Dissertations / Theses on the topic 'Refugees. Health and hygiene, Zambia'

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.

This study attests to the fact that disability is an issue in conflict-affected populations, in particular refugees. Refugees with disabilities living in Mayukwayukwa refugee camp also have poor HRQOL similar to other studies. Education was the only variable significantly correlated to the psychological and social domains of the HRQOL. The study highlighted that environmental and personal variables played a role in the determination of health related quality of life among refugees with disabilities.

This thesis explored the health practices and religious beliefs of the recent Soviet Pentecostal refugee population in the Portland, Oregon metro area. The methodology consisted of 25 in-depth interviews over a period of twelve months. Soviet Pentecostal refugees' health practices are influenced by their religious belief system which is Pentecostalism. The four primary factors that were found to have an affect on the refugees' health were lifestyle practices; coherence; or the meaning of suffering that religion provides; cohesiveness, or group belonging to the religious community, and world view provided by the underlying theology. The language barrier, distrust of outsiders, unfamiliarity with their belief system, and a limited understanding of their experiences of persecution may limit effective health care by professionals.

The study aimed at optimally assessing the impact of indoor residual spraying (IRS) and insecticide treated nets (ITNs) on vector species abundance, their infectivity and resistance status, and Plasmodium falciparum prevalence, malaria deaths and case fatality rates in the human population. Malaria prevalence surveys were conducted and routine surveillance data was retrospectively analyzed. The average P. falciparum prevalence in children between the ages of 1 and 14 years was below 10% across the study period. The intervention effect was more pronounced in IRS areas than in ITNs localities but with an incremental protective effect of their combined use. Age-specific comparison showed better intervention effect on children below 5 years than older children 5 to 14 years old. While the average number of deaths and case fatality rates in children under the age of five plunged precipitately, the reductions were more significant in IRS districts than in ITNs districts. Results indicate the need for supplementing parasite prevalence survey data with routine surveillance data in low transmission intensity areas and demonstrate the significance of evidence-based age-specific deployment of interventions. To monitor vector species abundance and infectivity, mosquitoes were collected daily using exit window traps. The three major vectors; An. gambiae s.s, An. arabiensis and An. funestus s.s, and three potential vectors of malaria, An. nili, An. rivulorum and An. funestus-like species were identified. Overall, the biggest impact of IRS and ITNs was on An. gambiae s.s, and An. funestus abundance. No An. gambiae s.s was collected in IRS localities, thus validating the fact that An. gambiae s.s and An. funestus are characteristically more amenable to control by IRS and ITNs than An. arabiensis. The transmission potential for all malaria vectors, as expressed by the calculated transmission index, was zero as none of the trapped mosquitoes tested positive for P. falciparum sporozoites. The identification of An. nili, An. rivulorum and An. funestus-like necessitate further research to determine their role in malaria transmission in the country. The low numbers of mosquitoes collected also indicate a compromise in the efficiency of exit window traps in low transmission settings, suggesting the need for their replacement with a more robust collection tool like the CDC light trap. While the persistence of An. arabiensis suggests the presence of resistance segregating in this population or, that this outdoor species is not in contact with IRS or ITNs, it could as well imply that it’s the one species perpetuating malaria transmission in these meso-to hypo- endemic areas. To determine the impact of interventions on insecticide resistance status of malaria vectors, susceptibility assays using the WHO standard protocol were conducted in 17 localities. High levels of resistance were detected in both An, gambiae s.l and An, funestus s.l to pyrethroids and DDT but with 100% susceptibility to malathion and bendiocarb. The level of resistance was significantly higher in IRS areas than in ITN areas. These findings indicate that resistance has been selected for following extensive vector control. Resistance to both DDT and deltamethrin in IRS localities and ITN areas with intense cotton growing was detected suggesting selection due to either historical use of DDT, gene flow or cross-resistance. All An. gambiae s.s were molecular s-forms and only the west (leu-phe) kdr was detected. Complete susceptibility to the organophosphates and carbamates provides a possibility to switch to these alternative insecticide classes for IRS. The detected increases in the malaria prevalence in localities with high insecticide resistance levels indicate vector control failure. These findings point to the need for information on underlying biochemical and molecular resistance mechanisms to make possible the design of an effective resistance management strategy, and for the assessment of the impact of resistance on interventions. The results indicate that the impact of malaria control can be optimally assessed by using a combination of epidemiological (routine surveillance and prevalence data) and entomological indicators, in the context of a malaria decision support system, to enhance policy formulation for objective implementation of malaria control interventions and rational use of available resources.

Magister Public Health - MPH
Background and Rationale The World Health Organization (WHO) has shown that the provision of Water Sanitation and Hygiene (WASH) in Health Care Facilities (HCFs) of many low and middle-income countries is poor. This is compounded by the lack of national plans and consolidated data on WASH in HCFs. This study assessed the availability and adequacy of Water Sanitation and Hygiene (WASH) infrastructure in 13 mission hospitals spanning 13 districts in Zambia. The objectives of this study were to identify the different kinds of WASH infrastructure available, and their adequacy, and factors influencing the status of WASH infrastructure and services in the selected hospitals. Methodology This study had a mixed methods design with semi-quantitative, descriptive and qualitative components. Assessments were conducted of the WASH infrastructure on the hospital property, and specifically in the male medical wards and outpatient facilities as two tracer areas, using a WHO checklist adapted and administered by the researcher. Checklist items were assigned scores (0=absent/bad to 2=on target/good) and total WASH scores for each facility compiled. For the qualitative component, individual semi-structured interviews using an interview guide were conducted, also by the researcher, with the facility managers and the head staff of the male medical wards. Results Overall coverage with an improved water source was reasonably good with 11 of the 13 hospitals reporting availability of improved water sources within the facilities. Hand washing basin coverage was similarly good. In contrast, coverage by well-functioning toilets was not as high, with 5 hospitals reporting toilets that were either broken, blocked, or having no running water and no toilet paper. Facility WASH scores varied from 22 (38%) to 57 (97%) out of a possible total of 58 points. Most of the Facility Managers indicated that the hospital WASH infrastructure was old, and with frequent breakdowns. This was worsened by lack of readily available spares and materials for repairing once there was a fault. Conclusion This study reveals an uneven coverage of WASH across facilities and elements, with poor sanitation a challenge across facilities. This is compounded by ongoing challenges in WASH infrastructure maintenance. Moving forward, there is need for government to develop a clear policy on WASH in HCFs. A national plan with resources and a monitoring framework need to be in place for streamlined support and tracking of progress by all stakeholders.

The program that was studied is part of the Child Health Program devised and supported by CARE International and implemented in Kanyama, a high density and low cost community found on the outskirts of Lusaka, Zambia. Diarrhoea was identified as one of the three most common diseases affecting the children under the age of five years. Through community participation, the program was implemented by the Kanyama residents to reduce the cases of diarrhoea, malaria and pneumonia among children aged five years and under. The main aim of this study was to explore the perceptions of the impact of community participation by the community leaders and community members in the diarrhoea prevention program and to establish constraints affecting participation.

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.

Background and aims: Recent decades have seen material shifts in global migration flows. Migrants now come to the UK for an increasing number of reasons and from an increasing number of countries. This presents a challenge for health services that must provide care to individuals with a broad range of needs. In particular, there is concern that asylum seekers and refugees (ASRs) are at heightened risk of poor wellbeing and of receiving suboptimal healthcare. Concurrent with these shifts in migration, increasing attention is being paid to noncommunicable diseases (NCDs), which are now the most significant drivers of morbidity and mortality in most regions of the world. In the UK, the burden of NCDs is not evenly distributed, with inequalities related to ethnicity and socioeconomic status shaping an individual’s risk of ill health. Little is known, however, about how diverse migrant groups, including ASRs, conceptualise health and respond to health prevention messaging. Against this backdrop, this thesis aims to understand the health-related experiences of one such group – asylum seekers and refugees (ASRs) from Sub Saharan Africa living in Glasgow Scotland. Specifically, it explores: a) perceptions of health, wellbeing, and illness causation, b) experiences of accessing primary and preventive healthcare, and c) the factors influencing these perceptions and experiences. It also seeks to elucidate professional perspectives on ASR health. Methods: To gain an in depth understanding of ASR health perceptions and experiences, as well as professional perspectives, a focused ethnography was undertaken. This approach utilised four qualitative methods: community engagement, participatory focus groups, semistructured interviews, and go- along interviews. In total 12 primary care and public health professionals were interviewed, and 27 ASRs took part in either a focus group, an interview, or both. The thesis took a theoretically informed approach, seeking to determine whether and how two theories – ‘candidacy’ (Dixon-Woods et al 2005) and ‘structural vulnerability’ (Quesada et al 2011) – might deepen our understanding of ASR health. Results: Candidacy enhanced understanding of how ASRs identified and responded to messages about ‘healthy lifestyles’. ASR participants considered keeping healthy to be an individual responsibility, with diet and exercise highlighted as especially important. At the same time, however, perceptions and experiences of health and wellbeing were shaped by a number of structural influences, which limited the capacity of ASRs to engage in health practices. Therefore, while ASRs considered health to be an individual choice in theory, they did not necessarily feel they had the ability to be healthy in practice. The theory of structural vulnerability proved useful in identifying the wider structural determinants that impacted on an individual’s capacity to respond. There were several important structural influences, including poverty, racism, discrimination, and language barriers. The greatest negative influence, however, and one that compounded all the others, was the asylum process. This diminished individuals’ capacity to identify as candidates for prevention messages, engage in preventive health practices, and/ or access care in an optimal fashion. Conclusions: Efforts to engage ASRs in preventive health programmes and practices must take into account the ways in which the immigration and asylum system acts as a determinant of health, affecting both what it means to be healthy and what capacity individuals have to engage. The NHS, together with non statutory bodies, has a role to play in mitigating some of the vulnerabilities to which ASRs are subject.

This study investigated the societal perception of refugee men as being a risk group, being polluted and the consequent risk of HIV infection they might face. It also determined the factors that could expose them to the risk of HIV infection while living in exile in South Africa.

Thesis (Mphil)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: Political instability involving civil wars which had been prevailing mostly within the African Great Lakes Region caused great numbers since the 1990s of civilian populations to move to and fro within the borders and sometimes beyond its frontiers in search of both safer homes and better living conditions. Socio-economic hardships experienced by these people constrained them to engage in various migration movements, thus making them more vulnerable to a variety of diseases and pandemics, among which Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). Sub–Saharan Africa has been bearing the brunt of HIV pandemic, and South Africa is believed to have the highest HIV prevalence. The present study was a quantitative survey exploring personal perception of HIV infection risk among African émigré communities of the Cape Metropolitan area. Only thirty four heterosexual active participants, who had joined their partners in South Africa after a certain period of temporary separation, were considered for final analysis using descriptive statistics. A relatively high perception of HIV infection risk was found among both males and females. However, the perceived risk did not necessarily determine sexual behaviour. No significant reciprocal relationship was found between the perceived risk and one important sexual risk behaviour. HIV and AIDS related stigma was found to be relatively high and the use of condoms prejudiced by tendencies of personal moralistic values. The present study has made relevant recommendations as to promote more preventive behaviours among the present African émigré community.
AFRIKAANSE OPSOMMING: Politieke onstabiliteit wat burgeroorloë meebring kom sedert die 1990’s meestal in die Groot Mere-streek van Afrika voor en het veroorsaak dat groot groepe van burgerlike bevolkings heen en weer tussen grense beweeg en soms grense oorsteek op soek na beter en veiliger tuistes en beter lewensomstandighede. Die sosio-ekonomiese ontberings wat deur hierdie mense ervaar is het hulle verplig om by verskeie migrasiebewegings betrokke te raak. Dit het hulle kwesbaar gemaak vir ’n verskeidenheid siektes en pandemies, waaronder die menslike immuniteitsgebreksvirus (MIV) en verworwe immuniteitsgebreksindroom (Vigs). Sub-Sahara-Afrika het die ergste van die MIV-pandemie getrotseer en Suid-Afrika het na bewering die hoogste MIV-voorkoms. Hierdie studie is ’n kwantatiewe opname wat die persoonlike persepsie van die risiko van MIV-infeksie onder Afrika-uitgeweke gemeenskappe in die Kaapse Metropoolgebied ondersoek het. Slegs 34 heteroseksuele, seksueel aktiewe deelnemers wat na ’n tydperk van tydelike skeiding by hul (lewens) maats in Suid-Afrika aangesluit het, is vir die finale analise oorweeg met behulp van beskrywende statistiek. Onder mans sowel as vroue is ’n relatief hoë persepsie van infeksierisiko gevind. Die waargenome risiko het egter nie noodwendig seksuele gedrag bepaal nie. Geen beduidende omgekeerde verhouding is tussen die waargenome risiko en een belangrike seksuele risikogedragsaspek gevind nie. Daar is bevind dat MIV en Vigsverwante stigma relatief hoog is en dat daar weens tendense van persoonlike moralistiese waardes vooroordeel teen die gebruik van kondome bestaan. Hierdie studie het relevante aanbevelings gedoen om meer voorkomende gedragspatrone onder die huidige Afrika-uitgeweke gemeenskap te bevorder.

A research report submitted to the faculty of the Humanities at the University of Witwatersrand in partial fulfilment of the degree of Master of Arts in Demography and Population Studies, June 2017
Background An estimated 2,000 women in Zambia suffer from obstetric fistula. Suggestions are that more women could be suffering from the same condition but do not report it due to fear of stigmatization. Incidences of obstetric fistula in Zambia may indicate that most pregnant women do not access the much-needed maternal health services, especially at the time of delivery. Therefore, understanding the factors that lead to obstetric fistula is vital for developing primary preventive interventions. This study estimated the prevalence and investigated the factors associated with obstetric fistula among women in Zambia. Methodology The study used data from the 2013-14 Zambia Demographic and Healthy Survey (ZDHS). A sample of 16,411 women aged 15-49 years old took part in the fistula module of the ZDHS. Descriptive and Complementary log-log regression model were conducted to assess the relationship between the covariates and obstetric fistula. Results The prevalence of obstetric fistula was estimated at 5.91 obstetric fistulas per 1000 women of reproductive ages. Age at first sex (AOR=0.86, CI: 0.77-0.97) and being in households of rich wealth status (AOR=0.36, CI: 0.14-0.79) were negatively associated with obstetric fistula. Conclusion Evidence suggest that in order to eradicate obstetric fistula in Zambia, there is need to implement interventions that will focus on improving the socioeconomic, health status, reproductive status, access to health care and use of healthcare resources of women.
XL2018

A Research Report submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements of the Degree of Master of Arts, Applied Ethics for Professionals. Johannesburg, 2017
Many asylum seekers and refugees in South Africa reportedly find it difficult to access basic health care services. The issue about foreign nationals in relation to health care can be considered from different angles. The concept of access, though, points to gate-keeping. Gate-keeping is the practice that guides decision making about who has access to what and to what extent they might enjoy benefits. In this essay, the question of whether gate-keeping is a morally justifiable practice in South Africa in relation to asylum seekers and refugees’ right to basic health care services is explored. It is concluded that carefully considered and consistently implemented gate-keeping might be a morally justifiable practice that could contribute to ensuring that resources are distributed fairly. It is also argued that the kind of gate-keeping often observed is inconsistent with human rights and Ubuntu precepts. These moral frameworks seem to be the main ones shaping the view of most South Africans as well as our institutional arrangements. Considering the current South African context in which asylum seekers and refugees have difficulty in accessing basic health care services, patriotic bias claims are considered. However, it is concluded that partiality towards compatriots ought not to hold sway when any human being’s basic needs are at stake.
MT2018

The last decade has been defined by the forced displacement of an unprecedented number of people, on a scale not seen since World War II. As of 2018, more than 71 million people across the globe have been forced to migrate as a result of conflict, natural disasters, drought and famine. More than 19 million crossed international borders seeking safety, and were formally registered as refugees. Forced migration has placed stress and pressure on surrounding low-and middle-income countries. This has been most notable in the Middle East and North Africa as a result of the crisis in Syria. Host countries in the Middle East and North Africa are overwhelmed by this rapid influx, particularly by the healthcare needs of this population. Stakeholders face difficulties providing health services to refugees, owing to the increased number of refugees in urban settings, the large demands on host country health systems and the epidemiologic transition towards non-communicable diseases (NCDs). Health challenges have been exacerbated by weaknesses in the global humanitarian architecture, that result in a fragmented and competitive sector that is unprepared for the current context. Few comparative analyses have examined the diversity of policies and practices aimed at improving services for urban-based refugees with NCDs in the MENA region. Furthermore, a variety of quantitative studies examined NCD incidence, prevalence and service utilization. However, these studies have quickly become outdated and do not explore, in adequate depth, the refugee experience and perspective on accessing NCD services in urban settings. Lastly, numerous NCD interventions have been recommended for LMICs. However, very little guidance exists to support actors addressing these health concerns in crisis-affected contexts. As a result, this dissertation is presented in three papers and responds to these gaps in the literature. Each paper focuses on a specific aim and research question and together they identify and provide recommendations for improvement to service delivery and policy formulation. Paper 1 identifies policies and practices, implemented by host countries and humanitarian actors, aimed at improving access to NCD services for urban refugees in the Middle East and North Africa. Paper 2 examines, using qualitative methods, the healthcare access experience of urban-based Syrian refugees who have been diagnosed with NCDs in Jordan. The third portion of this dissertation (Paper 3) is a policy series that provides recommendations for the government of Jordan and humanitarian actors to improve healthcare access for urban-based refugees with NCDs. It is anticipated that this series of publications will be relevant to traditional and non-traditional actors that respond to the health needs of refugees in urban settings in the MENA region.

The purpose of the study was to determine the factors that predict women’s risky sexual behaviour and HIV and AIDS knowledge. A quasi-experimental, pre-test-post-test research design, with a non-equivalent comparison group was conducted to determine if there was an association between young women’s sexual behaviour and HIV/AIDS knowledge on aspects of HIV/AIDS transmission and prevention and behaviour change. The study used both quantitative and qualitative approach. Data collection was done using semi-structured interview schedule and focus group discussion guide. The respondents who participated in the study were women between the ages of 15-25 years. Two groups of respondents participated in the study. Women in the quasi-experimental site (N=200) who received the intervention and women in the control site (N=200) who did not receive any intervention. Quantitative data were analysed with the help of a statistician and the Epi Info statistical package was used. Qualitative data obtained from the focus group discussion were analysed using Tesch’s method of analysis. The major inferences drawn from this study are that young women lack knowledge relating to HIV/AIDS and that some young women were engaged in risky sexual behaviours such as having multiple sexual partners and having unprotected sex. The study indicates that peer education strategy has the potential to make an impact on these young women. It has also shown that peer education can play an important role in increasing knowledge and reducing risky sexual behaviour.
Health Studies
D. Litt. et Phil. (Health Studies)

The purpose of the study is to investigate lived experiences of refugees when accessing healthcare services in Pretoria, South Africa. A qualitative phenomenological research approach was followed which assisted in exploring and describing the day-to-day lives of refugees living in Pretoria regarding their health outcomes. Face-to-face interviews were conducted on purposively selected participants, representing refugees from different African countries ranging from age 27 to 58 years. Collected data were transcribed, coded, and relevant themes were extracted and analysed by employing Colaizzi's seven-step analysis framework. Main findings demonstrated that the public healthcare services accessed by refugees, compared to private healthcare services, can be described as mostly dysfunctional. Also, healthcare providers from public healthcare services are often hostile towards refugees of African descent. Failure to speak a local language, unofficial documentation as viewed by a healthcare provider on duty, being a foreigner, and failure to pay undue consultation fees led to refugees being denied access to healthcare or receiving negative treatment in the public healthcare sector. Recommendations for programmes to promote human rights and refugee awareness in healthcare facilities could subsequently contribute to alleviating complications around access to healthcare services, which would denote improved health outcomes for the refugees.
Health Studies
M. P. H. (Health Studies)

A study entitled `Phenomenological study of ageing amongst the older persons in Zambia' was undertaken with the purpose of gaining an understanding of the ageing phenomenon within the Zambian context and provide frameworks that could be used by policy-makers and health professionals to formulate guidelines or interventions relevant to the lived experiences of older persons and the meaning attached to ageing or being old, and consequently maintain or improve the quality of life of older persons of Zambia. The objectives of the study were to describe (1) the lived experiences of the older persons of Zambia, and (2) the meaning they attached to ageing or being old within the Zambian context. A transcendental phenomenological design within the qualitative naturalistic approach was used to guide the research process and to assist the researcher to reach the purpose and objectives of the study. Focus group and in-depth individual interviews were conducted to generate data from twenty-seven (27) informants. Fifteen (15) informants participated in the focus group interviews and twelve (12) in in-depth individual interviews. In total, 24 in-depth individual interviews were conducted in term of two interviews per informants, and two focus group interviews. Data collection covered a period of three months. Coliazzi (1978) and Giorgi (1985) techniques for qualitative data analysis were used and verbatim excerpts form the transcribed interviews were used to support the themes that emerged from data and to provide a richer picture of the situation. Three frameworks derived from the findings of this study: (1) framework of the lived experiences of older persons of Zambia, (2) framework of the meaning of ageing or being old and (3) framework for understanding ageing within the Zambian context. The researcher believed that these frameworks would make a meaningful contribution toward the understanding and the development of policies and interventions that would assist in enhancing or maintaining the quality of life of older people of Zambia. The main findings of the results of this study indicated three most significant dimensions of the lived experiences of the older persons (health, socio-economic and psychosocial) that need to be taken into account when planning for any programs or interventions aimed at maintaining or improving the quality of life of older persons of Zambia. These interventions and programs should also address the negative feelings or meanings attached to the above experiences. The main findings of the results of this study also showed that the meaning of being old or ageing in Zambia does not depend on the health, socio-economic and psychosocial living experiences of the older person but it depends largely on the inner values of the older persons, such as spiritual, emotional and cultural beliefs. This means that maintaining or improving the quality of life of older persons in Zambia would require comprehensive programs or interventions that should take into account the health, socio-economic, psychosocial, spiritual, emotional and cultural needs of the older people.
Health Studies
D. Litt. et Phil. (Health Studies)

The study aimed at assessing the factors influencing the low involvement of men in prevention of mother-to-child transmission (PMTCT) of HIV programmes in the Mambwe district, Zambia. The factors studied were grouped as knowledge and awareness, socio-cultural, programmatic and demographic characteristics. A quantitative, exploratory study was used and 127 men were interviewed. The major findings were: Knowledge of PMTCT was the strongest factor which was positively associated with the level of men's involvement in PMTCT. Socio-cultural and programmatic factors were found to negatively influence men's involvement (although weakly); and among the demographic characteristics, age and level of education were positively associated with an increase in the level of involvement, while the duration of the relationship with the female partner was negatively associated with the level of men involvement.
Health Studies
M.A. (Public Health)