Dissertations / Theses: 'HIV/AIDS - Zambia'

1

Foster, Susan Dwight. "The socioeconomic impact of HIV/AIDS in Monze District, Zambia." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1997. http://researchonline.lshtm.ac.uk/682244/.

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Zambia has one of the highest HIV seroprevalence rates in the world, estimated in 1995 at 17%. Rural Monze district in the Southern province, the site of the study, has high rates of HIV, estimated at 10-12% in 1991. During the study, the district was affected not only by AIDS but also by the 1991-92 drought and by a bovine epidemic of East Coast Fever. This study documents the impact of HIV and AIDS on the health services and on the district economy, and draws some long term implications for the national economy. At the district hospital, approximately 44% of inpatients and 30% of outpatients were HIV seropositive as were 18% of rural health centre patients. Tuberculosis, other respiratory infections, and diarrhoea accounted for the majority of days in hospital. The HIV epidemic was found to be affecting the hospital staff as well, with mortality at Monze and neighbouring Choma hospitals rising from 2 per 1,000 nurse years in 1980 to 27 in 1991 - a 13-fold increase. Measures to increase supply, reduce losses, and make better use of existing staff are proposed. The household survey found that while patients were better off overall than the district population, there was no appreciable difference in wealth between patients with HIV infection and those without. HIV-positive patients were younger than HIV-negative patients, and had fewer children. The loss of a member with HIV would cause a rise in the average household's dependency ratio of 16-17%. Production was affected by HIV disease, with an average of 94 days' loss of labour (patients plus carers) in the final year of life. Implications for policy include the need to decentralize care of patients with HIV disease to health centres, and to protect and make better use of the health human resources. The impact of HIV/AIDS on rural production, with approximately 1 in 3 district households having a member with AIDS, combined with external factors such as removal of subsidies, changes in marketing processes under structural adjustment, and long term drought, makes it increasingly difficult to eke out a living from farming. Combined with the lure of apparent employment opportunities in urban areas created by deaths due to AIDS, these factors may contribute to increased urbanization, making it difficult for Zambia to replace declining copper revenues with increased yields from agricultural production.

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2

Kaliki, Chipalo. "An analysis of expenditure on HIV/AIDS patients in Zambia." Master's thesis, University of Cape Town, 2006. http://hdl.handle.net/11427/9323.

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Includes bibliographical references (leaves 85-89).
According to the 2000/2001 Zambia Demographic and Health Survey (ZDHS), HIV/AIDS prevalence is 16% and is expected to be higher in the next five years. The disease is quite pervasive across all sectors of economic activity, but the impact is especially acute on the Zambian health sector, which is faced with increasing demands on healthcare for not only HIV/AIDS but other diseases such as malaria, tuberculosis, cholera, diarrhoea, to mention but a few. It is therefore essential that expenditure on HIV-related care among different health care systems be analysed so as to determine areas of relatively greater need. It is against this background that this study entitled, "An analysis of expenditure on HIVIAIDS patients in Zambia", was conducted. The main objective of the study is to analyse expenditure on HIV-related care and treatment among the different health care systems and geographical localities in Zambia. The study used utilisation data on total and HIV-related outpatient visits and inpatient days collected from the country's facility based database called the Health Management Information System (HMIS); and HIV-prevalence data compiled from the Central Statistics Office's report on Epidemiological Projections. Expenditure data on the other hand was compiled from the National Health Accounts (NHA) report for 1999-2002 and separate data on HIV/AIDS expenditure was collected from the District Health Boards reports for 2003. Utilisation and HIV-prevalence data were then combined with expenditure data to estimate the overall utilisation of services by HIV-positive patients and the annual expenditure required to meet the burden of HIV/AIDS. Both utilisation and expenditure statistics were analysed and compared according to different levels of healthcare and geographical localities. Data analysis was exploratory and descriptive.

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3

Banda, Davies. "Sport and the multisectoral approach to HIV/AIDS in Zambia." Thesis, Loughborough University, 2013. https://dspace.lboro.ac.uk/2134/14988.

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Sport is increasingly being recognised for the contribution it can make to the Millennium Development Goals and, in particular, the response to the HIV/AIDS pandemic. This study is based on Zambia, a low-income country, heavily affected by the HIV/AIDS pandemic in sub-Saharan Africa. The study focuses on National Sports Associations (NSAs), which are quasi- autonomous organisations at meso level of policy analysis. Centring on three NSAs: Football Association of Zambia (FAZ), Zambia Basketball Association (ZBA) and Netball Association of Zambia (NAZ), this study critically analysed the organisational responses of each of the selected cases towards the HIV/AIDS multisectoral approach. The study adopted a case study approach which utilised semi-structured (face-to-face and telephone), interviews, focus group discussions and documentary analysis for data collection. Comparative analysis of all three cases revealed differences in how each case mainstreamed HIV/AIDS based on power, resources and forms of collaboration. Meso-level analysis was utilised to examine workplace HIV/AIDS policy formulation and implementation. In addition, meso-level analysis also helped reveal forms of health-related collaborations with both internal and external agencies. Macro-level theories of the state were useful in examining power relations between the Zambian state and civil society. The application of policy network theory, global health governance, multiple streams framework, and the top-down and bottom-up approaches to policy implementation proved useful in drawing attention to how each NSA case responded differently to the mainstreaming of HIV/AIDS. The political power of football as a national sport and the Association s access to foreign resources enabled FAZ to influence HIV/AIDS policy implementation and build of strong collaborative relationships with government than the ZBA and NAZ. The study concludes that lack of political steer from the top has re-introduced a new foreign top-down approach as those with resources from the Global North influenced policy formulation and implementation within all three cases. The conclusion also found useful the application of post-colonialism and development theories when examining international sport-for-development practices. This finding revealed the power imbalances between Global South practitioners and Global North funding partners.

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4

Kunda, Rosaria. "Vulnerable children, schooling and the feminisation of the AIDS pandemic in Zambia." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_4874_1189597212.

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This study aimed to explore the gender imbalances that exist in access to education and participation in schooling of the female orphans and vulnerable children, and also how this relates to the continuing feminisation of the HIV and AIDS pandemic in Zambia. The study was based on the premise that the girl child is disadvantaged in this area, and the HIV and AIDS pandemic in worsening the situation for female orphans and vulnerable children.

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5

Musumali, Rose M. "HIV disclosure in the workplace amongst public service workers in Zambia." University of the Western Cape, 2012. http://hdl.handle.net/11394/4645.

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Masters of Public Health - see Magister Public Health
With a prevalence of 14.3% among the 15-49 years age group, HIV/AIDS still constitutes a significant challenge in Zambia. In order to respond to the impact of HIV/AIDS within the workplace, government ministries have developed HIV-focused workplace policies and programmes that provide HIV/AIDS services. However, despite their availability, the number of employees accessing the services, especially those targetting HIV positive workers remains low. The fear (either perceived or real) of disclosing an HIV positive status is one likely reason for the low uptake of services. HIV-positive status disclosure is an important public health goal as it can create opportunities for an individual to access information and social and medical support, and this will affect career and workload related decisions. This exploratory, qualitative study aims to identify and describe the HIV-disclosure experiences of 12 openly HIV-positive Zambian public sector workers living in Lusaka and working in four Zambian Ministries. Both male and female public sector workers were interviewed. The participants’ experiences of disclosing their HIV positive status in the workplace were explored in depth in this study. With the aim of providing those responsible for overseeing and managing the Zambian public sector HIV workplace initiatives with some practical recommendations regarding the disclosure support needed by HIV-positive public sector workers. The study found that whilst participants had an initial fear of disclosing their HIVpositive status in the workplace, their HIV disclosure actually proved to be very beneficial. Not only did it allow their health-related needs (such as accessing medication and visiting a doctor) to be met, but their disclosure also encouraged others to also disclose their status. The recommendations are are aimed at creating a supportive working environment for people living with HIV within the Zambian public service, and offering suggestions to their managers on how best to support the process of disclosure amongst their staff.

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6

Chibwe, Duffrine Chishala. "An exploration of promoters and inhibitors of coordination between organizations involved in HIV/AIDS activities in Livingstone District, Zambia." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_1137_1188477226.

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The district health report for Livingstone, Zambia, outlined an increasing prevalence of HIV/AIDS iun the district. In 1998 the prevalence wsas at 29%, in 2000 at 30%, in 2002 at 31.8% and in 2004 at 31%. This was above the national prevalence of 20% according to CBoH statistics of 2004. The district has been implementing the HIV/AIDS prevention in various organizations during the past 3 years. Most of the organizations implementing the HIV/AIDS preventive activities do not work collaboratively with other sectors and this has resulted in un-coordinated activities and wstage of the limited resources. This exploratory qualitative study aimed at undestanding participants' perceptions of factors influencing coordination between different organizations that are involved in the implementation of HIV/AIDS activities, and to note the impact that this had in the implementation of activities in a multisectoral approach to HIV/AIDS prevention.

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7

Menda, Mutombo Dhally. "Assessment of sexual behaviour and knowledge of HIV amongst adolescent schoolgirls in a rural district in Zambia." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_8906_1182746875.

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Adolescents&rsquo
sexual activity is associated with maternal and child health problems, and sexually transmitted infections including HIV/AIDS. The aim of this study was to assess the sexual behaviour patterns of adolescent schoolgirls and the level of knowledge they have with regard to the prevention and transmission of HIV infection, as well as to determine which factors are associated with their various sexual behaviour patterns. A cross-sectional descriptive survey of 420 adolescent schoolgirls aged 15 to 19 years, from 3 of the 9 secondary schools situated in Petauke District, in rural Zambia, was conducted. The sample of schoolgirls was obtained using a multi-stage systemic sampling technique.

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8

Conner, Deborah. "Implementing HIV/AIDS global fund programs : funding disbursement mechanisms in Zambia." Master's thesis, University of Cape Town, 2008. http://hdl.handle.net/11427/3792.

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Includes abstract.
Includes bibliographical references.
The dissertation explores how variations in fund performance can be explained. Certain hypotheses suggested in the literature are set out that have been advanced to account for the differential performance of principal recipients. The dissertation analyzes the performance of the various funding mechanisms by exploring systems and procedures; public or non-governmental status; implementation models; staffing issues; NGO and CSO involvement in project implementation; and the absorption of funds. The dissertation makes an assessment of the significance of each factor in improving or worsening the performance of a disbursement mechanism, and draws some broad preliminary conclusions about how differences in disbursement performance can be explained.

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9

Chimfwembe, Richard. "The Roman Catholic Church and the United Church of Zambia challenged by HIV and AIDS, which results in creating poverty among Zambian people." Diss., Pretoria : [s.n.], 2006. http://upetd.up.ac.za/thesis/available/etd-09182007-123736.

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10

Freudenthal, Solveig. "Visualising the invisible : exploring interactive video in HIV prevention in rural Zambia /." Stockholm, 2000. http://diss.kib.ki.se/2000/91-628-4183-1/.

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11

Öjteg, Katarina. "Socio-economic determinants og HIV in Zambia : a district-level analysis /." Lund, 2008. http://www.gbv.de/dms/zbw/594026369.pdf.

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12

Carm, Ellen. "Caught in Culture? : Cultural Transformation through HIV/AIDS Prevention Education in Zambia." Doctoral thesis, Stockholms universitet, Institutionen för pedagogik och didaktik, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-138117.

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The study explores the role and contribution of education in developing a localized and relevant HIV/AIDS prevention strategy through a multi-voiced approach, involving the educational institutions, as well as the traditional leaders, community-members, including parents. The study comprised all public schools in one Zambian province from 2002-2008. The study explores, among other factors, the role of traditional culture in mitigating and exacerbating the spread of the disease. Zambia was one of the countries hardest hit by the HIV/AIDs epidemic, and one of the few countries in the region that, in 2002, had a clear policy on the role of education in fighting the epidemic. Through the process of developing and implementing a learner-centered interactive HIV/AIDS education program in the province. based upon MOE`s HIV/AIDS policies and strategies, syllabi, and teachers guides, and at the same time emphasizing the broader community as a point of departure. The qualitative and interpretivist research was conducted within a constructivist grounded theoretical approach. The study applies comprehensive and multilayered perspectives while utilizing a broad range of methods. Documentary analyses, structured and semi-structured interviews, in depth conversations with traditional and educational leaders, teachers, parents and pupils, were all carried out during the period of the study. Nvivo, a computer-supported data analysis tool was used to support the process of categorizing the qualitative data and the study applied Cultural- and Historical Activity Theory for analytic purposes. The study revealed the mismatch between the decentralized, national HIV/AIDS prevention education approach, as stated in the policy documents and the global UNAIDS, centralized and cross-sectoral strategies favored by the Zambian government. The uncoordinated efforts did not reach the grassroots level, where professionals, at district and school level, perceived and applied policies in highly different ways, if at all reaching students and the communities. The main categories of drivers of the epidemic were of socio-cultural and economic character, e.g. polygamy, sexual cleansing, local healing, gender inequality and poverty, sexual violence, multiple concurrent sexual partners and prostitution, but there were also variety of local drivers, depending upon context. When analyzing the participatory approaches of the HIV/AIDS prevention strategy, predominantly, at the school-community level, the findings revealed that the traditional leaders, being legitimate leaders in their kingdoms, and the custodians of culture and traditions, were found to be gate openers to promote behavioral change and cultural transformation in their villages. The traditional leaders worked hand in hand with the schools and the villagers. Their involvement legitimated that discourses and HIV/AIDS prevention actions were taken at school as well as within their own chiefdom. Utilizing their traditional leadership structures, the chiefs sustained their cultural rites, e.g. cleansing, in order to chase away the evil spirits, by turning the rites into practices that do no put people at risk for contracting HIV. Particularly at the global and state level, culture has been seen as drivers of the epidemic. The study revealed that the traditional leaders used their role as significant others, became gate-openers, using their legitimate role as custodians of culture to transform cultural rites and practices.

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13

Bah, Ida. "Gender inequality and HIV/AIDS in Zambia : A study of the links between gender inequality and women's vulnerability to HIV/AIDS." Thesis, Södertörn University College, School of Social Sciences, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-357.

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Today it has been estimated that 40 million people worldwide are carrying the deadly virus known as HIV. Despite the fact that the virus can affect men and women alike, an increasing proportion of people living with HIV are women and girls, and this proportion is continuing to grow. This writing is dedicated to explore the factors that drive the epidemic.

The purpose of this paper is to explore the links between gender inequality and women's vulnerability to HIV/AIDS as well as to enhance our understanding of what is it like to be a young woman in Zambia, a country where the HIV/AIDS epidemic has hit hard. The research is done through a qualitative study with secondary sources and interviews as means of collecting data. The point of departure is theories of gender inequality, where the patriarchal structures and men's domination over women are explained.

The result of this study is that gender inequality, the subordination of women and men's predatory behaviour are major contributors of the epidemic, the larger numbers of women with HIV/AIDS and the women's younger age.

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14

Ndhlovu, Japhet. "Combating HIV : a ministerial strategy for Zambian churches." Thesis, Stellenbosch : Stellenbosch University, 2008. http://hdl.handle.net/10019.1/5492.

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Thesis (DTh (Practical Theology and Missiology))--Stellenbosch University, 2008.
ENGLISH ABSTRACT: This work is about a missiological praxis for the creation of 'Circles of Hope' as an entry point for faith based organisations and, particularly, local churches in Zambia for an effective battle in the fight against HIV (Human Immunodeficiency Virus). The HIV pandemic is one of the worst tragedies to have befallen humankind in the 21st century. Lost to many people is the fact that it does not affect all regions of the globe equally. Figures show that over 70% of PLWHA (people living with HIV) are in sub Saharan-Africa while most affected are young and therefore, in theory, energetic. With an overall HIV prevalence rate of 16% and a life expectancy of 34 years, HIV has severely impacted the lives of Zambians across the country. Stigma remains one of the most significant challenges in Zambia across the prevention-to-care continuum. The wider environment of these effects and statistics has provided for us the wider contextual situation. The Church in Zambia and, indeed, in the entire sub-Saharan African region cannot afford to hide its head in the sand anymore. The impact of HIV is being felt at all levels of society. This has posed a threat to economic progress and human development by attacking the most economically productive age group and reversing gains in life expectancy and child survival. The increasing burden on health budgets has stretched national and community resources to the limit, leaving no room for complacency or pretence about the magnitude of the problem. Since some members of the Church are positively infected, we can safely say of the Church: the body of Christ has HIV. HIV is a national disaster. It cannot be managed without mobilising all the sectors within a nation. The Church in Zambia needs to make HIV prevention a matter of compelling priority. The Church is an instrument for the missional praxis of the triune God. Theology in this work is not so much a scientific endeavour that begins and ends with analysing contexts and texts, rather it is an imaginative way of finding new answers to the new situation brought about by the presence of HIV (Hendriks, 2004: 30). In this work the researcher contends that measures are required to develop strong theological reflections and education which would result in the establishment of Circles of Hope in all local congregations. These Circles of Hope would act as a fountain for promoting behavioural change, support action for safer sexual behaviour, and combat stigmatisation and discrimination against people with known HIV infection. There must be appropriate theological reflections that touch on the work of the reign of God. A relevant HIV theology will necessarily involve the laity, will watch out for fundamentalist views, will be biblical in nature and will draw from Trinitarian understanding. The basis of moving from a theology of punishment to that of care, truth, freedom, justice and peace is the theology of community and companionship. This reflection is an attempt to have constructive interpretation of the present realities brought about by a time of HIV. One can only discern God‘s will for the present situation through critical and sensitive leadership in order to bring about genuine healing. The role of the local church and networking activities are essential commodities to realise a vision of a Zambia that is HIV competent. This then is the new ministerial strategy being spearheaded by the 'Circles of Hope' programme of the Council of Churches in Zambia. It is a challenge for Zambian churches.
AFRIKAANSE OPSOMMING: Die navorsing handel oor ŉ missiologiese begronde praksis vir die skepping van 'Kringe van Hoop' as 'n beginpunt vir geloofsgebaseerde organisasies en spesifiek die plaaslike kerk in Zambië in hulle stryd teen MIV (Menslike Immuniteits Virus). Die MIV pandemie is een van die ergste tragedies wat die mensdom in die 21ste eeu getref het. Wat baie mense nie altyd besef nie, is dat dit nie oral in die wêreld dieselfde impak het nie. Statistiek wys daarop dat meer as 70% van alle MIV positiewe mense Suid van die Sahara woon. Die meerderheid van die geïnfekteerdes is jonk met baie potensiaal. 16% van die bevolking in Zambië is MIV positief en het 'n lewensverwagting van 34 jaar. Die uitwerking hiervan raak die land en al sy mense. Naas voorkoming en versorging bly een van die grootste uitdagings wat die gemeenskap in Zambië moet aanspreek stigmatisering. Die groter konteks Suid van die Sahara vorm die agtergrond van elke land se spesifieke probleme. Ook Zambië en met name die kerk in Zambië sal die feite in die oë moet kyk. Die pandemie is 'n bedreiging vir ekonomiese vooruitgang en menslike ontwikkeling omdat dit die ekonomies mees produktiewe ouderdomsgroep afmaai, lewensverwagting verlaag en kindersterftes laat toeneem. Die toenemende las op die gesondheidsbegroting het die nasionale en gemeenskapshulpbronne grootliks uitgeput. Die omvang van die probleem kan op geen manier meer ontken en negeer word nie. Aangesien baie lidmate MIV positief is, kan 'n mens goedskiks verklaar dat die liggaam van Christus MIV het. Dit is ŉ nasionale tragedie. Die pandemie kan nie bestry word sonder dat al die sektore van die samelewing daarteen gemobiliseer is nie. Die kerk in Zambië moet die voorkoming van MIV as 'n uiters noodsaaklike prioriteit beskou. Die Kerk is 'n instrument vir die missionêre praksis van die drie-enige God. Die navorsing beskou teologie nie as 'n wetenskaplike onderneming wat bloot handel oor 'n analise van kontekste en tekste nie. Teologie is iets waarin jy handelend en verbeeldingryk toetree tot die aanspreek van 'n veelbewoë situasie en antwoorde probeer vind op die probleme (Hendriks, 2004: 30). Die navorsing werk met die hipotese dat die probleem vanuit 'n teologiese hoek benader moet word sodat teologiese beginsels die praktykteorie van Kringe van Hoop in plaaslike gemeentes sal onderskraag. Die studie voorsien dat die Kringe van Hoop die hoof dryfveer sal wees wat gedragsverandering sal bevorder, veiliger seksuele gedrag sal aanmoedig, en die stryd teen die stigmatisering en diskriminasie sal voer. Gepaste teologiese refleksie oor die heerskappy van God is noodsaaklik. 'n Revelante HIV teologie sal gewone lidmate insluit, sal bedag wees op fundamentalistiese sieninge, sal bybels wees en sal gebaseer wees op ŉ trinitariese godsbegrip. Die teologiese basis vir die wegbeweeg van 'n teologie van straf/oordeel na een van versorging, waarheid, vryheid, geregtigheid en vrede, is geleë in gemeenskap en kameraadskap. Hierdie refleksie is 'n poging om in 'n tyd van HIV 'n konstruktiewe interpretasie te gee van die huidige realiteite. Kritiese en sensitiewe leierskap behoort in die huidige situasie te poog om God se wil te soek om die gebrokenheid van 'n MIV siek gemeenskap aan te spreek. Die rol van die plaaslike kerk en netwerkingsaktiwiteite is onontbeerlik vir die realisering van die visie van ŉ Zambië sonder MIV. Die 'Kringe van Hoop'-program van die Zambiese Raad van Kerke is 'n bedieningstrategie wat die MIV pandemie wil aanspreek en wat die kerk in Zambië uitdaag om mee te doen.

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15

Kahenya, Grace Cecilia. "Challenges of scaling up laboratory services for diagnosis and monitoring tests of HIV/AIDS patients on antiretroviral therapy in Zambia." Thesis, University of Limpopo ( Medunsa Campus ), 2009. http://hdl.handle.net/10386/650.

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Thesis (MPH) --University of Limpopo, 2009
The aim of the study was to determine the challenges of scaling up and strengthening quality-assured laboratory services for diagnosis and monitoring tests for HIV / AIDS patients on Anti- retroviral Therapy (ART). The objectives of the study were to: review the current national HIV/AIDS/STI/TB policy, Laboratory policy, ART strategic plan and guidelines on the implementation of ART services in Zambia; assess the knowledge, attitudes, and practices (KAP) of medical doctors/clinicians and knowledge and practices of laboratory staff in the diagnosis and monitoring tests for HIV / AIDS patients on ART; assess the quality of laboratory services for diagnosis and monitoring tests of HIV / AIDS patients on ART in Zambia compared to WHO standard guidelines; quantify the time taken for CD4 count results to reach the ART centres and determine the difference between the knowledge, attitudes and practices (KAPs) of medical doctors/clinicians in the ART centres with and without laboratory services for diagnosis and monitoring tests for HIV/AIDS patients on ART in Zambia. The study design was a cross-section descriptive survey of one hundred and thirty-seven (137) ART centres in the public health sector of the nine (9) provinces in Zambia. The study population consisted of six directors and managers from the Ministry of Health at national level, medical doctors/clinicians, laboratory staff, district directors of health, in charge of ART centres, and data-entry clerks in charge of Health Information Management Systems (HIMS) from one hundred and thirty-seven (137) ART centres in the public health sector in Zambia. The study findings indicated that only 23% of public sector laboratories were offering a full complement package of quality-assured laboratory services to support the ART programme in Zambia. The HIV/AIDS policy, Laboratory policy, Laboratory Standard Operating Procedures (SOPs) and guidelines on ART scale-up implementation plans exist at national level but had not been fully disseminated to all the ART centres. The average number of qualified laboratory staff at district hospitals surveyed was one (1) qualified laboratory personnel which is lower than the WHO recommendation of four (4) staff per district hospital. Most of the laboratories had no CD4 count machines to support ART V services. Unfortunately, CD4 count results took more than a week to reach the ART centres. Laboratories surveyed indicated a lack of equipment maintenance plans and service contracts. External Quality Assessment for diagnosis and monitoring tests for HIV/AIDS patients on ART was not yet well established. The findings also indicated that Medical Doctors/Clinicians working in the ART centres with laboratory services to support ART programme had better prognosis and treatment of patients on ART compared to those working in the ART centres without laboratory services. There was no difference in the knowledge, attitude and practices of Medical Doctors/Clinicians in the diagnosis and monitoring tests for the management of HIV/AIDS patients on ART in ART centres with and without laboratory service to support the ART programme in Zambia. In conclusion, the Ministry of Health should improve and increase accessibility to fully functional laboratory services to support ART programmes in order to reduce turn-around time for the CD4 count results to reach the ART centres. CD4 count machines should be provided to all the laboratories in ART centres and include service maintenance contracts to support ART services. The policy and decision makers should improve and strengthen the quality of laboratory services by disseminating the National HIV/AIDS policy, Laboratory policy, Laboratory SOPs and guidelines on ART scale-up implementation plan. The recruitment, training and improvement of redistribution of qualified staff should be accelerated to accommodate the current high workload, range of tests performed and an increase in laboratory operations with ART scale-up programme. A standard format of recording and reporting CD4 count results should be put in place (i.e. computerised or manual system). The Ministry of Health should develop guidelines and establish quality assurance systems and affiliate the laboratories to participate in the &ADC regional External Quality Assurance for accreditation such as the South African National Accreditation Systems (SANAS), to support the ART programme.

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Nanyangwe, Lenganji. "Location, dislocation and risk for HIV: a case study of refugee adolescents in Zambia." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&amp.

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Refugees are not a new phenomenon and their plight has been felt the world over. Africa continues to see large numbers of people displaced through armed conflict, producing more refugees on the worlds&rsquo
most poverty stricken continent than any other.
The implications of these displacements of people dislocated from their places of habitual residence create much concern, particularly in the wake of the HIV/AIDS pandemic. Such dislocations and displacements imply separation from family and communities, including socio-economic benefits that accrue to them. There is an apparent problem of accessing health services, educational services, sources of livelihood and protection from sexual and emotional abuse. Refugee children and women are said to be the most vulnerable, although until recently adolescents in armed conflict were not considered as a
special group of children requiring special attention. The main objective of this research was to investigate levels of risk for HIV among refugee adolescents in Zambia and to determine how location relates to risk. Of particular interest was the difference in risk experienced in rural and urban areas. The researcher&rsquo
s hypothesis was that refugee adolescents in rural camps of Zambia are at greater risk because they lack adequate sources of income, health, and education in comparison to urban areas. The research was located within two theoretical underpinnings namely the social cognitive theory and the AIDS Risk Reduction Model (ARRM). The theory posits that a reciprocal relationship exists between environmental contexts, personal factors and behavior. The model explains how people change behavior that reduces risk for HIV by changing perceptions on sexual activity and when they enact the knowledge obtained from HIV preventive programmes. The methodology was located within both the qualitative and quantitative research
approaches. Qualitative because firstly, the research is a comparative case study and secondly, it is the first time such a study is being conducted. The researcher also made use of the quantitative through the survey and secondary HIV/AIDS statistical data.

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17

Mwale, Joyce Chali. "Factors affecting retention in care of patients on antiretroviral treatment in the Kabwe district, Zambia." University of the Western Cape, 2016. http://hdl.handle.net/11394/5251.

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Masters of Public Health - see Magister Public Health
Introduction: HIV and AIDS continues to be a major public health challenge for Zambia, which has the highest HIV prevalence rate of 13.1% in sub-Saharan Africa. Although individuals living with HIV/AIDS in Zambia have increased access to antiretroviral treatment (ART), not all patients who are initiated on antiretroviral treatment remain in care; with some patients being lost at different points in the continuum of care. The current study aimed to explore the factors affecting retention in care among patients receiving antiretroviral treatment at three primary health facilities in the Kabwe district in Zambia. Methodology: An exploratory qualitative study design was used to explore the patient, health systems and socio-economic factors that underlie retention on ART in three purposefully selected primary health care facilities in Kabwe district. Data was collected through in-depth interviews with 45 ART patients and three focus group discussions with 20 health care providers. The content of the transcribed interviews was analyzed thematically. Findings: The overall retention rate of the ART sites was found to be 65%. The main patient factors that influenced retention in care were side effects of antiretroviral drugs and weight increase as a sign of good health. The social related factors that influenced patient retention in care were stigma and non-disclosure of HIV status, faith healing, use of herbal remedies and alcohol use. The health system factors that contributed to poor retention of patients in care were long waiting times due to staff shortage, high patient load, travel distance to ART centers and transportation cost. Other health system factors reported by participants included shortage of third line ARV drugs and inadequate space in ART clinic. Finally, food shortage and mobility of patients due to employment were some of the identified economic factors that influenced patient retention in care. Conclusions: A large proportion of adult patients initiating ART in Zambia are poorly retained in care because of patient, health system, social and economic factors. In order to improve retention, more nurses and clinical officers should be trained in ART management to improve skills and address staff shortages. It would also be useful for Zambia to introduce community drug distribution points for delivering ARV refills to reduce the workload on the existing ART sites and reduce on the distances that patients have to travel to ART centers. Additionally, efforts should also be made to improve ART care by extending ART clinic days to include all the days of the week except Sundays.

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Chisa, Sume Percival. "Determinants of adherence in patients on ART on the Copper Belt Province in Zambia." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/4120.

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Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2010.
ENGLISH ABSTRACT: Chronic drug therapy has been fraught with many issues such as adherence, drug intolerance, long-term toxicity and resistance. In HIV/AIDS care, adherence is a major problem due to the fact that for success of the therapy, adherence must be in the region of ninety five percent. If this is not maintained the virus begins to mutate and resistant moieties appear, and this in turn leads to failure of the therapy. This high level of adherence is very difficult to maintain especially in patients who begin antiretroviral therapy (ART) for various reasons such as persuasion by health workers and family, and not due to their own conviction. They usually tend not to adhere to the therapy when symptoms resolve and they start feeling better. There are a number of factors that promote adherence and these are incorporated into HIV care for the programme to succeed. The research was intended to explore and describe factors causing patients to default ART on the Copper belt in Ndola at Ndola Central Hospital and to ultimately propose appropriate interventions to ensure improved return rates of patients on ART. Qualitative tools i.e. interviews and focus group discussions respectively were used, taking into account ethical considerations and data collected was then analyzed. Factors causing patients to default on ART were found to be poor social economic background, inadequate finance, unavailability of food, poor or little understanding of instructions, poor quality of counseling or low literacy levels, high pill burden, unpalatability of drugs and patient readiness to life time commitment to taking ARVS.
AFRIKAANSE OPSOMMING: Chroniese medisyneterapie is gepaard gaande met vele kwessies soos trou bly, weerstandsgebrek aan medisyne, langtermyn toksisiteit en weerstand. In MIV/Vigs sorg, is trou bly 'n groot probleem weens die feit dat vir sukses in terapie moet dit oor vyf-en-negentig persent wees. As dit nie gehandhaaf word nie sal die virus begin verander en weerstand weestandbiedende gedeeltes sal verskyn, en dit op sy beurt lei tot die mislukking van die terapie. Hierdie hoë vlak van trou bly is baie moeilik om te handhaaf veral in pasiente wie antiretrovirale terapie (ART) vir verskeie redes begin het soos oorreeding deur gesondheids werkers en familie, en nie deur hul eie oortuiging nie. Hulle neig gewoonlik om die terapie te laat vaar wanneer simptome verminder en hulle begin beter voel. Daar is verskeie faktore wat trou bly bevorder en wat ingelyf word in MIV sorg om die program te laat slaag. Die doel van hierdie navorsing was om die faktore te beskryf wat veroorsaak dat pasiente op die Copperbelt in Ndola by Ndola Sentrale Hospitaal hul ART verpligtinge nie nakom nie en om uiteindelik geskikte intervensies voor te stel om verbeterde terugkeer koerse van pasiente op ART te verseker. Kwalitatiewe insrumente, dit is, onderhoude en fokusgroupe is gebruik, met in agneming etiese kwessies, en data is daarna geanaliseer.

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Salati, Florence Chiwala. "The knowledge and attitutes of physiotherapists towards patients with HIV/AIDS in the Lusaka Province, Zambia." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=init_4458_1177919173.

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With the increase in the number of persons suffering from HIV/AIDS, physiotherapists are often required to treat these patients who present with respiratory and neurological complications. Although physiotherapists are at a lower risk of HIV infection in the workplace than nurses and doctors, it is necessary to determine their knowledge and perceptions of the risks, fears of HIV transmission and their attitudes towards patients with the disease. The aim of the study was to determine the physiotherapists knowledge of, and their attitudes towards patients with HIV/AIDS. It also explored whether the physiotherapists knowledge influences attitudes towards HIV/AIDS patients in Lusaka, Zambia.

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Andersson, Louise, and Karina Svensson. "Adolescents' knowledge, attitudes and beliefs about HIV/AIDS at a college in Zambia." Thesis, Kristianstad University College, Department of Health Sciences, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-4052.

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Background: The HIV-pandemic is a global concern. Everyday about 6000 adolescents become infected with HIV. The HIV-prevalence in Zambia among adolescents, between 15-24 years, were 3,8% for men and 12,7% for women in year 2005. Aim: The aim of this study was to explore adolescents` knowledge, attitudes and beliefs about HIV/AIDS in Livingstone in Zambia. Method: The sample consisted of 67 adolescents, 33 males and 34 females in age 15-24 years. The study design was mainly quantitative, using a questionnaire-based approach with both closed and opened questions. Data was analyzed by using SPSS and content analysis. Result: The result indicates a general high level of knowledge. The narratives expressed both a deep worry for the severity of the HIV epidemic, but also indicating optimism for change. Conclusion: The participants were hesitant concerning change. The complexity of the issue was clear, information about condoms and change of attitudes and beliefs are important, but in addition poverty has to be acknowledged in order to be able to fight HIV.

Bakgrund: HIV- pandemin är en global angelägenhet. Varje dag smittas runt 6000 ungdomar med HIV. 2005 var HIV förekomsten bland Zambiska ungdomar, 15-24 år, 3,8 % för män och 12,7 % för kvinnor. Syfte: Studiens syfte var att undersöka ungdomars kunskap, attityder och föreställningar angående HIV/AIDS i Livingstone i Zambia. Metod: Studiedeltagarna bestod av 67 ungdomar, 33 män och 34 kvinnor i åldrarna 15-24 år. Studiens design var kvantitativ, baserad på en enkät med slutna samt öppna frågor. Resultatet analyserades med SPSS respektive innehållsanalys. Resultat: Reultatet visade på en generell hög kunskap. Informanterna uttryckte både en djup oro över HIV-epidemins utbredning, men även en positiv antydan om förändring.

Slutsats: Deltagarna visade en ambivalens inför förändring. Det framkom att mer och bättre information om bland annat kondomer är viktigt samt en förändring av attityder och föreställningar. För att uppnå förändring måste helhetsperspektiv inklusive fattigdomsanalys inkluderas.

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Banda, Joshua H. K. "Impacts of congregation-based HIV/AIDS programmes In Lusaka, Zambia : how abstinence and marital fidelity efforts function in overall strategies addressing HIV/AIDS." Thesis, Middlesex University, 2017. http://eprints.mdx.ac.uk/21800/.

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The 2013-2014 Zambia Demographic and Health Survey (ZDHS) reported HIV prevalence rate among adults aged 15-49 at 13.3%, ranking Zambia 7th among countries experiencing devastating effects of a mature and generalised epidemic. This report is particularly noted as the first to measure HIV incidence1. Chanda Kapata2 et al. posting results from Zambia’s largest population-based mobile testing survey (2013–2014) placed the HIV prevalence rate generally lower. In 2002, the National AIDS Council (NAC) was established to lead a multisectoral national response to stem the tide. Government Agencies and the United Nations led the responses. In 1992, The World Health Organisation (WHO) observed that abstinence and marital fidelity might constitute strategies capable of completely eliminating the risk of infection from HIV and other sexually transmitted diseases (STDs). Yet funding for applicable initiatives has seldom been prioritised in this respect. On one hand, from the onset of global interventions, condoms were seen primarily as most potent towards reducing the risk of infection. On the other hand, in due course, the implementation of Abstinence and Being Faithful (AB) initiatives by Churches among others, has since been seen as holding massive comparative advantage in facilitating sustainable interventions for prevention and mitigation of AIDS impact. However, church-congregation engagement in AIDS work, for a while, remained under-researched, and applicable interventions were often undocumented and unmeasured in relation to impact. This study investigated (1) how interventions affect impacts in congregation-based HIV/AIDS programmes, and (2) how abstinence and marital fidelity function within the larger picture of overall strategies to combat AIDS. It examined the community work of the Circle of Hope Family Care Centre, a congregation-based HIV/AIDS support group initiative undertaken by the Northmead Assembly of God Church in Lusaka, Zambia. The main research question was: 1) Is a person’s sexual behaviour influenced by their attitude and behaviour towards God? Two subsidiary questions were: i) what are the factors that affect a person’s sexual lifestyle? ii) Does attendance at the church’s HIV/AIDS programmes cause a change of behaviour in a person’s sexual relationships? A triangulated methodology required the collection of both quantitative and qualitative data. The experimental design included a purposively selected intervention group and a control group. Both groups were studied by employing baseline first, and follow-up measures after three months. Quantitative data analysis was carried out in two stages comprising first, cross tabulations to examine the relationship between safer sexual behaviour and socio-economic variables. For the statistical analysis, chi-square tests of independence were conducted at the bivariate level, and the differences were determined at P < 0.01 and P < 0.05 significant level. Next, major predictors were carried out with the help of logistic regression analysis. The results of the logistic regression models were converted into odds ratios, which represented the effect of a one-unit change in the explanatory variable on the indicator of experiencing safer sexual practices and abstaining from sex. Qualitative data were analysed using Atals.ti software to produce the attendant themes and sub-themes. The results of the logistic regression analysis show that those who participated in the interventions were 4.1 times more likely to report having adopted new behaviour or modified old behaviour, specifically to live positively, than those who did not attend the interventions. Similarly, participants in the faith-based interventions were 2.3 times more likely than those who did not take part to report having adopted safer sexual practices. Further analysis revealed that those participants were more likely to report abstinence from sex than those who did not attend. The conclusion is that church congregations have immense comparative advantage to influence sexual behaviour through increasing captive audiences constituting the churches’ presence in the community. Additionally, their morally based interventions such as abstinence and marital fidelity show significant impact on sexual behaviour change and have potential to turn the tide of HIV/AIDS, as the tested models are replicable, scalable and sustainable.

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Mumba, Mumba. "Physical disabilities among adults with HIV/AIDS being managed by the Makeni home-based carers in Lusaka, Zambia." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&amp.

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HIV and AIDS are now being considered as a chronic disease. As people live longer the possibility of physical disability increases. This study aimed to investigate the nature of physical disability among HIV/AIDS adults cared for by the Makeni home-based carers in Lusaka, Zambia. Disability was measured based on the World Health Organisation International Classification of Functioning, Disability and Health. This study demonstrated that mostly mild impairments and mild to moderate activity limitations and participation restrictions exists among patients in the Makeni home-based care programme. This study concluded that physiotherapists and other health professionals will have to be more involved in the community home-based programs that are suited for people living with HIV/AIDS so that they are also provided with clinical assessments and rehabilitation services.

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Tembo, Doreen. "Strategies for HIV/AIDS prevention : a study of the policy of ABC in Zambia." Thesis, University of Oxford, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.550584.

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Abstinence, being faithful to one partner and correct and consistent condom use (known as ABC) has been a widely discussed and utilised HIV/AIDS prevention strategy. In 2003, policy analysts predicted that Zambia would follow the Ugandan trajectory of HIV/AIDS incidence decline, because both countries were implementing ABC. However Zambia presently remains one of the countries with the highest HIV/AIDS prevalence rates. Limited policy research has been carried out to investigate why countries that have utilised ABC have experienced different HIV policy outcomes. This study investigates this issue by studying the extent to which poor policy design, content or implementation was to blame. The study employs a mixed methods approach and the analysis was guided by Knoepfel et al.'s (2007) framework which examines the policy processes though the interaction of policy actors, resources and institutional rules. The study found that ambivalence towards condom promotion, gender inequity and stigma towards HIV/AIDS negatively affected the development of a comprehensive ABC public policy in the 1990s. Negative views over teaching young children comprehensive sexual education and condom use appears to have affected both policy content and implementation. The study found that the decentralised and diversified nature of sexual health education is benefiting youth of higher social economic status. The study findings indicate that aid agencies utilised resources to propel the policy process towards a more comprehensive ABC public policy approach after 2000. Stigma continues to challenge programs delivered through the workplace. Information on prevention is still required in addition to information on treatment. Finally the study indicates that communities affect sexual behaviour choices as the study found that knowing someone living with HIV/AIDS was associated with positive behaviour change. The study confirms that Knoepfel et al.'s framework is a useful tool in the study of public policy. The findings contribute to an understanding of the process of policy determination and the analysis of policy content. The findings underscore the importance of engaging with socio-cultural, economic and political factors that influence ABC in order to reduce negative societal norms if policy is to be successful. The study also highlights that dependency on foreign aid can lead to a loss of autonomy. This consequently may lead to the adoption of policies and programs that are not locally accepted. The analysis also illustrates the need to utilise the right type of universal and targeted communications and programs to target the different components of ABC.

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Dloski, Anna. "Communicating sexual reproductive health and rights to Zambian youth : A case study of the non-governmental organization Youth Vision Zambia." Thesis, Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-28972.

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HIV/AIDS is widely spread in Zambia. Numerous organizations work to disseminate information about how individuals can prevent themselves and others from infection. Youth Vision Zambia (YVZ) is a non- governmental organization that works from Lusaka, Zambia to increase knowledge about sexual reproductive health and rights among young people aged 10-24. This qualitative case study explores which means of communication strategies YVZ uses to reach and inform their target group about Sexual Reproductive Health and Rights (SRHR) by interviewing staff working for the organization. A qualitative survey was also conducted where 29 respondents belonging to the target group answered questions regarding the information about SRHR they have received from YVZ, how they were reached and if they find the work of YVZ of importance. In order to also get a perception about the interpersonal communication channels YVZ use I attended four meetings arranged for young people where the purpose was to discuss sexual health related issues conducting participant observations. In addition, YVZ put an extensive effort on providing an SMS-short code system which allows people to send questions related to SRHR and in turn get answers from a YVZ councilor. The aim was to seek answers to whether the users had found the SMS service useful or not. The results show a variety of different communication tools that YVZ uses in their daily work and in the light of previous research on communication for development and social change and health communication an analysis was carried out.
HIV/AIDS har stor spridning I Zambia. Ett flertal organisationer jobbar med att sprida information om hur individer kan förhindra sig själva och andra att bli smittade. Youth Vision Zambia (YVZ) är en icke- statlig organisation som verkar i Lusaka, Zambia och jobbar för att öka kunskapen om sexuell reproduktiv hälsa och rättigheter (SRHR) bland unga människor i åldrarna 10-24 år. Denna kvalitativa fallstudie utforskar vilka typer av kommunikationsstrategier YVZ använder sig av för att nå ut till samt informera deras målgrupp om dessa områden. För att göra detta intervjuades personal som jobbar på organisationen. Studien ämnar också undersöka hur ungdomar som tagit del av YVZ’s information uppfattar den, om de anser den värdefull samt hur de fick kännedom om deras arbete, detta gjordes genom att utforma en kvalitativ enkät. 29 enkäter var det som i slutändan användes till sammanställningen av resultat och genomförandet av analys. YVZ jobbar även till stor grad med interaktiv kommunikation i deras arbete i att informera och engagera ungdomar vilket styrde intresset till att även genomföra deltagarobservationer. Vid fyra tillfällen blev således dessa observationer genomförda. Vidare lägger YVZ stor vikt vid att kommunicera via mobiltelefoni vilket visar sig genom deras short message system (SMS) där de erbjuder tjänsten att genom att skicka ett SMS till ett kortnummer innehållande frågor rörande SRHR och genom att göra det få svar och råd från personal från YVZ. Detta resulterade i att en SMS-enkät skickades ut innehållande endast en fråga med syfte att ta reda på om användare av tjänsten har funnit den värdefull eller ej. Resultaten som framkommit genom att tillämpa dessa metoder visar på en variation av kommunikationskanaler som YVZ använder sig av i deras dagliga arbete och i ljuset av litteratur som belyser kommunikation för utveckling och social förändring and hälsokommunikation så lägger denna studie fram en analys angående dessa.

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Laurence, Charlotte. "International policy co-ordination and HIV/AIDS : the impact of the WHO/GPA's global AIDS strategy on the development of national HIV/AIDS policies in Britain and Zambia." Thesis, University of Bath, 2000. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.760748.

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Kanyemba, Phyllis Changu Bune. "Uptake of Voluntary Counseling and Testing at Ngungu Mini - hospital, Zambia." Thesis, University of the Western Cape, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_2251_1299558390.

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In countries like Zambia where HIV prevalence (14.3% in the age group 15-49 years) is one of the highest in sub-Saharan Africa, HIV testing is an important strategy to combat the HIV/AIDS epidemic, because it is a critical step towards HIV/AIDS care, treatment and support. Despite decades of HIV/AIDS information and education campaigns, only 10% of Zambians know their HIV status. This study aimed to describe the uptake of voluntary counseling and testing and factors associated with uptake at Ngungu Mini - hospital in Ngungu Township, Zambia. Methodology: A descriptive, cross-sectional survey was conducted among 100 adult clients accessing health care at Ngungu mini - hospital during the second week of January 2009. Participants were asked to fill in a questionnaire on VCT, knowledge, attitudes towards HIV testing, and factors that promote/hinder HIV testing. Data was captured with Excel and basic descriptive analysis done using SPSS version 16.0 and Epi Info Version 3.3.1.

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Berglund, Lena, and Mattias Norlander. "MÖJLIGHETER OCH HINDER INOM PREVENTIVT HIV/AIDS-ARBETE : En intervjuundersökning, i Zambia, om rådgivares upplevelser." Thesis, Mid Sweden University, Department of Social Work, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-72.

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HIV/Aids är ett av de största globala problemen och utmaningar av idag. Södra Afrika är särskilt drabbat och detta påverkar många olika delar av mänskligt liv. Syftet med denna uppsats har varit att söka ökad förståelse för hur maktstrukturer, utifrån fem rådgivares upplevelser, påverkar det preventiva HIV/Aids arbetet. Vilka faktorer som utgör möjligheter och hinder samt ifall maktstrukturer bidrar till att inte förändring av beteende sker trots kunskap om dess risker, har getts stort fokus. Det geografiska området för studien var södra Zambia. Det finns inget givet svar på vår forskningsfråga, utan resultatet visar snarare på motsatser och komplexitet. Vår utgångspunkt har varit att det inte finns något självklart rätt eller fel och inte heller en enda sanning. Dock är vår slutsats att de möjligheter som finns kan basera sig i att ta hänsyn till lokala förhållanden och maktstrukturer.

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Moomba, Kaala. "A qualitative study of barriers to adherence to antiretroviral treatment among patients in Livingstone, Zambia." Thesis, University of the Western Cape, 2012. http://hdl.handle.net/11394/4482.

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Magister Public Health - MPH
Introduction: Zambia is among the countries in the sub-Saharan African region most severely affected with HIV/AIDS. Approximately 1.2 million (14%) Zambians were living with HIV in 2010. Zambia introduced antiretroviral therapy (ART) in the public sector in 2002, starting with two pilot sites, and rolling it out throughout the country in 2004 and 2005. To date,approximately 350,000 people have accessed HIV treatment. The long-term success of ART programs depends on optimal adherence to ART by patients.In 2010 Livingstone General Hospital (LGH), the setting for the current research had over 7,000 enrolled for HIV care of whom 3,880 patients were on ART. By the end of June 2011, it was reported that 343 patients in this hospital were between 2 to 30 days late for their medication refill appointments. This meant that these patients had missed more than one dose, and thus not meeting the required 95% of medication for viral suppression. This study explored the barriers to medication adherence experienced by ART patients at Livingstone General Hospital (LGH). Methodology: An exploratory qualitative study was conducted. Six focus group discussions(FGD) were conducted with 42 patients on ART, and follow up semi-structured interviews with 7 patients identified during the FGDs. FGDs and semi-structured interviews were audio-tape recorded and transcribed verbatim. Thematic and content analysis of transcribed data was done. Results: The study found that the barriers to ART adherence included socio-economic factors such as poverty, use of traditional complementary and alternative medicines (TCAM) and religious beliefs. Patient related factors reported to negatively affect adherence were HIV related-stigma and discrimination, alcohol use, low literacy and education levels, busy daily schedules and forgetfulness. Regimen related factors included experiencing side effects to medication and complexity of treatment regimen. Negative staff attitudes, traveling long distances to health facility, long waiting times, lack of confidentiality, poor health information and poor patient-health provider relationships were the health system factors that negatively impacted on ART adherence. Conclusion: The combination and complexity of factors affecting adherence identified in this study have posed a challenge to adherence to ART. People have been forced to make adjustments to their routine lives in order to accommodate ART. The most problematic factor identified was the use of TCAM in combination with ART or as replacement of ART.

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Simuyaba, Melvin. "Experiences of early antiretroviral therapy (art) initiation among people living with HIV in Livingstone district in Zambia." University of the Western Cape, 2018. http://hdl.handle.net/11394/6547.

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Magister Public Health - MPH
Being healthy (‘feeling fine’) and health deterioration (‘getting sick’) were key health concerns among PLHIV prior to ART initiation. PLHIV often referred living with HIV as ‘being sick’ and experiencing poor health when already infected with HIV as ‘very sick’ and this perception about sickness and wellness partly determined the need and value placed on accessing HIV services. Motivations for starting treatment included needing to maintain or regain health, encouragement from HCWs, relatives and friends and believing in the effectiveness of ART to improve health. Prevention of HIV transmission to others was not cited to influence uptake. The majority of PLHIV reported stringent adherence to ART; even a half-hour delay in taking treatment was sometimes defined by participants as ‘non-adherence’. Initial reminders for taking ART (setting alarm, placing pills where visible) fell away as daily medication became routine. However, daily uptake of treatment had its own psychosocial and economic consequences which PLHIV had to navigate. With few exceptions, when taking the first line regimen, most PLHIV experienced both temporal (hallucinations, vomiting) and long-term (dizziness and irregular heartbeat) side-effects attributed to ART, which although not considered life threatening, could undermine ART adherence. HIV status disclosure was both limited and selective (mainly to spouses, close relatives, friends and co-workers) and deemed as promoting adherence to treatment and access to HIV services. HIV/AIDS stigma persisted even among relatively healthy PLHIV due to links with ‘promiscuity’, hampering disclosure and access to HIV services. Competing demands on participants’ time, especially livelihood activities, also disrupted accessing services. Good relationships between HCWs and PLHIV promoted access to services.

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Chilufya, Patrick Mukuka. "Impact of antiretroviral therapy on risky sexual behaviour in people living with HIV and AIDS (PLWHA) in Lusaka District of Zambia." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97951.

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Thesis (MPhil)--Stellenbosch University, 2015.
ENGLISH ABSTRACT: The aim of the study was to investigate to what extent the availability of antiretroviral treatment has influenced sexual risk behavior practices in people living with HIV and AIDS (PLWHA) in order to provide suggestions to improve HIV prevention messages. The study was conducted among adult HIV patients on ART aged 18 and above and affiliated to the Network of Zambian People Living with HIV/AIDS (NZP+) in Lusaka District. A purposive sampling method was used to select study units and a sample of 40 was selected. Data was collected from participants using a self-administered questionnaire. SPSS version 20 software computer package was used to analyze data. Chi- square was used to measure associations between dependent variables (risky sexual behavior and initiation of ART) and the independent variable (duration of time on ART). With the confidence interval set at 95%, the P value was used to ascertain the degree of significance by using the decision rule which rejects the null hypothesis if P value is equal or less than 0.05. The findings revealed that the participant's mean age was 2.8 ± 1.3 SD. More than half (68%, n=27) of the participants had adequate knowledge on HIV prevention while 90% (n=36) of participants had a good (positive) attitude towards ART. 82.5% (n=33) of the participants on ART had sexual intercourse in the last 6 month, and 21.2% (n=7) of these did not use a condom for secondary prevention. There was no significant correlation between being on ART and having sexual intercourse, condom usage or number of sexual partners OR (P value of 0.45 and 0.85), (P values 0.37 and 0.5) and (P value 0.34 and 0.57) respectively. In multivariable analysis, the majority of the respondents (35.5%, n=11) indicated that continued sensitization would improve HIV prevention messages to support communities affected. Few (29%, n=9) stated that: "promoting abstinence among the youths or use of a condom for those that are sexually active and intensifying VCT campaign would reduce HIV transmission" and 7% (n=2) of the respondents suggested that; "involving the families and communities affected, civic, religious, and traditional leaders to educate both the young and adult citizens in schools, colleges and churches to support PLWH and fight against HIV-related stigma and discrimination. Stellenbosch University https://scholar.sun.ac.za iii A significant association was not found between an increase in risky sexual behavior or an upsurge in the occurrence of unprotected sex, initiation of ART and duration of being on ART. The majority (83%, n=15) of the respondents on ART for less than sixty months had protected sexual intercourse and 73% (n=11) on ART for sixty months and above also used protection. This association was statistically not significant (Chi-square value 2.95. P value > 0.05). However; other studies need to explore these subjective interpretations further.
AFRIKAANSE OPSOMMING: Nie beskikbaar

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Lundström, Tomas. "The impact of Global Health Initiatives and HIV and AIDS Programs on the Zambian Health System." Thesis, Mittuniversitetet, Institutionen för hälsovetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-16554.

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Background: The Human immunodeficiency virus infection (HIV) and Acquired immunodeficiency syndrome (AIDS) epidemic peaked in 1999, which led to an increase in funding by donors and Global Health Initiatives (GHI) to combat the epidemic. This literature review examined how the substantial influx of funding for GHI’s and HIV and AIDS since early 2000 has impacted the health system in Zambia. Method: The method used for the study was a systematic literature review. Results: There is conflicting views and mixed evidence about whether GHIs and HIV and AIDS initiatives have benefitted the general health system. It is clear that GHIs and HIV and AIDS initiatives have added substantially to the increase in funding for health in Zambia. Furthermore, it seems likely that the special attention put on HIV and AIDS created an exclusive and skewed environment with increased capacity to tackle HIV and AIDS, but with less capacity built for health services in general. In-coming support from Global Health Initiatives and funding for HIV and AIDS in Zambia has to some extent been controlled by and led by the contributing donor, giving the Zambian authorities limited oversight of the resources. Conclusions: The influx of funding for HIV and AIDS has led to increased support for a specific disease, but it has not generated support to the health sector in general. It has also led to a fragmented approach, where HIV and AIDS have fallen outside of the regular coordination of the health sector. Keywords: Zambia, HIV and AIDS, Health systems, vertical initiatives, strengthening, impact.
Bakgrund: The Human Immunodeficiency Virus Infection (HIV) och Acquired Immunodeficiency Syndrome (AIDS) epidemin var på sin högsta nivå 1999, vilket ledde till en kraftig ökning av resurser från givare och globala hälsoinitiativ för att bekämpa epidemin. Denna genomgång av litteraturen undersökte hur denna tillväxt av resurser sedan början av 2000-talet påverkade hälsosystemet i Zambia. Metod: Den metod som användes för studien var en systematisk litteraturgenomgång. Det finns olika slutsatser och bevis för om insatser för HIV och AIDS och globala hälsoinsatser har gynnat hälsosystemet. Resultat: Det är klart att insatser för HIV och AIDS och globala hälsoinsatser har bidragit substantiellt till finansiering av hälsosektorn i Zambia. Studien visade att det är troligt att det särskilda fokus som HIV och AIDS fick skapade en exklusiv och snedvriden miljö, med ökad kapacitet för att hantera HIV och AIDS, men med mindre kapacitet för hälsosektorn generellt. Det stöd och resurser från globala hälsoinitiativ och för HIV och AIDS som Zambia fick del av, har till en del varit kontrollerat av och letts av bidragsgivaren, vilket ledde till att Zambiska myndigheter hade begränsad kontroll över dessa resurser. Slutsats: De ökade resurser som tillkom för att bekämpa HIV och AIDS innebar en ökad satsning på dessa sjukdomar men det har bevisats att detta inte genererade tillräckligt stöd till hälsosystemet. Detta ledde också till en fragmenterad satsning, där HIV och AIDS har hanterats utanför den vanliga samordningen av hälsosektorn. Nyckelord: Zambia, HIV och AIDS, Hälsosystem, vertikala initiativ, stärkande, effekt.

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Chaava, Thebisa Hamukoma. "Skills, training and support for carers in HIV/AIDS community home-based care: a case study of carers in Chikankata, Zambia." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&amp.

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The high prevalence of HIV/AIDS in Zambia has led to the development of innovative ways of coping with sickness related to this infection. HIV/AIDS home-based care is one such innovation designed in Chikankata Hospital in 1987. Home-based care depends on the availability of family members and community volunteers in the provision of care and support for People Living with HIV/AIDS (PLWHA).

This minithesis is based on a qualitative descriptive case study exploring perspectives regarding skills, supervision and support mechanisms for carers in the Chikankata HIV/AIDS Community-Home Based Care (CHBC) program. The study utilized documented research, focus group discussions with carers and structured interviews with local CHBC supervisors, national experts in CHBC, and PLWHA and their families, to collect data from 32 study participants.

The findings were that CHBC was being delivered by community volunteers with limited involvement from the local health services
that carers were highly motivated, personally and collectively mobilizing resources to meet the needs of CHBC clientele
that local arrangements for training, skills and support of carers were not aligned to national guidelines regarding process, content and duration of programmes
and that carers acquired skills in CHBC through formal and informal training processes and were facing challenges related to inadequate skills, poor infrastructure and extreme poverty in households caring for PLWHA.

Based on the findings the local arrangements for coordination of CHBC need to be strengthened and linked to formal processes for technical support, financial resources and materials for delivery of CHBC in line with existing guidelines on CHBC. The picture of the real situation of the carers that emerges from this qualitative study might inform the supervising organizations and policymakers on the gaps in the training and support of this crucial cadre in the provision of quality care for People Living with HIV/AIDS (PLWHA) at community level.

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Nyerges, Jana Ramona Alley. "HIV/AIDS prevention in Zambia a preliminary study of obstacles to behavior change in the copperbelt." Thesis, Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 2006. http://library.nps.navy.mil/uhtbin/hyperion/06Jun%5FNyerges.pdf.

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Thesis (M.A. in National Security Affairs)--Naval Postgraduate School, June 2006.
Thesis Advisor(s): Letitia L. Lawson, Jessica R. Piombo. "June 2006." Includes bibliographical references (p.61-67). Also available in print.

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Mulenga, Kennedy Chola. "Empowering church-based communities for home-based care : a pastoral response to HIV/AIDS in Zambia." Pretoria : [s. n.], 2007. http://upetd.up.ac.za/thesis/available/etd-09102008-155522/.

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Björk, Adina. "Co-ordinating HIV/AIDS strategies: The case of NGO`s and other development actors in Zambia." Thesis, Linnéuniversitetet, Institutionen för samhällsstudier (SS), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-85464.

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There have been many different efforts done to design coordination models for aid, but less research has been focusing on the efficiency and function of these implementation policies. Both the Paris Declaration and the Sector-Wide Approach has been launched with the purpose to improve countries aid coordination strategies. This by a joint cooperation between development actors at different levels of society, locally, nationally and internationally. This thesis aims to investigate what NGO`s, private businesses and the Zambian state are practically doing, through the methodological framework of a qualitative desk study. Focus will also be on Zambia`s aid coordination strategies within the health sector, and specially towards HIV/AIDS. This through a broad perspective, from the global policies which includes international donors, to the local level such as NGO`s (Sundewall, 2009).vThis paper aims to problematize the question of how development actors coordinate aid towards the health sector, to address the HIV&AIDS issue in Zambia. This by using social constructivist view, text analysis and two main analytical approaches. The community mobilization and the top-down & bottom up will be used as analysing tools, by an abductive approach (Klotz & Lynch, 2014; Campbell & Cornish, 2010; Fraser et al; 2005). Overall results provide information about two sides of argument of aid coordination. Some researchers argue for the negative impact of aid, through ineffective coordination through the existing fund mechanisms, like the current parallel funding within the health sector. These funds for HIV/AIDS are channelled separately through the National AIDS Council. However, others argue for the importance of aid to improve local community participation (Sundewall, 2009). Since the year of 2007 when Zambia adopted new aid policies by formulate the joint assistance strategy for Zambia JASZ, the country has had the structure to be able to follow the Paris declaration strategies from 2005. However, in practice the country still has overall improvements to do, since four of the indicators recorded a setback, while eight other targets showed a positive progress, but still need improvements (Leiderer, 2015).

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Chinkubala, Lontia. "To investigate the extent to which under-five HIV positive children access Antiretroviral Therapy (ART) : a case of Siavonga District of Southern Province of Zambia." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97087.

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Thesis (MPhil)--Stellenbosch University, 2015.
ENGLISH ABSTRACT: The impact of HIV/AIDS has affected all categories of people in society, including children under the age of five. This segment of the population depends entirely on adults and older children in order for them to survive. This research endeavoured to investigate the extent to which under-five HIV positive children access ART in Siavonga District in the Southern Province of Zambia. The necessity of such information for all cannot be over-emphasised as this category of the population under study is among the most neglected when it comes to issues of HIV/AIDS. Under-five HIV positive children need special attention in order for them to enjoy their right to survival and development. In terms of methodology, the research took an interpretive approach as it employed the qualitative methodology in its endeavours, in order to get an in-depth understanding of people’s views on the topic under research. Different interview schedules were used to collect data from community members, Community Health Workers (CHW), Home-based Care Providers (HBCP), staff of the Ministry of Health and District AIDS Task Force (DATF). The findings of this research addressed all the objectives but one. This research revealed that almost all the community members in Siavonga District had general knowledge about HIV/AIDS and the need for under-five HIV positive children accessing antiretroviral therapy. However, their attitudes and practices varied when it came to the application of this knowledge. According to respondents, the major challenges that under-five HIV positive children were facing when it came to accessing ART were as follows: food insecurity, followed by access to health facilities and social matters. Others included stigma and discrimination, long distances to health facilities, inadequate disposable income at household level and negative attitudes by some people who think that it is a waste of time and resources to give too much attention, including ART to under-five HIV positive children whom according to them will die soon. However, the majority of respondents indicated that there was need to accept these children like any other as they too had the right to live; hence, they needed care and support which included facilitating their access to ART. This research was an eye opener to all duty bearers to recognize and acknowledge the importance of under-five HIV positive children’s access to ART. This will contribute towards enhancing the will to step up efforts for this intervention. From the findings, it is evident that there is need for income generating activities to provide disposable income to people of Siavonga District so that they give appropriate support, particularly to children who are infected or affected by HIV/AIDS. Furthermore, more resources are required from NGOs, government and other stakeholders to enhance not only sensitization on the importance of the target population’s access to ART, but also provision of these ART services. All relevant stakeholders should heed the call to aggregate information for under-five HIV positive children in question so as to specially target interventions accordingly.
AFRIKAANSE OPSOMMING: Die impak van MIV/Vigs raak alle kategoriee van mense in die samelewing, insluitende kinders jonger as vyf jaar oud. Die segment van die bevolking is heeltemal afhanklik van volwassenes en ouer kinders om te oorleef. Hierdie navorsing poog om die omvang van kinders jonger as vyf, wie MIV positief is, se toegang tot antiretrovirale terapie (ART) in die Siavonga Distrik van die suidelike provinsie van Zambia te ondersoek. Die noodsaaklikheid van sodanige inligting vir alle sektore in die samelewing kan nie oorbeklemtoon word nie, aangesien hierdie kategorie van die bevolking een van die mees verwaarloosde is wanneer dit kom by MIV/Vigs verwante kwessies. Kinders jonger as vyf wie MIV positief is, moet spesiale aandag ontvang sodat hulle reg op oorlewing en ontwikkeling kan geskied. In terme van die metodologie het die navorsing ‘n beskrywende benadering gevolg om die kwalitatiewe metode in sy poging, ten einde ‘n in-diepte begrip van mense se standpunte oor die onderwerp onder navorsing te kry. Verskillende onderhoude is gebruik om data in te samel van gemeenskapslede, gesondheidswerkers in die gemenskap, tuisversorgers, personeel van die Ministerie van Gesondheid en Distriks vigs-taakspan. Die bevindinge van hierdie navorsing het al die doelwitte, behalwe een, aangespreek. Die navorsing het getoon dat byna al die gemeenskapslede in Siavonga Distrik algemene kennis het oor MIV/Vigs en die behoefte van kinders jonger as vyf se toegang tot ART. Hul houdings en praktyke verskil egter in die toepassing van hierdie kennis. Volgens die respondente is die grootste uitdagings wat kinders jonger as vyf ondervind wanneer dit kom by toegang tot ART is voedselonsekerheid, gevolg deur toegang tot gesondheidsfasiliteite en sosiale aangeleenthede. Ander sluit in stigma, diskriminasie, lang afstande na gesondheidsfasiliteite, onvoldoende besteebare inkomste op huishoudelike vlak en negatiewe houdings van sommige mense wat dink dat dit ‘n vermorsing van tyd en hulpbronne is om aan kinders jonger as vyf te spandeer, aangesien, die kinders in elk geval (volgens hulle) binnekort sal sterf.Die meerderheid van die respondente het aangedui dat dit nodig is om hierdie kinders soos enige ander kind te aanvaar en dat hulle ook die reg het om te leef: daarom dat hulle sorg en ondersteuning benodig, wat die fasilitering van hul toegang tot ART insluit. Hierdie navorsing het weer die klem geplaas op die belangrikheid van kinders jonger as vyf se toegang tot ART. Dit is duidelik dat daar ‘n behoefte is aan inkomste-genererende aktiwiteite en om besteebare inkomste aan die mense van Siavonga Distrik te voorsien, sodat hulle toepaslike ondersteuning kan bied, veral aan kinders wat deur MIV/Vigs geraak word. Verder is meer hulpbronne nodig van nie-regeringsorganisasies, die regering en ander belanghebbendes, nie net om die belangrikheid van die teikenbevolking se toegang tot ART nie, maar ook vir voorsiening van hierdie ATR dienste.

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Simms, Chris. "The reasons for increased childhood mortality in Zambia 1980-90 and their relevance in the 1990s." Thesis, University of Sussex, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.263914.

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Mulenga, Kennedy Chola. "Changing risky behaviour through worldview transformation : a pastoral intervention to the spread of HIV/AIDS in Zambia." Thesis, University of Pretoria, 2010. http://hdl.handle.net/2263/24798.

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The study investigates how the church in Zambia can effectively facilitate change toward reducing HIV-risky behaviour. The researcher posits that an intricate connection exists between HIV-risky behaviour and the socio-cultural context of majority people groups in Zambia. He further argues that much risky behaviour is imbedded in pervasive socio-cultural norms and traditions propelled by a worldview which essentially resists transformation. From an insider’s perspective the researcher will design a praxis model for transforming Zambian worldview facets with regard to HIV/AIDS predisposing behaviours in order to achieve enduring HIV risk reduction. The study reviews current literature on HIV behavioural change theories and models to understand where the theories have taken all the stakeholders, including theological praxis. The study will demonstrate the link between Zambian cultural worldviews and trends in sexual behaviour which, arguably, facilitates the proliferation of HIV risky behaviour. The study culminates in designing an evangelical theological praxis/model for transforming relevant cultural worldviews toward changing HIV risky behaviour in Zambia.
Thesis (PhD)--University of Pretoria, 2010.
Practical Theology
unrestricted

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Njekwa, Lumbwe Yuyi. "A case study of the flying angels HIV support group for people living with HIV and aids in Ng’ombe compound, Lusaka, Zambia." University of Western Cape, 2013. http://hdl.handle.net/11394/3917.

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Magister Public Health - MPH
HIV support groups have been widely adopted as part of care and support interventions in Zambia, yet there is very little research on the effectiveness of these groups in meeting the needs of the PLWHIV from the perspective of those who join them. This case study looks at a selected support group for People Living with HIV and AIDS (PLWHIV) facilitated by the Flying Angels, a faith based non-governmental organization established in 2007 by the Living Assemblies of God Church, in Ng‟ombe Township, Lusaka. The Support Group brings together around eighty young and old, married and single, men and women living with HIV and AIDS, to share experiences and find ways of coping with their situation. The qualitative case study sought to obtain a rich understanding of the experiences of members with a view to understanding the support they needed, the aspects of the support group that are relevant and effective to their situation, and which are not. In-depth interviews and focus group discussions methods were used to collect data. Discussion and interviews were audio-taped. Audio-recordings were translated during transcription, data organized, coded and thematically analysed.

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Mweemba, Prudencia. "Quality of Life among Rural and Urban Zambian Men and Women with HIV/AIDS." Kent State University / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=kent1216832245.

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41

Stull, Valerie Jo. "Agriculture programs impacting food security in two HIV/AIDS-affected Kenyan and Zambian communities." Thesis, Manhattan, Kan. : Kansas State University, 2009. http://hdl.handle.net/2097/2306.

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Waller, Marie-Katherine. "The silenced realities of HIV/AIDS: Women's Experiences through Changing Gender, Kinship and Moral Landscapes in Urban Zambia." Thesis, SOAS, University of London, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.406015.

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Chitambala, Cecilia. "Factors affecting HIV counselling and testing (HCT) in the provision of prevention of mother to child transmission (PMTCT) services among pregnant women in Kabwe, Central Province of Zambie." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/79955.

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Thesis (MPhil)--Stellenbosch University, 2013.
ENGLISH ABSTRACT: This research study looked at the factors that affect HCT in provision of PMTCT services. It explored the socio cultural and personal factors that affect HCT. It also established the knowledge level about HIV/AIDS and PMTCT among pregnant women in Kabwe. The transmission of HIV from mother to child contributes largely to HIV prevalence among children. Efforts to reduce this mode of transmission include increasing number of women who know their HIV status and increasing the number of HIV positive women who when pregnant take instructions and act on them to protect their children from the possibility of infection (Bartlett et al. 2004). Individuals can only know their HIV status once they are tested for HIV. However, there are socio cultural and personal factors among other factors that affect the access of HCT. The aim of this study was to identify socio cultural and personal factors that affect HIV counseling and testing in provision of PMTCT services among pregnant women in Kabwe, in order to make recommendations for the development of an intervention program to help improve uptake of HIV counseling and testing for PMTCT services. Both quantitative and qualitative methodologies were used to conduct this study. Focus Group Discussions were conducted with groups of pregnant women that have never been tested for HIV before and Key Informant Interviews with health care workers (midwives or nurses) to ask them about factors affecting HCT in provision of PMTCT services among pregnant women were used. A retrospective statistical report review was also used to ascertain the accessibility rate for the HIV counseling and testing for PMTCT services. In this light, statistical report review was used to collect the number of pregnant women attending ANC and number of pregnant women receiving HIV testing. The findings of this study revealed that the pregnant women had excellent knowledge about HIV/AIDS and the update of HCT was as good as 91% among pregnant women. The research also revealed domestic violence, accusation of promiscuity by partner, abandonment by partner, and stigma & discrimination as socio factors that affect HCT in provision of PMTCT. Religion, fear disbelief of test results was revealed as personal factors affecting HCT in provision of PMTCT. The research revealed decision making, tradition medicines, and practices as cultural factors affecting HCT in provision of PMTCT. The conclusion was made that fear of abandonment by partner, fear of being accused of being promiscuous by partner, and fear of domestic violence were the main factors why some pregnant women did not accept to take an HIV test during their pregnancies. It is also concluded that most men make decisions for their families. Women in homes have no powers to make decisions, so if the husband refuses her to take a test, the wife just has to comply. It is also concluded that a person’s ability to access health related services is shaped by socio cultural and personal factors among others factors. These findings fit well with the Anderson behavioral model which describes the individual factors as having three elements that relate to the individual’s ability to access and utilize health care services.
AFRIKAANSE OPSOMMING: Hierdie navorsingstudie het gekyk na die faktore wat 'n invloed HCT in die voorsiening van VMTKO dienste. Dit ondersoek die sosio-kulturele en persoonlike faktore wat HCT. Dit het ook die kennis oor MIV / VIGS en VMNKO onder swanger vroue in Kabwe. Die oordrag van MIV van moeder na kind dra grootliks by tot die voorkoms van MIV onder kinders (Bartlett et al. 2004). Pogings om hierdie wyse van oordrag te verminder sluit in toenemende aantal vroue wat hul MIV-status ken en die verhoging van die aantal MIV-positiewe vroue wat toe swanger neem instruksies en reageer op hulle om hul kinders te beskerm teen die moontlikheid van infeksie. Individue kan slegs weet wat hul MIV-status wanneer hulle getoets word vir MIV. Egter, is daar sosiaal-kulturele en persoonlike faktore onder ander faktore wees wat die toegang van HCT. Die doel van hierdie studie was om sosiaal-kulturele en persoonlike faktore wat die MIV-berading en toetsing in die voorsiening van VMTKO dienste onder swanger vroue in Kabwe te identifiseer, ten einde aanbevelings te maak vir die ontwikkeling van 'n intervensie program te help opname van MIV-berading en toetsing vir VMNKO dienste te verbeter. Beide kwantitatiewe en kwalitatiewe metodes is gebruik om hierdie studie uit te voer. Fokusgroepbesprekings is gevoer met groepe van swanger vroue wat nog nooit vir MIV getoets is voor en onderhoude met sleutelinformante met gesondheidsorgwerkersVroedvroue of verpleegsters) is gebruik om hulle te vra oor die faktore wat HCT in voorsiening van PMTCT dienste onder swanger vroue. 'n Retrospektiewe statistiese verslag review is ook gebruik om die toeganklikheid koers vir die MIV-berading en om vas te stel toetsing vir VMNKO dienste. In hierdie lig, is statistiese verslag hersiening gebruik word om die aantal swanger vroue wat die ANC en die aantal swanger vroue MIV-toetsing in te samel. Die bevindinge van hierdie studie het aan die lig gebring dat die swanger vroue het uitstekende kennis oor MIV / VIGS en die update van HCT was so goed as 91% onder swanger vroue. Die navorsing het ook aan die lig gebring huishoudelike geweld, beskuldiging van losbandigheid deur vennoot, verlating deur vennoot, en stigma diskriminasie as sosio faktore wat 'n invloed HCT in die bepaling van die PMTCT. Godsdiens, vrees ongeloof van toetsresultate is geopenbaar as persoonlike faktore wat HCT in die voorsiening van PMTCT. Die navorsing het aan die lig gebring besluitneming, tradisie medisyne, en praktyke as kulturele faktore wat HCT in die voorsiening van PMTCT. Die gevolgtrekking is gemaak dat vrees vir verlating deur vennoot, vrees daarvan beskuldig dat hy van promisku deur vennoot, en die vrees van huishoudelike geweld was die belangrikste faktore waarom sommige swanger vroue nie aanvaar het nie 'n MIV-toets te neem tydens hul swangerskappe. Dit is ook die gevolgtrekking gekom dat die meeste mense besluite neem vir hul families. Vroue in huise het geen magte om besluite te neem, so as die man weier om vir haar 'n toets te neem, die vrou net om daaraan te voldoen. Dit is ook die gevolgtrekking gekom dat 'n persoon se vermoë om gesondheid verwante dienste om toegang te verkry tot gevorm word deur die sosiaal-kulturele en persoonlike faktore onder andere faktore. Hierdie bevindings pas goed met die Anderson gedrags-model wat die individuele faktore beskryf met drie elemente wat betrekking het op die individu se vermoë om toegang te verkry tot en gebruik van gesondheidsorgdienste.

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Kanene, Cuthbert. "Assessment of the coverage and quality of HIV diagnosis, prevention and care activities within the TB programme in Livingstone District, Zambia." Thesis, University of the Western Cape, 2012. http://hdl.handle.net/11394/4506.

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Magister Public Health - MPH
In recognition of high dual burden of tuberculosis (TB) and Human Immunodeficiency virus(HIV) in Sub-Saharan Africa, the World Health Organization (WHO, 2004) provided guidance for implementing integrated HIV/TB services. This strategy has been implemented using different models ranging from partial to fully integrating, and evaluations of these models have been conducted to determine their effectiveness. The aim of this study was to describe and contrast the effectiveness of different models of implementation of HIV and TB integration at primary care level within the Tuberculosis (TB) programme in Livingstone District, Zambia The specific objectives of the study included; 1. To describe the models of integrated HIV and TB services that are currently implemented at four health facilities within the TB programme in Livingstone District at primary health care level. 2. To describe and contrast the coverage and quality of HIV diagnosis in the Tuberculosis(TB) programme achieved in the different facilities representing fully and partially integrated models of service delivery. 3. To describe and contrast the coverage and quality of HIV prevention activities in the Tuberculosis (TB) programme achieved in the different health facilities representing fully and partially integrated models of service delivery. 4. To describe and contrast the coverage and quality of HIV care activities received by coinfected clients in the Tuberculosis (TB) programme in the different facilities representing fully and partially integrated models of service delivery. 5. To describe the quality and outcomes of TB diagnosis and treatment in the different facilities representing fully and partially integrated models of service delivery. A research design using quantitative methodologies: a cross sectional survey and structured observations or review of patient records (quantitative) were used. The records of 814 TB clients notified in 2010 served as the study population while the sample of 464 (232 from partially and 232 from fully integrated) were randomly selected. Two data collection tools namely: patient record and HIV/TB register review; facility staff interviews (key informant interviews) were used and the results were analyzed using Epi info statistical package. In the study, all respondents gave informed consent and no personal information was collected from the retrospective record review. The HIV prevention interventions in this study were rated below 30% except for of HIV education (97%). Statistically significant differences (p-value<0.001) existed for condom provision at facility level. Poor performance reported for STI screening (below 2%) and PMTCT information (below 15%). The HIV testing rate was 94% among TB clients which was higher than the counseling coverage of 88%. Statistically significant differences (p value <0.001) at facility level existed for clients who received HIV test results. Sixty three percent (63%) of TB clients were also co- infected with HIV. ART assessment for TB clients was below 40% and statistically significant differences (p value=<0.001) between facilities were identified for this indicator. ART assessment of TB clients at the same facility they tested for HIV was above 50% for all facilities. The continuation of cotrimoxazole was poor at 38% and statistically significant differences (p value=<0.001) were identified for this indicator between facilities. Sputum testing was 85% while the cure rate was poor at 28% average for all facilities. Statistically significant differences (p-<0.001) were noticed at model level for clients cured. Although HIV prevention and care services were introduced in the TB program in Livingstone,they were not comprehensive enough to respond to the high HIV and TB co-infectivity. For HIV prevention, other than HCT and HIV education, the rest of the critical interventions such as condom provision, STI screening and treatment, and PMTCT intervention were neglected. The HIV care services such as ART assessment and CPT implementation were also poor. There is need to put in place systems to improve these services in the district to improve treatment outcomes. The differences that were noted in performance for the majority of the indicators were mainly at facility level as being a fully integrated facility did not guarantee effective integration or better performance.

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Nikisi, Joseph. "Access to antiretroviral treatment in the public sector, in Zambia." Diss., Pretoria : [s.n.], 2006. http://upetd.up.ac.za/thesis/available/etd-04282009-163207.

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Bwalya, Clement Mudala. "Retention in HIV care among female sex workers on antiretroviral treatment in Lusaka, Zambia: A retrospective cohort study." University of the Western Cape, 2020. http://hdl.handle.net/11394/8045.

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Master of Public Health - MPH
Background: HIV/AIDS remains a major public health issue that is affecting all population groups and communities in Zambia. Among the most affected groups are key populations (KPs) such as female sex workers. KPs are considered at high risk of contracting HIV but have limited access to HIV services and retention in care due to internalized stigma, discrimination, criminalization, and negative attitudes towards HIV treatment. Under the USAID Open Doors project in Zambia, KPs access comprehensive HIV prevention, care and treatment services. The test and treat strategy is implemented by the project in support of the UNAIDS 90-90-90 targets by 2020 to diagnose 90% of people living with HIV, put 90% of them on treatment, and for 90% of them to have suppressed viral load. Aim: This study aimed to determine retention in care among female sex workers (FSWs) in the first six months after ART initiation using the HIV care cascade. Methodology: A retrospective cohort study was conducted of all new HIV positive female sex workers (FSWs) initiated on ART between October 2018 and June 2019 (9 months period) based on the electronic records. Data were extracted from SmartCare, an electronic health record system used by the ART clinic. Microsoft Excel and Epi-Info 7 software were used for data entry and analysis. Kaplan–Meier survival analysis was conducted to examine differences in retention rates. Results: A total of 205 FSWs were initiated on ART, out of which 180 were active on ART (36 youths and 144 adults) and 25 were lost to follow-up (four youths and 21 adults) during the 9 months study period. Of the 180 FSWs active on ART, 36 were FSWs aged 18 – 24 years (youths) representing 90% retained in care while 144 were FSWs aged 25 – 42 years (adults) with 87% being retained on ART treatment. Retention in ART care was not significantly different in the survival curves between the age groups of FSW youths and FSW adults during the study period (p-value = 0.637). Retention in ART care was not statistically significant for education (p-value = 0.481), marital status (p-value = 0.545), and occupation (p-value = 0.169). Conclusion: Retention in ART care among FSWs was 88%. However, there were no significant differences by age group identified in this study. While this study shows 88% retention rate among FSWs, it will be used as a baseline in meeting the UNAIDS 90-90-90 goals.

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47

Sturesson, Annika, and Sara Håkansson. "Oral hygiene experience, knowledge of oral health and oral diseases and attitudes about oral health care : A questionnaire study among students of nursing in Zambia." Thesis, Högskolan Kristianstad, Sektionen för Hälsa och Samhälle, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-7367.

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The aim of the study was to investigate oral hygiene experience, knowledge of oral health and oral diseases and attitudes about oral health care among students of nursing at the School of Nursing in Livingstone, Zambia. The respondents were women and men in the ages between 20 and 43. A questionnaire consisting of 29 questions was handed out to 119 students. The results showed that the majority of the students brushed their teeth every day. Visits to dental clinics, however, were few. The most common reason for dental visits was pain. Most of the respondents knew about one or more HIV-related oral diseases, and the most common answer was oral candidosis. The overall knowledge of HIV/AIDS-related oral lesions was very high, and the majority of the respondents were interested to receive more information about the subject. The respondents had good knowledge in oral health and oral diseases, and the majority had a positive attitude concerning oral health care providers. The majority also considered collaboration between dental care and regular health care as essential. Although the knowledge about oral health was good, the result showed infrequent dental visits among the respondents.
Syftet med studien var att undersöka sjuksköterskestudenters munhygienvanor, deras kunskaper om oral hälsa och orala sjukdomar samt attityder till munhälsovård. Ett frågeformulär med 29 frågor delades ut till 119 andra- och tredje års studenter på sjuksköterskeskolan i Livingstone, Zambia. Respondenterna var både kvinnor och män mellan 20 och 43 år. Resultatet visade att flertalet studenter borstade sina tänder dagligen. Däremot var det ovanligt med täta tandvårdsbesök och den vanligaste orsaken till besök var smärta. Majoriteten av studenterna hade goda kunskaper om HIV-relaterade orala lesioner och det vanligaste svaret de uppgav var oral candida. De generella kunskaperna om HIV/AIDS- relaterade orala lesioner var väldigt goda och majoriteten av respondenterna var intresserade av mer information i ämnet. Generellt hade respondenterna goda kunskaper om oral hälsa, orala sjukdomar och majoriteten hade en positiv attityd till munhälsovård. Flertalet ansåg att ett samarbete mellan tand- och sjukvård var betydelsefullt. Trots den höga kunskapsnivån om oral hälsa visar resultatet att respondenterna inte besöker tandvården regelbundet.

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48

Nyman, Mikaela. "‘It is just culture’ : Eight young people’s perception of the gender roles in Zambia." Thesis, Linköpings universitet, Institutionen för kultur och kommunikation, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-97614.

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This study explores eight young people’s perception of the gender roles in Zambia, Lusaka. In this study I have asked the informants to define the genders and the result were that the genders are defined based on the biological sexes. The genders therefore become homogenous based on the male and female sex. The regulations of the genders were traditionally also based on assumed ‘biologically natural characteristics’. As I argue in this study that gender roles are social constructed I also present the socialization processes in the Zambian culture regarding initiation ceremonies and premarital ceremonies, which visualizes the regulations of the gender roles and the importance of marriages as it implies social status and identity. The young informants’ perception of the gender roles was based on a complex intermixture between the cultural norms, the Western influences and their own life experiences. This means that Zambian society is changing in response to external as well as internal influences and that globalization both facilitates change and may create problems, as different values and norms collide. The informants recognized a need of change in the perception of the gender roles due to the issues that the gender hierarchy contributes to. This study also discusses the fact that cultural norms causes lack of knowledge about sexual issues, which have devastating consequences. The informants argued that the cultural perception of a man as superior and the woman as inferior caused gender based violence, domestic violence and the HIV-epidemic to continue. Based on the informants awareness that many of the social challenges exist because of the patriarchal norms in society I argue that this awareness indicates that a change is in progress.

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49

Sikasote, Janet Precious Banda. "Effect of voluntary counselling and testing and a negative HIV result on risk behaviour : a qualitative longitudinal study in a Zambian mining community." Thesis, University of Edinburgh, 2010. http://hdl.handle.net/1842/4441.

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Background: Countries in sub-Saharan Africa are scaling up access to Voluntary Counselling and Testing (VCT) services as a strategy for HIV prevention, treatment, care and support. The international and national push to achieve targets for anti-retroviral therapy scale up has emphasised VCT as an entry point to treatment, with follow-up mostly directed at those who test positive. Yet over 60% of those testing are HIV negative. Limited understanding of how HIV voluntary counselling and testing, and receipt of a negative result impact on sexual behaviour has resulted in underdeveloped support for those testing HIV negative. Aims: To gain the perspective of those who have tested HIV-negative on the following: (1) the decision making process that precedes attendance for voluntary counselling and testing; (2) how voluntary counselling and a negative test result influence sexual behavioural intentions and reported subsequent behaviour; and (3) support systems and networks that would enhance the respondent’s ability to remain HIV negative. Method: Qualitative longitudinal study utilising semi-structured interviews, six months apart, with people who have tested negative and three one-off focus group discussions with counsellors. Participants were purposively sampled from VCT centres in two mining towns in Zambia. Interviews were digitally recorded, transcribed verbatim and analysed thematically with the aid of the qualitative data analysis software, Nvivo7. Cross-sectional analysis of all data sets was conducted and paired transcripts were analysed longitudinally to assess change over time. Results: Forty-two HIV-negative people were interviewed, with thirty-one returning for the follow-up interview (74% return rate). VCT was perceived as ‚testing for HIV‛. Before attending VCT most participants had gone through a protracted period of angst, resulting in a resolution to reduce number of partners, use condoms or abstain from sex. Counselling affirmed life choices, rather than initiating them. Although perception of the risk of HIV increased, misconceptions about HIV transmission persisted post-counselling. The negative test result provided impetus and resolve to implement or maintain life change. Themes identified were: (1) recognising personal susceptibility to HIV infection; (2) emotional and cognitive engagement with the problem of testing; (3) a driving need to know status (regardless of test result); and (4) empowerment and being in control providing the ability to plan for the future. Analysis of post-test support needs revealed two further themes: (1) reinforcement of behaviour change through additional knowledge, supportive networks, and life-skills training; and (2) access to recreational activities. There was no reported post-test increase in unsafe sexual behaviour among those that returned for the follow-up interview. Focus group findings reinforced those from interviews. Conclusions: This study has shown that in this population of people who tested HIV-negative: 1. the majority made life changes before attending VCT and used VCT to know their status 2. counselling consolidated pre-test decisions about risk behaviour and testing provided motivation to adopt safer behaviour and to maintain previous low- or no-risk behaviour and 3. there is a felt need for post-testing recreational activities, further HIV/AIDS education and participation in HIV prevention activities. Recommendations include: (1) the promotion of community-based interactive one-to-one and group information, education and communication (IEC) (to aid understanding and progression to the point where testing appears to be of optimum benefit) ; (2) referral to post-test support options such as support groups and inclusion on a text messaging list should be made available; and (3) post-test intervention strategies, for example, provision of result-specific IEC materials and active involvement in prevention activities should be developed and evaluated.

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Kelakazola, Henry Ilunga Kasongo. "W.H.O recommended infant feeding options: assessment of the challenges faced by HIV positive mothers in Mongu District, Zambia." Thesis, UWC, 2008. http://hdl.handle.net/11394/2869.

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Magister Scientiae (Biodiversity and Conservation Biology) - MSc (Biodiv and Cons Biol)
W.H.O infant feeding options are presented as a package in the prevention of HIV transmission from mother to child. These infant feeding options are namely exclusive breastfeeding, replacement feeding and other options such as wet nursing by a tested HIV negative woman and heat treated breast milk. However, in Zambia, like many other poor countries, the cultural attitude towards breastfeeding is that the breastfeeding period generally goes up to two years. This traditional way of feeding is so much rooted in local culture that any cessation of breastfeeding or any introduction of alternative feeding would be a source of concern at community and family levels. In addition, it is a well known fact that stigma and discrimination are still high in the country. It is with this background that we decided to carry out a study in Mongu district which aimed at assessing HIV positive mothers’ knowledge of WHO infant feeding options and looking at the challenges they face vis-à-vis these recommended feeding options. DATA COLLECTION METHODS A total of 10 experienced nurses, who have been working in the HIV/AIDS programme for more than 15 years, were trained in data collection. During home visit, semistructured questionnaires were used during face- to- face interviews of each HIV positive mother who voluntarily took part in the study. SAMPLING AND SAMPLE SIZE Systematic sampling technique was used to constitute our study sample. With this technique, a complete list of 5317 HIV positive mothers was constituted by listing all HIV positive mothers whose names were in the registers of PMTCT at the selected health institutions, and who had infants whose ages ranged from 6 months to 2 years. 1636 HIV positive mothers had babies whose ages were ranging between 6 months and 2 years. Out of the 1636 we selected randomly the first participant from the complete list, and then we went on selecting every 8th HIV positive mother up to the time we constituted a sample of 200 participants. Thereafter, the selected HIV positive mothers were visited individually in their respective households for interview by trained interviewers. During home visit, 5 selected participants declined to take part in our study while 195 HIV mothers voluntarily accepted to be interviewed. RESULTS Analysis of data collected from 195 HIV positive mothers revealed that 144 study participants or 73.8 %( 95% C I 67.6-80%) of all participants knew their status through the PMTCT programme where the “opt out” approach was used to routinely screen pregnant women for HIV during ante natal visit or when admitted to labour wards. It was also established that the assessment of knowledge among study participants of exclusive breastfeeding period was good. 96.9 %( 95% CI 95.66-98.14%) of participants stated that 6 months was the recommended duration for exclusive breastfeeding when the mother is HIV positive while only 3.07 %( 95% CI 0.65-5.49%) said that exclusive breastfeeding should go beyond 6 months. It was discovered that the majority of HIV positive mothers or 166 participants representing 85.1%(95% CI 80.1-90.1%) who participated in our study considered mixed- feeding as not appropriate for infant born from HIV positive mothers while 29 participants or 14.8%(95% CI 9.8-19.8%) said that mixed feeding was recommendable. It was also found that 95 participants representing 48.7 %( 95% CI 41.6- 55.7%) opted for exclusive breastfeeding, 61 participants or 31.2% (95% CI 24.7-37.7%) participants opted for formula milk while 39 or 20 %( 95% CI 14.4- 25.6%) of participants were mixed-feeding. It was discovered that 118 participants had breastfed. Among them, 53.4 %( 95% CI 46.4-60.4%) participants said that they had breastfeed for up to 6 months while 46.6 %( 95% CI 43-50.2%) said they had breastfeed for more than 6 months. Among those who had breastfed for more than 6 months, 58.1 %( 95% CI 54.6-61.6%) said that they had done so because of financial constraints; 21.8 %( 95% CI 16-27.6%) for fear of discrimination and stigmatization; and 20 %( 95% CI 14.4-25.6%) for fear of discrimination and stigmatization and financial constraints. We also discovered during our research that for the majority of study participants or 81.5%, the decision to opt for one of the infant feeding options was a product of discussion between the HIV positive mothers and other persons such as the husband, friends, relatives and health care provider. CONCLUSION In our study we discovered that though the knowledge of PMTCT and WHO infant feeding options among study participants was good, fear of stigmatization, discrimination and abandonment was high among interviewees. This fear explains why the implementation of WHO infant feeding options is still a serious challenge amongst HIV positive mothers in Mongu, as many HIV positive mothers do not want to be seen in the community as people carrying the virus. It is also for the same reason that our study participants had to choose people to whom to talk to about their HIV positive status and with who to discuss their chosen infant feeding options. Further, due to the high level of poverty among Mongu residents, financial constraint was another major challenge in the implementation of WHO recommended infants feeding options.

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