A development challenge in a crisis state - 'HIV and AIDS prevention in Zimbabwe': a case of Harare residents

Chiware, Sithembile (2013) A development challenge in a crisis state - 'HIV and AIDS prevention in Zimbabwe': a case of Harare residents. Masters thesis (MPhil), University of Sussex.

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Abstract

Background: This thesis critically examines the prevailing socio-economic and political conditions and how they impact on health behaviour change for Harare residents. The study examines the effectiveness of Behavioural Change Programmes (BC) as a Human immunodeficiency virus (HIV) prevention strategy when a country is in a crisis1. Zimbabwe is one of the 189 countries that have committed themselves to a comprehensive programme of national commitment and action to fight the HIV and AIDS epidemic by adopting the United Nations General Assembly Special Session (UNGASS) Declaration of Commitment on HIV and AIDS of June 2001. The Declaration of Commitment established a number of goals for the achievement of specific quantifiable and time-bound targets, including reductions in HIV infection among infants and young adults; improvement in HIV and AIDS education; health care and treatment; improvement in orphan support. In recent years, the Government of Zimbabwe (GoZ) has credited its HIV and the Acquired Immunodeficiency Syndrome (AIDS2) prevention strategies, in particular the BC programmes as the main driver of the significant decline in HIV prevalence rates3 from as high as 23.7% in 2001 to just 14.3 % in 20104. This exceptional decline occurred in the midst of economic meltdown, social breakdown, disorganisation, and an intolerable political environment in the country.

1 A Crisis in this thesis is defined as an event that leads to an unstable and dangerous situation affecting an individual, group, community or the whole society. It is negative changes in the security, economic, political, societal or environmental affairs, especially when they occur abruptly, with little or no warning. (Borodzicz, 2005).
2 A disease of the human immune system caused by the HIV. This condition progressively reduces the effectiveness of the immune system and leaves individuals susceptible to infections, (Weiss, 1993).
3 The number of people living with HIV in a defined population within a specified period.

Method: In attempting to analyse the dynamics between HIV and AIDS prevention programmes and Behavioural Change (BC) in a crisis state, this thesis is based upon fieldwork that was conducted in Harare, the capital city of Zimbabwe from March to December 2007. The methodologies used include a structured questionnaire, a series of in-depth interviews with selected key informants, participatory observations and secondary data collection. This was followed by inputting and critically analysing the data using computer software. However some of the statistics have since been up-dated to reflect new realities on the ground.

Theoretically, the study was based on the Health Belief Model (HBM) in attempting to predict sexual behavioural change in Harare . The HBM provided a deeper understanding of how people think about the risks of contracting a disease and how they make decisions regarding those risks. Other variables outside the HBM such as socio-economic factors, social norms and peer- influence on people's decisions regarding their health behaviours were also incorporated. The thesis is not entirely a comparative study per se; however a comparative analysis between different variables such as age, sex, income and levels of education was conducted to contribute to the theoretical formation of effective prevention models.

4 Ministry of Health and Child Welfare, Zimbabwe National HIV Estimates 2009

Results and Conclusion: Key research findings and the principal conclusion is that certainly, HIV prevalence rates in Zimbabwe have significantly declined. However, there needs to be favourable conditions that enable behavioural change to occur within a given population, and Zimbabwe does not seem to demonstrate these conditions. There are numerous other factors that have contributed to this decline, factors that conflict with the sole explanation by the Government that it is through their HIV and AIDS prevention strategies. The study concludes by arguing that declining HIV prevalence rates do not necessarily occur as a result of a successful intervention, in fact, a failure in HIV prevention strategies can also result in the decline in prevalence rates.

Item Type: Thesis (Masters)
Schools and Departments: School of Global Studies > Geography
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0643 Communicable diseases and public health > RA0644 Individual diseases or groups of diseases, A-Z > RA0644.A25 AIDS. HIV infections
Depositing User: Library Cataloguing
Date Deposited: 12 Dec 2013 11:21
Last Modified: 17 Sep 2015 13:03
URI: http://srodev.sussex.ac.uk/id/eprint/47125

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