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In recent years, anxieties have been expressed that the impacts of southern Africa's AIDS pandemic on young people today will damage their future livelihood prospects. Geographers have been remarkably reluctant to explore young people's future livelihoods, inspired by a concern to view young people as human beings, worthy of study in their own right rather than mere human becomings, of interest only as 'adults in the making'. Yet there is growing acknowledgement that young people, like older people, are always both 'being and becoming'. The connections between current and future lives merit much greater attention, both because experiences and actions in childhood and youth undoubtedly shape the futures of individuals and wider society, but also because young people's thoughts and actions are so often geared to the future, and this future orientation shapes their present worlds. This paper reports on research that set out to explore links between the impacts of AIDS and young people's livelihood prospects. Intensive case study research was undertaken, combining participatory methods and life history interviews with young people aged 10-24 in two villages, one in southern Malawi and the other in the mountains of Lesotho. By theorising a temporal dimension to de Haan and Zoomers' concept of livelihood trajectories, the paper focuses on the ways in which young people respond to both the immediate sustenance requirements of themselves and their households and their need to accrue assets for future livelihoods. Some young people's trajectories appear to be disturbed by the influence of AIDS, but with no systematic patterns. Beyond addressing empirical questions concerning the impacts of AIDS, the paper contributes to our understanding of how livelihoods are produced and to the conceptualisation of youth transitions as produced through the iteration of present and future. [ABSTRACT FROM AUTHOR]

This paper reports on a study with rural young people (aged 10-24 years) in Malawi and Lesotho, focusing on their opportunities to learn skills and access capital and assets to engage in income-generating activities (IGAs). Participatory group exercises and individual interviews provide many examples of how young people learn skills and start small businesses, as well as an insight into their strategic thinking about engaging in these livelihood options. Various factors, including the effects of AIDS, are shown to affect young people's prospects of succeeding in their ventures. Young people are very keen on starting IGAs, and are supported by adult members of their communities in asking for interventions to help them. We argue that expanded vocational and business training, focusing on locally appropriate types and scale of businesses, coupled with help to raise start-up capital has the potential to improve the chances of young people who are poor and/or AIDS-affected securing sustainable rural livelihoods in their futures. Since AIDS is intertwined with many other issues affecting young people's livelihoods, it is problematic to single out and target only AIDS-affected young people with interventions on skills building and IGAs. Policymakers' attitudes to vocational skills training and support for IGAs in Malawi and Lesotho are also explored, and policy recommendations made to support vulnerable rural young people in their attempts to build sustainable livelihoods. [ABSTRACT FROM AUTHOR]

Introduction: Shifting HIV treatment tasks from physicians to nurses and midwives is essential to scaling-up HIV services in sub-Saharan Africa. Updating nursing and midwifery regulations to include task shifting and pre-service education reform can help facilitate reaching new HIV targets. Donor-supported initiatives to update nursing and midwifery regulations are increasing. However, there are gaps in our knowledge of current practice and education regulations and a lack of information to target and implement regulation strengthening efforts. We conducted a survey of national nursing and midwifery councils to describe current nursing and midwifery regulations in 13 African countries. Methods: A 30-item survey was administered to a convenience sample of 13 national nursing and midwifery regulatory body leaders in attendance at the PEPFAR-supported African Health Profession Regulatory Collaborative meeting in Nairobi, Kenya on 28 February, 2011. The survey contained questions on task shifting and regulations such as registration, licensure, scope of practice, pre-service education accreditation, continuing professional development and use of international guidelines. Survey data were analyzed to present country-level, comparative and regional findings. Results: Task shifting to nurses and midwives was reported in 11 of the 13 countries. Eight countries updated their scope of practice within the last five years; only one reported their regulations to reflect task shifting. Countries vary with regard to licensure, pre-service accreditation and continuing professional development regulations in place. There was no consistency in terms of what standards were used to design national practice and education regulations. Discussion: Many opportunities exist to assist countries to modernise regulations to incorporate important advancements from task shifting and pre-service reform. Appropriate, revised regulations can help sustain successful health workforce strategies and contribute to further scale-up HIV services and other global health priorities. Conclusions: This study provides fundamental information from which to articulate goals and to measure the impact of regulation strengthening efforts [ABSTRACT FROM AUTHOR]

Increasingly, it is recognized that traditional narrow approaches to environment and health relations are insufficient to comprehend and respond effectively to the complexity of factors influencing human health. In response, a new approach, referred to as Ecohealth has emerged with the goal of assessing the multiple interactions that occur between components the ecosystem, the local and global political economy, and cultural systems, on the one hand, and the ways in which these biosocial interactions influence the nature, concentration, and entwinement of health problems in human populations, on the other. Those contributing to the development of the Ecohealth orientation also seek to identify evidence-based strategies for improving the health and living conditions of human populations and the sustainability of the ecosystems in which they live. Within anthropology and public health, in particular, one reflection of the broader Ecohealth approach is expressed in the concept of syndemics, which was developed during the 1990s to label the various interactions among comorbid diseases and other health conditions that increase the burden of suffering in populations and the encompassing social relations and conditions that amplify the likelihood of adverse disease interactions occurring. In southern Africa, a notable synergism has developed between HIV/AIDS and food insecurity that significantly threatens the health and well-being of diverse populations in the region. The purpose of this chapter is to examine the key epidemiological, environmental, social, and political economic features of the entwined HIV-affected food insecurity and food insecurity-affected HIV syndemics of southern Africa. [ABSTRACT FROM AUTHOR]

Families, the state and employers all have a broad if differentiated interest in securing the daily and generational reproduction of society. Whereas in Western countries, the past two decades have witnessed a progressive displacement of responsibility for social reproduction from the state to families, in southern Africa, day-to-day social reproduction has always remained overwhelmingly the preserve of families. Today, however, the AIDS pandemic is radically transforming family life for many children, and prompting concerns (arguably a moral panic) about the potential breakdown of social reproduction. Even in Africa, schools have long supplemented families in delivering generational reproduction, albeit geared around the transfer of “factual” knowledge and with a narrow focus on preparing new generations of workers. In light of the AIDS pandemic, a number of commentators have suggested ways in which schools could further substitute for the diminishing capacities of families. Based on interviews with decision-makers and analysis of policy documents, I explore a number of interventions being enacted in Lesotho's schools. I argue that such initiatives remain small in scale and often justified in relation to retaining children in school. In practice both government and employers remain more interested in the generational reproduction of workers than in daily reproduction. If the welfare needs of AIDS-affected children are to be met through schooling, there is a need for the education sector's role to be understood in relation to an ethics of care, rather than the functionalist production of a future workforce. [ABSTRACT FROM AUTHOR]

The southern Africa crisis represents the first widespread emergency in a region with a mature HIV/AIDS epidemic. It provides a steep learning curve for the international humanitarian system in understanding and responding to the complex interactions between the epidemic and the causes and the effects of this crisis. It also provoked much debate about the severity and causes of this emergency, and the appropriateness of the response by the humanitarian community.The authors argue that the over-emphasis on food aid delivery occurred at the expense of other public health interventions, particularly preventative and curative health services. Health service needs were not sufficiently addressed despite the early recognition that ill-health related to HIV/AIDS was a major vulnerability factor. This neglect occurred because analytical frameworks were too narrowly focused on food security, and large-scale support to health service delivery was seen as a long-term developmental issue that could not easily be dealt with by short-term humanitarian action. Furthermore, there were insufficient countrywide data on acute malnutrition, mortality rates and performance of the public health system to make better-balanced evidence-based decisions.In this crisis, humanitarian organisations providing health services could not assume their traditional roles of short-term assistance in a limited geographical area until the governing authorities resume their responsibilities. However, relegating health service delivery as a long-term developmental issue is not acceptable. Improved multisectoral analytical frameworks that include a multidisciplinary team are needed to ensure all aspects of public health are dealt with in similar future emergencies. Humanitarian organisations must advocate for improved delivery and access to health services in this region. They can target limited geographical areas with high mortality and acute malnutrition rates to deliver their services. Finally, to address the underlying problem of the health sector gap, a long-term strategy to ensure improved and sustainable health sector performance can only be accomplished with truly adequate resources. This will require renewed efforts on part of governments, donors and the international community.Public health interventions, complementing those addressing food insecurity, were and are still needed to reduce the impact of the crisis, and to allow people to re-establish their livelihoods. These will increase the population's resilience to prevent or mitigate future disasters. [ABSTRACT FROM AUTHOR]

Examines the role of migration on the spread of AIDS in Eastern and Southern Africa. Growth of urban population in the East African region correlated with the increase in AIDS cases; Conflicts in Sudan and the Horn of Africa creating populations vulnerable to the disease; Concerns that the disease will spread among refugee populations displaced from Southern African countries.