Electronic Theses and Dissertations (Masters)
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Item Factors associated with HIV knowledge among younger adolescents aged 12-14 years old in South Africa(University of the Witwatersrand, Johannesburg, 2024) Makgale. Tswelopele1.Background In 2019, there were 1.7 million adolescents aged 10-19 living with HIV globally, with 1.5 million in sub-Saharan Africa and 360,000 in South Africa. Early sexual debut, defined as having first intercourse at or before age 14, has significant consequences for adolescents worldwide. While sexual activity during adolescence is normal, early sexual debut is linked to risky behaviours. While efforts have been made to understand HIV/AIDS knowledge among older adolescents and young adults, research often neglects younger adolescents aged 12-14 years old. Poor HIV knowledge among this age group may increase transmission risk, delay diagnosis and treatment, and fuel stigma. It's crucial to focus on this age group to eradicate the disease, although research is limited due to the sensitive nature of discussing HIV/AIDS with younger adolescents. 2.Objective The two set objectives of this study were firstly, to examine levels of HIV knowledge among younger adolescents aged 12-14 years old in South Africa. Secondly, to identify the demographic, socioeconomic and subjective norm characteristics associated with HIV knowledge among younger adolescents aged 12-14 years old in South Africa. 3.Methodology This study utilised secondary data acquired from the fifth South African National HIV, Behaviour and Health Survey of 2017 – this was the latest survey available data was analysed using STATA version 14. The South Africa National HIV Prevalence, Incidence, Behaviour and Communication Survey (SABSSM) is a national population-based survey conducted for surveillance of the HIV epidemic in South Africa. The sample for the study was younger adolescents aged 12-14 years old. The weighted sample of 927 861 was selected and used for analyses. The dependent variable in this study was HIV knowledge, defined as having accurate knowledge of all HIV-related questions from the survey. Eight questions assessing HIV and AIDS knowledge, perceptions, and stigma were used. Adolescents were asked about the curability of AIDS, reducing HIV risk by having fewer sexual partners, whether a healthy- looking person can have HIV, mother-to-child transmission, risk reduction by monogamy with an uninfected partner, HIV transmission through shared food, condom use, and male circumcision reducing HIV risk. The original response options were 'yes', 'no', and 'don't know', with 'don't know' responses excluded to ensure that the data accurately reflected the participants knowledge on HIV and AIDS. The dependent variable had three categories: low HIV knowledge (1-3 out of the eight questions answered correctly), average HIV knowledge (4-5 out of the eight questions answered correctly), and comprehensive HIV knowledge (6-8 questions answered correctly). A Multinomial Logistic Regression model was employed to analyse HIV knowledge. The data analysis was done in three phases. The first phase included descriptive analyses of utilised in the study through a ranked frequency and percentage distribution table and sex ratio which was used to explore the HIV knowledge levels based on sex. The second stage included Pearson’s chi-square test which were to measure the associations between the demographic, socioeconomic and subjective norms. The third stage included an unadjusted (bivariate) and adjusted (multivariate) Multinomial Logistic Regression which was employed to examine the demographic, socioeconomic and subjective norms associated with HIV knowledge among younger adolescents aged 12-14 years old in South Africa. 4.Results Less than half of younger adolescents (47.0%) had comprehensive HIV knowledge. The relative risk ratio shown in the multivariate Multinomial Logistic Regression model showed that the respondent’s age, sex, race, place of residence, province, grade, orphanhood status and subjective norms are significant predictors of HIV knowledge among younger adolescents aged 12-14 years old in South Africa. These associations indicated that non-African female adolescents are less likely to possess HIV knowledge compared to Black male adolescents, but generally, female adolescents have a slightly higher relative risk of possessing comprehensive HIV knowledge compared to their male counterparts (1.01, P<0.05; CI=0.99-1.03). Adolescents residing in rural areas have higher relative risks of possessing average and comprehensive HIV knowledge compared to those in urban areas, with relative risks increasing by 1.52 (P<0.05; CI=1.48-1.52) and 2.18 (P<0.05; CI=2.13-2.24), respectively. Additionally, willingness to share food with someone who has HIV/AIDS shows no significant difference in the relative risk of having average or comprehensive HIV knowledge (RRR:0.641; P<0.05; CI=0.62-0.65), while willingness to play with someone who has HIV/AIDS decreases the relative risks of having average and comprehensive HIV knowledge by factors of 0.32 (P<0.05; CI=0.32-0.33) and 0.13 (P<0.05; CI=0.12-0.13), respectively. Furthermore, adolescents uncomfortable discussing HIV/AIDS with at least one family member have decreased relative risks of possessing average and comprehensive HIV knowledge by factors of 0.27 (P<0.05; CI=0.27-0.28) and 0.30 (P<0.05; CI=0.29-0.30), respectively. These results highlight the importance of demographic and social factors in understanding HIV knowledge among young adolescents in South Africa. 5.Conclusion Despite significant efforts by the South African government to integrate HIV education into the national school curriculum and collaborate with NGOs and civil society groups, adolescents aged 12-14 still lack comprehensive HIV knowledge. Understanding HIV early plays a vital role in reducing stigma and discrimination associated with HIV/AIDS, fostering a supportive and inclusive atmosphere. It also promotes critical thinking among adolescents, empowering them to question myths and misunderstandings about the disease, thereby encouraging healthier behaviours and attitudes. The hypothesis for this research was that there is no association between demographic, socioeconomic and subjective norm characteristics and HIV knowledge among younger adolescents in South Africa. The multinomial logistic regression showed significant results. Therefore, the null hypothesis was rejected. Post the completion of the National Youth HIV Prevention Strategy (2022-205), it will become mandatory for the government to evaluate and refine the policy framework to include those under 15 years. Including those aged 12-14 years old will be crucial for fostering a generation equipped to safeguard their sexual health and make informed choices, thereby perpetuating the efficacy and relevance of HIV prevention efforts within the broader national agendaItem A Critical Inquiry into The Ethical Justification(s) For Decriminalising Cannabis Use In South Africa(University of the Witwatersrand, Johannesburg, 2024) Moolla, Sadiyyah; Attoe, Aribiah DavidThe right to privacy, as contained in the Constitution of the Republic of South Africa, grants individuals the right to engage in certain activities, insofar as those activities are private, without infringement by individuals or the state. The said right is what was relied upon by the Constitutional Court in the decision to decriminalize Cannabis, for private use. However, there is a marked difference between that which is legal and that which is moral. In this thesis, I will grapple with the ethical justifications for the decriminalization of Cannabis. Using the Ubuntu ethical theory, I will show that there is in fact no ethical justification for impeding on a moral agent’s right to consume cannabis. I will begin by providing some arguments for and against the legalisation of cannabis use, showing their merits and their demerits. I will then provide an account of Ubuntu ethics and show how its tenets bear on the right to consume cannabis.Item An analysis of the relationship between HIV-testing and cervical cancer screening uptake among females of reproductive age (15-49 years old) in South Africa(University of the Witwatersrand, Johannesburg, 2024) Madubye, Koketšo Tholo; Wet-Billings, Nicole DeBackground: Higher income countries (HIC) have threefold testing coverage over lower to middle income countries (LMIC). Cervical cancer is the 4th most prevalent cancer among females globally, and a key contributor to mortality in Southern Africa. In LMIC, including South Africa, only 9% of the eligible screening cohort had ever undergone cervical cancer screening. This study examined the gap in understanding the relationship between HIV testing behaviours and the uptake of cervical cancer screening. Methods: The study was conducted in South Africa, utilising the 2016 South African Demographic and Health Survey (SADHS), as a secondary data source. The sample size of this study was a weighted (n) distribution of 4,199 females. The study design is cross-sectional, the outcome variable of interest in this study was the uptake of cervical cancer screening and the predictor variable is HIV Testing. The data by SADHS (2016) was analysed through the three phases: univariate, bivariate and multivariate. At the bivariate level, contingency tables were employed, using the Pearson chi-square test of association which examined the strength of crude relationships between cervical cancer screening and the study of independent variables. In addition, a multivariate analysis through the employment of a binary logistic regression as the outcome of the study was categorised with ‘yes’ and ‘no’ binary responses. Results: The findings of this study indicated that 33% of females of reproductive age had ever undergone cervical cancer screening, while 62.5% responded affirmatively to having tested for HIV. Females who tested for HIV displayed a higher propensity to having undergone cervical cancer screening, 37.43% female respondents who tested for HIV had undergone screened for cervical cancer, as opposed to those who didn’t test, which only 10.19 % screened for cervical cancer. Conclusions: 37.43% female respondents who tested for HIV had undergone screened for cervical cancer. Among those who did not test for HIV, 10.19 % screened for cervical cancer. There is still much to be done to improve cervical cancer screening among females, while HIV testing remains high, cervical cancer screening is alarmingly low. The 2017 Cervical Cancer Prevention and Control Policy functions as a mediating apparatus, additional supplementations targeting females below the age of 30 remain a necessityItem A relational history of space, administration and economic extractivism in the Mogalakwena Local Municipality in Limpopo, South Africa (1948-2000)(University of the Witwatersrand, Johannesburg, 2024) Pearson, Joel DavidThis dissertation seeks to contribute to existing local government scholarship by presenting a situated and relational historical study of the Mogalakwena Local Municipality in present-day Limpopo Province of South Africa. By adapting and extending Gill Hart’s spatial-relational methodology, this study draws out key mechanics of change over time in the Mogalakwena area since the early 20 th century. This historical analysis reveals that the shifting array of power relations which together structured the field of rural local governance came to be enacted and concretised through specific and identifiable processes of spatial transformation, administrative government, and economic extractivism. While existing scholarship has elaborated on aspects of these processes, the present study insists on analysing all three together, in relation to each other, attentive to forms of both mutual constitution and contradiction, and cognisant of how these processes feed into political dynamics of varying scales – local, regional, and national. As such, the thesis argues that these three sets of processes should be understood as axes of rural local governance. This analysis draws off an empirical foundation compiled from archival and oral history sources, and which points to three broad historical conjunctures of local governance in Mogalakwena over the apartheid and early democratic eras. The first, spanning the period between the early 1950s and early 1970s, is identified as an era of state-building and remaking the countryside under the ascendant National Party (NP), one in which the white central state initiated massive and sweeping transformations of rural areas to bring to life its “Bantustan strategy”. The second conjuncture, defined as the terminal phase of apartheid from the late 1970s through to the end of the 1980s, was one in which rural local governance came to be dominated by forms of resistance, reform and repression when bottom-up political forces challenged the reach and authority of the apartheid central state in rural localities. And during the third conjuncture, the transitional period of national negotiations and democratisation between 1990 and 2000, rural local governance came to be defined by uneven and contested initiatives towards institutional amalgamation, deracialisation and redress. In considering the field of rural local governance within which the Mogalakwena Local Municipality operates today, this study concludes that the three axes together remain key determinants in structuring local and regional power relations. While dramatic new power relations have unfolded within and around the municipality since its creation in the year 2000, this study concludes that these have continued to be materialised through intertwined spatial, administrative and extractivist processes which extend back into history. As such, it suggests a new systematic approach for the study of local government institutions, histories of the state in rural areas, and studies of the state more broadly.Item Hugging the Crocodile: South Africa’s (RSA’s) tense relationship with the International Criminal Court (ICC)(University of the Witwatersrand, Johannesburg, 2024) Bux – Williamson, Fatima Bee BeeThis qualitative research delves into the Republic of South Africa's (RSA) foreign policy framework concerning its involvement in the International Criminal Court (ICC), focusing on the cases of Uhuru Kenyatta and Omar al-Bashir. Rooted in the constructivist paradigm, from Sikkink and Finnemore's (1998) theoretical framework, the study examines the interplay of RSA’s domestic political considerations, regional dynamics, international pressures, and legal and political considerations, and domestic intricacies that have shaped RSA’s dynamic position vis-à-vis the ICC. The research scrutinises RSA’s initial compliance with and advocacy for the ICC trial, utilising the context of the Uhuru Kenyatta case. It conducts an analysis of the roles played by norm entrepreneurs, civil society actors, and the intricate domestic sociopolitical landscape. The study, equally, engages in a thorough exploration of diplomatic missions and negotiations, critically assessing their effectiveness and influence on RSA’s foreign policy paradigm. Moreover, the research assesses broader regional dynamics, with an acute focus on the African Union (AU) and its pivotal role in guiding (RSA’s) strategic decision-making processes. On the contrary, the inquiry into the Omar al-Bashir case ventures into RSA’s intricate web of domestic political considerations, regional dynamics, international pressures, and legal and political variables. This discussion aims to identify similarities and differences between the cases, shedding light on their implications for the fluctuating relationship between South Africa and the ICC. This research study enriches the academic dialogue by conducting a comprehensive qualitative analysis of (RSA’s) engagements with the ICC. Meticulously examining (RSA’s) diplomatic evolution within the ICC framework, the study offers valuable insights into the dynamics that have influenced its foreign policy development over time. By addressing existing literature gaps, this research contributes to a more nuanced understanding of the factors shaping South Africa’s evolving relationship with the ICC.Item The Relationship Between Sensory Disability Status and Contraceptive Use Among Women Aged 15- 49 Years Old In South Africa(University of the Witwatersrand, Johannesburg, 2024) Sifora, Kutlwano Katlego Kimberly; De Wet-Billings, NicoleBackground: Studies suggest that disability significantly hinders access to reproductive health services, particularly family planning, in low- and middle-income countries. Women with disabilities have a low contraceptive use rate, leading to increased risks of unintended pregnancies and health complications. This study examined the relationship between sensory disability status and contraceptive use in South Africa. A sensory disability is a condition that affects one or more of the body's sensory functions like sight, hearing, touch, taste, or smell. In this study, sensory disabilities focused on hearing and visual impairments. Methods: The study employed a cross-sectional design using the 2016 South Africa Demographic and Health Survey. The study focused on women of reproductive age (15–49 years old) in South Africa, who were sexually active and provided information on both their contraceptive use and sensory disability status. The outcome variable of this study was contraceptive use, and the main independent variable was sensory disability status. The control variables included demographic characteristics namely age, race, marital status, province, and place of residence, as well as socioeconomic characteristics such as employment status, wealth status, education, family planning messages, and contraceptive knowledge. The analysis was conducted using Stata 17.0 on a weighted sample of 6 683 sexually active women aged 15–49 years old who answered questions on contraceptive use. The data analysis was done in three phases. For the first phase, cross-tabulations and chi-square analysis were used to demonstrate the levels of contraceptive use as well as all characteristics of women. For the second phase, bivariate binary logistic regression models were used to determine the relationship between each of the independent variables and the outcome variable of contraceptive use. Lastly, for the third phase, a stepwise multivariate binary logistic regression was utilised to determine the relationship between sensory disability status and contraceptive use among women aged 15– 49 years old in South Africa. Results: Among South African women of reproductive age, 55.4% were using contraceptives. Women with sensory disabilities were shown to have lower odds of using contraceptives than those without sensory disabilities, even after adjusting for all other variables [OR: 0.78, CI: 0.63873 - 0.95227]. Significant associations with contraceptive use were observed for factors xi including age, race, marital status, education and province. Compared to women aged 15–24, women aged 35–39 had a much lower likelihood of using contraceptives. [OR: 0.46, CI: 0.38150 - 0.55364]. Women from races other than black were also observed to have lower odds for contraceptive use compared to black women [OR: 0.75, CI: 0.61098 - 0.92237]. Conversely, married women were significantly more likely to use contraceptives than women who were never married [OR: 1.23, CI: 1.05328 - 1.42899]. Additionally, women with secondary [OR: 1.98, CI: 1.28089 - 3.07512] or higher education [OR: 2.40, CI: 1.49931 - 3.83750] exhibited a significantly higher likelihood of contraceptive usage compared to those lacking formal education. Women residing in Western Cape [OR: 1.83, CI: 1.29743 - 2.57637], Eastern Cape [OR: 1.66, CI: 1.27747 - 2.15886], Northern Cape [OR: 1.61, CI: 1.18574 - 2.19087], KwaZulu Natal [OR: 1.51, CI: 1.17797 - 1.92456], North West [OR: 1.43, CI: 1.01266 - 2.01228], and Mpumalanga [OR: 1.50, CI: .15808 - 1.93439] were found to have a higher likelihood of using contraceptives compared to women residing in Limpopo. Conclusions: Low contraceptive use among women with sensory disabilities in South Africa highlights the need for inclusive reproductive health services, addressing communication, information access, and societal attitudes to ensure informed decisions.Item What are the reasons behind the poor access of Covid-19 vaccines in Africa?(University of the Witwatersrand, Johannesburg, 2023-09) Xaba, Lumkile Thobile; Moore, CandiceDespite the pandemic and initiatives such as COVAX that were put in place for fair and equal distribution of vaccines, the African continent remains the least vaccinated continent in the world. Incorporating evidence from articles, journals and policies, this study demonstrates that the African continent had the least and poorest access to vaccines. This research paper aims to understand why Africa has received the least vaccines and is the least vaccinated continent. The paper looks at the availability of vaccines in Africa and the appropriate options available in healthcare settings to receive Covid-19 vaccines. Literature is used by various scholars to understand the reasons behind the poor access to vaccines which have resulted to low vaccine uptake in Africa. It aims to look at the various contributing factors to this phenomenon, “why has the African continent been the least vaccinated?” To respond to these issues, this study uses the theories of classical realism and institutional liberalism to discover why Africa was the least vaccinated continent. Data has been collected from March 2022 and subjected to discourse analysis to help further understand the reasons behind the poor access of vaccinations during Covid-19 in Africa. We find that there are both internal and external reasons behind the poor access in Africa and both national and international factors have contributed to poor vaccine access.Item Classical Liberalism and the Distribution of Benefits and Burdens with respect to Health-Care(University of the Witwatersrand, Johannesburg, 2023-08) Tsengiwe, Siyabulela Thomas; Allais, LucyThe South African government is proposing major health policy reforms, the National Health Insurance (NHI), in response to extreme inequalities in healthcare, where the middle and upper classes have access to quality healthcare in the private sector and the majority is subjected to poor healthcare in the public sector. The debate is fierce among South Africans as to what should be the appropriate healthcare policy for the country. Fundamentally, healthcare is an ethical issue of how benefits and burdens should be distributed in society and can better be understood through moral reflection. At the heart of this study is a critical review of one of the influential theories of justice, namely, classical liberalism that normally finds its expression in social and economic policies and in this case the focus is on healthcare. The question that this study seeks to answer is: can classical liberalism produce the right distribution of benefits and burdens with respect to healthcare? The suggestion of this study is that classical liberalism gives an inadequate account of how to distribute benefits and burdens with respect to healthcare. For more coherent accounts, the study proposes that we need to look in the direction of John Rawls and social equality. Government’s approach seems to borrow from elements of Rawls and social equality.Item The Place of Independent Candidates in South Africa’s Multi-party Democracy(University of the Witwatersrand, Johannesburg, 2023-10) Simelane, Nkanyiso Goodnews; Glaser, DarylThis study aims to assess the place of independent candidates and elected independents in South Africa’s multiparty democracy. This research attempts to answer the core question of ‘What role do independent candidates and elected independents play in South Africa’s multiparty democracy?’ This question will be explored by focusing on the electoral performance of independents in local government. The focus is on local government because South Africa’s current electoral system only permits independents to run and hold office at the local government level. The research will mainly draw from results of the local government elections in 2000, 2006, 2011, 2016, and 2021. It will further briefly analyse the provincial and national levels of government and elections to interrogate the possible impact that of allowing independents to stand nationally might have for the future of independent candidates in the country. This research is situated in the broader debate about electoral reform in South Africa since the dawn of inclusive democracy. Scholars have debated the extent to which SA’s current electoral system allows for adequate accountability and citizen involvement. In recent times, the debate was reignited by a Constitutional Court (CC) judgement supporting independent candidates’ integration into the national and provincial elections. In the case of New Nation Movement NPC and Others v President of the Republic of South Africa and Others 2020 (6) SA 257 (CC) (11 June 2020), the CC declared the Electoral Act unconstitutional insofar as “it requires that adult citizens may be elected to the National Assembly and Provincial Legislatures only through their membership of political parties.” What this judgement practically meant is that Parliament must make the necessary legislative amendments and electoral reform to allow for independent candidates (who are not members of a political party) to stand and, if elected, hold office in the provincial and national legislatures by 11 June 2022. As independent candidates in the general elections is a new phenomenon in the SA context, independents have contested locally. This research attempts to extract some key data and analysis on the performance of independents at local level in order to provide statistical foundations for future scholarship on independent candidates in SA.Item The Impact of the International Human Rights Regime on Personal Security: A Comparative Study of South Africa and Saudi Arabia(University of the Witwatersrand, Johannesburg, 2023-07) Ragooloo, Prebashnee; Zähringer, NataliePersonal security has become an important issue area to the international community since its differentiation as an aspect of human security (United Nations Human Development Report 1994, 25). The protection of the personal security of people is reliant on international and domestic criminal justice systems. The personal security of people within territories of democratic forms of government are expected to be more protected. Using a comparative method of analysis, South Africa and Saudi Arabia have been selected for this study due largely to the different types of government to determine the degree of personal security that people have in the respective countries. Unexpectedly, Saudi Arabia offers a greater protection of personal security to people within its territory due to the harsh punishments it administers to perpetrators of violent crime. The findings of the study indicate that democracies do not offer greater protection to people from physical violence as a result of its compassionate criminal justice laws. On the other hand, while authoritarian forms of government such as Saudi Arabia is viewed negatively, it affords people within its territory greater protection from violent crime. This study has found that a non-democratic regime (Saudi Arabia in this case) is found to be better a ensurer of personal security than a democratic regime. A key recommendation for future study could be that of comparing a greater number of democratic and non-democratic regimes and to gauge what a bigger sample of comparison could deliver.