MIV/VIGS-berading in 'n Suid-Afrikaanse gemeenskap : 'n kritiese beskouing

Du Toit, Monica (2002-12)

Thesis (MA)--University of Stellenbosch, 2002.

Thesis

ENGLISH ABSTRACT: The human immune deficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) have already reached a magnitude in Southern Africa which can hardly be addressed by the existing structures. HIV counselling is considered to be an important preventative and supportive strategy in the battle against HIV. In recent years therefore, urgent attempts have been made to provide HIV/AIDS counselling services throughout South Africa. The researcher had a firsthand experience of such an attempt as manager of HIV counselling services for a NGO working in a peri-urban community. She realised that although the ideal outcome and aims of HIV counselling have been widely documented, very little research has been done on the implementation of these principles in health systems with limited resources. It was thought that a meaningful contribution could be made to the development of HIV counselling services in a specific South African community by critically exploring current HIV counselling services in such a community. This exploration entailed the following: • reviewing the literature on HIV counselling; • clarifying the goal of HIV counselling; • clarifying behaviour change as an outcome of HIV counselling; • exploring the influence of the Stellenbosch context on the content and outcome of HIV counselling; and; • exploring to what extent the goals of HIV counselling (as prescribed by international and national literature) are pursued in the Stellenbosch context. The ecological model and an action research method were used to direct this study. The researcher used her position and experience as manager of the HIV counselling services within a non-governmental organisation to access sources of information. Direct and participatory observations were utilised to gather information regarding the implementation of HIV counselling services in the community. The model of Raeburn and Seymour (1979) and specifically the overview phase have been used as a framework to organise the data and to describe the HIV counselling system in the specific community. The researcher concluded that the theoretical principles that were identified as prerequisites for effective HIV counselling services were often irreconcilable with the management skills, context, infrastructure and aims of the primary health services within the district. It was highlighted that a systemic understanding of the impact of the environment should be considered when future models and outcomes are formulated and implemented. Finally, alternative suggestions for the management, the formulation of outcomes and the utilisation of personnel in HIV counselling in this specific community were discussed.

AFRIKAANSE OPSOMMING: Die Menslike Immuniteitsgebreksvirus (MIV) en Verworwe Immuniteitsgebreksindroom (Vigs) in Suider-Afrika het reeds 'n omvang bereik wat beswaarlik deur die bestaande strukture aangespreek kan word. MIV-berading word beskou as 'n belangrike voorkomende en ondersteunende strategie in die stryd teen MIV. In die laaste paar jaar is dringende pogings dus aangewend om MIV-beradingsdienste in die hele Suid Afrika beskikbaar te stel. Die navorser het eerstehandse ervaring gehad van hierdie inisiatief as bestuurder van MIV -beradingsdienste vir 'n nie-regeringsorganisasie wat werksaam is in 'n semilandelike gemeenskap. Alhoewel die ideale uitkoms en doel van MIV -berading wyd gedokumenteer is, het sy besef dat baie min navorsing gedoen is oor die implementering van hierdie beginsels in gesondheidsisteme met beperkte bronne. Daar is geredeneer dat 'n betekenisvolle bydrae gemaak kan word tot die ontwikkeling van MIV -beradingsdienste binne 'n spesifike Suid-Afrikaanse gemeenskap deur die huidige MIV -beradingsdienste in so 'n gemeenskap krities te verken. Hierdie verkenning het die volgende behels : • literatuur oor MIV -berading te bestudeer; • MIV-berading se doelwitte te verhelder; • gedragsverandering as uitkoms van MIV -berading te verhelder; • te eksploreer hoe die Stellenbosch konteks die inhoud en uitkoms van MIV -berading beïnvloed; en • te eksploreer tot watter mate die doelwitte van MIV -berading ( soos voorgeskryf deur internasionale en nasionale literatuur) in die Stellenbosch konteks nagestreefword. Die ekologiese model en 'n aksienavorsingsmetode is gebruik om die ondersoek te rig. Die navorser het haar posisie en ervaring as bestuurder van MIV -beradingsdienste binne 'n nie-regeringsorganisasie gebruik om toegang te verkry tot inligting. Direkte en deelnemende waarneming is gebruik om inligting in te samel rakende die implementering van MIV -beradingsdienste in die gemeenskap. Die model van Raeburn en Seymour ( 1979) en spesifiek die oorsigfase is gebruik as 'n raamwerk om data te organiseer en die MIV -beradingsisteem in die spesifieke gemeenskap te beskryf. Die navorser het tot die gevolgtrekking gekom dat die teoretiese beginsels wat geïdentifiseer is as essensiële voorvereistes vir effektiewe MIV -beradingsdienste in soveelopsigte onversoenbaar is met die bestuursvaardighede, konteks, infrastruktuur en doelwitte wat binne die spesifieke primêre gesondheidsdienste geld. Dit is beklemtoon dat In sistemiese verstaan van die invloed van die omgewing en die inagneming van die sisteem belangrik is wanneer toekomstige doelwitte geformuleer en modelle geïmplementeer word. Alternatiewe voorstelle vir die bestuur van beradingsdienste, die formulering van uitkomsdoelwitte en die benutting van personeel in hierdie dienste is ten slotte bespreek.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/52938
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