Nutrition education practices of primary school teachers in a resource-constrained community in Gauteng, South Africa.

We investigated the nutrition education (NE) practices of teachers of grade 4‒7 learners in 11 primary schools (85% of total number) of the Bronkhorstspruit district (Gauteng Province) to identify opportunities for improving NE in these schools. A descriptive cross-sectional survey was carried out among a convenient sample of the teachers (N = 73) using a structured nutrition education practice questionnaire. Descriptive data analysis was done. Results showed that the majority of the teachers taught nutrition in about 10% to 20% of their teaching time. Thirty percent had no training to teach nutrition, and most teachers (86%) would like to receive training in nutrition. Teachers mostly taught nutrition as part of the curriculum (67%) and very few (18%) integrated nutrition into other subjects. Needing improvement were adequate classroom time for nutrition education delivery, continuing training in nutrition for teachers, and provision of up-to-date instructional materials for teaching nutrition.

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.

Coping in an HIV/AIDS-dominated context: teachers promoting resilience in schools.

This paper explains how teachers in schools function as resources to buoy resilience in the face of human immunodeficiency virus/acquired immune deficiency syndrome-compounded adversities. We draw on participatory reflection and action data from a longitudinal study with teachers (n = 57, 5 males, 52 females) from six schools in three South African provinces. The study tracks the psychosocial support offered by teachers following their participation in the Supportive Teachers, Assets and Resilience project. Verbatim interview transcriptions were thematically analysed and three themes (as well as subthemes and categories) emerged: (i) Teachers use resources to promote resilience in schools [teachers use (a) systems and (b) neighbourhood health and social development services to identify and refer vulnerable cases]; (ii) Teachers form partnerships to promote resilience in schools [teacher partnerships include (a) children and families, (b) community volunteers and (c) community organizations, businesses and government] and (iii) School-based support is offered to vulnerable individuals [by means of (a) vegetable gardens, (b) emotional and health support and (c) capacity development opportunities]. We conclude that teachers can promote resilience in schools by establishing networks with service providers that function across systems to support vulnerable groups. We theorize that the core of systemic networks is relationships, that relationship-driven support networks mitigate the effects of cumulative risk and school-based networks can enable schools to function as resilience-promoting resources.

HIV and/or AIDS awareness among adolescents in a South African at-risk rural community.

BACKGROUND: The devastating effects of HIV and/or AIDS are widely documented. Despite ongoing efforts to address the challenges associated with the pandemic, the impact on children orphaned because of the disease, as well as on adolescents, remains problematic. More specifically, orphaned adolescents living in poverty are particularly vulnerable and are often exposed to, for example, emotional and physical abuse and transactional sexual exploitation. Against this background, the importance of informed awareness among adolescents is continually emphasised, yet the outcomes of awareness campaigns require ongoing research. OBJECTIVES: The main objective of this study was to explore HIV and/or AIDS awareness among adolescents living in a rural community in South Africa, in the Chris Hani District of the Eastern Cape Province. Sixteen adolescents (aged 12-24) who had lost one or both of their parents because of HIV and/or AIDS-related reasons were purposefully selected to participate in the study. METHOD: For this qualitative investigation, we implemented a descriptive case study design. Semi-structured individual interviews, observation and field notes were used to collect and document data, and inductive thematic analysis was completed using the software programme Atlas.ti 7. RESULTS: The three themes that were identified relate to HIV and/or AIDS awareness, disclosure of parents' HIV and/or AIDS status and experiences of adolescents surrounding the death of their parents. Adolescents of the community viewed HIV and/or AIDS as an infectious disease that can lead to death; however, this can be prevented by avoiding at-risk sexual behaviour. Schools and family members were the main sources of information regarding HIV and/or AIDS to the participants. Even though parents tended not to disclose their HIV and/or AIDS status, adolescents became aware of their parents' status when reading about this on their parents' medical report cards or when being told about the status by others following the death of their parents. For adolescents, their parents' deaths were associated with the parents being chronically ill or showing visible signs of deterioration such as weight loss. CONCLUSION: The study concludes that even though current campaigns and informative interventions have seemingly succeeded in ensuring HIV and/or AIDS awareness among adolescents - also those in remote areas - continued educational campaigns are important. Such initiatives may prove to be beneficial by focusing on ways that parents can discuss HIV and/or AIDS-related issues with their children and disclose an HIV-positive status.

Power-sharing Partnerships: Teachers' Experiences of Participatory Methodology.

BACKGROUND: This article reports on the experiences of teachers as coresearchers in a long-term partnership with university researchers, who participated in an asset-based intervention project known as Supportive Teachers, Assets and Resilience (STAR). In an attempt to inform participatory research methodology, the study investigated how coresearchers (teachers) experienced power relations. We utilized Gaventa's power cube as a theoretical framework and participatory research as our methodologic paradigm. METHOD: Ten teachers of a primary school in the Eastern Cape and five teachers of a secondary school in a remote area in the Mpumalanga Province in South Africa participated (n=15). We employed multiple data generation techniques, namely Participatory Reflection and Action (PRA) activities, observation, focus group discussions, and semistructured interviews, using thematic analysis and categorical aggregation for data analysis. RESULTS: We identified three themes, related to the (1) nature of power in participatory partnerships, (2) coreasearchers' meaning making of power and partnerships, and their (3) role in taking agency. CONCLUSION: Based on these findings, we developed a framework of power sharing partnerships to extend Gaventa's power cube theory. This framework, and its five interrelated elements (leadership as power, identifying vision and mission, synergy, interdependent role of partners, and determination), provide insight into the way coresearchers shared their experiences of participatory research methodology. We theorise power-sharing partnerships as a complimentary platform hosting partners' shared strengths, skills, and experience, creating synergy in collaborative projects.

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.

Formative evaluation of the STAR intervention: improving teachers' ability to provide psychosocial support for vulnerable individuals in the school community.

The article describes the pilot phase of a participatory reflection and action (PRA) study. The longitudinal investigation explores teachers' ability to provide psychosocial support within the context of HIV/AIDS following an asset-based intervention. The study ensued from our desire to understand and contribute to knowledge about the changed roles of teachers due to adversity in the community, specifically in relation to HIV/AIDS and education. The supportive teachers, assets and resilience (STAR) intervention was facilitated from November 2003 to October 2005 and consisted of the research team undertaking nine field visits and facilitating 20 intervention sessions (2-3 hours each), and 12 post-intervention research visits have been conducted to date. Ten female teachers were selected for participation through random purposeful sampling at a primary school in an informal settlement outside Port Elizabeth, South Africa. Data-generation included PRA activities, observation, informal interactive interviews, and focus group discussions. The data were analysed by means of inductive thematic analysis. We found that the teachers did not view vulnerability as being related to children or HIV/AIDS in isolation, but rather that their psychosocial support to children and the school community was inclusive across a spectrum of vulnerabilities and services. We argue that teachers who are inclined to provide such support will fulfil this role irrespective of understanding policy or receiving training. We contend that teachers are well-positioned to manage school-based psychosocial support in order to create relevant and caring spaces for vulnerable individuals in the school community.

HIV and/or AIDS Awareness among Adolescent Orphans in one of the South African Rural Communities

Background: The devastating effects of HIV and/or AIDS are widely documented. Despite ongoing efforts to address the challenges associated with the pandemic; the impact on children orphaned due to the disease; as well as on adolescents; remain problematic. More specifically; orphaned adolescents living in poverty; are particularly vulnerable and are often exposed to e.g. emotional and physical abuse; and transactional sexual exploitation. Against this background; the importance of informed awareness amongst adolescents is continually emphasised yet the outcomes of awareness campaigns require ongoing research.Objectives: The main objective of this study was to explore HIV and/or AIDS awareness among adolescents living in a rural community in South Africa; in the Chris Hani District of the Eastern Cape Province. Sixteen adolescents (aged 12-24) who had lost one or both of their parents due to HIV and/or AIDS related reasons were purposefully selected to participate in the study.Method: For this qualitative investigation; we implemented a descriptive case study design. Semi-structured individual interviews; observation and field notes were utilised to collect and document data; and inductive thematic analysis was completed using the software program Atlas.ti 7.Results: The three themes that were identified relate to HIV and/or AIDS awareness; disclosure of parents' HIV and/or AIDS status; and experiences of adolescents surrounding the death of their parents. Adolescents of the community viewed HIV and/or AIDS as an infectious disease that can lead to death; however that this can be prevented by avoiding at-risk sexual behaviour. Schools and family members were the main sources of information regarding HIV and/or AIDS to the participants. Even though parents tended not to disclose their HIV and/or AIDS status; adolescents became aware of their parents' status when reading of this on their parents' medical report cards or when being told about the status by others following the death of their parents. For adolescents; their parents' deaths were associated with the parents being chronically ill; or showing visible signs of deterioration such as weight loss.Conclusion: The study concludes that; even though current campaigns and informative interventions have seemingly succeeded in ensuring HIV and/or AIDS awareness amongst adolescents - also those in remote areas - continued educational campaigns are important. Such initiatives may prove to be beneficial if focusing on ways that parents can discuss HIV and/or AIDS related issues with their children and disclose an HIV positive status