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Item Perceptions and experiences of female partners of clients of voluntary medical male circumcision in Harare, Zimbabwe(2017) Mazambara, FineIntroduction Zimbabwe is lagging behind on its target to scale up Voluntary Medical Male Circumcision (VMMC). The engagement of female partners in VMMC demand creation is important as they can play an important role in their male partners’ decision to uptake VMMC. Exploring women’s perceptions and experiences will help to better understand factors behind low uptake of VMMC in Zimbabwe as efforts are being made to scale up VMMC for HIV prevention. The aim of the study was to explore female partners’ underlying perceptions and experiences of having their partners undergo medical male circumcision in order to inform the development of promotional messages on the basis of women’s experiences with VMMC. Methods The study was conducted in Mbare, an urban high density suburb in the southern district of Harare utilising qualitative methodology. Individual in-depth interviews were conducted using an in-depth interview guide. Through purposive sampling a total of twenty female partners of medically circumcised men attending antenatal clinic between February and May 2016 were recruited. Interviews were audio recorded and transcripts were analysed using content analysis. Results The results show that women were knowledgeable about VMMC. The perception towards medical male circumcision was linked to the perceived benefits of VMMC. The main role that women played was encouraging their male partners. The perception of women towards VMMC was generally good. The perceived benefits of having a circumcised partner were Fine Mazambara 872453 iv reduced risk of HIV and STIs, improved sexual experience, improved hygiene, improved sexual communication, no need to use condoms and improvement of the relationship. The risk perception towards HIV and STIs was decreased after the male partner’s VMMC and fear of risk compensation was reported. Women had misconceptions about adverse events of circumcision and the age at which men can be circumcised. Mass media was the main source of VMMC information for women. VMMC was understood to offer direct protection from HIV for women and circumcised men were understood to being conferred full protection from HIV and STIs. Conclusions Women have knowledge on VMMC although their knowledge on adverse events associated with circumcision, age at which men can be circumcised, indirect protection for women, and partial protection for men can be improved. The perceptions of women towards VMMC were influenced by the perceived benefits of having a circumcised partner. The main perceived benefits of having a VMMC client as a male partner is reduced risk of HIV and STIs and improved sexual experience. Targeted health messages directed at women should therefore aim at increasing women’s knowledge of VMMC, include improved sexual experience and take gender issues into consideration.Item Exploring the feasibility of using different cellular telephone based messaging platforms as demand creation channels for voluntary medical male circumcision in Gauteng, South Africa(2015-03-27) Coats, Gareth MichaelThree randomised control trials in Kenya, Uganda and South Africa have shown that Voluntary Medical Male Circumcision (VMMC) reduces the risk of heterosexual HIV transmission to men by up to 60%. This has resulted in a WHO and UNAIDS recommendation to promote VMMC as part of comprehensive HIV prevention programming. In order for South Africa to achieve its 80% national coverage target of VMMC, significant investment needs to be made in demand creation programming. The Centre for HIV/AIDS Prevention Studies (CHAPS) provides free VMMCs through 28 community based clinics and hospitals in Gauteng, North West and Limpopo Provinces. In 2013, CHAPS demand creation activities have resulted in some increases in demand but CHAPS have committed to exploring additional demand creation opportunities. In terms of reach, mobile telephones are highly prevalent in South Africa, with more than 90% of South African households surveyed in 2011 reporting to have at least one cellular telephone in the home. The ongoing advancement of mobile phones to allow data transfer and internet access also means that more ‘Technology-Poor’ or ‘ICT Have-nots’ will be able to access the ever increasing knowledge content of the internet, participate in digital social-domains and be reached in shorter times and at lower costs.Item Attitudes of doctors and nurses towards task-shifting of male circumcision to nurses in Swaziland(2014-10) Jonasi, SolomonBackground: Male circumcision (MC) has a substantial effect in reducing HIV infections in men by 60 -70% making it one of the best available evidence-based biomedical HIV prevention interventions. Swaziland included Voluntary Medical Male Circumcision (VMMC) as part of its comprehensive HIV prevention package but the national scale up has been constrained by the limited availability of trained physicians, who are the only professionals permitted to perform the surgery. Task-shifting has been proposed as a possible strategy to increase service providers in the face of HIV and AIDS and the human resource for health crisis. Study Aim: The aim of this study was to determine the attitudes of doctors and nurses towards task shifting of male circumcision procedures to nurses in 2012. Methodology: A cross-sectional, descriptive survey was carried out. A self-administered questionnaire with close-ended rating and reverse coded questions was distributed to all nurses and doctors affiliated to the non-governmental organization (NGO), governmental, missionary and privately-run VMMC clinics nationwide. Data from returned questionnaires were entered, cleaned and analyzed using Statistical Package for Social Science (SPSS) version 22 and Microsoft Excel. Analysis of the internal reliability of the questionnaire scale and sub-scales was conducted. The main statistical procedures were descriptive statistics and tests of association. Results: The study recruited 398 participants (25.4% doctors and 74.6% nurses), of which 44.2% were male and 56% were Swaziland nationals. This study found that 80.4% of the participants (doctors and nurses) had a positive attitude towards the reform of task-shifting VMMC to nurses. Nurses had a more positive attitude than doctors (p<0.001), while male nurses had a significantly more positive attitude than female nurses (p<0.001).However, there was no significant difference between the attitudes of male and female doctors (p=0.130). The study found that sex (p=0.001), profession (doctor vs. nurse) (p<0.001), nationality (expatriate vs. local) (p<0.001) and having ever practically performed the surgical procedure (p<0.001) were significantly associated with the participants attitude. However, their primary role (administrator vs. clinician) (p=0.059) and time spent in the VMMC programme (p=0.112) did not significantly influence the participants’ attitude towards the task-shifting policy reform. Conclusions and Recommendations: Doctors and nurses in Swaziland generally have a positive attitude towards task-shifting of male circumcision to nurses. Nurses, males, participants with longer exposure and practical experience in VMMC, older participants and expatriates had even more positive attitudes towards the reform than their counterparts. The findings of the study suggest that the government should consider development of a task-shifting policy after further research that looks into determining attitudes of other stakeholders in VMMC and should also consider strategies to address the special groups that had lower or negative attitudes towards the reform than their counterparts, such as through sensitization campaigns. Feasibility, cost-effectiveness and other practical issues in our setting also need to be taken into consideration, including a possible trial (pilot). The reform should, however, be introduced with consideration of aspects of adequate training, development, supervision and support, administrative regulation, staff motivation and recognition.Item The effect of institutional shareholders on the level and mix of South African chief executive officers' compensation(2009-11-06T07:19:07Z) Surve, YaserAgency theory would predict that, given the presence of large or powerful shareholders in a company, agency costs would be reduced. Excessive executive compensation can be regarded as being an externality problem that stems from the agency problem. Agency theory would also then predict that executives in companies with large shareholders would receive less compensation and a larger proportion of long-term incentive-based compensation than companies with smaller shareholders. The validity of these two hypotheses has been tested using a unique cross-sectional, time series dataset and two statistical techniques. The first set of tests involve the construction of multiple regression models in order to provide evidence as to whether Chief Executive Officer (CEO) compensation is affected by institutional shareholders. The second method, using statistical tests of differences between means, involves separating the sample into two sub-samples, namely management- and owner-controlled firms, to ascertain whether these two groups remunerate their CEOs differently to each other, thus testing the hypotheses in an alternative manner to the regression models. This report examines whether the presence of institutional shareholders affects the level and mix of CEO compensation for 50 companies listed on the JSE Securities Exchange over the five-year period 2002-2006. Original findings on the value of share options awarded to CEOs are presented, along with the trends in the level and mix of CEO compensation. Further research findings also include trends in the level of institutional ownership of listed companies over this period. The results of both the regression models and tests for differences of means provide statistical evidence in support of the assertion that the presence of institutional shareholders do not have an effect on either the level or mix of CEO compensation. Suggested reasons for this result range from shareholder apathy, to not considering executive remuneration to be a significant enough issue for institutional shareholders, and finally to the suggestion that institutional shareholders perceive the level and mix of compensation paid to South African CEOs to be a fair reflection of their value to their company.