Browsing by Author "Van Hove, Geert"
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Item Building a health-promoting schools conceptual framework model as a strategy to address barriers to learning and to promote healthy development of school-aged children(University of the Western Cape, 2014) Ntagungira, Egide Kayonga; Struthers, Patricia; Van Hove, GeertAfter suffering almost total collapse. Rwanda has made impressive post-genocide progress. Many children of school going age are now attending school, but regrettably, only half complete primary school. High numbers of orphans, disabled children and a growing number of children from child-headed households still suffer the consequences of the poverty inherited from the past. Health problems include HIV/Aids, STIs, malaria, tuberculosis, enteric diseases, mental health problems, hunger and malnutrition. Use of drugs and substance abuse, unwanted pregnancies, lack of support services, unavailability of teaching and learning materials, inflexible curricula and poor teaching methodologies also contribute to learning breakdown. It is against this background that this thesis was conducted to investigate the development of a health-promoting schools model to provide an appropriate strategy to address barriers to learning and to promote healthy development of school children in Rwanda. Two research questions were the focus of this research, first, how does a health-promoting schools model provide an appropriate strategy to address barriers to learning and to promote healthy development of school-aged children in Rwanda and second, what are the participants’ views on and understanding of the model and its potential use in their schools? A mixed methods research design that employed both qualitative and quantitative approaches was used. The study followed sequential implementation: Phase 1 was concerned with the identification of the components for the model. It was a case study of four schools, two rural schools and two urban schools in Kigali City. The sample included 60 teachers, pupils, principals and parents from schools and nine key informants who were policymakers from the Ministries of Education and Health and Social Welfare, line institutions and the UNICEF. Data collection strategies included focus group discussions, semi-structured, in-depth individual interviews, a transect walk and observations. Data analysis was through content analysis. Eight themes emerged out of the data: school leadership and management; school health policies; pupil wellbeing; school partnership with parents, families and local communities; school health services; factors affecting teaching and learning for all children; teacher wellbeing; and a healthy physical school environment. These themes became the components that informed the development of a health-promoting schools model. In Phase 2, the degree of understanding of this proposed model and its components were investigated in each school community.Item A mobile school-based HCT service – is it youth friendly?(Taylor & Francis Open, 2016) Lawrence, Estelle; Struthers, Patricia; Van Hove, GeertBACKGROUND: Despite an increase in HIV Counselling and Testing (HCT), few young people have been tested. It has been suggested that they do not test because formal health services (where HCT is provided) are often not youth friendly. The World Health Organisation describes a youth-friendly health service (YFHS) as one which is accessible, equitable, acceptable, appropriate, and effective. A mobile school-based model has been implemented by a non-governmental organisation in Cape Town in an attempt to make HCT more youth friendly and accessible to young people. The objective of this study was to explore whether this mobile school-based HCT service is youth friendly. METHODS: The study was descriptive, using three qualitative data collection methods: observation of the HCT site at two secondary schools; interviews with six service providers; and direct observation of 21 HCT counselling sessions. KEY RESULTS: The mobile school-based HCT service fulfilled some of the criteria for being a YFHS. The service was equitable in that all students, irrespective of race, gender, age, or socio-economic status, were free to use the service. It was accessible in terms of location and cost, but students were not well informed to make decisions about using the service. The service was acceptable in that confidentiality was guaranteed and the service providers were friendly and nonjudgemental, but it was not considered acceptable in that there was limited privacy. The service was appropriate in that HCT is recommended as an intervention for decreasing the transmission of HIV, based on evidence and expert opinion; however, in this case, HCT was provided as a stand-alone service rather than part of a full package of services. Moreover, studies have suggested that young people want to know their HIV status. The service was ineffective in that it identified students who are HIV positive; however, these students were not assisted to access care. CONCLUSION: Providing HCT in the school setting may make HCT more accessible for students, but it needs to be provided in an equitable, accessible, acceptable, and effective way.