Governing Oneself Through HIV Diagnosis to Antiretrovirals.

The article focuses on the experience of reinventing oneself post HIV diagnosis when living on antiretrovirals. Six women and men enlisted for antiretrovirals in South African public health facilities were interviewed, and a qualitative analysis was conducted drawing on Foucault's theory of governmentality. For the participants, the prevailing governing rationality of taking personal responsibility for their health is synonymous with self-recovery and restoration of self-determination. From the hopelessness and despair of HIV diagnosis, for all six participants, committing to antiretrovirals enhances their capacity to take back control of their transformation from victim to survivor, and with it, a sense of personal integrity. Yet, an unwavering resolve to use ARVs is not always possible for some of them, is not preferable or is not always desirable, which perhaps signals that for certain people living with HIV, their life-long journey of self-governance with ARVs is likely to be characterized by constant contradictions.

Bearing the right to healthcare, autonomy and hope.

In this article, I discuss the significance of understanding within the context of the campaign for affordable and accessible HIV/AIDS treatments in South Africa, the transformational effects of the interplay between political rationality and affect for HIV-positive subjectivities. The article focuses on the policy tactics, in 2001, of the lobbying for a policy to prevent mother-to-child-transmission of HIV. A close reading of the lobby groups' rationalization of healthcare as a fundamental human right reveals a strategic attempt to recast a sense of helplessness into self-responsibilization, which concurrently involved nourishing hope in the preferred future for women with HIV to be afforded the right to individual choice associated with self-determination. Therefore, the struggle for a policy to prevent mother-to-child-transmission of HIV - an exemplary initiative to reconstitute HIV-positive subjectivity - maneuvered within both rationalizing and emotive spaces. Ongoing engagement of the broader campaign's contribution to redefining being HIV-positive thus also necessitates accounting for the effects of the convergence of political rationality and emotion in its tactically emancipatory project.

Primary health care service delivery in South Africa.

PURPOSE: The paper's aim is to determine the role of non-profit organizations (NPOs) in filling possible gaps in primary health care (PHC) service provision. DESIGN/METHODOLOGY/APPROACH: District (n = 10) and sub-district needs (n = 14) analyses were conducted in five South African provinces. In each case, the district/sub-district manager was interviewed using a semi-structured interview guide. FINDINGS: The service gaps identified were understaffing/lack of capacity, difficulty in retaining and recruiting staff, service disparities, inaccessibility of services/low-service utilisation and limited funding. It was believed that NPOs could fill these gaps. About 83 per cent perceived the relationship between government and NPOs as good. Contract monitoring, quality of service, communication and quality control were said to be unsatisfactory. The majority of sub-districts (11) indicated that they provided supplies to NPOs; 50 per cent perceived the relationship between the sub-districts and NPOs as good or very good. NPOs have critical role to play in PHC service delivery. ORIGINALITY/VALUE: The study provides critical information required to make informed effective strategic decisions that support district/sub-district performance and sustainability in a decentralized health system.