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Despite a sound policy framework, the right of learners with disabilities in South Africa to inclusive and equitable quality education is not being met. A key reason hindering the realisation of this right is that there are very few teacher education programs focused on supporting learners with disabilities. Acknowledging the urgency of teacher education, in this paper we draw on qualitative data from 109 teacher participants and 39 course facilitators of a series of disability inclusion-focused teacher education short courses in the Western Cape province of South Africa. Based on their experience of the courses, we consider how teachers can be empowered to meet the diverse needs of their learners within an inclusive framework. Findings highlight that professional and personal growth facilitated a more empathic understanding of learners and the opportunity to collaborate with others, enabling teachers to find creative ways of solving problems faced in their workplaces. To support teachers in meeting the needs of their learners, teacher training should facilitate active reflection on the role they play in shaping the lives of their learners, and prepare teachers to respond to challenges strategically, taking advantage of the resources available to them within and beyond their school environment. [ABSTRACT FROM AUTHOR]

In response to the COVID-19 pandemic, South Africa implemented a national lockdown including a ban on the sale of alcohol. This paper describes adults' perspectives on this alcohol ban, focusing on whether they support or oppose this regulation. As part of a longitudinal study that documents South African's experiences of the COVID-19 lockdown, qualitative data were collected from 49 adults and analyzed thematically. Perspectives are framed around the overarching theme of "lives versus livelihoods," presented as support and/or opposition to the ban. Participants who endorsed the ban, as preserving "lives," thought that it facilitated social distancing and therefore limited the spread of COVID-19. Those who opposed the ban suggested that it undermined the "livelihoods" of South Africans, in the context of an already-strained economy. Our findings show that decisions around whether to support or oppose the alcohol ban were informed by critical reflections on the wider socio-behavioral and health implications of such regulations. Further implications are discussed. [ABSTRACT FROM AUTHOR]

Background: This paper provides an overview of a series of studies undertaken to assess the appropriateness and understanding of the revised, draft South African Paediatric Food-Based Dietary Guidelines (SA-PFBDGs) amongst mothers/caregivers of children aged 0–5 years. Previous exposure to guidelines with similar messages, barriers and enablers to following the guidelines were also assessed. Design: Qualitative methods were used to collect data from 38 focus-group discussions (isiXhosa = 11, Afrikaans = 11, English = 10 and siSwati = 6) resulting in 268 participants. Setting: Breede Valley sub-district (Worcester), Stellenbosch Municipality (Stellenbosch, Pniel and Franschhoek) and Northern Metropole (Atlantis, Witsand, Du Noon and Blouberg), City of Cape Town, Western Cape province, as well as Ehlanzeni District (Kabokweni) in Mpumalanga province. Subjects: Mothers/caregivers older than 18 years who provided informed consent to participate. Results: The majority of participants had previous exposure to guidelines with similar messages to the SA-PFBDGs. Information sources included nurses, local clinics, family, friends and media. Possible barriers to following the guidelines included limited physical and financial access to resources; cultural/family practices, poor social support and time constraints. Outdated information, misconceptions, inconsistent messages and contrasting beliefs were evident. The vocabulary of some messages was not well understood. Education on infant and young child feeding and visual portrayal of the guidelines could aid understanding. Conclusion: A degree of rewording should be considered for improved understanding of the revised, draft SA-PFBDGs. Once adopted, the guidelines can be used to educate various stakeholders, including parents, caregivers, healthcare providers and educators, on the correct nutritional advice for children aged 0–5 years ensuring the healthy growth and development of young children in South Africa. [ABSTRACT FROM AUTHOR]

The care offered to children living with HIV (CLHIV) experiencing HIV-related disability is often challenged by caregiver illness, poverty and poor support structures in and around communities. Since caregiver needs directly influences the care offered to CLHIV this paper aimed to explore the experiences of the caregivers of CLHIV in order to inform an appropriate rehabilitation model in South Africa. A qualitative enquiry using in-depth interviews with 14 caregivers (one male and thirteen females) of CLHIV experiencing disability in a peri-urban setting was conducted. Data were analysed using thematic analysis. Four themes emerged from the interviews: understanding of HIV-related disability and rehabilitation, challengers to care and well-being, enablers to care; and perceived needs of caregivers. The study revealed that caregiver burden is influenced by the availability of resources and social support services. Financial constraints, poor access to rehabilitation and reduced support networks challenged the care offered to CLHIV. The perceived needs of the caregivers in this study included appeals for improved social security, housing, accessible rehabilitation and education. Changes in government policy guiding social support, employment, education and rehabilitation interventions are needed to improve the availability of resources, education, health and well-being of CLHIV and their caregiver's in South Africa. [ABSTRACT FROM AUTHOR]

This article reports on a study conducted to explore the barriers towards accessible quality higher education for students with disabilities (SwDs) in a South African Open Distance and e-Learning (ODeL) institution. The ultimate purpose of this study is to understand and shed light on the challenges that need to be addressed to improve the Unisa practices in a manner that would ensure accessible quality higher education for SwDs. As such, this study which is of a qualitative nature employed a single case study research design wherein nine interviews with lecturers from seven teaching colleges at Unisa are conducted. The findings reveal that, based on the perceptions of lecturers, quality higher education for SwDs at Unisa is hampered by lack of awareness and clear procedures to identify SwDs, inaccessible learning material for SwDs and lack of capacity by lecturers to support SwDs. While it is expected that this study may not culminate in recommendations for practice as a result of limitations posed by its design, it is anticipated that its logical ending points will serve to influence future practice. Nevertheless, it is recommended for future research in South African ODeL to focus on identifying best practices that can be adapted to enhance quality higher education for SwDs in relation to the above-mentioned challenges. [ABSTRACT FROM AUTHOR]

Worldwide, researchers routinely study children indirectly through adults who act as proxies for such children. The call for researchers to rather study children directly and adopt less intrusive child-friendly methodologies has become louder. The draw-and-write technique is regarded as a less intrusive child-friendly method of collecting data that can be used for this purpose. This paper reports the findings of a qualitative study that sought to establish the feasibility of the draw-and-write technique in exploring the resilience of children orphaned by AIDS. This study involved a convenience sample of 23 IsiXhosa-speaking orphaned children aged from 13 to 17. The participants were in grades 6 to 10 and they resided in two child and youth care centres in the Eastern Cape province of South Africa. As part of the draw-and-write technique the participants were asked to make drawings of what enabled them to cope with their lives and to write short narratives in which they explained their drawings. Inductive content analysis was used to analyse the data and this process yielded two main themes, namely: personal protective resources and socio-ecological protective resources. The findings show that complex combinations of personal and socio-ecological resilience resources enabled the resilience of the orphaned children. The findings challenge researchers not to be oblivious to alternative child-friendly methods of research such as the draw-and-write technique when young people are the unit of analysis. The findings of this study have implications for research as well as practice in the field of education and psychology. [ABSTRACT FROM AUTHOR]

Teaching is one of the most stressful occupations, with high stress and burnout levels of teachers necessitating intervention. This is especially relevant for South African teachers tasked with additional responsibilities of dealing with HIV/AIDS issues, as well as attending to normal curricula duties. A burnout prevention intervention, based on Paulo Freire’s adult educational approach, using transpersonal psychology techniques, was introduced to HIV/AIDS coordinator teachers (n = 27) at high-risk schools in the Western Cape, South Africa, who attended six three-hour weekly workshops. This paper presents the bottom-up thematic analyses of the group, as well as individual global analysis (n = 10) of the qualitative data, derived from focus group interviews and workshop evaluations after the intervention, providing insights into the experiences of workshop participants and their teaching contexts. The mind map of one participant is illustrated. The findings of the study confirmed that transpersonal practices (TP) presented in psychoeducation workshops were helpful in mediating stress and burnout in the work and personal contexts of teachers dealing with HIV/AIDS. TP offer practical applications of right brain emotional and social intelligence practices that could be incorporated into care and wellness school programmes for teachers vulnerable to stressors related to HIV/AIDS. [ABSTRACT FROM PUBLISHER]

The SARS-CoV−2 (COVID−19) virus severely impacted children around the globe; however, the impact on children with disabilities, such as cerebral palsy (CP) has been exacerbated due to the significant changes to their daily routines, and access to services and supports. During the spread of COVID−19, the country imposed restrictions and subsequent lockdown. The care demands may be compounded for children with CP and their families living in South Africa due to existing inequalities, and economic and access barriers. The study explored the access and support experiences of caregivers caring for children with CP during the COVID−19 pandemic in South Africa. A qualitative research design was employed. Eighteen caregivers consisting of 16 mothers and 2 fathers participated in the current study using semi-structured interviews on access and support needs for their children with CP. Thematic analysis of the data yielded themes related to: (1) fear of the unknown, (2) navigating changing caregiver roles, (3) financial stressors, and (4) opportunity despite adversity. While the lockdown measures continue to change and ease, it is important that provisions are made for children and their families both during and after the pandemic such as financial, social, family, and environmental support. In addition, recommendations for healthcare professionals working with vulnerable children and their families have been provided. [ABSTRACT FROM AUTHOR]

Prostate cancer is among the most prevalent forms of cancer worldwide and is reported to have the highest incidence, mortality, and 5-year prevalence rate of all cancers among men living in Africa. Despite this widespread burden in the African continent, little is known about the perspectives and experience of prostate cancer among African men. To further understand experiences among patients living in urban South Africa, we conducted in-depth, semi-structured qualitative interviews to examine the perceptions and experiences of 28 Black African prostate cancer patients receiving treatment at a major tertiary hospital in Johannesburg, South Africa. Our data explored four major areas of patients' experiences with prostate cancer: detection, diagnosis, treatment, and follow-up care. Our results showed that the experience of living with prostate cancer among low-income, Black South African men is a stressful and emotionally painful experience due in part to men feeling that they had insufficient knowledge about their own condition and feeling disempowered or ill-equipped to manage their cancer. These feelings were strongly associated with distrust or dissatisfaction with physicians and the health care system. Resilience factors include social support from family, friends, and religious communities, acceptance of their diagnosis, religion, and positive appraisals of their medical care. [ABSTRACT FROM AUTHOR]

Children living in resource-constrained environments have high levels of unmet psychosocial needs. Through participatory focus groups, we juxtaposed the views of 55 children aged 7–10 years from resource-constrained settings in South Africa and Pakistan, with those of 96 service providers, focusing on available sources of psychosocial support. Children largely relied on individual and relational resources, with limited awareness of structural supports. Service providers focused less on children's capacity, instead viewing schools and community-based resources as essential sources for psychosocial support. Children's agency and capacity should be recognized and bolstered to inform service planning, community-based interventions, and systemic change. [ABSTRACT FROM AUTHOR]

Social networks and social support are important factors in medication adherence among people living with HIV (PLWH). Social networks can provide emotional, logistic, and material support leading to increased overall engagement in care. Certain populations of PLWH may have more limited access to social support, including those reentering community settings from correctional facilities. During periods of incarceration, social connections with family and friends may be frayed, reduced, or lost. This study, conducted in South Africa, explored the role of social support during community reentry among PLWH being released from correctional facilities. We conducted in-depth interviews with 41 community reentrants living with HIV. Qualitative analysis identified the challenges with establishing social support during reentry and the greater need for social support to remain engaged in HIV care in the community compared to in the correctional facility. These findings highlight challenges during community reentry and the importance of social support for these individuals. [ABSTRACT FROM AUTHOR]

Progress in adolescent sexual and reproductive health (SRH) remains unequal: adolescent pregnancies are more likely to occur in marginalised communities, or in very poor households. This study aimed to comprehend from adolescents' own perspectives, the circumstances of falling pregnant and coping with motherhood in informal settlements in South Africa, to better understand the SRH challenges adolescents in these settings may face. A qualitative study was carried out over a two-month period in 2019 to analyse the perceptions held by adolescents in informal settlements served by four community-level clinics in the adjacent township. We found that adolescents face overlapping barriers in seeking to avoid unintended pregnancy in informal settlements. Once they become mothers, their trajectory is limited by the resources and support available from their own parents, particularly their mothers, and to a lesser extent, their partners. We draw on the concept of agency to examine their accounts and to highlight the importance of addressing broader contextual constraints. [ABSTRACT FROM AUTHOR]

Objectives: HIV prevalence among sexual and gender minority (SGM) individuals in South Africa is among the highest in the world; however, SGM migrants, an especially vulnerable subgroup of both the SGM and migrant populations, have frequently been overlooked in the country's robust public health response. This qualitative study, guided by syndemics theory, explored the processes by which SGM migrants in South Africa are exposed to HIV risk and those that may reduce this risk. Design: We conducted 6 focus groups with a total of 30 SGM migrants living in Cape Town. Participants were men who have sex with men, women who have sex with women, and transgender women. Transcripts were analyzed using grounded theory. Results: Participants identified a number of interrelated factors (insecure immigration status, financial and housing instability, food insecurity, stigma and discrimination, and lack of social support) contributing to HIV risk. While some took PrEP or HIV medication, adherence could be affected by structural and psychosocial barriers. Conclusion: Interventions that respond to the syndemic impacts on HIV outcomes are needed to reduce disease burden among SGM migrants in South Africa. [ABSTRACT FROM AUTHOR]

Objectives: To assess the appropriateness and understanding of the revised, draft South African Paediatric Food-Based Dietary Guidelines (SA-PFBDGs) amongst mothers/caregivers of children aged 0–12 months. Exposure to guidelines with similar messages, barriers and enablers to following of the guidelines were also assessed. Design: Qualitative data were collected from 14 focus-group discussions (FGDs), conducted in isiXhosa (n = 5), English (n = 4) and Afrikaans (n = 5), totalling 73 mother/caregiver participants. Setting: Worcester, Breede Valley sub-district, Western Cape province. Subjects: The study population included mothers/caregivers who were older than 18 years. Results: The majority of participants had previous exposure to variations of messages similar to the revised, draft SA-PFBDGs. Health platforms and practitioners (community health centres, antenatal classes, nurses, doctors) and social networks and platforms (family, magazines, radio) were mentioned as primary sources of information. Barriers to following the messages included: inconsistent messages (mainly communicated by healthcare workers), contrasting beliefs and cultural/family practices, limited physical and financial access to resources, poor social support structures and the psycho-social and physical demands of raising a child. Conclusion: The revised, draft SA-PFBDGs for the age range 0–12 months have been field-tested in English, Afrikaans and isiXhosa. The messages in some of the revised, draft SA-PFBDGs were not understood by the participants, indicating that a degree of rewording should be considered to facilitate understanding of the guidelines by the public. The National Department of Health should consider the findings of this study, and use these standardised messages to optimise infant and young child feeding. [ABSTRACT FROM AUTHOR]

Patients with drug-resistant tuberculosis (DR-TB) have received community-based care in Eswatini since 2009. Trained and compensated community treatment supporters (CTSs) provide directly observed therapy (DOT), injectables and psychological support. We examined the acceptability of this model of care among DR-TB patients, including the perspective of family members of DR-TB patients and their CTSs in relation to the patient's experience of care and quality of life. This qualitative research was conducted in rural Eswatini in February 2018. DR-TB patients, CTSs and family members participated in in-depth interviews, paired interviews, focus group discussions and PhotoVoice. Data were thematically analysed and coded, and themes were extracted. Methodological triangulation enhanced the interpretation. All patients and CTSs and most family members considered community-based DR-TB care to be supportive. Positive aspects were emotional support, trust and dedicated individual care, including enabling practical, financial and social factors. Concerns were related to social and economic problems within the family and fears about infection risks for the family and the CTSs. Community-based DR-TB care was acceptable to patients, family members and CTSs. To reduce family members' fears of TB infection, information and sensitisation within the family and constant follow-up appear crucial. [ABSTRACT FROM AUTHOR]

Spina bifida myelomeningocele is a major cause of disability among adolescents. However, little research is available in low-income nations such as South Africa. Investigating the contributors and hindrances to well-being in adolescents with spina bifida myelomeningocele may yield novel insights. In this study we included both adolescents and their primary caregivers to examine their perspectives on caring for and facilitating improvements in the life of the adolescents living with spina bifida myelomeningocele. To identify and document the perceptions of adolescents with spina bifida myelomeningocele and their primary caregivers on the factors that contribute to and hinder the well-being of adolescents living with spina bifida myelomeningocele in South Africa. An explorative qualitative research design was utilized, guided by a positive psychology theoretical framework. Fourteen participants, consisting of seven adolescent-primary caregiver dyads, were interviewed. Data were analyzed using thematic analysis and coded inductively using ATLAS.ti software. We identified eight themes describing participants' perceptions on contributors and hindrances to the well-being of adolescents with spina bifida myelomeningocele. Contributing factors included: family support, social groups, special needs education, sport participation, striving for independence, and finding meaning in life. Hindrances included: structural (lack of resources, medical care and mobility challenges) and social (bullying and harmful friendships, secrecy about the condition, social isolation and unhappiness) hindrances to well-being. Acknowledging the contributors and hindrances to the well-being of adolescents with spina bifida myelomeningocele is crucial for guiding informed positive interventions and preventing blind spots. Given the limited number of positive contexts, concentrated effort is required to facilitate opportunities for growth in a range of environments. Primary caregivers lack insight into the positive and negative aspects of the adolescents' lives. We suggest families prioritize bonding time and open communication. Exploring the perspectives of adolescents living with spina bifida and their parents regarding well-being is important to develop appropriate interventions. Adolescents living with spina bifida value social support and social interaction as ways to maintain well-being. Special needs education institutions with curriculums tailored to adolescents with spina bifida promote comfort, acceptance, and personal excellence. Sport contributes to the mental, social and physical well-being of adolescents with spina bifida. Sport inspires and offers opportunities for success, it improves school attendance, increases positive affect, and provides opportunities for close relationships with friends and family. Finding ways to mitigate the stigma around spina bifida is necessary to improve adolescents' well-being within South Africa. [ABSTRACT FROM AUTHOR]

The purpose of the current study was to explore the challenges experienced by hearing parents when parenting a child with hearing loss. Using a qualitative purposive sampling design, interviews were conducted with 13 parents (9 mothers, 4 fathers) residing in Cape Town, South Africa. Four salient themes emerged, namely: 1) communication is difficult, hard, and frustrating; 2) lack of knowledge and information about hearing loss makes it difficult to parent; 3) little or no support makes for a lonely journey; and 4) support identified by parents for parents. The findings of the study have important implications for collaboration and partnerships between parents and health and family practitioners within South Africa for the design and development of supportive interventions for parents parenting a child with hearing loss. [ABSTRACT FROM AUTHOR]

Abortion providers and pregnant people who undergo abortion potentially face significant stigma. Researchers have started to explore how womxn respond to abortion stigma, usually focusing on individual strategies in managing or reducing stigma effects. Drawing on narrative data from research conducted on womxn's and healthcare providers' experiences of the pre-abortion healthcare encounter in the South African public health sector, we highlight how stigma may be resisted in social ways within this context. Everyday chatter and informal social support amongst womxn in the waiting room provided a counterpoint for health service providers' ascription of shame to the womxn, and a sense of solidarity amongst the womxn. Health service providers narrated their decision to do abortion work through the socially affirming hero canonical narrative, and womxn described their counselling as helpful. These social and discursive practices resist the awfulisation of abortion and provide relief for the womxn and the healthcare providers in particular contexts. [ABSTRACT FROM AUTHOR]

Research on adolescent sexuality, health and parenting has gained much attention in recent years. This growing body of research, however, has arguably limited qualitative outputs on HIV-positive adolescent mothers' sexual and reproductive health choices, needs, and rights in South Africa that could lead to informed policymaking. Through in-depth interviews conducted with a select group of ten HIV-positive adolescents and three key informants, the article explores the sexual, motherhood, risk discourses and reproductive health issues and rights of HIV-positive adolescent mothers as they come to terms with choices they have made and the challenges ahead. The findings highlight the dominant narratives on what are deemed to be the forces that shape these adolescent mothers' new social realities. With existing policies in place for adolescents, it is argued that a "one-size-fits-all" policy approach does not work, especially for HIV-positive adolescent mothers. Drawing on this identified gap and the tensions between individual needs, and the public welfare provision, the article highlights the need for tailored policy that will accommodate and promote the overall well-being of HIV-positive adolescent mothers and their children. [ABSTRACT FROM AUTHOR]

Human trafficking affects numerous countries worldwide, including South Africa. Given the multiple consequences and human rights violations to victims, trafficking requires a collective multi-disciplinary response involving social workers. This was a qualitative study looking at social service provision to adult victims of human trafficking at shelters in two provinces in South Africa. The findings revealed that a range of services are offered by social workers at shelters and that rights-based intervention approaches must always inform anti-trafficking efforts. [ABSTRACT FROM AUTHOR]

The challenge facing the mental health field today is the lack of knowledge related to interventions and services that will help people recover from severe mental health problems. In addition, the reluctance of social workers to embrace the recovery-oriented mental health practice is attributed to their lack of knowledge. Hence, they regard recovery in mental health as misleading and unrealistic.The article provides the findings on the social workers' lack of knowledge and understanding of the recovery-oriented mental health practice. The social workers are based in non-governmental organizations in Tshwane, South Africa. Semi-structured interviews were conducted to gather data from social workers. Findings confirmed the lack of knowledge regarding the recovery-oriented approach, which has not yet been implemented in South Africa. Mental health services continue to be informed by the traditional medical model. [ABSTRACT FROM AUTHOR]

This qualitative study explored the psycho-educational and social interventions provided for orphans and vulnerable children (OVC) in a community-based organisation (CBO) in Soweto, South Africa. The study involved 12 OVC (males = 40%, and females = 60%; aged 10 to 18 years). Data was collected using individual interviews, focus group discussions, and autobiographies. The thematically analysed data revealed that the OVC received psychological interventions through mentorship and peer-group support in the CBO. Educational interventions included the provision of school uniforms and educational materials, as well as sponsorship of tuition, sports and excursion fees. Academic track records presented a challenge, however, which was attributed to the enormous numbers of OVC under the care of the CBO. It was further established that social interventions were addressed by empowering the OVC with life skills and providing economic support for their families, specifically to pay rent and provide meals. The major contributions of this study are to note the importance of the CBO in addressing issues related to the lack of counselling, the stigmatisation of OVC by community members and the need for empowerment of their families by providing income-generating activities. The information obtained is useful in opening up avenues for interested parties to further explore the effectiveness of these psycho-educational and social interventions in improving the lives of OVC in society. [ABSTRACT FROM AUTHOR]

Although South Africa has the largest number of people on antiretroviral therapy (ART) in the world, many HIV clients drop out of care immediately after HIV diagnosis. This qualitative study explored the perceptions and experiences of newly diagnosed clients on the role support groups play in linking and retaining newly diagnosed clients in HIV care in Mbandazayo peri-urban location. The data were analysed using the thematic content analysis approach. Data revealed four mechanisms through which support groups appeared to link and retain newly diagnosed clients in the HIV care continuum. First, support groups were a formal link between newly diagnosed clients and health facilities. Second, support groups mitigated the effects of both felt and enacted stigma, thereby facilitating acceptance of HIV diagnosis among newly diagnosed clients. Third, support groups were an advocacy and networking tool for newly diagnosed clients to make their health related needs, challenges, and concerns known to local health clinics, thereby forging and maintaining a close relationship with their local health facilities. Last, support groups were spaces within the community where practical needs of newly diagnosed clients are met, which in turn help in retaining them within support groups, and facilitate their linkage and retention in the HIV continuum of care in Mbandazayo. Our findings suggest that HIV support groups are critical in enhancing linkages and retention of newly diagnosed clients in HIV care. With the introduction of universal test and treat (UTT) in South Africa, our findings suggest that support groups can play a significant role in retaining HIV care clients who are diagnosed and immediately enrolled on ART. [ABSTRACT FROM AUTHOR]

Through in-depth interviews with service providers from non-governmental organisations (n = 58), this article describes the intricacy of familial relationships for women with intellectual disabilities in South Africa who experience gender-based violence. The findings suggest that families navigate social stigma, limited resources and isolation, whilst trying to be vigilant against gender-based violence and disability-related violence, and respond to it as it happens. However, family members are also simultaneously implicated in violence perpetration. We suggest that a social relational model of disability could help account for these crucial intra-familial dynamics. [ABSTRACT FROM AUTHOR]

In rural South Africa, high HIV prevalence has the potential to affect the care and support that kin are able to provide to those living with HIV. Despite this, families seem to be largely resilient and a key source of care and support to family affected by HIV. In this article, we explore the motivations for the provision of care and support by kin. We use the results of a small-scale in-depth qualitative study conducted in 10 households over 6 months in rural KwaZulu-Natal, South Africa, to show that family obligation and conditional reciprocity operate in varying degrees and build social capital. We highlight the complexity of kin relations where obligation is not guaranteed or is limited, requiring the consideration of policy measures that provide means of social support that are not reliant on the family. [ABSTRACT FROM AUTHOR]

The maintenance of social networks amongst migrant diasporas has been previously emphasized. When caring for a new baby in particular, however, hands-on social supports are needed. These social supports are poorly understood for migrants. This qualitative study of maternal postpartum support included 23 in-depth interviews with postpartum migrant women and nine focus groups with adult men and women (N = 48) in Cape Town. The absence of nonworking women specifically, and social support generally, was central to migrants' descriptions of stress and infant feeding. The absence of elder and other nonworking women in migrant contexts mayaddvulnerability to alreadymarginal communities. [ABSTRACT FROM AUTHOR]

Background The training of healthcare professionals impacts the health of individuals with intellectual disabilities (ID). This study presents an analysis of how medical students at the University of the Witwatersrand, Johannesburg, South Africa, are trained to treat this marginalised population. Methods This was an exploratory qualitative study using multiple methodologies, including a curricular review, 18 purposively selected key informants’ interviews, and 3 focus group discussions, with medical students across 4 relevant teaching departments. Using Lennox and Diggens’ curricular framework, thematic content analysis was conducted to identify dominant themes and subthemes. Results Of Lennox and Diggens’ 15-point model of knowledge, skills, and attitudes, 3 aspects were not taught, and attitudes fared the most poorly whereas skills fared the strongest. Differences in the quality and nature of training offered on clinical rotations were highlighted, and the practical exposure to patients with ID was found to be limited. Conclusions The shortfalls in content and unplanned clinical exposure suggest that a more focused teaching approach to people with ID will result in greater competence and confidence in graduates. [ABSTRACT FROM PUBLISHER]

Background:Healthcare workers have been at the forefront of dealing with the impact of HIV and AIDS at all stages of the pandemic. This brings new challenges to include disability into HIV care. However, the implications for healthcare workers in an already fragile health system along with HIV-related disabilities in persons living with HIV are little understood. This study examined the healthcare workers’ perspective on disability in HIV care. Method:This article describes a qualitative study using in-depth interviews with 10 healthcare workers in a semi-urban hospital setting in KwaZulu-Natal, South Africa. The study aimed to understand healthcare workers’ experiences with disability in the context of HIV. The International Classification of Functioning Disability and Health (ICF) was used as a guiding framework to understand disability. Results:Healthcare workers described HIV-related disabilities on all three levels of disability, namely impairments/ body function, activity limitations and participation restrictions, as affecting the livelihood of their patients and household members. Issues also arose from disability and stigma that were perceived as affecting adherence to antiretroviral treatment. In addition, healthcare workers encounter challenges in dealing with the increased needs of care and support for those people living with HIV who experience HIV-related disabilities. They indicated a limited ability to cope and respond to these needs. Primarily they arrange additional referrals to manage complex or episodic disabilities. Participants also identified issues such as excessive work load, lack of resources and training and emotional challenges in dealing with disability. Conclusion:Healthcare workers need support to respond to the increased needs of people living with HIV who have HIV-related disabilities. Responses need to reflect: 1) increase in rehabilitative staff including in community outreach programmes; 2) skills training in HIV-related disability; and 3) psychosocial support for healthcare workers. [ABSTRACT FROM PUBLISHER]

Cash transfer (CT) programmes are increasingly being used as policy instruments to address child poverty and child health outcomes in developing countries. As the largest cash-transfer programme in Africa, the South African Child Support Grant (CSG) provides an important opportunity to further understand how a CT of its kind works in a developing country context. We explored the experiences and views of CSG recipients and non-recipients from four diverse settings in South Africa. Four major themes emerged from the data: barriers to accessing the CSG; how the CSG is utilised and the ways in which it makes a difference; the mechanisms for supplementing the CSG; and the impact of not receiving the grant. Findings show that administrative factors continue to be the greatest barrier to CSG receipt, pointing to the need for further improvements in managing queues, waiting times and coordination between departments for applicants trying to submit their applications. Many recipients, especially those where the grant was the only source of income, acknowledged the importance of the CSG, while also emphasising its inadequacy. To maximise their impact, CT programmes such as the CSG need to be fully funded and form part of a broader basket of poverty alleviation strategies. [ABSTRACT FROM AUTHOR]

Objective:Social support provided to caregivers of children has been shown to be protective for caregiver health, parenting and child psychosocial outcomes. However, little work in Southern Africa provides insight on the relationship between caregiver social support and child wellbeing. This report discusses exploratory qualitative findings from a larger mixed methods study, on caregivers’ perceptions of the pathways through which received support affects their children's lives. Methods:In-depth semi-structured interviews were conducted with 24 adult primary caregivers of children (aged 10–17 years) living in an HIV-endemic resource-constrained urban South African community. Thematic analysis of the data was supported by NVivo. Results:Caregivers perceived the social support they received to positively affect their children's health and behaviour, both directly and through a positive influence on their (the caregivers’) mental health, parenting and decision making. Information, advice and encouragement emerged as key types of support explaining perceived effects. Conclusion:Future research should continue to explore pathways explaining the relationship between caregiver social support and child psychosocial wellbeing with similar populations, and quantitatively investigate direct and indirect effects of potential mediating factors. Findings speak both to the importance of psychosocial support for parenting interventions and the potential to strengthen child-focused interventions through the broader family social network. [ABSTRACT FROM PUBLISHER]

A number of studies indicate that social support is associated with better health outcomes among HIV-positive caregivers of children, suggesting its potential importance for interventions aimed at safeguarding the well-being of this population. However, there is very little published literature assessing the support–health relationship or evaluating applied social support interventions with HIV-positive populations in HIV-endemic contexts of the developing world. The global literature on social support and health suggests that, in order to refine theory and improve interventions, greater attention should be paid to specific dimensions of support, such as types and sources, as well as the processes through which support may be affecting health outcomes. This article presents and discusses data from in-depth interviews with 12 HIV-positive primary caregivers of children living in an HIV-endemic, low-resourced, urban South African community. The primary aim of this qualitative work was to provide further insight into survey findings of a positive relationship between social support and self-reported general health and functioning, by exploring caregivers' personal experiences of being supported within their community, and their perceptions on how this “informal” support may be influencing their health. Our qualitative data highlight the importance of instrumental and emotional support for this population, the relevance of support provider characteristics and some of the processes or pathways that are likely explaining the support–health link. These processes include psychological factors such as mastery and hope, coping strategies and positive health behaviours. We provide recommendations for future research to further this work, and discuss implications for health interventions. [ABSTRACT FROM PUBLISHER]

Objective: This article explores the psychological issues experienced by adolescents affected by HIV and living in a residential care facility. Method: This was a multi-method, exploratory study. Data were collected through one focus group discussion with adolescents at the residential care facility, individual interviews with caregivers and ethnographic observation. Data were obtained from a residential care facility for HIV affected and infected children and mothers in Gauteng. Results: Findings suggest that for adolescents in this study, living in a residential care facility offered both opportunities and challenges. Adolescents at the facility enjoyed material and, to some extent, emotional support. Association with a facility known as a HIV and AIDS care facility, however, had a negative impact on the adolescents. Additionally, the lack of significant attachment figures, asserting their independence and challenging the authority and the expectations of the facility appeared to be significant developmental challenges. Adolescents reported experiencing a range of emotional and psychological problems, some of which were present before they arrived at the facility. Conclusion: Living in a care facility can be both a protective and a risk factor; additional studies on the availability and the impact of alternate forms of care are suggested. [ABSTRACT FROM AUTHOR]

An increasing body of literature shows that HIV/AIDS and mental health issues are closely related. In spite of this, the mental health correlates of HIV and AIDS remain largely unacknowledged and under-researched in sub-Saharan Africa. Furthermore, despite guidelines by the World Health Organization insisting that counselling with integrated psychological or mental healthcare helps people living with HIV or AIDS (PLHIV) to deal with their disease status and thus increases their quality of life, the services and interventions to address this significant health burden are still lacking, making the HIV/AIDS and mental-health nexus a sizeable social services and health problem. As part of an ongoing research programme at the University of the Witwatersrand to address this, the article reports on a baseline study that sought to identify the nature and extent of counselling and support services available to PLHIV in Gauteng Province. The study found that available counselling and support services are focused largely on voluntary counselling and testing for HIV (VCT), which appears to be primarily an educational intervention rather than a therapeutic modality. Service providers within this framework have inadequate knowledge and capacity to identify mental health problems. The findings of this study point to a strong need for integrated HIV/AIDS services that include assessment of mental health and substance abuse problems and their appropriate management. Appropriate training and supervision of healthcare workers and counsellors is an essential component in the identification and referral of HIV patients with mental health problems. [ABSTRACT FROM AUTHOR]