- ItemExploring conceptualisations and praxis of community engagement with Stellenbosch University student leaders(Stellenbosch : Stellenbosch University, 2023-03) Demas, Grant Henry; Naidoo, Anthony V.; Stellenbosch University. Faculty of Arts and Social Sciences. Department of Psychology.ENGLISH ABSTRACT: Community engagement (CE) is a mandatory enterprise at South African higher education institutions (SAHEIs). One of the main reasons for this is to redress the damaging legacy of apartheid. Historically, these institutions were designed to be complicit in perpetuating the objectives of apartheid, and it is therefore important that due great care be exercised in how these institutions conceptualise and enact CE. This study explored SU students’ conceptualisation and praxis of CE. Twenty-one SU student volunteers in various CE leadership roles, within the ambit of their student club, society, residence, and faculty structures, were individually interviewed with the view to develop a theoretical explanation to explore the question: What is the theoretical explanation for Stellenbosch University students’ conceptualisation and praxis of voluntary community engagement? This was accomplished this by applying a grounded theory approach to analyse each interview transcript until a narrative emerged from the themes that were generated, from which a theoretical explanation was developed. I found that family, faith (religion), school, neighbourhood as formative microsystem contexts, and the broader socio-political and historical macrosystemic context in South Africa shaped this study’s participants’ conceptualisation and praxis of CE. Initially their CE praxis was predominantly motivated by altruistic intentions and then morphed into transactional and, in some cases, transformative ideals, as a consequence of participation in their CE initiatives. This study contributes to understanding the conceptualisation and implementation of CE as it provides a rich description of CE from different perspectives of students volunteering within their club and societies’ structures. It also provides insight into how university structuring of CE can enable and support Stellenbosch University https://scholar.sun.ac.za iii student based voluntary initiatives. The findings suggest that in order to achieve transformative ideals of CE, it is imperative to imbed an awareness of contextual influences and to adequately prepare and consistently support the students who stand in this critical position between the university and its engagement with external organizations and communities.
- ItemExplanatory models of child intellectual disability: Views of caregivers, spiritual healers and traditional healers in Khayelitsha, Cape Town(Stellenbosch : Stellenbosch University, 2021-12) Mkabile, Siyabulela; Swartz, Leslie; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.ENGLISH ABSTRACT: n South Africa healthcare services are not limited to biomedical care. However, biomedical services for people with intellectual disability (PWID) are still sparse in South Africa. Lack of sufficient and efficient biomedical services for PWID has prompted service users to explore alternative non-biomedical approaches for both their mental and medical healthcare needs. These alternative non-biomedical approaches include, but are not limited to, traditional and spiritual healing methods. To achieve this, I used both Kleinman’s Explanatory Models of illness and Bronfenbrenner’s socioecological model as frameworks to guide the study for the individual interviews and focus group discussions with caregivers and parents of children with ID, traditional healers and spiritual healers who resided in an urban low socio-economic setting in Cape Town. Findings from this study suggest that although there is a universal understanding and conceptualisation of ID in the Western biomedical professional sector, there are differences in the understanding, conceptualisation and management of ID in both popular and folk sectors. In addition, caregivers, parents, traditional healers and spiritual healers almost all used similar terms to biomedical terms of ID. The majority of participants from both traditional and spiritual healing methods believed collaboration with the biomedical sector was possible and desirable, with only a minority who were not in favour. The lived experiences of carers of children with ID revealed the struggles, isolation and hardship experienced by families of children diagnosed with this condition. The physical, economic and social marginalisation of children and families with ID, given the context of poverty and lack of access to quality services in which they live, as well as the stigma and lack of understanding of what ID is, all compounded the difficult experience of raising a child with ID.
- ItemExploring the implementation of a community health worker programme for maternal and child health in the rural Eastern Cape, South Africa(Stellenbosch : Stellenbosch University, 2020-12) Laurenzi, Christina; Tomlinson, Mark; Coetzee, Bronwyne; Skeen, Sarah; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.ENGLISH ABSTRACT:Community health worker (CHW) programmes are regarded as important solutions for improving health care services and outcomes for mothers and children globally. In low- and middle-income countries (LMICs), CHWs may be able to bridge widening gaps between limited human resource capacity and population health needs. However, despite the expansion of CHW programmes, we lack evidence for their effectiveness at scale. Even well-researched evidence-based programmes, when broughtto scale, tend to lose some of their effectiveness. Implementation science methods have emerged as one way to investigate why programmes succeed or fail, by providing researchers with frameworks to examine processes related to delivery, quality, and context. In this dissertation, I explore the processes underpinning the delivery of a CHWprogramme in rural South Africa. This study addressed four related research questions, focused on CHW fidelity to training, client responses to and engagement with the programme, and contextual aspects that affect the programme’s delivery. I utilised a combination of data sources, including transcripts from audio recordings of CHW home visits (n=84), interviews with clients of the programme (n=26), and interviews with CHWs themselves (n=10). The findings of this study identify programmatic strengths, with high levels of fidelity to training in communication skills; instructive and mutually supportive relationships between CHWs and their clients; and dedicated CHWs who regularly prioritise their clients’ needs. These findings also echo persistent challenges in programme implementation, including occupational burdens and pressures for CHWs, and barriers for clients in linking to health care within an under-functioning health system. This dissertation points to the importance of continued training, client and community consultation, and identification of contextual challenges to make programme implementation more effective before they are able to be scaled. It also emphasises the need to adopt a human-centred approach to designing and implementing CHW programmes, shifting away from a technical, vertical mode of providing much-needed services.
- ItemAdapting and piloting a cognitive-behavioural group therapy-based anxiety intervention programme for vulnerable children from a disadvantaged background within the South African context(Stellenbosch : Stellenbosch University, 2019-12) Myburgh, Naomi; Loxton, H. S.; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.ENGLISH ABSTRACT: Anxiety is a prevalent psychological problem amongst children worldwide and has been identified as a concerning mental health issue in need of intervention, especially amongst vulnerable children within disadvantaged South African contexts. Within such contexts, access to mental health services is particularly limited due to a lack of resources that diminish service delivery capacity. Importantly, anxiety symptoms have demonstrated a trend towards the development of anxiety disorders and numerous associated negative outcomes in the absence of intervention. Cognitive-behavioural therapy (CBT)-based programmes have been established as an efficacious response to child anxiety disorders and effective as a preventive approach. Notably, preventive interventions have the potential to reduce demands on resources and increase reach with more universal dissemination by non-expert programme facilitators. Recent advances in CBT-based anxiety intervention research have pointed to the potential of brief, intensive formats as a cost-effective, accessible and child-friendly treatment alternative for childhood anxiety problems. The potential value of the contextual adaptation of evidence-based programmes and outcomes measures to fit with new priority populations has also been established. The adaptation of existing interventions may overcome context-specific barriers to the delivery of programmes. The current study was motivated by a dearth of intervention research in the South African context and the need for accessible, cost-effective and contextually tailored mental health services for vulnerable children in disadvantaged semi-rural farming communities in South Africa. In response, the current study was implemented in two phases. Phase 1 entailed the contextual adaptation of the group, CBT-based, Dutch Dappere Kat anxiety prevention programme, based on information obtained from multiple community consultations. This resulted in the formulation of the brief, intensive, Afrikaans Ek is Dapper (BRAVE) group CBT-based anxiety prevention programme. Phase 2 entailed a pilot study implementation and evaluation of the BRAVE programme with a mixed methods quasi-experimental design (with an immediate intervention group, a delayed intervention group, and pre-, post- and follow-up outcomes measures). A sample of 21 children (aged 9 to 14 and in Grades 3 to 7) participated in the pilot study implementation and programme evaluation on three semi-rural farm sites. Quantitative data pertaining to the preliminary effectiveness of the BRAVE programme were collected at four-time points (T1-T4). Qualitative data pertaining to the perceived effectiveness, feasibility and acceptability of the BRAVE programme were collected session-wise and at 3-months post-intervention. The pilot study mixed methods preliminary effectiveness evaluation produced promising trends in response to the BRAVE programme with a significant reduction in overall anxiety symptom scores over time. However, significance findings were variable and were interpreted with caution in the context of concerns with the outcomes measures identified in Phase 1 and the relatively small sample size of Phase 2. Qualitative data indicated promising outcomes in terms of the perceived effectiveness and benefit of the programme with reports of the acquisition, application and generalisation of programme-based coping skills post-intervention. Furthermore, feasibility outcomes were good and indicated that a brief, intensive implementation on farm sites by programme facilitators is worth considering. Finally, the programme and its adaptations yielded good acceptability as reported by both participants and programme implementation observers. The outcomes and findings of the current South African study, a first of its kind, was critically reviewed with recommendations for future research of a similar nature. Keywords: anxiety symptoms, vulnerable children, CBT-based programmes, brief intensive prevention, contextual adaptation, vulnerable children, pilot study.
- ItemThrough a different lens: examining commonality and divergence in constructions and depictions of the sexuality of persons with physical disabilities in South Africa(Stellenbosch : Stellenbosch University, 2018-12) Hunt, Xanthe; Swartz, Leslie; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.ENGLISH ABSTRACT: Historically, people with disabilities have been held in contempt or pitied by the non-disabled members of the communities in which they live, and by society as a whole. One area in which people with disabilities have been excluded and discriminated against is that of sexuality. Sexuality has been deemed the purview of the non-disabled. The societal inability, or disinclination, to reconcile sexuality and disability has had damaging consequences for people with disabilities who have variously been infantilised, and treated as asexual. The international literature suggests that this stereotype of asexuality has been more widely applied to individuals with physical disabilities than to those with other disabilities. In low- and middle-income countries there is a gap in the state of knowledge concerning a. the attitudes of non-disabled people towards the sexuality of people with physical disabilities; and b. the experiences of sexuality (including sexual and reproductive health, relationships and sexual activity) of people with physical disabilities. In this dissertation, I survey the attitudes of some South Africans, from different backgrounds, with different levels of education, knowledge about, and exposure to, people with physical disabilities, towards the sexuality of people with physical disabilities. Secondly, I present and discuss accounts of lived experience – as gathered in a photovoice study – of sexuality and of sexual and reproductive health care amongst people with physical disabilities. I propose photovoice and self-representation as means by which the narratives illuminated in answer the second question, may be presented and made “real”. In the survey segment of the study, I found that non-disabled South Africans perceive people with physical disabilities to be less sexual than they are. This appears to be underpinned not only by a belief that people with physical disabilities are less sexual than non-disabled people, but also by non-disabled people’s active desexualisation of people with physical disabilities in interactions, and negation of the gender of people with physical disabilities. In the photovoice segment of the study, I found that a sample of South Africans with physical disabilities were concerned with their sexual fitness – their suitability as sexual subjects. This originated in their ideas about how non-disabled people might view their different-than-average embodiment, or how they viewed their embodiment as measured against internalized non-disabled norms. I reflect on the value of photovoice as methodology, and the value of self-generated images of the sexuality of people with physical disabilities in challenging societal representations. These images go some way to right the wrong of past misrepresentation which parallels and perpetuates the exclusion of people with physical disabilities from sexual life. I discuss future directions for inquiry into physical disability and sexuality, with a special interest in the global south context.