to children on ART by teachers. The study explored the experiences of teachers providing care and support to school children on antiretroviral therapy in Swaziland. The study used interpretative phenomenological analysis design. The study population was primary schools teachers in Swaziland. Data were collected through individual semi structured interviews from 16 purposively selected teachers. Data were analysed using interpretative phenomenological analysis framework for data analysis. Three superordinate themes emerged from data analysis namely: (1) Increased responsibility, (2) inadequate support and (3) psychological impact. The increased responsibility is related to ensuring that children who are on antiretroviral therapy have eaten before taking antiretroviral treatments, are properly dressed, receive proper education and health care and protected from bullying and social exclusion. Inadequate support for teachers makes caring for the learners very challenging. The psychological impact of caring for these learners are sense of accomplishment, demotivation; helplessness and emotional pain. Recommendations are made to ensure support for teachers rendering care and support to children on antiretroviral therapy.
M.A. (Nursing Science)
Health Studies

AIM The purpose of this study was to explore and describe factors that contribute to the non-initiation of Antiretroviral Therapy (ART) amongst Pre-Antiretroviral Therapy eligible patients and to make recommendations for health care workers to enhance early initiation of pre-ART-eligible patients for primary health care facilities in Swaziland. METHOD A qualitative design was applied in rural primary health care (PHC) facilities in the Hhohho region of Swaziland. The target population for this study included nurses who have successfully completed the National Nurse Led Antiretroviral Therapy Initiation in Swaziland (NARTIS) training, and who actively initiated ART to eligible patients in rural PHC facilities. Data was collected through semi-structured interviews and field notes. Purposive, convenient sampling was applied. Eleven respondents were interviewed for the study, and data was collected until data saturation was reached. Data from transcripts and field notes was analysed and categorised with thematic analysis through Tesch’s open coding process. RESULTS The study identified the following three predominant themes: 1) systematic enablers of prompt ART initiation, 2) barriers to prompt ART initiation, 3) sources of support. Categories included public health care (PHC) factors, community level factors, the interdependence of the health care system, patient centred barriers, individual patient agency, and NARTIS nurse support. CONCLUSION The recommendations for health care workers that emerged from the study included continued HIV treatment scale-up and decentralisation to grass roots levels, aggressive treatment prioritisation among pre-ART patients, building the capacity of the local health care system and continued research initiatives. It is hoped that recommendations emerging from the findings of this study will have positive implications for programming and practice regarding the initiation of ART for eligible pre-ART patients in Swaziland.
Health Studies
M. PH.

Text in English
Background: Children living in child-headed households have health needs that require treatment and care. Matsanjeni is one of the poorest socio-economic areas of Swaziland with the high number of children orphaned by HIV and AIDS who are often living without adequate family and social supports. These conditions are known for increasing people vulnerability to diseases and hindering access and utilization of health services. However, children living in child-headed households in Matsajeni community do attend the primary health care (PHC) services on regular basis. What influence the utilization of the above services by children living in child-headed households in the Matsanjeni community is not clear and well documented. Aim of the study: To explore and describe the views of children living in child-headed households in a rural community of Swaziland regarding factors influencing their utilization of PHC services. Design: A qualitative descriptive design was used to guide the study. Purposive sampling was used to select the most senior child from child-headed households in a rural community. Semi-structured individual face-to-face interviews were used to generate data. Data saturation was reached after twenty interviews. Thematic content analysis was used to analyse data. The researcher used Andersen behavioural model was to identify and organised the emerged themes. Ethical clearance was obtained from the Ethics Committees of the University of South Africa and the Ministry of Health of Swaziland. Results: Fear to develop a deadly disease, perceived seriousness of the condition, desire for compliance to medical treatment, and community support emerged as enablers of primary health care services utilisation among children living in child-headed households. While lack of money, ignorance, shortage of healthcare personnel, negative behaviour and attitude of health professionals, long waiting hours, unreliable transportation system, and long distance emerged as inhibitors of primary health care services utilisation among children living in child-headed households. Conclusion and recommendation: The results of this study add to our understanding factors that positively and negatively influence the utilisation of primary health care services among children living in child-headed households in rural communities. The findings suggest that the utilisation of primary health care services among children living in child-headed households is influenced by need for care-enabling resources-experience of care triad. Behavioural and social welfare interventions are needed to enhance the utilisation of primary health care services among this vulnerable section of the community in Swaziland. Recommendation for further research is also articulated.
Health Studies
M.A. (Public Health)