Candice Reardon

Children’s psychosocial wellbeing in the context of HIV/AIDS and poverty: a comparative investigation of orphaned and non-orphaned children living in South Africa

BackgroundRecent studies have questioned whether orphanhood is primarily associated with key dimensions of psycho-social wellbeing in children living in circumstances of material deprivation and high prevalence of HIV and AIDS.MethodsThis study uses cross-sectional data from a longitudinal study conducted between 2004-2007 to examine the psychosocial well-being of orphans and non-orphans in the Amajuba District of KwaZulu-Natal, South Africa. Psychosocial wellbeing included an assessment of orphans’ and non orphans’ level of anxiety and depression, affability and resilience. Stratified cluster sampling, based on both school and age, was used to construct a cohort of recent orphans and non-orphans and their households, randomly selected from schools.ResultsLevels of anxiety and depression, affability and resilience did not differ significantly between orphans and non-orphans, nor did salient household, poverty and caregiver characteristics vary substantially amongst orphans and non-orphans. Multivariate analyses indicated that children’s psychosocial outcomes, when controlling for orphan status and related demographic variables were more strongly influenced by household composition/size, living above or below the poverty threshold and factors associated with the caregiver-child relationship and caregiver health.ConclusionsThe results muster additional evidence for moving beyond narrow definitions of vulnerability associated exclusively with orphanhood to consider the multitude of material, social and relational factors affecting the psycho-social well-being of children in general who are living in circumstances of poverty and HIV and AIDS.

Preparing for export? Medical and nursing student migration intentions post-qualification in South Africa

Abstract Background The migration of health professionals can have a profound impact on health systems around the globe. The International Organization for Migrations (IOM) Mobility of Health Professionals Research Project (MoHProf) aimed to improve knowledge about the migration of healthcare professionals and understand migration intentions and factors influencing the migration of medical and nursing students. Objectives The study aimed to determine the proportion of nursing and medical students who were intending to emigrate, their attitudes and beliefs about, and the factors influencing their decision to emigrate. Method This study was conducted at three medical schools and one nursing school in South Africa (n = 298) amongst 260 medical and 38 nursing students. One hundred and twenty-five students were in the final year of their studies and 143 were in their prefinal year. Thirty students did not indicate the year of their studies. Every student present on the day of data collection completed a questionnaire comprising psychometric and survey-based questions. Descriptive and inferential statistics were used to analyse the data. Results More than a third (37%) of the respondents intended to work or specialise abroad. The majority of medical (58.9%) and nursing (66.6%) students intended to leave SA within five years of completing their medical or nursing studies. The perception of poor working conditions within the health sector, such as long work hours, high patient loads, inadequate resources and occupational hazards, influenced medical students to consider emigrating from South Africa. Conclusion The high number of medical and nursing students intending to emigrate requires a reassessment of effectiveness of retention strategies for doctors and nurses in the South African healthcare system and actions to improve working conditions in the public healthcare sector.

“Shaping up”: The relationship between traditional masculinity, conflict resolution and body image among adolescent boys in South Africa

In South Africa, traditional versions of masculinity that once bestowed power and privilege onto white heterosexual men are being contested. White adolescent males must negotiate this changing environment at a time when they themselves are engaging in the process of identity development. Given the recent emergence of the masculine body ideal, the muscular mesomorph, and its association with traditional masculinity, this study sought to examine the relationship between traditional masculinity, conflict resolution and body image among a sample of predominantly white adolescent males in South Africa. The relationships between these variables were examined in accordance with Connells theory of body-reflexive practices (1995), which views the body as both an “object” and “agent” of practice. Our findings revealed that support for traditional masculine norms among adolescent males was associated with the desire for a larger, more muscular body and the use of maladaptive conflict resolution styles that exhibit a low concern for the welfare of others. In the context of recent sociocultural changes, these findings suggest that conflict resolution and the redefinition of the male body may be an emerging arena that provides new possibilities for young white males to enact a form of male power that is seen to be maladaptive in our context.

‘Learning the basics’: young people’s engagement with sexuality education at secondary schools

Abstract School-based sexuality education remains a key response to the HIV epidemic. Drawing on findings from an ethnographic study, this study explores how young people engage with sexuality and HIV- and AIDS-related education as it is delivered through the Life Orientation (LO) learning area in South Africa, in order to understand the dynamics that support or hinder engagement. Focus group discussions were held with Grade 9 and 11 learners (aged 14–18 years) from 16 randomly selected public secondary schools across three provincial districts. Results show that enjoyment of LO education was related to perceived relevance and distinctiveness, informal lesson delivery, subjective assessment standards and seemingly minimal effort. However, the perception of reduced effort tarnished the status of LO and young people’s motivation to participate. Learner engagement is influenced by a variety of cognitive, affective and behavioural pathways including internalised discourse around HIV and AIDS, gender and sexuality; the quality of youth–educator relations and teaching competencies; peer pressures; and broader cultural dynamics. The cultivation of a learning environment in which young people share and debate their views promotes engagement and critical thinking. In-service and pre-service educator training, structured activity plans and monitoring are recommended to advance the content knowledge and pedagogy of educators.

Masculinities, cultural worldviews and risk perceptions among South African adolescent learners

This study investigated the relationship between masculinities, cultural worldviews and societal risk perceptions in a sample of adolescent school-going boys in South Africa. Connell’s theory of hegemonic masculinity and cultural theory of risk provided the theoretical frameworks for this study. The findings showed that males conforming to the traditional masculinity type were more likely to endorse a hierarchical and individualist worldview. They were also less concerned about the impact of a number of societal risks on the South African public such as environmental risks and risks associated with crime and social instability than participants conforming to the progressive masculinity type. Participants conforming to progressive masculine norms were more likely to hold an egalitarian worldview. The results of mediation analyses suggest that among self-identified traditional and progressive males in our study, judgements about certain risk concerns are best understood through their views of society and the preferred forms of social organisation and power in society. Given the above findings, it is suggested that intervention strategies in risk management need to appreciate that subjective processes of risk identification are fundamentally gendered in nature and may be influenced by one’s cultural worldview.

Psychosocial and behavioural correlates of attitudes towards antiretroviral therapy (ART) in a sample of South African mineworkers

Despite being one of the worst affected sectors in South Africa, the mining sector has proven to be one of the most active in intervention efforts in the fight against HIV and AIDS (Ellis, 2007). Owing to low uptake rates of antiretroviral therapy (ART) in mining companies in recent years (Connelly & Rosen, 2006) and the positive relationship between attitudes towards ART and ART uptake (Cooper et al., 2002; Horne, Cooper, Gellaitry, Leake, & Fisher, 2007), this study sought to describe and investigate the psychosocial and behavioural correlates of attitudes towards ART in a sample of South African mineworkers. A total of 806 mineworkers from a large South African mine participated in this quantitative study. Despite a high rate of HIV testing behaviour (83.0%) as well as favourable attitudes towards ART, analysis indicated that temporary employees and contractors were more vulnerable in terms of HIV risk, HIV testing behaviours and ART knowledge and attitudes. Employees who had more positive attitudes towards ART were more knowledgeable of ART and, importantly, had a more favourable attitude towards the mines HIV/AIDS treatment programme. These findings are discussed in relation to the low ART uptake rates in this context and recommendations for the improvement of ART uptake amongst employees at this mining site.

An examination of the factors fueling migration amongst Community Service practitioners

Abstract Background Research is needed in order to understand the potential influence of the Bilateral Agreement between South Africa and the United Kingdom (UK), as well as other more recent international and local policies restricting movement of South African health workers abroad; and to determine what effect they have on the migration intentions and plans of health professionals in South Africa. Aim The aims were to (1) explore the migration intentions and the factors that influence these intentions amongst Community Service (CS) nurses and doctors; (2) explore their views and opinions about the Bilateral Agreement between the UK and South Africa (SA) and other UK policies around the recruitment and employment of foreign health professionals; and (3) understand the impact of these policies on the migration plans of these CS doctors and nurses. Method Qualitative focus groups and interviews were conducted with 23 CS doctors and nurses. To supplement this, 6 interviews were conducted with nurses and a doctor who had worked in the UK. Results A higher disposition toward moving abroad was apparent amongst those who had experienced a challenging and frustrating CS year. Poor working conditions, including long work hours, high patient loads and inadequate resources and equipment, as well as low salaries and the perceived ambivalence of the government to the complaints of health practitioners, were influencing decisions to migrate abroad. Conclusion The findings suggest that government efforts to better manage, recognise and respect the work and contribution of health professionals to the country would go a long way toward retaining health professionals.

The Madikwe Forum: a comprehensive partnership for supporting governance of Botswana's HIV and AIDS response.

There is a need for actors within the philanthropic sector to pursue collaborative partnerships with developing nations which could result in sustainable country-led responses to HIV and AIDS. There is also a need to evaluate the structures governing these partnerships in order to determine their effectiveness in strengthening national responses to HIV and AIDS. This article presents findings from a qualitative study of a governance structure of the African Comprehensive HIV/AIDS Partnerships (ACHAP), namely the Madikwe Forum. The investigation sought to critically reflect on the role and effectiveness of the Madikwe Forum in Botswanas response to HIV and AIDS and to consider the value of such a forum for other developing nations and partnership arrangements. The findings indicate that the Madikwe Forum has enabled considerable progress in the implementation of ACHAP-supported initiatives in Botswana. The constructive working relationship and close alignment between ACHAP and the Botswana governments objectives and priority areas were viewed as critical to this success. However, problems exist regarding the operation of the forum as well as a lack of focus on monitoring and evaluation, which requires the forums urgent attention.

Validation of the Perceived Sense of School Membership Scale: A South African Version:

This study explored the factor structure and psychometric properties of the Perceived Sense of School Membership (PSSM-18) Scale in two samples of South African adolescents. Principal components analysis (n = 1,052; males = 50.86%, Mage = 14.89, SD = 1.68) supported the retention of 15 items across a revised, three-factor structure of acceptance, belonging, and inclusion (PSSM–South African version [PSSM-SA]). Confirmatory factor analysis (n = 1,418; males = 49.86%, Mage = 14.93, SD = 1.70) provided an acceptable level of fit for the PSSM-SA. The structure was found to be invariant across sex, age, and poverty quintile groupings. Follow-up group comparisons showed selected scales were able to discriminate between groups and predicted alcohol and substance use, and the mean inter-item correlations indicated each scale possessed an appropriate level of internal consistency. The findings suggest the PSSM-SA is a valid and reliable measure of school belonging among South African high school–age children.

Validation of the child and youth resilience measure among South African adolescents

Resilience is a dynamic, interactive process between resources that contribute to safeguarding a person and the adversities they experience. Within this promotional framework of resilience, this study sought to validate the Child and Youth Resilience Measure (CYRM-28) among a sample of South African adolescents (N = 1854). Confirmatory factor analysis supported a superior level of fit for a 24-item, three-factor model (i.e., individual/social, familial, and community/spiritual). Internal consistency and test-retest reliability estimates at a 12-month interval (N = 648) supported the reliability of the scales. Higher scores on the scales were associated with feeling more connected at school, greater parental monitoring perceptions, and lower sexual risk, confirming the convergent and criterion validity of the instrument. Partial discriminative power was evidenced based on selected scale distinctions according to age and sex groupings. Collectively, the findings suggest the 24-item CYRM is a valid and reliable self-report measure to assess the availability of resources associated with resilience in South African youth.