Browsing by Author "Vermaak, Kerry."
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Item Demographic, socio-economic, and the lifestyle risk factor of cigarette smoking associated with asthma in South African adults in 2017.(2019) Singh, Tanuja.; Vermaak, Kerry.The current study aimed to explore demographic factors, socio-economic factors and modifiable risk factors, mainly cigarette smoking, and the influence they had on asthma among South African adults in the year 2017. The general objective of the study was to determine the relationship of these factors on asthma and the prevalence of asthma and cigarette smoking in 2017. The study used the theoretical framework in the context of the World Health Organization’s Commission on Social Determinants of Health. The study was a quantitative research design that used the National Income Dynamics Survey dataset, wave 5 conducted in 2017 in South Africa. A sample of 15750 (aged 15-65) was used in this study, with 623 asthma diagnoses. The dependent variable was asthma and the independent variables were cigarette smoking, gender, age, race, marital status, employment status, geographic area, education attainment and household with per capita income. The results of the study confirmed significant associations between race, geographical area, education attainment and asthma. Coloureds and Whites were more likely to be diagnosed with asthma. Those residing in urban areas were more likely than those living in rural areas to have a asthma diagnosis. Those who attended Grade 10-11 and those with no matric were less likely to report been diagnosed with asthma. It was discovered that those who had a higher socio-economic standing may be less likely to have been diagnosed with asthma. Asthma is a major burden globally and has made its mark in South Africa. Controlling risk factors, along with the demographic and socio-economic risk factors will only help alleviate the exacerbations of the disease. Policies and health strategies have been put into place and should be practices on the daily to further treat and manage asthma. More studies on asthma should create an additional awareness and understanding of this non-communicable disease.Item The determinants of childhood diarrhea and acute respiratory infection: testing the importance of community-level determinants in Eswatini.(2020) Simelane, Maswati Sonboy.; Vermaak, Kerry.Background: It has been noted that regardless of the observed decline in childhood mortality in developing countries, the mortality rate is still extremely high. Approximately 30 countries in Africa and Asia need to triple their current standard of reduction of childhood mortality to realise the sustainable development goal (SDG) number 3 of ensuring healthy lives and wellbeing for all age groups. The study investigated the following research questions: 1. what is the prevalence of childhood diarrhoea and ARIs? 2. What are the individual, household and community-level factors associated with childhood diarrhoea and ARIs? 3. To what extent do community-level factors explain variations in childhood diarrhoea and ARIs? 4. Which clusters or communities have a higher burden of childhood diarrhoea and ARIs? Methodology: The study used a pooled secondary data analysis approach utilising data from the 2010 and 2014 Eswatini Multiple Indicator Cluster Surveys (MICS) that were cross-sectional. The study utilised 5340 children aged below five years as the unit of analysis. The outcome variables of the study were child diarrhoea and acute respiratory infection. The single-level multivariate logistic regression, multilevel multivariate logistic regression and Quantum GIS were used to answer the study questions. STATA 13 was used for the analyses. Results: The study found that the magnitude of diarrhoea in Eswatini was 16.2% among underfive children. In the multilevel model, child age, current height for age, toilet facility region of residence overall community diarrhoea, were found to be important variables. For instance, children aged 6-11 months and 12-23 months were 434% and 290% respectively, more likely to have diarrhoea relative to those aged less than 6 months. Children with a normal and above normal current height for age had 91% and 93% respectively increased odds of having diarrhoea compared to those with a growth deficit. Children from households with no toilet facility were 283% more likely to have diarrhoea compared to those from households with a flush toilet. Residents in the Hohho region were 159% more likely to have diarrhoea compared to children who resided in the Lubombo region. Children from communities that had medium and high overall community diarrhoea were 26% and 877% more likely to have diarrhoea compared to children from communities with low overall community diarrhoea. The results showed a substantial variation of diarrhoea across communities. The individual-level factors explained 5.6% of diarrhoea across communities; household factors explained 65.3% of the variation while community-level factors explained 85% of the variation even though it was not significant. The Mapping analysis revealed that the severity of diarrhoea was most pronounced in the Manzini region and the Shiselweni region when compared to the Hhohho region. A total of 31% of the constituencies had a high prevalence of diarrhoea between 18.4-28.1% in the Manzini region. A consideration of the Shiselweni region revealed that 50% of the communities had a high prevalence of diarrhoea of between 18.4-28.1% The study found that the magnitude of ARI in Eswatini was 20.9% among under-five children. In the multilevel model, maternal age, household wealth index, shared toilet with neighbours, and region of residence were important factors that explained the variation of ARI across communities. Individual factors explained about 76.05 % as shown by the PVC; household level factors explained about 94% of the variance, and community-level factors explained about 93.6% of the variation of child ARI across communities. The study mapped the prevalence of ARI across communities (clusters) and found that the Hhohho region had four constituencies with a high prevalence of ARI, Motshane, Mbabane South, Mbabane East, Nkhaba and Tiphisini. In the Manzini region, five constituencies had a higher burden of ARI, namely Lamgabhi, Kwaluseni, Ntontozi, Mafutseni and Ludzeludze. In the Shiswelweni region, the burden of diarrhoea was higher among five constituencies, namely Zombodze, Mbangweni, Kubuta, Ngudzeni and Sigwe. In the Lubombo region, the burden of ARI was higher at Lubulini, Hlane, and Mhlume. Conclusion: The study demonstrated that the prevalence of diarrhoea and ARI are still very high and a persistent public health problem in Eswatini. The causes of the high magnitude of diarrhoea and ARI vary by individual, household and community factors. Policies that aim to ensure reduction in child morbidity from diarrhoea and ARI in Eswatini include strategies and programmes that rectify characteristics of the community contexts which mainly in the socially and economically disadvantaged communities and regions of Eswatini.Item Determinants of the use of bed nets for the prevention of malaria for children under 5 years in the Democratic Republic of Congo.(2017) Mukabaha, Ciza Silva.; Vermaak, Kerry.This study was conducted to explore the determinants of bed net usage for the protection of children under the age of five against malaria in the Democratic Republic of Congo (DRC). The study aims to know the different socio-economic factors that affect child survival of malaria using bed nets and to determine the impact of these factors on bed net usage in preventing infection with the malaria parasite. The objectives are to determine child characteristics, mother or caregiver characteristic, and household characteristics associated with the use of bed net. To determine the impact of these above-mentioned characteristics, data from the second Demographic and Health Survey in the DRC (EDS-RDC II) was used. Data collected from 2013 to 2014 was analyzed using STATA IC version 2013 to answer research questions such as; the association between participant demographics and bed net usage, maternal education, marital status and their association with child protection using bed net. The last this research answered are more related to the gender of household head, the location of the household where the child lived as well as the household wealth and their influence on child sleeping or not to sleep in the bed net. Data was weighted to make the result nationally representative. The findings reveal that there is a relationship between most of the socioeconomic factors and the use of bed net for the protection of children under the age of five years in the DRC. Age of the child influences the use of bed net, this is so as the findings show that the younger a child is, the higher the chance of him/her sleeping under a bed net and vice-versa. The research findings also show that children who are under the care of a single mother have less chances of sleeping under the bed net as against children under the care of both parents who have higher chances of sleeping under bed nets. The importance of mother’s education is justified by this study because the less educated a woman is, the lesser the chances of a child sleeping under the bed net. Household wealth also shows an impact on the child survival against malaria.Item Dietary practices as a lifestyle risk factor for non-communicable diseases among the elderly in a rural setting in KwaZulu-Natal.(2018) Zulu, Maxwell Mbuso.; Vermaak, Kerry.Increases in non-communicable diseases (NCDs) prevalence have been noted in low and middle income countries (LIMCs). As a result, poor dietary practices have been identified as one of the leading modifiable risk factors for NCDs (Lim, Vos et al, 2012). This is because LIMCs are undergoing through nutrition transition stage in the 21st century. However, studies have shown that there is a lack of research about NCDs prevalence in South Africa, in the population aged 50 years and above, even though South Africa has largest population aged 60 years and above in Sub-Saharan Africa (Phaswana-Mafuya et al, 2013, 2). Therefore, a qualitative study was conducted among 20 elderly participants, from age 65 years and above in a rural setting in KwaZulu-Natal. This was conducted through a semi-structured, in-depth interviews in Nyangwini, a rural setting in the South Coast of KwaZulu-Natal. Health Belief Model (HBM) seven theoretical constructs were used in analysing the findings of this study. Among twenty participants of this study, nineteen participants had at least two to four NCDs, and only one participant had one NCD. These NCDs included high blood pressure, sugar diabetes, arthritis, cardio vascular diseases, cancer, kidney diseases and foot disease. According to this study, the most vulnerable age group to NCDs are the elderly, from age 60-70 years and above. The major themes that emerged from this study, related to poor dietary practices, the frailty of old age, awareness about diet in relation to NCDs, no land to cultivate, lack of money, high costs of food, unappetizing healthy meals, scarcity of fresh/quality produce, poor quality of available healthful food, scarcity of seeds, scarcity of vegetables, scarcity of fruits and geographical isolation of the rural setting to healthy food, high sodium intake in food, high fat intake in food, eating too much and low food variety and dietary diversity . As a result, participants had a low consumption of fruits and vegetables. Moreover, due to poor status of the elderly participants in a rural setting, they had a high consumption of chicken and a low consumption of red meat. This study has justified or established as a premise, the need for more research to be conducted about dietary practices as a lifestyle risk factor for NCDs among the elderly in a rural setting in KwaZulu-Natal.Item Dietary practices as a lifestyle risk factor for non-communicable diseases among the elderly in a rural setting in KwaZulu-Natal.(2018) Zulu, Maxwell Mbuso.; Vermaak, Kerry.Increases in non-communicable diseases (NCDs) prevalence have been noted in low and middle income countries (LIMCs). As a result, poor dietary practices have been identified as one of the leading modifiable risk factors for NCDs (Lim, Vos et al, 2012). This is because LIMCs are undergoing through nutrition transition stage in the 21st century. However, studies have shown that there is a lack of research about NCDs prevalence in South Africa, in the population aged 50 years and above, even though South Africa has largest population aged 60 years and above in Sub-Saharan Africa (Phaswana-Mafuya et al, 2013, 2). Therefore, a qualitative study was conducted among 20 elderly participants, from age 65 years and above in a rural setting in KwaZulu-Natal. This was conducted through a semi-structured, in-depth interviews in Nyangwini, a rural setting in the South Coast of KwaZulu-Natal. Health Belief Model (HBM) seven theoretical constructs were used in analysing the findings of this study. Among twenty participants of this study, nineteen participants had at least two to four NCDs, and only one participant had one NCD. These NCDs included high blood pressure, sugar diabetes, arthritis, cardio vascular diseases, cancer, kidney diseases and foot disease. According to this study, the most vulnerable age group to NCDs are the elderly, from age 60-70 years and above. The major themes that emerged from this study, related to poor dietary practices, the frailty of old age, awareness about diet in relation to NCDs, no land to cultivate, lack of money, high costs of food, unappetizing healthy meals, scarcity of fresh/quality produce, poor quality of available healthful food, scarcity of seeds, scarcity of vegetables, scarcity of fruits and geographical isolation of the rural setting to healthy food, high sodium intake in food, high fat intake in food, eating too much and low food variety and dietary diversity . As a result, participants had a low consumption of fruits and vegetables. Moreover, due to poor status of the elderly participants in a rural setting, they had a high consumption of chicken and a low consumption of red meat. This study has justified or established as a premise, the need for more research to be conducted about dietary practices as a lifestyle risk factor for NCDs among the elderly in a rural setting in KwaZulu-Natal.Item Digital transformation and its effects on socioeconomic outcomes in South Africa: a micro-analysis of digital transformation on economic and social welfare.(2021) Rushambwa, Tawonga.; Vermaak, Kerry.Digital Transformation is the present era’s wave of technological transformation, pervasive and fast-paced with the promise of unparalleled human development and progression. Various studies have presented opportunities in sustainability, increased income, increased opportunities for entrepreneurship, social inclusion and equalization. However, challenges have also been noted including technology-induced job displacement and its potential to displace the incomes of people. This study is an attempt to map the societal conditions under which digital transformation can be instrumental in generating net social and economic welfare. Using a mixed-methods approach, the study investigates socioeconomic dynamics of individuals and households, termed the physical divide, juxtaposed against the digital transformation processes. In one of the major findings of the study, it was concluded that where digital transformation occurs under broadly under-skilled labour force, and poorly resourced social institutions and arrangements, digital transformation will more likely exacerbate socioeconomic inequalities leading to net welfare loss. The study also established the existence of a physical and digital divide of long duration in South Africa, with the inequalities likely to engender losses in welfare due to fast-paced change under digital transformation. The study also established that socioeconomic characteristics, skills and job competencies differ sharply across population groupings and continue based on access to developmental opportunities, assets, facilities and services which must be resolved for successful digital transformation.Item Estimating the impact of maternal sociodemographic factors on nutrition and anthropometric outcomes of mothers and children in South Africa.(2021) Simon, Benjamin Aye.; Vermaak, Kerry.The overriding purpose of this study was to determine the impact of maternal socioeconomic and/or sociodemographic factors on both maternal and childhood nutrition and health in South Africa. This study draws on a customised theoretical model that put into account the UNICEF framework and the foetal-maternal interaction model as a probable theoretical model of maternal and neonatal nutrition and morbidities. The framework is structured around four (4) stages that result in both maternal and childhood nutritional intake and morbidity. In it, the interplay between the UNICEF and the foetal-maternal relationship frameworks highlights that maternal and childhood nutrition and health is not a simple problem with a single simple solution. A similarly intricate series of approaches – multifaceted and multisectoral – are necessary to effectively deal with it. This study adopted a non-experimental quantitative research approach for extracting the required data for this study. The researcher used a secondary data from the 2016 South Africa Demographic and Health Survey (SA-DHS), which complies with common demographic health surveys research design policy. The use of an explanatory research approach allows the researcher to provide an in-depth evaluation, investigation, understanding and insight analysis about the current state of maternal and under-fives health relative to nutrition in South Africa. Consequently, a survey research design was used to enrolled 1460 participants into the study from a total target population of 4081 – indicating that the SA-DHS is representative in nature. The SA-DHS 2016 followed a stratified sample technique by employing a two-stage stratified design with a probability proportional to size and systematic sampling of the dwelling units. The findings from this study revealed that 73.11% of the respondents met the minimum complementary feeding index relative to the 26.90% who did not. Furthermore, using the household wealth index as a proxy indicator for maternal socioeconomic status of households, the results statistically associate maternal socioeconomic status and complementary feeding practice – where (X2 = 23.56; p-value = 0.000). Suggesting that high wealth index households are more likely to meet the minimum acceptable dietary diversity relative to those with low wealth index. Similarly, after controlling for confounders, the results from the logistic regression negatively associate minimum acceptable diets with maternal education and household wealth index. Indicating lower or no education and lower wealth index were associated with not meeting the minimum acceptable diets of under-fives. On maternal BMI, the results found that the average BMI for the sample was 28.06 kg/m2, with 63.60% of the mothers either (overweight 29.85% or obese 33.75%), 33.91% regarded as having normal weight and 2.49% regarded as underweight. As a result, the results from this study statistically associated maternal employment (X2 = 18.18; p-value = 0.000), place of residence (X2 = 9.55; p-value = 0.023), and household wealth index (X2 = 33.19; p-value = 0.000) with maternal nutritional status in South Africa. Indicating that employed mothers, urban mothers and mothers who fell under high income households are associated with higher rates of obesity. On childhood nutritional status, 89.34% of the under-five children had normal weight-for-age (WAZ), while only 5.20% of the children were either severely underweight or underweight (WAZ). Regarding height-for-age Z scores (HAZ), 73.18% of the children had normal heightfor- age, 15.66% were stunted, 7.04% were severely stunted, and 4.13% were tall. On weightfor- age Z Scores (BAZ), 58.31% of the children had normal weight-for-age, 22.43% were overweight, 16.09% were obese, and 3.17% were underweight. The results further found that the level of malnutrition among under-five children were higher among unemployed mothers than employed mothers as follows: severe stunting (77.50% vs 22.50%), being underweight by WAZ (80.00% vs 20.00%), and obesity by BAZ (72.68% vs 27.32%) for unemployed and employed mothers respectively. However, except for severe stunting, the prevalence of malnutrition among under-five children were higher in urban areas than rural areas as follows: underweight by WAZ (57.14% vs 42.86%), severe stunting (48.75% vs 51.25%), and obesity by BAZ (56.28% vs 43.72%) for urban and rural areas children respectively. On the impact of maternal socioeconomic factors on childhood nutritional and health outcomes, the bivariate analyses negatively associated low maternal wealth index and stunting (HAZ) among underfives. Both the bivariate and multivariate analyses associated maternal BMI with birthweights and childhood nutritional status. Suggesting that higher maternal BMI led to higher weightfor- age as well as higher height-for-age among under-fives. In conclusion, the results from this study present a direct evaluation of the association between maternal anthropometrics characteristics and childhood nutritional status. Poor infant and young child feeding practices, on the other hand, is caused by low or poor maternal household wealth index working synergistically with other factors such as urbanity, employment and education. In summary, the findings presented in this study suggests that obesity and other maternal- and child-related nutritional and health issues is a consequence of the complex relationship among many factors including environmental (such as dietary intake), genetic (the link between maternal BMI and childhood nutritional status), and socioeconomic/sociodemographic factors (such as maternal age, parity, household wealth index, education, employment, etc) which eventually result in energy imbalance that either directly or indirectly impact on both maternal and childhood nutritional and health outcomes in South Africa.Item Experiences of young Xhosa men who undergone medical male circumcision in the Western Cape.(2017) Silimfe, Zola Melody.; Vermaak, Kerry.The provision of medical male circumcision (MMC) in public health facilities was introduced as a strategy to curb the high rate of new HIV infections in South Africa. However, in the South African context, traditional male circumcision (TMC) is practiced across different tribes as a rite of passage from boyhood to manhood. Unfortunately, TMC has been associated with high numbers of deaths among young men attending local initiation schools. While TMC and MMC differ in terms of surgical procedures, both procedures are for the removal of the foreskin. A significant difference between the two procedures is the fact that TMC is linked to an age old cultural practice that serves as a rite of passage to manhood, while MMC is mainly meant to decrease the risk of HIV infection in heterosexual men. This research study investigates Xhosa men who opt for MMC instead of TMC. It aims to understand their knowledge of MMC and factors that influenced their decisions to opt for MMC and its related social and masculinity negotiations. This study will elucidate the complexities within which these men view MMC and ‘[negotiate their masculine and cultural identities. The methodology adopted is qualitative, to provide a rich, in-depth understanding of the phenomenon being studied. A total of 9 Xhosa men who have undergone MMC in the past two years were recruited to participate. The men were 20-29 years old at the time of the study, and resident in Cape Town. Semi-structured individual interviews were used to explore the men’s understandings of their masculine and cultural identities in relation to their decision to opt for MMC. The participants reported that health benefits and access to health care systems were among the main influences that prompted them to opt for MMC. Social media played a huge role in providing information on MMC and influencing young men to opt for MMC. The Brothers for Life campaign was one of the most effective campaigns that assisted to reach out to men and encourage them to get circumcised. The use of public figures leading the campaigns did have a positive impact on people. The challenge that the young men experienced was that within the Xhosa culture circumcision is a rite of passage from boyhood to manhood. Participants described the reactions of family and friends to their decision as varied. Some participants experienced discrimination from their family members based on their decision to opt for MMC.Item Exploring factors impacting on sexual and reproductive health service utilisation among immigrant women living in Pietermaritzburg, KwaZulu-Natal.(2021) Mnisi, Jabulile Yolokazi.; Vermaak, Kerry.While the utilisation of sexual and reproductive health (SRH) services among women significantly impact their health outcomes, research shows growing recognition to understand how access to SRH services impacts individuals’ use of these services. Globally, the increased accessibility of SRH services has seen improvements in the utilisation of these services among women. However, studies suggest that there are underlying inequalities in SRH service utilisation between migrant and non-migrant women. In countries of destination, immigrant women often face significant barriers to accessing and utilising sufficient SRH care and claiming their right to health. To understand these barriers, this study explored factors that impact the accessibility and utilisation of SRH services among immigrant women in Pietermaritzburg, KwaZulu-Natal in South Africa. The qualitative data used in this study was collected from 13 immigrant women over the age of 20 years, who were sampled using purposive and snowball sampling in Pietermaritzburg, KwaZulu-Natal. The findings of this study show that there are contextual, predisposing, resource, and need factors that influence the accessibility and utilisation of SRH services among immigrant women in Pietermaritzburg, KwaZulu-Natal. Participants noted experiences of xenophobia, prejudice, discrimination, and marginalisation as a result of the language barrier and inability to produce documentation that allows them to be in South Africa. In addition, while most participants are employed in the informal sector, they noted challenges of not affording medical aid/insurance to seek SRH care in the private healthcare sector when denied in the public healthcare sector. On a positive note, they expressed joy and a sense of relief to be in South Africa because they believed that the socio-economic and health situation of the country is better than the situation in their homelands. The importance and relevance of this study bring advocacy and awareness to the broader aspects of SRH, by taking into consideration the status quo of immigrant women in utilisation of SRH services in South Africa.Item Exploring health and variation of work place informality of women working within the informal sector in central Durban.(2019) Khumalo, Buhle.; Vermaak, Kerry.The informal sector serves as a poverty reduction platform that provides paid employment for those who do not have adequate education and skills to obtain or sustain a “formal” employment or livelihood. Women are more likely to be found in vulnerable formsof work, and within the informal sector there are more women employed compared to men.Research has typically focused on how different forms of employment within the formal economy impact on the health of individuals, showing a relationship between employment conditions and health outcomes. This study aimsto explore how variations in employment in the informal sector may impact on the health of women.A qualitative study was conducted among women working in the informal sector in Durban. Initially, a snowball sampling approach was adopted,and a criterion sampling approach was used. A total of 18 in-depth interviews were conducted with waitresses, domestic workers, and street vendors, characterising increasing levels of informality. Thematic analysiswas used to analysethe qualitative research. The themes were divided,based on employment category i.e. domestic workers, street vendors and waitresses. The themes that emerged looked at employment, health, children’s health, health protection and informality. None of the women interviewed had medical health insurance asameans of protection, and were largely reliant on the public health sector. In addition to a lack of medical aid, most of the women were confronted with not being able to collect any form of paid leave,or did not have an additional income that could take care of them when they did not go in to work.Challenges in public healthcare facilities such as long waiting hours as a result of short staffing exacerbated the loss of income through hours spent away from their stalls in the case of street vendors, when they neededto seek health care. The study found that based on informality, government orientated funds like the Unemployment Insurance Fund only paid out to domestic workers and waitresses, yet at the same time not all of the women within these two categories were able to receive these funds. For street vendors the receiving of any form of reimbursement relating to health care was not feasible. ivWomen in the informal working sector faceddifferent challenges as compared to women in the “formalised/informal” working sector. Street vendors in the study were shown to be the most vulnerable participants,as they were faced with a lot of challenging factors like transportation, irregular working hours, not enough time to seek health care, no paid leave and no protection programmes to cover their health needs. There is a need to distribute adequate resources to public health care facilities,regardless of social status, as this provides quality health care for all persons.Item Exploring perceptions and stigma of tuberculosis among the young adults in a rural area of KwaZulu-Natal.(2021) Khumalo, Siphesihle.; Vermaak, Kerry.Tuberculosis continues to remain as one of the major health problems and it is the leading cause of death among youth in South Africa. Although several studies have explored community perceptions when it comes to tuberculosis, little is known about youth perceptions specifically. Therefore, this study aimed at exploring the perceptions and potential stigma of tuberculosis among young adults in a rural area of KwaZulu-Natal. This was the qualitative research study which adopted the individual in-depth interviews to collect data among the young adult males and among the young adult females aged between 18 to 35 years. The interviews were audio taped, translated and transcribed to verbatim English. The results revealed that while there was a high level of awareness of TB as a potential health condition, specific knowledge of transmission and treatment varied among the participants and it include the false beliefs regarding how TB could be prevented. The results also revealed that young adults had a positive interrelation with people who were infected with tuberculosis.The results further revealed the young adults possible stigma of tuberculosis by revealing some of the mitigating factors for tuberculosis stigma which were the lack of knowledge, fear of the disease, HIV/AIDS and tuberculosis interrelation as well as the reactions into fear and discrimination of tuberculosis. The results then showed young adults perceptions of TB infected people living in the community where it presented the attitudes of young adults towards tuberculosis infected individuals as well the community attitudes towards tuberculosis infected individuals. Therefore, the study findings revealed that the young adults did not uniformly hold, nor did they demonstrate stigma towards the individuals with tuberculosis. However, they were aware about the existing stigma in the community that is attached to tuberculosis within the rural area of KwaZulu-Natal.Item Exploring social media networks as an agent to encourage secondary abstinence and condom use to prevent HIV infection among black female students at the University of KwaZulu-Natal, Howard College Campus.(2018) Likoti, Palesa Grace.; Vermaak, Kerry.In South Africa, unprotected heterosexual intercourse is the leading cause of HIV/AIDS among the youth. An estimated 410 000 women from the age of 15 are living with HIV/AIDS (UNAIDS, 2016). This leaves the heavy burden of HIV/AIDS infections to be carried by women. The disproportionate number of females infected to that of men, calls for new and innovative preventative measures to be developed in order to protect women from HIV/AIDS infections and to allow them to be more in control when it comes to HIV/AIDS prevention. Additionally, the South African government together with non-governmental organisations, has developed strategies and campaigns with the purpose of educating the youth about HIV/AIDS and how to live healthier lives. Although approximately 49 per cent of new HIV/AIDS infections among the general population has decreased, there is still a call for new preventative measures to be implemented that put women at the forefront thereof (UNAIDS, 2016). The body of literature in this research investigates how social media has been used as a tool in disease prevention globally and its success. This research seeks to explore secondary abstinence and condom use among black females at the University of KwaZulu-Natal, Howard College Campus, through social media. Moreover, this study employed 12 in-depth interviews and used snowball sampling as well as convenient sampling as part of the data collection method. The study adopted a qualitative approach and the data collected was manually analysed, organised and transcribed. In addition to this, a thematic analysis was employed to make sense of the findings where themes were derived during the coding process (Bertrand, 2004b). Furthermore, the DOI Theory was employed to empower this study. The DOI Theory consists of 8 elements that were linked to the data in order to make sense of the findings. The findings of this study presented evidence that when designing HIV/AIDS prevention communication messages, it is imperative to consider an individual’s culture and how it plays a role in an individual’s descision-making process and their way of life. Moreover, the use of influencers is important in order to model good behaviour which can be diffused into a society with the objective of normalising it. The findings of this study presented eveidence that social media networks aimed at prwventinh HIV prevention among black female students at UKZN, Howard College campus may not have fulfilled their objective due to issues such as HIV stigma, male dominace and culture.Item Factors affecting antenatal care utilization in South Sudan : evidence from 2010 South Sudan house survey.(2015) Arop, Biong Deng Kuol.; Vermaak, Kerry.Maternal mortality in South Sudan was estimated to be as high as 2054 per 100,000 live births, amongst the highest mortality in the world. The utilisations of antenatal care (ANC) services, which provide the opportunity for early diagnoses and preventions of complications during pregnancy, are crucial to reducing maternal mortality. This study is meant to identify the factors that affect the utilization of ANC services among pregnant women aged 15 – 49 years in South Sudan using the Second South Sudan Households Survey (SSHHS II). Methods The Second South Sudan Households Survey was conducted using the UNICEF’s Multiple Indicator Cluster Survey (MICS) methodology. The population used in this study is the 4,067 women who gave birth in the last two years before the survey. The dependent variables in this study were any ANC and adequate ANC utilisation, defined as the proportion of pregnant women who had attended ANC, and were seen by a skilled professional (a doctor, a nurse or skilled midwife) at least once during their pregnancy. The second indicator was the proportion of pregnant women who had attended ANC at least four times during their pregnancy, and were seen by any health provider. The explanatory variables were the women's age, age at first marriage, marital status, parity, maternal educational level, household wealth quintile, geographical location (states) and place of residence (urban or rural). Results More than half 56% of the women did not use ANC services at all during their pregnancy, and only 18% used ANC adequately, while 26% of the selected women used it inadequately. Multivariate analysis shows that most of the explanatory variables were strong predictors to ANC utilization at least once, while household wealth seems to be the only variable predicting the utilization of ANC services by women of South Sudan at least four times. However, pregnant women with primary and secondary level of education were 2.04 and 2.32 times, respectively, more likely to use ANC than women with no education. Likewise, women in the fourth and the richest (fifth) quintiles were twice and three times, respectively, more likely to utilize ANC than those in the poorest quintile. Conclusions In conclusion the utilization of ANC in South Sudan was inadequate and far from satisfactory. The findings show a high level of illiteracy among women of South Sudan, but education variables were shown to be significantly associated with at least one ANC utilization. This result implies that providing women with at least primary education will enhance the likelihood of ANC utilization, and may increase with improved education. Nevertheless, this study has proved household wealth is the only variable that has influence on the mother’s utilization of ANC services at least four times or more.Item The factors associated with cigarette smoking among young adults (16-25 years) in South Africa.(2018) Amber, Colleen Morkel.; Vermaak, Kerry.Cigarette smoking is a worldwide health concern and evidence of the impact it has on the health of smokers and non-smokers is indisputable. Young adults are a “risk prone” segment of populations, as young smokers may underestimate the risk of tobacco addiction and are often uninformed about the dangers of smoking. In addition, tobacco smoking in developing countries is a bourgeoning epidemic that requires further research. The study design of this dissertation was a secondary analysis of the existing National Income Dynamics Survey (NIDS) data. The first nationally representative cohort study (wave 1) was conducted in South Africa in 2008, with wave 3 in 2012. A sample of 5528 for wave 1 and 6155 for wave 3 of young adults (aged 16-25) was used. The dependent variable was reporting to have “Ever smoked regularly” and independent variables included age, gender, population group, geographic location, education and economic variables. The study found that among young adults in South Africa, the percentage of young smokers has remained relatively unchanged between the two NIDS waves. Participants reported that they started smoking in their mid- to late- teens, and smoked an average of 7 cigarettes a day. Smoking was more prevalent in males and was positively associated with age. Smoking was particular prevalent among the Coloured population group. People in urban areas were more likely to smoke and education had a mitigating effect on smoking prevalence. Smoking in young adults remains an important problem in South Africa and there is an urgent need for further research into developing creative anti-smoking strategies and interventions that are culturally and linguistically appropriate. Research that informs these programmes can reduce youth smoking and have long-term benefits for public health.Item Fertility choices of sero-positive women in the community of Welbedacht West KwaZulu-Natal.(2016) Zuma, Modestar Sinenhlanhla.; Vermaak, Kerry.Recent literature on childbearing and HIV has found a plethora of evidence suggesting that many women living with HIV continue to desire children, become pregnant and give birth after knowing their HIV status. This desire to have children has been associated with the availability of HAART and PMTC interventions and its improvement in the quality of life for sero-positive women. Although HIV- prevalence and fertility rates are amongst the highest in sub-Saharan Africa, little is known about how HIV infection affects the fertility preferences of women in KwaZulu-Natal.The purpose of this qualitative study was to explore fertility choices of sero-positive women in the community of Welbedacht West south of Durban in KwaZulu- Natal. Availability sampling was used to select twelve women of child bearing age who were part of a local support group. The sample included nine participants who were receiving antiretroviral therapy. Data was collected through in-depth interviews lasting about 45 minutes to an hour in isiZulu. These interviews were tape recorded translated into English after the interview process was completed; they were later transcribed to aid analysis. Data was analyzed using thematic analysis. The findings of this study revealed that sero-positive women desired having children and an HIV positive status was not a factor but their intentions were the primary determinants of behaviour as the theoretical framework used indicates. A risk it all approach in order to fulfil desired intentions proved to be a key theme. All participants had children pre-diagnosis and only four had children post diagnosis. A decision to conceive for some participants is influenced by pressure as a result of their marital, social and situational context.Item Hypertension in South Africa between 2008 and 2017: an analysis of National Income Dynamics study data.(2020) Shezi, Simangele Azande.; Vermaak, Kerry.The world is faced with unprecedented increases in non-communicable and lifestyle-related diseases. This growth is of grave concern as these diseases have become the leading cause of global mortality. Hypertension is one of the leading lifestyle-related diseases. In South Africa, the increase in the prevalence of hypertension seeks to threaten a healthcare sector that is already inundated with a high burden of HIV/AIDS, tuberculosis as well other infectious and non-communicable diseases. Against this backdrop, this study aimed to determine the burden of hypertension between 2008 and 2017 in South Africa as well as the demographic and socioeconomic profiles of those that are at risk in order to contribute to the growing but limited existing body of literature that examines this. It is a quantitative study which analysed secondary data from the National Income Dynamics Surveys’ Waves 1 and 5 using multivariate logistic regression to determine the relationship between independent demographic and socioeconomic variables and hypertension. The sample size from this data is over 28 255 individuals and 7305 households. The study also employed the Social Determinants of Health (SDOH) as the underlying theoretical framework to guide the study. Key findings indicate that overall, there is a significant association between high blood pressure and demographic and socioeconomic factors amongst South African adults. High blood pressure was highest amongst females than males and those aged 65+. The data analysis also revealed that high blood pressure was impacted by marital status, wealth quintile, educational attainment and employment status. Interestingly, contradictory to the literature reviewed, the study found that White South Africans were most at risk instead of Africans. Whilst the literature highlighted the importance of behavioural changes to combat hypertension, it equally emphasized the need to look at health factors beyond biological and genetic factors. The study recommends that future policies and intervention strategies recognize that improving the socioeconomic status and decreasing demographic inequality is imperative in any attempts aimed at decreasing negative health outcomes. Underestimating the influence these factors have, will lead to futile combat efforts as the prevalence of hypertension and other diseases grow rapidly.Item Immigrants and xenophobia : perception of judicial system personnel and experiences of Ethiopian immigrants in accessing the justice system in Newcastle, South Africa.(2012) Haile, Theodros Azbaha.; Vermaak, Kerry.The overwhelming number of people residing outside country of origin has created anxiety and fear in the immigrant receiving countries over the potentially destabilising effect on the country’s resources. This may provoke controversy because of the fears that they may be competing unfairly with hosts for jobs, housing and other welfare services. Hence, migrants are increasingly becoming vulnerable to racism, xenophobia and discrimination. The justice system protects the rights of migrants. Equal access to justice entails the right of migrants to initiate and proceed with legal matters through the justice system without hindrances. On the side of the state, access to justice also includes the obligation of the state to investigate violations and persecute the perpetrators according to the law. Hence, with this context in mind, this study explored the perception of justice system personnel on the services they provide to non-South African citizens, specifically to Ethiopian Immigrants in the Newcastle area. It also explored the experience of Ethiopian asylum seekers and refugees in interacting with the locals and in accessing justice system within the greater Newcastle area in the KwaZulu Natal Province. In total, 20 interviews were conducted, of which 8 are justice system personnel and 12 Ethiopian asylum seekers and refugees. The findings suggest that the majority of justice system personnel perceive that foreigners are equal in the eyes of the law and get equal treatment as that of South Africans. It was found that the majority of justice system personnel lack knowledge of refugee law and this has been an obstacle in day to day running of courts. The findings also show that language services and Legal Aid are available to locals and as well as foreigners. It was also found that case dockets get lost due to corruption and negligence, and this resulted in impunity for some of the perpetrators of xenophobic violence. The findings also suggested that asylum seekers and refugees agreed that the justice system is fair and that there are good provisions that accommodate everyone. Some, however, expressed discontent and claimed that they faced discrimination. They portray the police as unfriendly and indicated that they have experienced abuse and discrimination. The findings also suggest that police harass and abuse refugees by invading their premises without a search warrant.Item The impact of indoor air pollution on the respiratory health of children in South Africa.(2014) Mashita, Poopedi.; Vermaak, Kerry.This study investigates the impact of indoor air pollution on respiratory health of children in South Africa. Biomass in the form of wood, crop residuals, and animal dung is used in most low income households as main fuel for cooking and heating. The study used quantitative methodology using secondary survey data from GHS2010 conducted by Statistics South Africa. Bivariate, independent and nested logistic regression analyses were conducted to examine the impact of indoor air pollution on respiratory health of a sample of 0 to 17 year old South African children. Results showed that children living in households that used unclean energy sources were more likely to have asthma compared to those who stayed in households that use clean energy sources. Female children had higher risk of having asthma compared to children. Regression analyses also observed that younger children below the age of 5 years were generally more likely to have asthma compared to those aged 5 years and above. There were higher odds of having asthma for children living outside KwaZulu Natal compared to those living in the province. There was a positive relationship between odds of having asthma and level of socioeconomic status. Based on the findings of the study, use of unclean energy sources for household purposes increases the risk of having respiratory health problems for children.Item The impact of relationship dynamics on regular condom use in a South African rural community : a case of Vulindlela.(2014) Masango, Zandile.; Vermaak, Kerry.Condoms, when used correctly and consistently, are one of the most effective methods to prevent sexually transmitted infections, including HIV; and unplanned pregnancies among sexually active individuals. In South Africa, the male condom is the most freely available and distributed method of contraception, yet young people still engage in risky sexual practices. Condom use is normally determined by considering whether a condom was used during the last sexual encounter. The purpose of this study was to determine which relationships dynamics were associated with consistent condom use within a rural South African setting. A secondary analysis was conducted on data from Project Accept; a randomized control trial. The analysis, with 2596 respondents, took the form of a bivariate Chi-square and multivariate binary logistic regression to determine which factors had an association with regular condom use among all the sampled respondents, the male respondents and the female respondents respectively. The findings of the study showed that among all the sampled respondents and the female respondents respectively, type of relationship, number of sexual encounters, HIV status and occupation were significantly associated with consistent condom use. The other variables included; such as age, sex, level of education, religion, number of sexual partners, age difference and household socioeconomic status did not show an association with consistent condom use among all the sampled respondents and female respondents respectively. Among the male respondents, only the type of relationship and number of sexual encounters were significantly associated with consistent condom use while sex, level of education, occupation, religion, number of sexual partners, HIV status, age difference and household socioeconomic status were not significantly associated with consistent condom use among this group of respondents. These findings show that consistent condom use is impacted by a number of relationship dynamics, and that there is a need to focus on enhancing communication, negotiation and ultimately consistency of condom use among heterosexual couples.Item The impact of socioeconomic and demographic factors on breastfeeding : analysis from the 2007 Swaziland demographic and health survey.(2014) Simelane, Maswati S.; Vermaak, Kerry.Aim: Studies that investigate the main predictors of breastfeeding duration are important in realising the WHO recommendation of breastfeeding for two years and beyond. The main aim of the study was to model the impact of socioeconomic and demographic factors on the rate and duration of breastfeeding, while controlling for health sector variables. A secondary analysis of the 2007 Swaziland Demographic and Health Survey (SDHS) was conducted to achieve this aim. Sample: A total sample of 2,812 women aged 15-49 reported the birth of at least one child born within five years of the survey. However only 2,601 women out of the 2,812 had information on the duration of breastfeeding of their last born children, and these were used as a sample for analysis in this study. Thus 211 from the 2,812 were considered missing. Method: To establish the effects of the socioeconomic and demographic variables on the breastfeeding rate (ever breastfed) while controlling for health sector variables, a multivariate logistic regression was used. Furthermore, to model the impact of socioeconomic and demographic variables on the duration of breastfeeding, three logistic regression models were fitted to the data for children breastfed for at least six, 12 and 24 months of age. Results: The rate of ever breastfeeding was found to be 94.3 % in Swaziland. In the multivariate logistic regression, highly educated women, women residing in urban areas, women residing in the Manzini region, delivery through cesarean section, and non-use of modern contraceptives were associated with lower odds of ever breastfeeding. For the duration of breastfeeding three binary logistic models were fitted at six, 12 and 24 months. Of the mothers with a child aged 6 to 11 months at the time of the survey, 17.5% had breastfed for at least six months. In the multivariate analysis, highly educated mothers, those older than 20 years, mothers residing in urban areas, and mothers who delivered at a health facility were more likely to have breastfed their last born child for at least six months. Among mothers with a last born child aged 12 to 23 months at the time of the survey, 39.8% reported to breastfeeding for at least 12 months. In the multivariate analysis less educated and uneducated mothers, mothers aged 35 and above, mothers residing in rural areas, mothers with a parity of one child, mothers using modern contraceptives, and mothers who delivered in a health facility had higher odds of breastfeeding for at least 12 months. At the time of the survey only 13.1% of the mothers with a last born child aged 24 and above reported breastfeeding for at least 24 months. In the multivariate analysis mothers from the poorest households had the lowest odds of breastfeeding for at least 24 months compared to the poorer and richest households. Mothers older than 20 years, those who were married, mothers who delivered in a health facility, and were using modern contraceptives were more likely to report have breastfed their last born child at 24 months during the time of the survey. Conclusion: The study found that the rate of ever breastfeeding is common in Swaziland. However, more attention need to be focused on the duration of breastfeeding as it is below the WHO recommendation with only 13.1% of children breastfed up to two years and beyond. The study found that SES, demographic and health sector variables were significant predictors of breastfeeding.