Could a culturally and age-appropriate song contribute towards malaria prevention in primary school learners?

BACKGROUND: Although it is a preventable disease, malaria continues to present one of the major global health challenges. The disease is especially deadly to children under the age of 5 years. This is partly due to the fact that they have yet to build up an immune system to help protect them against malaria. As a prevention strategy, music is one way of communicating knowledge to young children and could therefore potentially be used to change children's behaviour in order to avoid getting sick from malaria. This exploratory study aimed to compare intervention strategies designed to educate and improve knowledge growth about malaria and its prevention in Grade 3 learners in a high-risk malaria region in Vhembe District, Limpopo Province, South Africa. METHODS: Various intervention strategies were employed and evaluated to determine the most effective intervention method. The study was split into two Phases. Phase 1 used a culturally and age-appropriate song as an intervention, along with a drama piece, a song and drama piece combination, and a control group. The most effective intervention strategy determined during Phase 1 was then subjected to Phase 2, against a control group to validate its efficacy. Questionnaires were used during pre-intervention and post-intervention interviews to evaluate the knowledge growth, if any, of the learners of selected primary schools in two different areas in Vhembe District. Pre-intervention interviews were followed by a specific intervention, based on the respective study groups. After 6 weeks, the post-intervention interviews were done to determine how much learners managed to learn and retain from the intervention received. RESULTS: The study found that the group that had only the song as intervention was the most effective learning intervention method in both Phases 1 and 2. Both phases showed that there was statistical significance in almost all of the nine questions asked on the questionnaires. CONCLUSIONS: The study concluded that a culturally and age-appropriate song can play a significant role in developing behavioural changes and spreading awareness against disease in a high-risk malaria region.

Determinants of intergenerational sexual relationships and HIV risk among South African women outpatients in Gauteng.

Age-discrepant sexual relationships may place women at risk for HIV infection in South Africa. Results are based on medical records and case-control interview data of 889 sexually experienced women outpatients aged 15-29 in a Gauteng township. Women with partners at least ten years older (intergenerational) show an elevated chance of having an early sexual debut, concurrent and transactional partners, and intimate partner violence. Hardship during childhood including parental loss, food insecurity and abuse are related to age asymmetric relationships. HIV is two times more likely (aOR=1.96) with an intergenerational partner. Transactional sex increases the odds of HIV independently (aOR=1.76) as does intimate partner violence (aOR=1.6). To the extent that transactional and intergenerational sex overlap the chance of contracting HIV increases more than two-fold (uOR=4.57). Girls (15-19) with intergenerational partners face the highest chance of HIV (uOR=8.55) compared to other age groups. They are also five times more likely than controls to have lived with a cross-age partner. Our findings indicate there are multiple pathways emanating from childhood leading to women's choice of intergenerational partners, and the link to HIV is strongest among the youngest women.

Telling stories and adding scores: Measuring resilience in young children affected by maternal HIV and AIDS.

"Telling stories and adding scores: Measuring resilience in young children affected by maternal HIV and AIDS", demonstrates how a concurrent mixed method design assisted cross-cultural comparison and ecological descriptions of resilience in young South African children, as well as validated alternative ways to measure resilience in young children. In a longitudinal randomised control trial, which investigated psychological resilience in mothers and children affected by HIV/AIDS, we combined a qualitative projective story-telling technique (Düss Fable) with quantitative data (Child Behaviour Checklist). The children mostly displayed adaptive resilience-related behaviours, although maladaptive behaviours were present. Participating children use internal (resolve/agency, positive future expectations, emotional intelligence) and external protective resources (material resources, positive institutions) to mediate adaptation. Children's maladaptive behaviours were exacerbated by internal (limited problem-solving skills, negative emotions) and external risk factors (chronic and cumulative adversity).

The role of parenting in affecting the behavior and adaptive functioning of young children of HIV-infected mothers in South Africa.

Prior investigations suggest that maternal HIV/AIDS poses significant challenges to young children. This study investigates the relationships between mothers' psychological functioning, parenting, and children's behavioral outcomes and functioning in a population of women living with HIV (N = 361) with a child between the ages of 6 and 10 years in Tshwane, South Africa. Utilizing path analysis, findings revealed that maternal depression is related to increased parenting stress and parent-child dysfunction, maternal coping is related to parenting style, and maternal coping, parenting style and stress, and parent-child dysfunction are associated with children's behavior and functioning, with parenting emerging as an important mediator. These findings suggest that interventions for women living with HIV and their children should not only address maternal psychological functioning (depression and coping), but should also focus on parenting, promoting a positive approach.

Behavior and psychological functioning of young children of HIV-positive mothers in South Africa.

Adults with HIV are living longer due to earlier diagnosis and increased access to antiretroviral medications. Therefore, fewer young children are being orphaned and instead, are being cared for by parents who know they are HIV positive, although they may be asymptomatic. Presently, it is unclear whether the psychological functioning of these young children is likely to be affected or, alternatively, whether it is only when a mother is ill, that children suffer adverse effects. We, thus, aimed to compare the behavior and psychological functioning of young children (aged 6-10 years) of HIV-positive and HIV-negative mothers. We also aimed to examine the association between HIV status disclosure and child outcomes. This study uses cross-sectional data from the baseline assessment of a randomized controlled trial conducted in Tshwane, South Africa. Participants (n=509) and their children were recruited from area health clinics. Among the 395 mothers with HIV, 42% reported symptoms of HIV disease. Multivariate linear regression models suggested that after adjusting for socio-demographic characteristics, children of HIV-positive mothers had significantly greater externalizing behaviors than children of HIV-negative mothers. Importantly, children whose mothers were symptomatic had greater internalizing and externalizing behaviors compared with children of HIV-negative mothers, but this was not true for children of asymptomatic mothers. Additionally, among children of HIV-positive mothers, those who had been told their mothers were sick compared with children who had been told nothing had less internalizing and externalizing behaviors and improved daily living skills. This study, therefore, provides evidence that maternal HIV disease can affect the behaviors of young children in South Africa but, importantly, only when the mothers are symptomatic from their disease. Furthermore, results suggest that disclosure of maternal illness but not HIV status was associated with improved behavior and psychological functioning among young children.

Comparing Mental Health, Wellbeing and Flourishing in Undergraduate Students Pre- and during the COVID-19 Pandemic.

There has been a preponderance of studies on student mental health, wellbeing and flourishing during the COVID-19 pandemic. Few studies have compared data on student mental health and wellbeing before and during the pandemic. The purpose of the current study was to compare mental health and wellbeing in undergraduate students before and during the COVID-19 pandemic. Survey research was conducted with three groups of undergraduate students (n = 905) from diverse scientific fields at a large, urban university in South Africa. Data was collected by means of electronic surveys, combining full-scale items from three instruments, the Mental Health Continuum Short Form, the Flourishing Scale and the Fragility of Happiness Scale. Data was analysed by the Statistical Package for the Social Sciences (SPSS), the Analysis of Moment Structures (AMOS) and R software. The results indicate that while the mental health and wellbeing of students declined during the pandemic concerning their perceived ability to contribute to society, having supportive and rewarding social relationships and them being engaged and interested in their daily activities, it also improved in terms of their perceived ability to manage their daily lives (environmental mastery), being challenged to grow (personal growth) and in terms of their views that society was becoming better (social growth/actualisation).

An Assessment of the Reliability and Validity of the PERMA Well-Being Scale for Adult Undergraduate Students in an Open and Distance Learning Context.

BACKGROUND: The PERMA well-being scale measures the multidimensionality of well-being in human populations. It highlights positive emotions, engagement, relationships, meaning, and accomplishment. Despite the empirical advancement and evolution of the PERMA scale in different settings, its applicability to open and distance learning (ODL) has not been adequately established among undergraduate students in sub-Saharan Africa. METHODOLOGY: Our study examines the theoretical reliability, validity, and five-factor structure of the shortened 35-item version of the PERMA well-being scale as it was adapted in an ODL tertiary institution in Botswana. The PERMA model of well-being and self-determination theory (SDT) served as theoretical frameworks. We evaluated the adapted PERMA scale's reliability, construct validity, confirmatory factor analysis, and measures of invariance to assess if the data of undergraduate students in an ODL context study fitted the PERMA model of a well-being five-factor structure. We used a multi-stage sampling scheme incorporating a convenience sampling approach where the respondents were invited to voluntarily participate in the study through a WhatsApp group, followed by snowball sampling where we asked the participants to add others to the WhatsApp group during the timeline of the survey; the sample comprised 215 respondents (age: mean = 38.17, standard deviation = 6.472). We collected data from former and active undergraduate B.Ed. (Bachelor of Education) degree students from five regional campuses of the open university through an online survey built into the Qualtrics platform. The Cronbach's alpha indicated that one item should be removed from the engagement domain. RESULTS: The overall adapted scale retained a 34-item PERMA well-being scale in the particular ODL context. The goodness of fit indices confirmed the five-domain structure with the 34 items. CONCLUSIONS: The psychometric properties of the 34-item adapted PERMA well-being scale suggest that it can be a valuable and feasible instrument in ODL in sub-Saharan Africa. Furthermore, the adapted scale can be applied in educational settings moving towards open and distance e-learning forms of delivery.

Measuring mental health and well-being of South African undergraduate students.

BACKGROUND: Increased investment in optimal student mental health and well-being has been noted by universities around the world. Studies show the need for contextually relevant, granular understandings of specific aspects of student mental health and well-being. METHODS: A survey was conducted at two time points - at the beginning and end of the academic year - at a large, urban university in South Africa. The Mental Health Continuum-Short Form, the Flourishing Scale, and the Fragility of Happiness Scale were used in the testing of undergraduate students from a variety of scientific disciplines. Two separate comparisons were made, based on the baseline data (n = 551) and the follow-up data (n = 281). In Comparison 1 (baseline, n = 443; follow-up, n = 173), two independent, biographically (very) similar groups were compared. Comparison 2 (n = 108) compared the results from the baseline and follow-up of the same group of students who completed the instruments at both time points. RESULTS: Results indicate a significant decline in mental health and well-being for both groups (independent and dependent) over the course of the academic year. Both follow-up groups were found to have lower psychological, emotional and social well-being, psychological flourishing, and reduced mental health, in comparison with the baseline groups. CONCLUSIONS: The statistically significant decreases in the mental health and well-being of participants in this study indicate the need for substantive interventions to support student mental health and well-being. Strong foci for well-being interventions should include self-efficacy, sense of direction, meaning and creating a sense of belonging.

The role of reproductive coercion in women's risk for HIV: A case-control study of outpatients in Gauteng, South Africa.

OBJECTIVES: To investigate how reproductive coercion, or men's attempts to control their partners' use of contraception, may contribute to adverse reproductive health outcomes for women including abortions, sexually transmitted infections, and HIV for young women in South Africa. METHODS: Findings are based on a case-control interview study of 882 South African women outpatients aged 15-29 years, 48.5% (n=427) of whom were HIV seropositive. Covariates include demographics, intimate partner violence, sexually transmitted infections, having an abortion, using long-acting reversible contraception, and unequal sexual relationship power. RESULTS: Most covariates with the exceptions of abortion and unequal relationship power increase the risk of HIV, and all relate to reproductive coercion. Intimate partner violence is strongly associated with reproductive coercion (odds ratio 3.86, 95% confidence interval 2.89-5.15). When intimate partner violence is included in the full model reproductive coercion remains a significant predictor of HIV by 42%, and acts as a partial mediator between IPV and HIV. CONCLUSION: Findings confirm the significance of reproductive coercion as a risk marker for HIV. Reproductive coercion undermines women's reproductive health and warrants clinical intervention. Recommendations are offered for clinical practice within the South African context to increase training and assessment and provide covert long-acting reversible contraception as one pathway towards promoting women's reproductive autonomy.

A randomized clinical trial of an intervention to promote resilience in young children of HIV-positive mothers in South Africa.

OBJECTIVE: The objective of this study is to assess the efficacy of an intervention designed to promote resilience in young children living with their HIV-positive mothers. DESIGN/METHODS: HIV-positive women attending clinics in Tshwane, South Africa, and their children, aged 6-10 years, were randomized to the intervention (I) or standard care (S). The intervention consisted of 24 weekly group sessions led by community care workers. Mothers and children were in separate groups for 14 sessions, followed by 10 interactive sessions. The primary focus was on parent-child communication and parenting. Assessments were completed by mothers and children at baseline and 6, 12 and 18 months. Repeated mixed linear analyses were used to assess change over time. RESULTS: Of 390 mother-child pairs, 84.6% (I: 161 and S: 169) completed at least two interviews and were included in the analyses. Children's mean age was 8.4 years and 42% of mothers had been ill in the prior 3 months. Attendance in groups was variable: only 45.7% attended more than 16 sessions. Intervention mothers reported significant improvements in children's externalizing behaviours (ß = -2.8, P = 0.002), communication (ß = 4.3, P = 0.025) and daily living skills (ß = 5.9, P = 0.024), although improvement in internalizing behaviours and socialization was not significant (P = 0.061 and 0.052, respectively). Intervention children reported a temporary increase in anxiety but did not report differences in depression or emotional intelligence. CONCLUSION: This is the first study demonstrating benefits of an intervention designed to promote resilience among young children of HIV-positive mothers. The intervention was specifically designed for an African context and has the potential to benefit large numbers of children, if it can be widely implemented.

Development and piloting of a mother and child intervention to promote resilience in young children of HIV-infected mothers in South Africa.

This paper describes the process of developing a parallel intervention for HIV-positive mothers and their young children (6-10 years) with a view to strengthening the relationship between them. Strong mother-child relationships can contribute to enhanced psychological resilience in children. The intervention was developed through action research, involving a situation analysis based on focus group discussions; intervention planning, piloting the intervention and a formative evaluation of the intervention. Participants supplied feedback regarding the value of the intervention in mother-child relationships. The findings obtained from the formative evaluation were used to refine the intervention. Two parallel programmes for mothers and children (15 sessions each) were followed by 10 joint sessions. The intervention for mothers focused on maternal mental health and the strengthening of their capacity to protect and care for their young children. The intervention for children addressed the development of their self-esteem, interpersonal relationships and survival skills. The formative evaluation provided evidence of good participation, support and group cohesion. Qualitative feedback indicated that the activities stimulated mother-child interaction. A similar intervention can easily be applied elsewhere using the detailed manual. The insights gained and lessons learnt related to mother and child interaction within an HIV-context that emerged from this research, can be valuable in other settings, both in Sub-Saharan Africa and elsewhere.

Speech-language therapists supporting foundation-phase teachers with literacy and numeracy in a rural and township context.

Language is required for learning, but educators often find it difficult to facilitate listening and language skills while they have to adapt to a new national curriculum with an outcomes-based approach for which they have not necessarily been adequately trained. A multifaceted support programme was developed for foundation-phase educators to facilitate listening and language for literacy and numeracy, with a particular focus on language for numeracy. The aim of the research was to determine the value of this particular support programme for foundation-phase educators in two different contexts (a semi-rural and a township context). A mixed methods approach with a concurrent, equal status triangulation design was used, where qualitative data were transformed to quantitative data in order to be compared in a matrix. The results show that the participants benefited to varying degrees from the programme. The combination of workshops, practical and mentoring components proved to be an effective means of support. The results indicate a need for pre-training selection procedures as more effective support can be provided to homogeneous groups.

Reconceptualising vulnerable children by acknowledging their assets.

We report on a study that sought to find alternative pathways to conceptualising vulnerable children. We have extracted a section from a longitudinal study that focuses on the ways in which vulnerable children in a rural community in South Africa cope with the impact of HIV and AIDS. We relied on the concepts of assets, resources and capacities to guide our understanding of 'vulnerable children', in an attempt to open up conceptualisations of the term, which have previously almost exclusively focused on deficits and needs. The study used a case study design with a small group of children who were engaged in making memory boxes. The study shows that numerous resources and capacities for coping and well-being are evident within and around the children. Most prominent among the capacities of the participants in this study are a positive identity and essential social competencies.

Telling stories and ading scores: measuring resilience in young children affected by maternal HIV and AIDS

"Telling stories and adding scores: Measuring resilience in young children affected by maternal HIV and AIDS""; demonstrates how a concurrent mixed method design assisted cross-cultural comparison and ecological descriptions of resilience in young South African children; as well as validated alternative ways to measure resilience in young children. In a longitudinal randomised control trial; which investigated psychological resilience in mothers and children affected by HIV/AIDS; we combined a qualitative projective story-telling technique (Duss Fable) with quantitative data (Child Behaviour Checklist). The children mostly displayed adaptive resilience-related behaviours; although maladaptive behaviours were present. Participating children use internal (resolve/agency; positive future expectations; emotional intelligence) and external protective resources (material resources; positive institutions) to mediate adaptation. Children's maladaptive behaviours were exacerbated by internal (limited problem-solving skills; negative emotions) and external risk factors (chronic and cumulative adversity)."