Impact of the HIV/AIDS pandemic on non-communicable disease prevention

HIV/AIDS continues to ravage sub-Saharan Africa, and in South Africa accounts for 30% of all mortality, making it the leading cause of death. The epidemic has had other negative effects, which have not been fully realised. Among these is the fact that, paradoxically, the awareness programmes implemented to prevent major spread of HIV/AIDS have complicated the prevention of non-communicable diseases (NCDs)

Communication on sexual issues between migrant males and their partners: a study undertaken in rural South Africa

INTRODUCTION: Women stay alone with their children in rural places while their husbands I partners work away from home for varying periods of time. Such fluctuating migration may cause difficulty in communications and may spread sexual transmittable infections (STI) and the human immunodeficiency virus (HIV). OBJECTIVE: This study explored ways in which black women in rural South Africa communicated with partners, who were migrant workers, on issues related to sexual matters. Method: This is a qualitative study where four focus groups were utilized to allow the women to describe their experiences, and to verbalize their feelings, beliefs, and perceptions in this area. PARTICIPANTS: Four focus groups consisting of six females between the ages of 16 - 48 who had partners that were employed as migrant labourers and do not live at home. Setting: A rural area in Hlabisa jurisdiction. DATA COLLECTION: An interview schedule with open questions were used to facilitate the focus group discussions Findings: The women, who saw their partners infrequently, were unlikely to communicate with them about sexual matters, including STI, HIV, and contraception to prevent unintended pregnancy. Poor communication severely constrained the possibility of reducing the risk of these outcomes. Raising the subject could be interpreted as a violation of the trust attached to the monogamous relationships of these Zulu women. The women felt they owed their returning husbands sexual intimacy and refusal was not an option because it was typically countered with force. CONCLUSION: The desire and need for sexual communication carried a price that was too high for women to pay. Control of their sexuality was mostly in the hands of their partners, upon whom they were economically and socially dependent. At this point in the HIV pandemic is it important to cultivate and identify the relevant social, cultural and behavioural norms that could reduce risk situations that tend to favour the spread of HIV

Fear of sexually transmitted infections among women with male migrant partners – relationship to oscillatory migration pattern and risk-avoidance behaviour

BACKGROUND: In South Africa, former apartheid laws encouraged rural males seeking employment to migrate to urban areas, moving weekly, monthly or annually between their rural families and urban workplaces. The combination of the migrant labour system and long family separations caused an explosion of serious health consequences, among others sexually transmitted infections (STIs) in the migrant population. OBJECTIVE: To describe some correlates of male migration patterns for the rural women left behind, especially the fear of STIs that this engendered in them and their risk-avoidance behaviour. Setting and subjects. In KwaZulu-Natal, 208 prenatal patients who were partners of oscillating male migrant workers were interviewed to determine their demographic and behavioural characteristics, and their fear of STIs. RESULTS: Thirty-six per cent of the rural women said that they were afraid of contracting STIs from their returning migrant partners. Women who saw their partners infrequently were more fearful of STI transmission, and were less able to have sexual communication. However, almost none of the women protected themselves, while only 8% used condoms, primarily for contraceptive purposes. CONCLUSIONS: These results reflect the gender-based power relationships of South African male migrants and their rural partners, the social and economic dependency of the women on their migrant partners, and the women’s social responsibility to bear children. The results point to the need to go beyond interventions that simply seek to modify behaviour without altering the forces that promote risk taking and discourage risk reduction, and the need to develop appropriate interventions to curb STIs and decrease HIV.Fogarty International Trainin

Community intervention for the emerging epidemic of non-communicable diseases

No Abstract. South African Journal of Clinical Nutrition Vol. 19(2) 2006: 56-6

Ability to manage diabetes – community health workers’ knowledge, attitudes and beliefs

BACKGROUND: Diabetes constitutes a significant health problem in South Africa. Early detection and good management can prevent or delay complications, with national guidelines for diabetes treatment now available to facilitate this. However, problems are being encountered with their implementation and there is evidence that preventive care is still inadequate in South Africa. Community health workers (CHWs) are lay personnel employed to serve as a link between professional health care staff and the community. They visit homes and can be a powerful force for diabetes prevention and adherence to treatment regimens, given appropriate knowledge. METHOD: We conducted a study to evaluate the knowledge, beliefs and attitudes of a group of CHWs serving a poor urban area, using focus groups and personal interviews. RESULTS: The CHWs did not have the requisite knowledge, attitudes and beliefs to make a positive impact on prevention and management of diabetes. For example, they cited eating sugar as a cause of diabetes. They advised folk remedies that purportedly diluted the blood sugar. Their patients took prescribed medication irregularly. Obesity was not considered an important risk factor. Poverty, however, was recognised as an obstacle to proper treatment. CONCLUSION: Training is clearly needed to empower the CHWs with skills to work within their communities to identify risk factors for diabetes and other non-communicable diseases, with emphasis on diet and physical activity.National Research Foundation, and the Provincial Administration of the Western CapeDepartment of HE and Training approved lis

Obesity among black South African women

Obesity and associated non-communicable diseases such as Type 2 diabetes, hypertension, and ischaemic heart disease were previously thought to be diseases of affluent countries, but they are becoming increasingly prevalent in developing nations. Accessibility to cheap unhealthy food, global trade and market development influence nutrition transition towards diets with high fat and sugar contents. A decrease in physical activity due to urbanisation and other environmental factors such as crime and violence are thought to lead to an increased risk of obesity. Positive beliefs about body weight among black African women, together with the idea of association of thinness with HIV/AIDS virus infection are believed to fuel the obesity epidemic amongst this population This paper describes some of the contributory factors which black South African women are faced with in making choices about healthy living. A multisectoral approach will be needed to fight the epidemic of obesity and associated diseases.National Research Foundation (NRF) and the University of the Western Cap

Eigenstructure Assignment Techniques Applied to Helicopter Flight Control Law Design

This thesis is concerned with the application of eigenstructure assignment methods to helicopter flight control law design. Helicopters are inherently multivariable dynamic systems and, in some cases, can be unstable. Pilot workload is increased by the effects of the cross-coupled helicopter dynamics. As well as providing stability and reducing pilot workload the controller has to produce satisfactory handling qualities and ride quality over a range of flight conditions. Eigenstructure assignment methods are reviewed and previous results from the use of these methods are discussed. The need to adopt a modified approach is established by considering the complex nature of the helicopter control problem in that the controller should decouple the helicopter's dynamics, track pilot inputs and meet helicopter handling requirements. A multivariable control law design method which cancels zeros and zero directions and also creates a decoupled tracking system is presented. The effect of output selection on system zero positions is tabulated Control law design is performed on an 8th order linear model of the helicopter's rigid body dynamics. An inner/outer loop structure is adopted. The inner loop contains a scheduled controller which provides stability and a decoupled response across a range of flight conditions while the outer loop involves a proportional plus integral controller to augment performance. The resulting controlled system meets helicopter handling qualities requirements. Actuator and rotor dynamics that were not included at the design stage are added to the model to test for robustness. The controller is then tested on helicopter models for flight conditions other than that at which the design was produced and it is shown to be robust to the changes. The linear helicopter model is then replaced by a non-linear representation. It is shown that the controller continues to give good performance with the non-linear model. The non-linear controlled system is then tested for disturbance rejection by adding turbulence to the simulation. The ability of the system to filter out sensor noise is also investigated. The results show that the controller maintains stable behaviour across the range of flight conditions for which the inner loop controller was scheduled, responses which are decoupled are achieved and handling quality requirements are met