Faculty of Health Sciences
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Item Caregivers experiences of living with an adolescent who abuses drugs in the Sol Plaatjie Municipal area in the Northern Cape(2024) Ditshetelo, Nomonde Patience; Hillerman, L. A.; Sokhela, Dudu GloriaAim Drug abuse by adolescents has devastating effects on the ability of their families and caregivers to function. The aim of the study was to explore and describe the caregiver’s lived experiences of living with an adolescent who was abusing drugs and receiving treatment in selected drug rehabilitation institutions. Research Design and Approach A qualitative, descriptive, and contextual with a phenomenological approach. was adopted to explore caregivers’ lived experiences living with adolescents who abuse drugs. Research setting The study was conducted at four purposively chosen Non-Governmental Organizations (NGOs) rehabilitation institutions situated in the Sol Plaatjie Municipality in Kimberly in the Northern Cape Province. Participants were recruited from selected rehabilitation government institutions and NGOs in the Sol Plaatjie Municipal area after full ethics approval was obtained from the DUT Institutional Research Ethics Committee (IREC). A non-probability purposive sampling, also known as the judgment sampling method, was used in this study. to interviews with 15 purposively selected caregivers whose adolescents were abusing drugs. Interviews were recorded and then simultaneously translated and transcribed. Thematic analysis was used to identify themes related to the experiences of caregivers of adolescents with a drug abuse problem. Results Results show that the behaviour of these adolescents created an environment that led to feelings of shame and embarrassment, family disintegration, conflicts, and communication breakdown, suicidal feelings, and stress related ailments of these caregivers. Participants experienced personal challenges which included psychological and emotional effects of fear, stress, pain, and self-blame. Participants also highlighted family disruptions and financial drain as adverse experiences as a result of their adolescents’ behaviour. Conclusion The study results highlighted the psychosocial challenges experienced by those caregivers of adolescents who abuse drugs. These findings underscore the need for efforts to be directed at the development of formal support interventions for caregivers of adolescents who are affected by this public health scourge.Item Exploring adolescents and young people's candidacy for utilising health services in a rural district, South Africa(Springer Science and Business Media LLC, 2019-03-28) Nkosi, Busisiwe; Seeley, Janet; Ngwenya, Nothando; Mchunu, S. Lerato; Gumede, Dumile; Ferguson, Jane; Doyle, Aoife M.We use the 'candidacy framework' to describe adolescents' and young people's (AYP) experiences of health services in a rural KwaZulu-Natal district, South Africa.Methods
A qualitative approach was used including group discussions, in-depth and key informant interviews with a purposive sample of AYP (n = 70), community leaders (n = 15), school health teams (n = 10), and health service providers (n = 6).Results
Findings indicate tacit understanding among AYP that they are candidates for general health services. However, HIV stigma, apprehensions and misconceptions about sexual and reproductive health, and socio-cultural views which disapprove of AYP pre-marital sex undermine their candidacy for sexual and reproductive services.Conclusion
Consideration and understanding of the vulnerabilities and reasons AYP exclude themselves will inform interventions to address their health needs. AYP's participation in the design of health services will increase their acceptability and encourage uptake of services.Item Community perceptions of the socio-economic structural context influencing HIV and TB risk, prevention and treatment in a high prevalence area in the era of antiretroviral therapy(National Inquiry Services Center (NISC), 2018-03) Ngwenya, Nothando; Gumede, Dumile; Shahmanesh, Maryam; McGrath, Nuala; Grant, Alison; Seeley, JanetFollowing calls for targeted HIV prevention interventions in so-called "hotspots", we explored subjective perceptions of community members in places considered to be high HIV and tuberculosis (TB) transmission areas and those with low prevalence. Although more people now have access to antiretroviral therapy (ART), some areas are still experiencing high HIV transmission rates, presenting a barrier to the elimination of HIV. A rapid qualitative assessment approach was used to access a sample of 230 people who contributed narratives of their experiences and perceptions of transmission, treatment and prevention of HIV and TB in their communities. Theoretical propositions case study strategy was used to inform and guide the thematic analysis of the data with Research Department of Epidemiology & Public Health, University College London, London, UK. Our results support the concept of linking perceived control to health through the identification of structural factors that increase communities' sense of agency. People in these communities did not feel they had the efficacy to effect change in their milieu. The few socio-economic opportunities promote social mobility in search of better prospects which may have a negative impact on community cohesion and prevention strategies. Communities were more concerned with improving their immediate social and economic situations and prioritised this above the prevention messages. Therefore approaches that focus on changing the structural and environmental barriers to prevention may increase people's perceived control. Multifaceted strategies that address the identified constructs of perceived control may influence the social change necessary to make structural interventions successful.Item The impact of self-interviews on response patterns for sensitive topics : a randomized trial of electronic delivery methods for a sexual behaviour questionnaire in rural South Africa(Springer Science and Business Media LLC, 2017-08-17) Harling, Guy; Gumede, Dumile; Mutevedzi, Tinofa; McGrath, Nuala; Seeley, Janet; Pillay, Deenan; Bärnighausen, Till W.; Herbst, Abraham J.BackgroundSelf-interviews, where the respondent rather than the interviewer enters answers to questions, have been proposed as a way to reduce social desirability bias associated with interviewer-led interviews. Computer-assisted self-interviews (CASI) are commonly proposed since the computer programme can guide respondents; however they require both language and computer literacy. We evaluated the feasibility and acceptability of using electronic methods to administer quantitative sexual behaviour questionnaires in the Somkhele demographic surveillance area (DSA) in rural KwaZulu-Natal, South Africa.Methods
We conducted a four-arm randomized trial of paper-and-pen-interview, computer-assisted personal-interview (CAPI), CASI and audio-CASI with an age-sex-urbanicity stratified sample of 504 adults resident in the DSA in 2015. We compared respondents' answers to their responses to the same questions in previous surveillance rounds. We also conducted 48 cognitive interviews, dual-coding responses using the Framework approach.Results
Three hundred forty (67%) individuals were interviewed and covariates and participation rates were balanced across arms. CASI and audio-CASI were significantly slower than interviewer-led interviews. Item non-response rates were higher in self-interview arms. In single-paper meta-analysis, self-interviewed individuals reported more socially undesirable sexual behaviours. Cognitive interviews found high acceptance of both self-interviews and the use of electronic methods, with some concerns that self-interview methods required more participant effort and literacy.Conclusions
Electronic data collection methods, including self-interview methods, proved feasible and acceptable for completing quantitative sexual behaviour questionnaires in a poor, rural South African setting. However, each method had both benefits and costs, and the choice of method should be based on context-specific criteria.