Suchergebnisse

This paper begins with estimates of fatherhood in South Africa, in the absence of formal measures of paternity. It highlights several salient features of fatherhood in the country, particularly low rates of marriages and father absence from households, and it traces their roots in colonialism and Apartheid, the political system in South Africa under which Black people were systematically oppressed. We point out that some forms of father absence illustrate the commitment of men to supporting their families by their willingness to seek migrant work far from their homes. Examples are given of government policies to support fathers and some of the major civil society efforts are described. The paper closes with important themes about fatherhood in work with young children.

South African male attitudes towards children, fatherhood and childrearing remain an important topic for
research and policy development given concerns about men's engagement with children and the family. This study
utilizes a subsample of males from the national South African Social Attitudes Survey to profile attitudes of males cross
analyzed by survey designated racial groups. Results show that males in general, have a positive attitude towards having
children and feel that they are not a burden. A greater number of Black African males than the other racial groups believe
children are a financial burden and restrict employment choices. Most males believe that men want to have a loving
relationship with children and perform best as fathers if married to the mother. The majority of them believe that it is a
crisis in the country that many fathers do not co-reside with their children. Consistent across racial groups, most males are
split about discipline with half believing in spanking, and that it teaches children right from wrong. Most males believe
that it is better to talk to children than spank them. In examining responses to survey questions, Black African males
trended away from the prevalent attitudes more than Colored, Asian Indian, and White males. Family service providers
can utilize these attitudes of men in planning intervention programs and policy development.

South Africa bears the world's largest burden of HIV with over 6.4 million people living with the virus. The South African government's response to HIV has yielded remarkable results in recent years; over 13 million South Africans tested in a 2012 campaign and over 2 million people are on antiretroviral treatment. However, with an HIV & AIDS and STI National Strategic Plan aiming to get 80 percent of the population to know their HIV status by 2016, activists and public health policy makers argue that non-invasive HIV self-testing should be incorporated into the country HIV Counseling and Testing [HCT] portfolios. In-depth qualitative interviews (N = 12) with key stakeholders were conducted from June to July 2013 in South Africa. These included two government officials, four non-governmental stakeholders, two donors, three academic researchers, and one international stakeholder. All stakeholders were involved in HIV prevention and treatment and influenced HCT policy and research in South Africa and beyond. The interviews explored: interest in HIV self-testing; potential distribution channels for HIV self-tests to target groups; perception of requirements for diagnostic technologies that would be most amenable to HIV self-testing and opinions on barriers and opportunities for HIV-linkage to care after receiving positive test results. While there is currently no HIV self-testing policy in South Africa, and several barriers exist, participants in the study expressed enthusiasm and willingness for scale-up and urgent need for further research, planning, establishment of HIV Self-testing policy and programming to complement existing facility-based and community-based HIV testing systems. Introduction of HIV self-testing could have far-reaching positive effects on holistic HIV testing uptake, giving people autonomy to decide which approach they want to use for HIV testing, early diagnosis, treatment and care for HIV particularly among hard-to reach groups, including men.

This paper utilizes critical theory to interrogate and problematize the practice of anonymising research sites as an ethical imperative. The contributing authors conduct research in and with various communities in southern Africa, position themselves and work from and within diverse areas and specialities of the social sciences. This article is developed from their rich and wide spectrum of field experience with a great diversity of communities, but mainly the poorer, under-resourced, socially and economically marginalized. The authors strongly identify with these communities whose anonymity in published research is seen as marginalizing. Such research sites are places and communities where these researchers grew up and live in, and thus not just as peripheral or 'out there' entities. Therefore, the naming of research sites in this context is deemed as being ethical, out of respect for participants, for a contextually embedded understanding, and for well-targeted interventions and policy influence.

Introduction HIV self-testing (HIVST) has the potential to increase uptake of HIV testing among untested populations in sub-Saharan Africa and is on the brink of scale-up. However, it is unclear to what extent HIVST would be supported by stakeholders, what policy frameworks are in place and how variations between contexts might influence country-preparedness for scale-up. This qualitative study assessed the perceptions of HIVST among stakeholders in three sub-Saharan countries. Methods Fifty-four key informant interviews were conducted in Kenya (n=16), Malawi (n=26) and South Africa (n=12) with government policy makers, academics, activists, donors, procurement specialists, laboratory practitioners and health providers. A thematic analysis was conducted in each country and a common coding framework allowed for inter-country analysis to identify common and divergent themes across contexts. Results Respondents welcomed the idea of an accurate, easy-to-use, rapid HIV self-test which could increase testing across all populations. High-risk groups, such as men, Men who have sex with men (MSM), couples and young people in particular, could be targeted through a range of health facility and community-based distribution points. HIVST is already endorsed in Kenya, and political support for scale-up exists in South Africa and Malawi. However, several caveats remain. Further research, policy and ensuing guidelines should consider how to regulate, market and distribute HIVST, ensure quality assurance of tests and human rights, and critically, link testing to appropriate support and treatment services. Low literacy levels in some target groups would also need context-specific consideration before scale up. World Health Organization (WHO) policy and regulatory frameworks are needed to guide the process in those areas which are new or specific to self-testing. Conclusions Stakeholders in three HIV endemic sub-Saharan countries felt that HIVST will be an important complement to existing community and facility-based testing approaches if accompanied by the same essential components of any HIV testing service, including access to accurate information and linkages to care. While there is an increasingly positive global policy environment regarding HIVST, several implementation and social challenges limit scale-up. There is a need for further research to provide contextual and operational evidence that addresses concerns and contributes to normative WHO guidance.

IntroductionHIV self‐testing (HIVST) has the potential to increase uptake of HIV testing among untested populations in sub‐Saharan Africa and is on the brink of scale‐up. However, it is unclear to what extent HIVST would be supported by stakeholders, what policy frameworks are in place and how variations between contexts might influence country‐preparedness for scale‐up. This qualitative study assessed the perceptions of HIVST among stakeholders in three sub‐Saharan countries.MethodsFifty‐four key informant interviews were conducted in Kenya (n=16), Malawi (n=26) and South Africa (n=12) with government policy makers, academics, activists, donors, procurement specialists, laboratory practitioners and health providers. A thematic analysis was conducted in each country and a common coding framework allowed for inter‐country analysis to identify common and divergent themes across contexts.ResultsRespondents welcomed the idea of an accurate, easy‐to‐use, rapid HIV self‐test which could increase testing across all populations. High‐risk groups, such as men, Men who have sex with men (MSM), couples and young people in particular, could be targeted through a range of health facility and community‐based distribution points. HIVST is already endorsed in Kenya, and political support for scale‐up exists in South Africa and Malawi. However, several caveats remain. Further research, policy and ensuing guidelines should consider how to regulate, market and distribute HIVST, ensure quality assurance of tests and human rights, and critically, link testing to appropriate support and treatment services. Low literacy levels in some target groups would also need context‐specific consideration before scale up. World Health Organization (WHO) policy and regulatory frameworks are needed to guide the process in those areas which are new or specific to self‐testing.ConclusionsStakeholders in three HIV endemic sub‐Saharan countries felt that HIVST will be an important complement to existing community and facility‐based testing approaches if accompanied by the same essential components of any HIV testing service, including access to accurate information and linkages to care. While there is an increasingly positive global policy environment regarding HIVST, several implementation and social challenges limit scale‐up. There is a need for further research to provide contextual and operational evidence that addresses concerns and contributes to normative WHO guidance.