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Cultural Practices and Beliefs Affecting Hiv and Aids Management Among Tsonga People in Bushbuckridge

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Cultural Practices and Beliefs Affecting Hiv and Aids Management Among Tsonga People in Bushbuckridge CULTURAL PRACTICES AND BELIEFS AFFECTING HIV AND AIDS MANAGEMENT AMONG TSONGA PEOPLE IN BUSHBUCKRIDGE by LYNETTE FANISA BALOYI Submitted in accordance with the requirements for the degree of DOCTOR OF PHILOSOPHY IN NURSING in the subject HEALTH STUDIES At the UNIVERSITY OF SOUTH AFRICA PROFESSOR AH MAVHANDU-MUDZUSI 2019 STUDENT NUMBER 582-632-2 DECLARATION I Lynette Fanisa Baloyi declare that “CULTURAL PRACTICES AND BELIEFS AFFECTING HIV AND AIDS MANAGEMENT AMONG TSONGA PEOPLE IN BUSHBUCKRIDGE” is my original work. I declare that all sources that I have used or quoted have been acknowledged through reference. This work has not been submitted for any other degree at any other institution of higher learning. 23 September 2019 Signature Date ii DEDICATION I am dedicating this thesis to the following: • My late dad, Phillip Charles Baloyi whose love for education was immeasurable, • My mother Busisiwe Mabel Baloyi for caring and supporting schooling, • My one and only late brother Sydney Baloyi for encouraging me through his eloquence in English, • My late sister Sponono and my three sisters Sonty, Zodwa, Zandy and my only child, Carol and her family. iii ACKNOWLEDGEMENTS I would like to thank God Almighty for keeping me safe until the completion of this research. For the rest of the period when I was busy with this work, I have approached different people who contributed a lot and supported me to continue doing this work. It is not possible to list all of them here. However, I would like to send my special thanks to the following: • Prof AH Mavhandu-Mudzusi for making sure that this thesis is taking good shape and is completed. Your effort and encouragement have really helped. • Prof MM Moleki who encouraged me and handed me to Prof AH Mavhandu- Mudzusi who ensured that there was progress. • Prof AS Van der Merwe who supervised me during the proposal phase of this research. • University Ethics Committee, Mpumalanga Province, Bushbuckridge Sub-district, and supervisors of Primary Health Care facilities who made it possible for me to conduct the study. • Unisa Bursary section for funding my studies. • The editors of this thesis. • Mr VA Kheswa, the librarian for Health Studies students who assisted me with all the releVant articles for my studies. • My family members, co-workers, friends and neighbours for encouraging me. • Tsonga community members of Bushbuckridge who were available and volunteered to participate in this study. • Touch Flo internet café’ for assisting me with the technological part of my work. iv ABSTRACT This ethnographic study explored and described practices and beliefs that may have an impact on the management of HIV and AIDS among Tsonga people in Bushbuckridge. Data was collected through face to face in-depth individual interviews with 19 key informants who are highly knowledgeable about the Tsonga culture. The researcher used ethnographic content analysis to analyse data. Findings indicated that language, rituals, beliefs related to the origin of diseases, traditional healers, and tattoos are among Tsonga cultural practices and beliefs that have an impact on management of HIV and AIDS. Some of the practices increase the risk of HIV infection while some assist in the reduction of the risk of HIV infection. Based on the findings of the study and literature, the researcher managed to develop a contextual, cultural approach model for HIV and AIDS management for Tsonga people in Bushbuckridge. The model development was guided by Leininger theory of culture, care, diversity, and universality. To organise the model, the researcher used CIPO model to guide the elements of the cultural approach model. Though the model takes into consideration global and national context, the main focus was the local context in particular Bushbuckridge. The success of this model is dependent on the availability of knowledgeable healthcare practitioners, relevant resources and engaged community structure. The process of the model includes Cultural Care Preservation, Cultural care Accommodation, and Cultural care Re-patterning. The expected output of the model is modification of HIV risky cultural practices, improved health-seeking behaviour, reduction of new HIV infections and reduction of HIV and AIDS-related deaths. Based on the study outcomes, the researcher makes several recommendations in relation to implementation of the model, Nursing Practice and Education, and further research. The study has contributed to the body of knowledge in relation to cultural practices and management of HIV and AIDS. The model can be utilised to enhance nursing education and practice and further research. Key concepts: Acquired Immune Deficiency Syndrome, Culture, Cultural practices, Human Immunodeficiency Virus, Management, Tsonga. v TABLE OF CONTENTS DECLARATION .............................................................................................................. ii DEDICATION ................................................................................................................ iii ACKNOWLEDGEMENTS ............................................................................................. iv ABSTRACT .................................................................................................................... v TABLE OF CONTENTS ................................................................................................ vi LIST OF FIGURES ....................................................................................................... xiii LIST OF TABLES ........................................................................................................ xiv LIST OF ANNEXURES ................................................................................................ xv LIST OF ABBREVIATIONS ......................................................................................... xvi CHAPTER ONE: ORIENTATION OF THE STUDY ....................................................... 1 1.1 INTRODUCTION ...................................................................................................... 1 1.2 BACKGROUND TO THE RESEARCH PROBLEM .................................................. 1 1.3 PROBLEM STATEMENT ......................................................................................... 2 1.4 PURPOSE OF THE STUDY ..................................................................................... 3 1.5 RESEARCH OBJECTIVES ...................................................................................... 3 1.6 RESEARCH QUESTIONS ....................................................................................... 3 1.7 SIGNIFICANCE OF THE STUDY ............................................................................. 4 1.8 DEFINITIONS OF KEY CONCEPTS ........................................................................ 4 1.8.1 Acquired Immune Deficiency Syndrome (AIDS) .................................................... 4 1.8. 2 Beliefs................................................................................................................... 4 1.8.3 Cultural practices ................................................................................................... 5 1.8.4 Human Immunodeficiency Virus (HIV) .................................................................. 5 1.8.5 Management ......................................................................................................... 5 1.8.6 Tsonga .................................................................................................................. 5 1.9 THEORETICAL FOUNDATION OF THE STUDY..................................................... 5 1.9.1 Theoretical framework ........................................................................................... 5 1.9.2 PARADIGM ........................................................................................................... 7 1.9.3 Research Approach ............................................................................................... 8 vi 1.9.4 Research Design ................................................................................................... 8 1.10 RESEARCH METHODOLOGY .............................................................................. 9 1.11 MEASURES TO ENSURE TRUSTWORTHINESS ................................................. 9 1.12 ETHICAL CONSIDERATIONS ............................................................................... 9 1.13 STRUCTURE OF THE STUDY .............................................................................. 9 1.14 CONCLUSION ..................................................................................................... 11 CHAPTER TWO: LITERATURE REVIEW.................................................................... 12 2.1 INTRODUCTION .................................................................................................... 12 2.2 SEARCH PROTOCOL ........................................................................................... 12 2.2.1 Formulation of an aim, review objective and relevant review question ................ 12 2.2.2 Keywords and Search Terms .............................................................................. 13 2.2.3 Inclusion Criteria .................................................................................................. 13 2.2.4 Search Strategy ................................................................................................... 13 2.3 APPRAISAL AND SYNTHESIS OF LITERATURE ...............................................
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