Philosophiae Doctor - PhD (School of Public Health)

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https://hdl.handle.net/10566/11949

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Browsing by Subject "Adolescents"

Now showing 1 - 5 of 5
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    Assessing the influence of gender socialization on early adolescents’ behaviors and perceptions towards sexual and reproductive health and gender-based violence in low socio-economic, urban neighborhoods, Cape Town: a quantitative study
    (University of the Western Cape, 2023) Kinoshita, Rinko; Cooper, Diane
    Early adolescents (EAs), aged between 10 and 14, account for half of 1.2 billion adolescents worldwide. During early adolescence (EA), many EAs experience puberty and social and cognitive shifts. This is a period when gender norms are shaped manifesting in their perceptions and behaviors. Unequal gender norms may negatively affect adolescents’ sexual and reproductive health (ASRH), including early pregnancy, violence, and mental health. There is a paucity of evidence on how EAs construct gender norms, and how unequal gender norms may impact their health and well-being.
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    Conceptualisation and operationalisation of mental wellness: Developing an instrument to measure mental wellness among adolescents living with HIV in South Africa
    (University of the Western Cape, 2022) Orth, Zaida; van Wyk, Brian
    Adolescents living with HIV (ALHIV) are a key population in the fight against HIV and AIDS. The comparatively poorer treatment outcomes of ALHIV in relation to child and adult HIV populations indicate the need for a health response to improve adolescent ART service delivery. Research suggests that improving mental wellness may be imperative to improving HIV-treatment behaviours such as long-term adherence and engagement in care. However, little is known about what mental wellness means for ALHIV. It is further unknown what critical mental wellness concepts should be targeted in adolescent interventions. Ultimately, understanding mental wellness in ALHIV is essential to design programmes that will help them navigate their chronic condition to lead healthy and productive lives.
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    Development of evidence-based context appropriate public policy reform models that coherently promote healthy food environments and food consumption patterns in Zambia
    (University of the Western Cape, 2022) Mukanu, Mulenga Mary; Mchiza, Zandile June-Rose
    The double burden of malnutrition is a growing concern globally. In Zambia, it is estimated that of children under five years, 35% are stunted, while 5% are either overweight or obese. In the adult population, 24% are overweight, while 90% do not meet the dietary requirement of consuming five portions of fruit a day. Evidence suggests that unhealthy dietary habits developed by children can contribute to poor health outcomes in adulthood. However, Zambia's nutrition policies are not changing rapidly enough to address the development of new challenges associated with the double burden of malnutrition. Policy reforms should be implemented to re-engineer food environments to support access to healthier food options and make these foods preferable to consumers in critical age groups like adolescence.
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    Harnessing Resilience: An exploration into individual and contextual factors that facilitate uptake of sexual and reproductive health services (SRHS) and HIV testing amongst South African youth
    (University of the Western Cape, 2022) Cooper, Diane; Christie, Sarah Spence
    Youth is generally defined as young people between the ages of 14- 24 years, however, in South Africa the age range is extended to 34 years. In 2020, the estimated youth population (14-35 years) in South Africa was 20.1 million, with just over 5 million being between the ages of 15- 19 years. In 2009, the World Health Organization (WHO) described South Africa as experiencing a ‘youth health crisis’, reflective of a syndemic disease burden caused by early childbearing, poor nutrition, high HIV incidence, sexual risk behavior, substance abuse, violence, and injuries.
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    School-based HIV counselling and testing: providing a youth friendly service.
    (University of the Western Cape, 2012) Lawrence, Estelle; Struthers, Patricia; Van Hove, Geert
    HIV counselling and testing (HCT) is an essential element in the response to the HIV epidemic. There are still major gaps in research about the best ways to provide HCT, especially to young people. School-based HCT is a model which has been suggested for providing HCT to young people in a youth friendly manner. This study was aimed at producing recommendations for providing a youth friendly school-based HCT service using the World Health Organisation (WHO) framework for youth friendly health services. It was conducted in six secondary schools in Cape Town, where a mobile HCT service is provided by a nongovernmental organisation (NGO). It was an exploratory descriptive study, using a mixed-methods approach. Twelve focus group discussions (FGDs) were held with learners to explore their needs with regards to school-based HCT. An evaluation (which consisted of observation of the HCT site, service provider interviews and direct observation of the HCT counselling process) was done to determine whether the mobile school-based HCT service was youth friendly. A learner survey was conducted with 529 learners to investigate the factors that influence the uptake of HCT and to explore learners’ behaviours and experiences under test conditions. In the FGDs, learners said that they wanted HCT to be provided in schools on condition that their fears and expressed needs were taken into account. They wanted their concerns regarding privacy and confidentiality addressed; they wanted to be provided with information regarding the benefits and procedure of HCT before testing took place; they wanted service providers to be competent to work with young people, and they wanted to be assured that those who tested positive were followed up and supported. On evaluation of the mobile school-based HCT service, it was evident that the service did not meet all the needs of the learners nor did it have all the characteristics of a youth friendly health service. The model of ‘mass testing’ used by the NGO did not fulfil learners’ expressed need for privacy with regards to HCT. Service providers were friendly and non-judgemental but had not been trained to work with young people (especially marginalised groups e.g. young men who have sex with men). The information needs of learners were not addressed, and learners were not involved in the provision of the HCT service. Learners who tested positive were not assisted in accessing care and support. The learner survey revealed a high uptake of HCT (71% of learners) at schools with learners who do not identify themselves as Black, with female learners and older learners being more likely to have had an HIV test. Factors that influenced uptake of HCT were complex, with learners reporting many different motivators and barriers to testing. Of concern was the low risk perception of leaners with regards to HIV infection and the fact that learners who tested HIV positive were not being linked up with treatment and care. Based on the findings of the study, recommendations were made for providing youth friendly school based HCT. A multisectoral approach, with learner and community involvement, was suggested in order to provide a service which is equitable, accessible, acceptable, appropriate and effective.