Determinants of the choice of health care facility utilised by individuals in HIV/AIDS-affected households in the Free State province of South Africa

This paper analyses differences in the choice of health care facility by individuals in HIV/AIDS-affected households in the Free State province of South Africa. Illness is more prevalent and severe amongst poorer affected households. The probability that individuals seek private versus public health care conditional on individual and household specific socio-economic variables is investigated. Significant determinants of choice of health care facility are income, severity of illness, the burden of illness and death in the household, the number of people in the household with access to medical aid, and secondary education. The demand for private health care over public health care is sensitive to income, with those from the lowest income quintile on average being less likely to switch to private health care than those in the highest income quintile. The planned roll-out of anti-retroviral treatment in public health care facilities in South Africa therefore will be crucial in enabling infected persons from poor households access to treatment. The provision of free treatment at public facilities may also see health care shift from private to public providers in the longer term.

Democracy, liberation and the vote in South Africa's first democratic election: the Matla Trust Voter Education survey

Paper presented at the Wits History Workshop: Democracy, Popular Precedents, Practice and Culture, 13-15 July, 1994

Management of Pain During Intrauterine Device Insertion

Presented to the Faculty of the University of Alaska Anchorage in Partial Fulfillment of the Requirements for the Degree of MASTER OF SCIENCEIncreased use of intrauterine contraception is desirable to achieve safe, highly effective, long-acting, and reversible means to prevent unintended pregnancy. For most women, intrauterine device (IUD) contraception is a viable option for protection from an unplanned pregnancy. Fear of pain during insertion is one barrier to IUD use. The aim of this project was to identify best practice evidence for different types of interventions for the management of pain during IUD insertion. Evidence for pain management strategies was critically appraised, and the most recent information synthesized into evidence-based recommendations to promote point-ofcare decisions.Abstract / Table of Contents / List of Figures / List of Tables / Background / Literature Review / Purpose / Evidence-based Practice Model: The Star Model of Knowledge Transformation / Methods / Discussion: Evidence Summary / Cervical Priming / Mon-pharmacological Interventions / Discussion: Implications for Practice / Discussion: Translation into Guidelines / Significance to Advance Nursing Practice / Dissemination / Summary / Conclusion/ References / Appendice

Hegemonic Struggles of the African National Congress: From Cacophony of Morbid Symptoms to Strained Renewal

The contemporary condition of the African National Congress (ANC) of South Africa, viewed through the lens of hegemony and by means of four sets of correlates of decline and potential renewal, reveals an organisation that has turned away from lethal decline, yet by 2018 was battling to reconstitute a powerful, united historical bloc to underpin a new hegemony. The assessment is executed across the outward fronts of the ANC in relation to the people, the state, and elections, and on the inward side, the ANC organisationally. The ANC, up to late 2017, had undergone a process of hegemonic decline that appeared irreversible. Manifold morbid symptoms of hegemonic decline were evident. In late 2017 the ANC secured a leadership change that held the potential to reverse the decline and reinvigorate the ANC’s prospects for hegemonic hold, even if at best it would be a long-term, incremental process. Yet, at the centre, the organisation remained riven with factionalism that pivoted around power and control over public resources; those entrenched in the status quo ante were fighting back, and the new order was struggling to emerge. By drawing together these symptoms (correlates) of decline and possible reversals, the article synthesises the state of ANC hegemony as the movement approaches 25 years in political power.Betrachtet man den gegenwärtige Zustand des Afrikanischen Nationalkongresses (ANC) in Südafrika im Bezug auf Hegemonie, Niedergang und potenzielle Erneuerung, zeigt sich eine Organisation, die dem tödlichen Verfall entgangen ist, aber im Jahr 2018 dafür kämpft, als vereinter Block die einstige hegemoniale Stellung wiederzuerlangen. Die Analyse umfasst die äußeren Beziehungen des ANC zur Bevölkerung, zum Staat und zu den Wahlen, aber auch seine interne Organisation. Der ANC hatte bis Ende des Jahres 2017 einen Machtverfall zu verzeichnen, der unumkehrbar schien. Vielfältige Symptome des hegemonialen Verfalls waren offensichtlich. Ende 2017 gelang ein Führungswechsel an der Spitze des ANC, der potenziell den Niedergang aufhalten und die hegemoniale Stellung des ANC wiederbeleben kann, auch wenn dies bestenfalls ein langfristiger und inkrementeller Prozess ist. Der Kampf verschiedener Fraktionen um Macht und Kontrolle über öffentliche Ressourcen spaltet die Partei noch immer. Die Anhänger des alten Status quo wehren sich während sich eine neue Ordnung herausschält. Der Artikel zeigt den Zustand des ANC auf, der bald 25 Jahre an der Macht ist, indem er die Symptome des Niedergangs und möglicher Umkehrungen zusammenführt

Social grants as safety net for HIV/AIDS-affected households in South Africa

South Africa has a well-developed system of social security and the reach of the social grant safety net has expanded rapidly over the past five years. Social grants are likely to play an important role in mitigating the impact of HIV/AIDS, given that eligibility for these grants is driven largely by the increasing burden of chronic illness, the mounting orphan crisis and the impoverishment of households associated with the epidemic. This paper investigates the role of social grants in mitigating the socio-economic impact of HIV/AIDS in South Africa, using data from a panel designed to investigate the household impact of the epidemic. Data were collected from a total of 351 purposively sampled households interviewed four times over a period of two and a half years. Affected households were more dependent on income from social grants compared with households that had never experienced morbidity or mortality. A significantly larger proportion of affected households qualified for social assistance. Access to the old age pension remained relatively stable, highlighting the high takeup rate of this grant, while access to the child support and disability grant increased over time. Yet, take-up of these grants remains low and there is still much scope to improve take-up rates. Social grants also play an important role in poverty alleviation. The rate of poverty reduction continued to increase over time in affected households, but remained relatively stable in the case of households that had not experienced morbidity or mortality. This saw the gap in the incidence, depth and severity of poverty between affected households and households that had not experienced morbidity decline. Social grants also translated into a significant reduction in the severity of poverty in affected households. Keywords: HIV/AIDS, poverty, social assistance, public transfers, social grants, South Africa. RÉSUMÉ Le système de sécurité sociale de l'Afrique du Sud est très bien développé et le filet de sécurité de subventions sociales s'est répandu assez rapidement au cours de cinq dernières années. Les subventions sociales joueraient un rôle important en atténuant l'effet du VIH/SIDA, étant donné que le droit à ces subventions est largement influencé par l'augmentation du fardeau des maladies chroniques, la crise des orphelins qui s'accroît, ainsi que l'appauvrissement des foyers associé à l'épidémie. Cette article étudie le rôle de subventions sociales qui atténuent l'impact socio-économique du VIH/SIDA en utilisant des données provenant d'une commission d'enquete. Cette commission a pour mission d'examiner l'effet de l'épidémie sur un foyer. Des données ont été requis auprès de 351 foyers interviewés en tant qu'échantillon ciblé. Ces foyers ont été interviewés à quatre reprises au cours de deux ans et demi. Les foyers qui sont touchés par l'épidémie dépendaient beaucoup plus sur les subventions par rapport à ceux qui n'ont jamais été affectés par la morbidité et la mortalité. Une grande partie de foyers affectés a droit à l'aide sociale. L'accès à la retraite est resté relativement stable tandis que l'accès au soutien d'enfant et à la pension d'invalidité a augmenté au cours du temps. Pourtant, les demandes de subventions restent assez basses et il y a encore beaucoup de travail à faire afin d'améliorer le taux de demandes. Les allocations sociales jouent un rôle important en réduisant la pauvreté. Le rythme de réduction de la pauvreté a continué à augmenter au cours du temps dans des foyers touchés.Toutefois, dans le cas des foyers non-touchés, le rythme de réduction est resté relativement stable. De ce fait, l'écart créé par la fréquence, la profondeur et la gravité de la pauvreté entre les foyers affectés et ceux qui ne le sont pas diminue. Les allocations sociales ont réduit la gravité de pauvreté de manière significative dans les foyers affectés. Mots clés: le VIH/SIDA, la pauvreté, l'aide sociale, le transfert public, les allocations sociales, l'Afrique du Sud. SAHARA J Vol.1(1) 2004: 45-5

Out-migration in the context of the HIV/AIDS epidemic: evidence from the Free State province

This paper investigates the characteristics and determinants of out-migration in the context of the HIV/AIDS epidemic, using data from a panel designed to investigate the household impact of the epidemic. Departure models show that individual attributes, notably age and gender, play an important role in explaining out-migration from households that have not experienced morbidity or mortality. In affected households, a number of household-level variables, notably the gender of the household head, place of residence, family structure, the dependency ratio, human capital and household size, feature as important determinants of out-migration. Health shocks in the form of increased mortality, which characterises the impact of the epidemic, independently explain part of observed differences in out-migration from affected households, the out-migration of ill persons from affected households, and the out-migration of orphaned children from affected households. Thus, migration represents an important strategy for poorer households having to cope with the HIV/AIDS epidemic, both as an economic survival strategy and as a social strategy aimed at accessing support from the extended family