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RESEARCH project submitted to the SCHOOL of. IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF A. DEPARTMENT OF University. EFFECTS OF WOMEN LITERACY ON COMMUNITY HIV / AIDS LEVEL of control in KENYA: a SURVEY of ELDORET TOWN.
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Effects of Women Literacy on Community Hivaids Level of Control in Kenya
RESEARCH project submitted to the SCHOOL of. IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF A. DEPARTMENT OF University. EFFECTS OF WOMEN LITERACY ON COMMUNITY HIV / AIDS LEVEL of control in KENYA: a SURVEY of ELDORET TOWN.
RESEARCH project submitted to the SCHOOL of. IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF A. DEPARTMENT OF University. EFFECTS OF WOMEN LITERACY ON COMMUNITY HIV / AIDS LEVEL of control in KENYA: a SURVEY of ELDORET TOWN.
LEVEL OF CONTROL IN KENYA: A SURVEY OF ELDORET TOWN
By
A RESEARCH PROJECT SUBMITTED TO THE SCHOOL OF
. IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF A .. DEPARTMENT OF .. UNIVERSITY DATE.. DECLARATION Dec!"!#$%& 'y C!&($(!#e I declare that this project is my original work and that it has neither been presented in any other institution for examination and/nor for the award of a certificate. That no part of this work shall be reproduced without the consent of the author and/or that of the .. University. N!)e: . . S$*&.. D!#e Dec!"!#$%& 'y S+,e"-$.%" I declare that this project has been submitted for examination with my authority as .. University upervisor. N!)e: .. S$*&.. D!#e ii DEDICATION To my family members! relatives and colleagues iii ACKNOWLED/EMENT I would like to first of all acknowledge the presence of "lmighty #od for giving me the grace and power to write this research project. I would like to acknowledge the effort of my supervisor . for wise guidelines commitment! advice and encouragement throughout this work. I could also appreciate my parents through their commitment s both morally and financial assistance. .. University! and the $unicipal %ouncil of &ldoret all deserve my kind and heartfelt appreciation! were it not for them this .. would have not been possible. 'n the other hand I would also dedicate my project to all my fellow students of for their wise guidelines! motivation! criticism and encouragement in . iv ABSTRACT $any people are still suffering from (I)/"I* infections despite all those control and management strategies in place for people affected by (I)/"I*. %ommunity responses to the (I)/"I* pandemic already include self+sacrificing home+based care for the sick and the matter+of+fact integration of orphans into already stressed extended families. The educational programme on (I)/"I* control may have a considerable impact on increasing consistent control and management of (I)/"I*. &ven with the much published information in the media! electronic! and or print media! there are still people! especially women and the vulnerable groups! suffering from the disease. *oes women literacy protect against (I) infection through the health skills and disease related information it transmits to learners! or is there something inherent in the very process of becoming more literate that helps themselves protect against infection, -hile they are clearly right to argue that the increased knowledge! information and awareness that education provides are important protectors against infection! it is believed that the general impact of education in and of itself may be the most significant factor. It is either they are health illiterate or ignorant or even lacking resources to help tackle this challenge. Therefore the purpose of this study was to investigate on the impacts of -omen .iteracy on (I)/"I* control in /enya. The objective of this study was to find out the forms of health literacy types of women on (I)/"I*. The findings of the study will be useful to policy makers on (I)! which would result in the legislative acts which provide protection to government employees! labour organi0ations! the educational sector! and private entities. The study was guided by the theory of (ealth .iteracy developed by -ood! 123334. To achieve the objectives of the study! survey research design was adopted and the focus of this study was cross+sectional. The study was carried out at selected community health centres in &ldoret Town. &ldoret is a town in western /enya and the administrative centre of Uasin #ishu *istrict of 5ift )alley 6rovince. The total population is approximately 7893 employees of the surveyed community health centres. The participants in this study were :878 192; females! and <=; males4 from selected community health centres in the entire &ldoret town. The study targeted a cross section of employees from various departments across all levels and areas of work. The researcher distributed the >uestionnaires randomly! which were clarified and explained ade>uately to the respondents. The >uestionnaires were collected on agreed dates. It used tables! charts! percentages! and chi s>uare was also be used in analysis the .ikert scaled data. The study found out that educationally disadvantaged women were not able to access information on (I)/"I* control due to socio+economic pressures. The results of the survey clearly indicated a significant gap in knowledge about (I) prevention among women. ?irstly! more effective measure should be taken to ensure and subsidi0e female adolescents to finish twelve years of compulsory educations@ this will not only reduce women entering in to commercial sex but will increase protection use among 6rotections and their clients. v TABLE OF CONTENTS C%&#e&# P!*e *eclaration..............i *edication..ii "cknowledgement............iii "bstract.iv Table of %ontents..v .ist of ?igures..vii .ist of Tables..........viii .ist of "bbreviations and "cronymsix 'perational *efinitions of Terms......x CHAPTER ONE: INTRODUCTION :.3 Introduction..........: :.: Aackground to the tudy..........: :.2 tatement of the 6roblem.< :.8 'bjectives of the tudy7 :.9 5esearch Buestions..........= :.< 5esearch (ypotheses...= :.C ignificance of the tudy.= :.7 cope and .imitations of the tudy.D :.7.: The cope of the tudy.D :.7.2 .imitations of the tudyD :.= Theoretical ?ramework......:3 CHAPTER TWO: LITERATURE REVIEW 2.3 Introduction:: 2.: (istorical *evelopment of .iteracy...:: 2.2 The Theoretical ?ramework.......:8 2.:.: The %oncept of (I)/"I* %ontrol:9 2.8 5eview of .iterature......:< 2.9 Issues affecting access to literacy programmes.........:< 2.< The impact of -omen literacy on (I)/"I* control...:C 2.C The ambiguous role of literacy in the context of (I)/"I*.........:7 2.7 "ccess to (ealthcare and (ome $anagement of (I)......:7 2.= Information .iteracy on (I)/"I* 6revention of Transmission.........:= 2.D .iteracy on 6revention of (I)/"I*:D 2.:3 The Impact of .iteracy and the (I)/"I* %ontrol2: 2.:3.: Using literacy to protect against (I) infection22 2.:: ummary of .iterature.....28 CHAPTER THREE: RESEARCH DESI/N AND METHODOLO/Y 8.3 Introduction....2< 8.: 5esearch *esign.2< 8.2 The tudy "rea..2< 8.8 Target 6opulation...2C 8.9 ample i0e and ampling Techni>ues.2C 8.< *ata %ollection 6rocedure.27 vi 8.C *ata %ollection Instruments..27 8.C.: Buestionnaire..2= 8.7 6ilot tudy..2D 8.7.: )alidity of the Instruments.....2D 8.7.2 5eliability of the Instruments..2D 8.= *ata "nalysis.83 CHAPTER FOUR: DATA PRESENTATION0 ANALYSIS AND INTERPRETATION 9.3 Introduction....8: 9.: *emographic Information..8: 9.:.: .iteracy of 5espondents.82 9.:.2 5espondents "ge *istribution82 9.:.8 5espondents $arital tatus82 9.:.9 5espondents &ducational .evel..88 9.:.< 5espondents .ength of tay in the *epartment.88 9.2 6resentation of #eneral Information..89 9.8 /nowledge on (I)/"I* Transmission...89 9.9 ources of information on (I)/"I*...8< 9.< /nowledge on (I)/"I* 6revention...8C 9.C Impact of (I)/"I* on the &ducation ector and 5espondents in 6articular..87 9.7 5espondentsE %oping $echanisms....87 9.= 6ercentage distribution of respondents by age and knowledge of (I) transmission8= 9.D 6ercentage distribution of respondents by education and knowledge of (I) transmission..8D 9.:3 6ercentage distribution of respondents by duration and knowledge of (I) transmission...93 9.:: 6ercentage distribution of respondents by last weekEs income and knowledge of (I) transmission..9: 9.:2 6ercentage distribution of respondents by area and knowledge of (I) transmission.9: 9.:8 6ercentage distribution of respondents with participation in activity of (I) prevention program by knowledge of (I)/"I*92 9.:9 6ercentage distribution of respondents by self perceived risk and knowledge of (I) transmission92 9.:< "ssociation between safe sex practice and socio demographic characters98 9.:CF 6ercentage distribution of safe sex practice of -omen literacy by socio demographic factors! programmatic factors! psycho+social factors and knowledge of (I) transmission..99 CHAPTER FIVE: DISCUSSIONS0 CONCLUSIONS AND RECOMMENDATIONS <.3 Introduction9C <.: *iscussions of ?indings.9C <.2 %onclusions97 vii <.8 5ecommendations..9D <.9 uggestions for further tudies..9D 5eferences<3 "ppendices...<8 viii LIST OF FI/URES F$*+"e P!*e ?igure 9.:F 5espondentsE %oping $echanisms.8= ix LIST OF TABLES T!'e P!*e Table 8.:F ampling ?rame......27 Table 9.:F .iteracy *istribution of 5espondents.82 Table 9.2F 5espondents "ge *istribution82 Table 9.8F *istribution of 5espondents $arital tatus88 Table 9.9F *istribution of 5espondents .evel of &ducation88 Table 9.<F .ength of tay in the *epartment..89 Table 9.CF /nowledge on (I)/"I* Transmission8< Table 9.7F ources of Information on (I)/"I*8< Table 9.=F /nowledge on (I)/"I* 6revention....8C Table 9.DF 5espondentsE $ost 5eferred ource of Information on (I)/"I*..8C Table 9.:3F Impact of -omen .iteracy on (I)/"I* %ontrol..87 Table 9.::F 6ercentage distribution of respondents by age and knowledge of (I) transmission 1GHD3=4...8D Table 9.:2F 6ercentage distribution of respondents by education and knowledge of (I) transmission 1GH=D24.8D Table 9.:8F 6ercentage distribution of respondents by duration and knowledge of (I) transmission 1GHD3=4...93 Table 9.:9F 6ercentage distribution of respondents by last weekEs income and knowledge of (I) transmission.9: Table 9.:<F 6ercentage distribution of respondents by area and knowledge of (I) transmission 1GHD3=4.9: Table 9.:CF 6ercentage distribution of respondents with participation in activity of (I) prevention program by knowledge of (I)/"I* 1GHD3<4...92 Table 9.:7F 6ercentage distribution of respondents by self perceived risk and knowledge of (I) transmission..92 Table 9.:=F 6ercentage distribution of safe sex practice of -omen literacy by socio demographic factors! programmatic factors! psycho+social factors and knowledge of (I) transmission..99 x OPERATIONAL DEFINITION OF TERMS AIDS+ "c>uired immune deficiency syndrome ART1 "ntiretroviral treatment BSS +Aehavioral urveillance urvey HIPAA1 (ealth Insurance 6ortability and "ccountability "ct ILY1International .iteracy Iear SPSS +tatistical 6ackage for ocial ciences SSA1 ub+aharan "frica STI.+exually Transmitted Infections IEC+Information! &ducation and %ommunication CCB+%ommunication for %hange of Aehaviour xi CHAPTER ONE: INTRODUCTION 2.3 I&#"%(+c#$%& This chapter gives provides the background of the study! the statement of the problem! the objectives of the study! the research >uestions! hypotheses of the study! the significance of the study! the scope and limitation of the study and finally theoretical framework. 2.2 B!c4*"%+&( #% #5e S#+(y There is a popular assertion that information is power! wealth and most importantly good health and that good health is a prere>uisite for wealth and power ac>uisition. %orrect information has the ability to make a U+turn in the life of an individual! family! community! region and the nation at large if properly exploited. Information and conse>uently health is an indispensable instrument for individual/national/regional/global development. ustainable development re>uires a healthy and vibrant workforce empowered with the right kind of information and tools. "c>uired immune deficiency syndrome 1"I*4 is a major public health problem. In 2337! worldwide over 88 million people were infected with human immunodefiency virus 1(I)4! the cause of "I*. In the same year! an estimated 2.7 million new infections occurred. UG"I*! 1233=4 estimated that 2 million people died from "I*+related illnesses in 2337. ub+aharan "frica 1"4 is the worst affected area! with some countries still experiencing an expansion of the epidemic. The prevalence of (I) varies enormously within "F it is much higher in east and southern "frica than in west and central countries. (I)+positive people will develop "I* within = to :3 years after infection and die one to two years later! unless they take antiretroviral treatment 1"5T4. They die from opportunistic infections such as tuberculosis! from cancer! or from general weakening and wasting. (I) is transmitted by unprotected sexual contact! by needle exchange in intravenous drug use! and through vertical transmission from mother+to+child. If infected blood comes into contact with an open wound intravenous drug use or blood transfusions4! (I) can be transmitted. The transmission of (I) from mother+to+child can occur during pregnancy! at childbirth or during breastfeeding. -ithout preventive treatment! the transmission rate from mother+to+child before : or during birth is around 2< percent. This can be reduced to one percent if antiretroviral drug treatment and caesarean section are available. 6revention through reducing risk behaviour is the key in reducing (I) infection! since "5T treatment coverage in the developing world remains low and after more than 23 years of research an effective vaccine is not yet available. $oreover! "5T does not cure the patient and the viral load may return to high levels after treatment is stopped. The different behavioural interventions to prevent (I) transmission are described below. (ealth education can impact the (I) prevalence by changing risk behavior. J"A% campaignsE are an example of health education in which people are advised to delay sexual debut or abstain from sex 1" from "bstinence4! to reduce the number of partners and stick to one partner 1A from Ae faithful4! and to use protections. Unfortunately! the "A% approach has only occasionally achieved significant behavior change and it continues to be debated among experts in (I) prevention. %orrect use of latex protections reduces the risk of sexual transmission of (I) by about =<;. If protections are used consistently! the effectiveness can be as high as D<;. *isadvantages of protections are that they are not always accepted! and that they need a continuous supply. 6rotections are also not used if pregnancy is wanted. The use of protections depends on the type of partnerF it is often higher during commercial sex contacts than with regular partners. The uptake of other physical barriers! such as female protections and diaphragms! has been modest. *iaphragms may in the future play an important role as a mechanism to deliver antimicrobial or antiretroviral products. "mong the alternative educational delivery systems currently being explored is the use of interactive radio. The appointment of itinerant respondents! based at central schools! who oversee tutors engaged by community groups! is another. 5ecogni0ing that the standard formal school system is not ade>uately e>uipped to meet the needs of all children! some communities have established their own schools! with their own respondents! curricula and management structures. " community+based school may be able to respond very rapidly to community and learner needs and may benefit from the commitment fostered by local ownership and control. 2 Aut community based schools run the risk of becoming second+rate educational institutions serving only the poorest students. There is the especially troubling possibility that governmental education authorities may view the establishment of such schools as absolving them of responsibility for the education of the communities they serve and thus for some of those most in need of public assistance. The world is therefore is looking for viable techni>ues of eradicating the scourge! this calls for more awareness campaigns which is done through health literacy capacity buildings. (ealth literacy is crucial if patients are to benefit from health care. 6eople who cannot read or understand the words used to describe health problems! diagnostic tests! medications! and directions for care experience yet another source of confusion in negotiating the health care system and are significantly handicapped in the tasks of self+care or caring for family members. The state of general functional literacy in the United tates is not high. "ccording to the Gational "dult .iteracy urvey 1/irsch! et. al.! :DD84! nearly half of all adult U.. citi0ens have difficulty with reading skills. The state of health literacy can be even lower than general functional literacy because the medical vocabulary people encounter in health care settings or in the news is more complex than that of other areas of life! and because changes in the nature of illness from episodic to chronic conditions and in health care delivery now re>uire patients to be active participants in their care. ?or example! the patient is the primary caregiver in diabetes. The health care provider assists the patient! since nearly all diabetes care occurs outside the formal health care environment. In addition to self+care for illness! patients must now make critical life choices on entrance into the health care system. %onsent to treatment! (ealth Insurance 6ortability and "ccountability "ct 1(I6""4 acknowledgements! advanced directives! health history forms! and assignment of responsibility all must be completed before entering the patient treatment area. The actual instructions for care! directions to other facilities for diagnostic procedures known by either mystifying initials or KhardL names like Kcomputeri0ed tomography!L and prescriptions and product inserts that appear to be written in a 8 foreign language are difficult enough for educated people but can be overwhelming to those with limitations in health literacy. The only health literacy research focused on a rural population 1$ontalto et. al.! 233:4 was conducted to assess the literacy level of a clinic population and the resultant adjustments in care made by the health care providers. (ealth care providers who are aware of the very real ill effects of low health literacy may be more willing to consider it in their care. -illiams! Aaker! 6arker! and Gurss 1:DD=4 compared the health literacy of people with hypertension and diabetes to knowledge about the disease and found that only around half of those with inade>uate health literacy knew important clinical signs re>uired for disease self+management. #lycemic control was worse for people with diabetes and health literacy problems according to chillinger et al. 123324. The combination of inade>uate health literacy and chronic illness! such as diabetes! reduces the likelihood that people will participate in their care to the extent needed for effective disease management 1%hwedyk! 23384. The complexity of adherence to (I) therapies is made more difficult for those with low health literacy. Interventions directed at those with low health literacy were recommended after health literacy was identified as an independent predictor of missed drug doses for (I)+seropositive men and women 1/alichman! et. al.! :DDD4. It is important that new methods are developed for women to protect themselves! since it may be difficult for them to negotiate protection use. 6r&6 pills and microbicides are good options! since they can be used before sexual intercourse! and women themselves can be in control. Unfortunately! safe and effective microbicides have not been found yet. " recent review of microbicides trials showed that four trials were stopped prematurely due to poor safety and efficacy. 'ne completed trial showed no reduction in (I) ac>uisition and in an ongoing study a low dose trial arm was discontinued. ome fear that the use of new (I) interventions may lead to risk compensation that is the increase in risk behavior when people feel themselves protected by the new intervention. This is especially important if new interventions are only partially effective! which most often the case is. 5isk compensation due to a false sense of security has been reported in vaccine safety trials and could also occur in male circumcision and 6r&6. "dditional information and 9 education should be provided to people who visit health care centers to obtain their pills or to undergo circumcision. " recent study showed that participating in a 6r&6 trial in #hana decreased risk behavior! probably as a conse>uence of counseling and associated protection provision 6roblems with health literacy also increase the costs of care. %ompared with persons with ade>uate health literacy! persons of low health literacy experienced greater difficulty in navigating the health care system 1-eiss! :DDD4! <3; more hospital admissions 1Aaker! -illiams! 6arker! and %lark! :DD=4! and more errors in personal health management 1-illiams! et. al.! :DD=4. &stimates of 233: expenditures for health care as a result of low literacy ranged from M82+<= billion 1%enter for (ealth %are trategies! 23384. 2.6 S#!#e)e&# %7 #5e P"%'e) $any people are still suffering from (I)/"I* infections despite all those control and management strategies in place for people affected by (I)/"I*. The government is also challenged by the scourge as it needs large capital resources to alleviate the (I) situation in the country. %ommunity responses to the (I)/"I* pandemic already include self+sacrificing home+based care for the sick and the matter+of+fact integration of orphans into already stressed extended families. %ommunity participation+which would be vital to social development whether or not there were an (I)/"I* crisis+must also be central to the transformation of the education delivery system in response to the challenges of (I)/"I*. The educational programme on (I)/"I* control may have a considerable impact on increasing consistent control and management of (I)/"I*. -ith stigmati0ation and discriminatory attitude towards people living with (I)/"I*! it is difficult to approach these individuals in the community setting with preventive efforts and safe sexual practices. ?urthermore! the public campaigns and advertisement on (I) and its prevention! often carried in the electronic media do not get to majority of the populace because of poor access to such facilities. This could account for the poor knowledge of (I) found at baseline among our respondents. < The impressive increased consistency (I)/"I* control during the follow up period demonstrated how efficacious such intervention programme for (I) positive individual. -ith such good knowledge! respondents that engage in risky sexual practices like multiple sex partners will appreciate the need for consistent protection use to prevent (I) and TIs. (igher educational attainment which no doubt will increase the knowledge of (I) transmission is also a significant predictor of consistent protection use. *espite the absence of a medical vaccine against (I) infection! society has at its disposal a Nsocial vaccineO! the vaccine of education. everal strategies have been established to expound on the notion of good health through user friendly health information packages and these include the I&% 1Information! &ducation and %ommunication4 or %%A 1%ommunication for %hange of Aehaviour4 amongst others. To achieve better health for the greater majority of the population the right kind of information must be obtained through a variety of channels basically involving research. " well designed study will produce information that targets specific problems thus improving on decision making and conse>uently a positive >uality of life. %onversely! poorly collected data misinforms and breeds bad policies with resultant adverse effects on the population. 'nce the right information has been generated! it has to be packaged in a user friendly manner that will be better understood by the end users or the community. 'nce this information is understood the resultant effect is appropriate health education of the individual! family or community. ?or example! in the past! children presenting with convulsions either from infections or particularly from cerebral malaria were taken to pit toilettes and their heads inserted through the hole for some period. This was thought to cure the child of some bad spirit or the underlying ailment. Thanks to information and education! parents now know that convulsing children should be sponged with water to bring down their body temperature before they are rushed to the nearest health care facility. This information has reduced the high fatality rate of convulsing children as was the case in the past. (ealth information can therefore avoid health epidemics and also improve on the >uality and efficiency of health care service delivery by providing tools to help health care professionals deliver the highest >uality of care. C &ven with the much published information in the media! electronic! and or print media! there are still people! especially women and the vulnerable groups! suffering from the disease but are not aware of how to handle the situation. *oes women literacy protect against (I) infection through the health skills and disease+ related information it transmits to learners! or is there something inherent in the very process of becoming more literate that helps themselves protect against infection, -hile they are clearly right to argue that the increased knowledge! information and awareness that education provides are important protectors against infection! we believe the general impact of education in and of itself may be the most significant factor. It is either they are health illiterate or ignorant or even lacking resources to help tackle this challenge. Therefore the purpose of this study was to investigate on the impacts of -omen .iteracy on (I)/"I* control in /enya. 2.8 O'9ec#$-e. %7 #5e S#+(y The general objective of this study was to investigate on the impact of women literacy on (I)/"I* control in /enya. The specific objectives includedF i4 To find out the forms of health literacy types of women on (I)/"I* ii4 To find out the causes of -ork 6lace+.iteracy related (I) control iii4 To examine if there exist strategies of elimination of (I) in work places iv4 To examine how education has contributed to the existence and/or non+existence of -ork 6lace+.iteracy related (I) control behaviours 2.: Re.e!"c5 Q+e.#$%&. The general research >uestion of this study wasF what is the impact of education on women (I) control in the work places, The specific research >uestions includedF i4 -hat are the types of (I) control common in the work places, ii4 -hat are the causes of -ork 6lace+.iteracy related (I) control, iii4 -hich strategies are used to eliminate (I) in work places, iv4 (ow education has contributed to the existence and/or non+existence of -ork 6lace+.iteracy related (I) control behaviours, 7 2.; Re.e!"c5 Hy,%#5e.e. H3 2 : -ork 6laces are prone to (I)s H3 6 : There is no association between education and (I) in work places 2.< S$*&$7$c!&ce %7 #5e S#+(y The findings of the study will be useful to policy makers on (I)! which would result in the legislative acts which provide protection to government employees! labour organi0ations! the educational sector! and private entities that employ :< or more workers. In addition to the issue of e>ual pay! prohibitions against literacy+based (I) control apply to health and insurance benefits! vacation pay! bonuses and stock options! and reimbursement for business+related travel expenses. In :DD8! passage of the ?amily and $edical .eave "ct entitled workers to job security/restoration during approved absences related to personal and family medical emergencies. This legislation also acknowledged for the first time that attending to sick family members wasnOt just the purview of women. -omen in "merica were first granted the right to vote in :D23. Ay :D9=! the United Gations had developed and implemented the Universal *eclaration of (uman 5ights! giving women world+wide the right to vote when it stated that P&veryone has the right to take part in the government of his country! directly or through freely chosen representatives. The will of the people shall be the basis of the authority of government@ this will be expressed in periodic and genuine elections which shall be by universal and e>ual suffrage and shall be held by secret vote or by e>uivalent free voting procedures. Thus the study will add value to the knowledge of the current campaigns against (I) in the work places! politics! and socio+economic activities. 2.= Sc%,e !&( L$)$#!#$%&. %7 #5e S#+(y 2.=.2 T5e Sc%,e %7 #5e S#+(y The study was carried out in selected organisations in &ldoret town! 5ift )alley 6rovince. This area of coverage was reliable in obtaining the information suitable to achieve the objectives of the study. " larger coverage would have been essential! as it would have reduced the degree of sampling error thus improving on the findings but the small area was opted for. "lso the study was based on the theoretical framework in which only the variables under the theory would be = considered for (I) in work places created a smaller scope of coverage for the study. This means that any variable! or phenomenon outside this scope whether important would not be considered for investigation. 2.=.6 L$)$#!#$%&. %7 #5e S#+(y everal limitations may have affected the outcomes of this research. ?irst! selection bias may have excluded those who were unable to read who did not want to reveal their literacy problems. If this did occur! the results would have yielded an even greater literacy problem within the rural clinic clientele. hame and embarrassment are common among those with literacy difficulties! and making the choice not to participate in a study in which the patient would perform poorly is a self+protective mechanism. Those who attempt to conceal their literacy difficulties are at increased risk for treatment failure if they are unable to follow written prescriptions. econd! the proportion of ethnic minorities in the sample was not large enough to represent rural "frican "mericans. ?urther research should strive to achieve diversity in the sample to assess if a difference exists in the health literacy of rural dwellers based on ethnicity. ?inally! vision of the participants was not assessed and may have affected the performance of some of the participants! although none indicated difficulty during data collection. 'ne of the most common reasons given for inability to complete forms is vision difficulty. KI forgot my glassesL may actually mean KI cannot read these words.L "ssessment of visual acuity by the researchers will ensure that the word recognition is not limited by inability to see the printed words. 2.> T5e%"e#$c! F"!)e?%"4 The study was guided by the theory of (ealth .iteracy developed by -ood! 123334. The theory refers to the ability to use and correctly interpret health information is important for people who contend with one or more chronic diseases. 'ften! those with chronic illness have complex medical management needs! and likely take multiple prescription drugs. The oral or written instructions for medication management may be insufficient or confusing. This is a patient D safety issueF non+adherence or misuse of medications can result if patients do not understand their prescriptions. It suggests that patients with lower literacy levels and those who take a greater number of medications were less able to understand their medication labels. The study found that even if patients understood the words on the label! most could not correctly demonstrate how to take the medication suggesting the importance of communicating clear directions and assisting with any skill+building necessary to take the medication as directed. :3 CHAPTER TWO: LITERATURE REVIEW 6.3 I&#"%(+c#$%& This chapter involves systematic identification! location and analysis of the previous studies related to the matter under investigation. It is useful chapter that entails analysis of casual observations and opinions related to this study. %hapter two! through the literature review! helped the researcher to get a thorough understanding and insight into past works and trends records concerning the conflicts in organi0ational settings. The literature review enabled the researcher to identify key areas that have thoroughly been researched on the strength of weaknesses of past researchers! and identify the gaps to be filled from these studies. 6.2 H$.#%"$c! De-e%,)e&# %7 L$#e"!cy The increased knowledge! skills! attitudes! and self+confidence that come with ac>uisition of literacy skills have been demonstrated to help women in many waysF they more effectively pursue income+generating activities 1-orld Aank! :DD<4 and become more active in community groups and organi0ations 1"rcher and %ottingham! :DDC4. "dditionally! literate adults better understand the legal system so that they are able to protect themselves from abuse and exploitation 1.ind! :DD<4@ they more effectively pursue their individual and family health needs and they provide better support for their childrenEs schooling. ince its foundation in :D9C! UG&%' has been at the forefront of literacy efforts and dedicated to keeping these high on national! regional and international education agendas. Aeginning with its report on ?undamental &ducation 1:D974! UG&%' has taken great interest in literacy as part of its efforts to promote basic education. Qust as the Universal *eclaration of (uman 5ights defined education as a fundamental right! literacy has also been considered something to which every person is entitled until the mid+:DC3s! a right primarily understood as a set of technical skillsF reading! writing and calculating. 6romoting literacy was fundamentally a matter of enabling individuals to ac>uire these skills! irrespective of the contents and methods of their provision. The nature of literacy work consisted in making it possible for the maximum number of individuals to ac>uire these skills. :: This conception led to mass literacy campaigns aimed at the eradication of illiteracy within a few years 1the econd International %onference on "dult &ducation! $ontreal! :DC34. %ontrary to their intention! such campaigns whose influence is still felt revealed that literacy cannot be sustained by short+term operations or by top+down and unisexual actions primarily directed towards the ac>uisition of technical skills that do not give due consideration to the contexts and motivations of learners and follow up closely on accomplishments. "nother lesson learnt in the more successful campaigns! often carried out in overtly political frameworks! has to do with the important role played by political will and social mobili0ation in literacy efforts 1Ahola! :D=94. The :DC3s and :D73s brought attention to the ways in which literacy is linked with socio+ economic development! and the concept of Kfunctional literacyL was born. 6rogrammes for functional literacy designed to promote reading and writing as well as arithmetical skills necessary for increased productivity were the subject of many national and international campaigns. ?or all that! the concept of Kfunctional literacyL marked a turning point in the modern history of education. It allied education and especially literacy with social and economic development and expanded the understanding of literacy beyond the imparting of basic technical skills 1-orld %ongress of $inisters of &ducation on the &radication of Illiteracy! Teheran! :DC<4! if only with a view to increased productivity. %ontributing to this expanded understanding! 6aulo ?reire honoured by UG&%' for his literacy work in :D7< R spotlighted the political dimension of literacy. (e developed a method for teaching literacy in terms of cultural actions immediately relevant to the learner. Aest known is his method of Kconscienti0ationL! which encourages the learner to >uestion why things are the way they are and to undertake changing them for the better 1?reire! :D724. This approach moved literacy beyond the narrow socio+economic confines of the &xperimental -orld .iteracy 6rogramme and located it s>uarely in the political arena! emphasi0ing connections between literacy and politically active participation in social and economic transformation In the :D=3s and :DD3s! this work served as the basis for the further elaboration of what literacy means and how it is ac>uired and applied. *uring International .iteracy Iear 1I.I4 in :DD3! UG&%' and the international community addressed literacy issues for all age groups in both industriali0ed and developing countries. :2 6.6 T5e T5e%"e#$c! F"!)e?%"4 The theory of health literacy is the ability to use and correctly interpret health information is important for people who contend with one or more chronic diseases. 'ften! those with chronic illness have complex medical management needs! and likely take multiple prescription drugs. The oral or written instructions for medication management may be insufficient or confusing.
This is a patient safety issueF non+adherence or misuse of medications can result if patients do not understand their prescriptions. " study by *avis and colleagues demonstrated that patients with lower literacy levels and those who take a greater number of medications were less able to understand their medication labels. The study found that even if patients understood the words on the label! most could not correctly demonstrate how to take the medication suggesting the importance of communicating clear directions and assisting with any skill+building necessary to take the medication as directed. -hile medication management is an important aspect of health literacy! the conse>uences of low health literacy can have a wider impact. These may include failure to recogni0e signs and symptoms of illness! inattention to preventive care or self+ management! and unwillingness to talk with medical providers out of fear or shame. %onfirming patientsO understanding! regardless of the relative complexity of medical information! has been suggested as a universal precaution for health care providers. 6lain communication in the medical context would benefit persons at every education level! because any interaction with the health care system carries at least some degree of stress. This stress may in turn reduce ability to process and recall information. Aecause patients with chronic disease are often in the position of having to self+monitor their condition and adjust their therapy! teaching them self+care behaviors and helping them master the needs of their condition can be a relevant approach. This is often a stepped and tailored process! with periodic refreshers to ensure that patients sustain their self+management skills over time. " thoughtful look at your health care system can turn up many ideas for paperwork reduction! streamlined or standardi0ed processes! and clear! simple communication all elements of truly patient+centered care. :8 6.2.2 T5e C%&ce,# %7 HIV/AIDS C%&#"% "ddressing the (I)/"I* crisis creatively and flexibly means adjusting educational delivery systems. This entails establishing broad principles governing relevant timetables and education and training calendars while allowing schools! colleges and communities to regulate scheduling in ways that respond to locally experienced needs. Aut more than this is necessary. There may be+and often are+too few respondents in "I*+affected communities. 6eople may not be able to attend school because of costs or demands at home+at least not until they are older. The needs of students of different ages! and the needs of girls and boys! may differ widely and re>uire age or literacy+ differentiated responses. " traditional educational system centred on a physical structure and conceived in a relatively rigid and hierarchical way+with one teacher in charge of a class of forty or more students+may have difficulty creating and maintaining appropriately flexible delivery systems. "mong the alternative educational delivery systems currently being explored is the use of interactive radio. The appointment of itinerant respondents! based at central schools! who oversee tutors engaged by community groups! is another. 5ecogni0ing that the standard formal school system is not ade>uately e>uipped to meet the needs of all children! some communities have established their own schools! with their own respondents! curricula and management structures. " community+based school may be able to respond very rapidly to community and learner needs and may benefit from the commitment fostered by local ownership and control. Aut community based schools run the risk of becoming second+rate educational institutions serving only the poorest students. There is the especially troubling possibility that governmental education authorities may view the establishment of such schools as absolving them of responsibility for the education of the communities they serve+and thus for some of those most in need of public assistance. 6.8 Re-$e? %7 L$#e"!#+"e The study reviewed various literatures done on the same area of study. The main aim of this study was to investigate the impact of women literacy on (I)/"I* prevention intervention targeted at urban group of participants. The study used social+oriented presentation formats! such as discussion between similar females and role+play. The following section presents the information on the previous literatures. :9 6.: I..+e. !77ec#$&* !cce.. #% $#e"!cy ,"%*"!))e. In (I)/"I*+affected contexts many barriers may exist for adults attending women literacy classes. 6rimary barriers may include where and when classes are held as well as attitudes towards adults! specifically while being educated. 'ther issues that may hamper access to women literacy provisions are age! literacy! language! religion! cultural norms and traditions! ethnicity! nutritional state! health! in particular (I)/"I*! disability and other kinds of vulnerabilities. 6overty is a strong factor which pushes people in or from (I)/"I*+affected countries into all kinds of activities to secure survival of their families and at the same time prevents them from using educational opportunities. The access to >uality humanitarian assistance and services! including food aid! shelter material and basic health services is often a precondition for refugees to be able to participate in women literacy and adult basic education programmes. In the face of shrinking inflows of external aid! these priorities usually focus on formal education. ecurity concerns! limited mobility and lack of funds can restrict the educational options! particularly for girls and women. The search for physical protection is a driving force for refugees affected and traumati0ed by war. In most situations girls and women would not attend classes which took place at distant and inaccessible locations or in the evenings due to security concerns. ocial and religious norms as well as policies on womenEs freedom of movement can also restrict womenEs mobility! as is the case in "fghanistan and Ira>. These include access to documentation! money to pay for transportation and male escorts. " study by the -omenEs %ommission for 5efugee -omen and %hildren on "fghan women and girls returning from Iran to the (erat 6rovince in "fghanistan in 233:! found only 83; of the entire sample literate. The study also identified a number of reasons why women did not attend adult women literacy classes organi0ed by the Iranian -omen literacy $ovement 'rgani0ation. Time and distance seemed to be the most important factor. $obility and conservative cultural patterns also played a role. The number of literate females increased the longer they were in Iran. ome adults felt ashamed to go to women literacy classes. -omen had to look after children and disabled family members or were suffering from trauma and nervous disorders. "nother reason why most adults did not benefit from any outreach services :< could be that many of the latest refugees in Iran are Jillegal immigrantsE and have had to avoid contact with formal institutions in order to escape detection and deportation 1"0erbaijani+ $oghadam! .! 233:4. The latter reason! paired with a lack of information and language problems is also preventing JillegalE immigrants! who fled from their crisis+affected countries to industriali0ed countries! from making use of existing women literacy and language courses. 6.; T5e $),!c# %7 W%)e& $#e"!cy %& HIV/AIDS c%&#"% The accountability of women literacy and adult basic education programmes implemented or supported by international agencies is reduced mainly to financial! administrative! operational and technical aspects. It is extremely difficult to find evaluation studies that would assess the impact of women literacy programmes on learners and their (I)/"I*+affected environment. Usually empirical evidence is missing in cases where relevant statements are made in terms of peace+building and stability+promoting effects of educational interventions. *espite this shortcoming it is worthwhile to analyse some good practice examples that reflect innovative ways towards building sustainable peace in communities and societies. 6.< T5e !)'$*+%+. "%e %7 $#e"!cy $& #5e c%&#e@# %7 HIV/AIDS #enerally women literacy and education are seen as inherently benevolent and conducive to reducing and overcoming instability and violence. (owever! examples from different countries show that education may become a contested terrain under conditions of inter+ethnic (I)/"I*s environments. " recent UGI%&? study highlights some negative aspects of education in relation to (I)/"I*! such as the use of education as a weapon in cultural repression of minorities 1suppression of language! traditions! art forms! religious practices and cultural values4! segregated education that serves to maintain ine>uality between social groups! the manipulation of history and textbooks for political purposes! the inculcation of attitudes of superiority! and also negative practices of literacy+based (I) control 1Aush! /./ altarelli! *.! 2333F84. Therefore! women literacy and education cannot be tackled in isolation. Their role and potential to exacerbate (I)/"I* must be carefully analysed and comprehensively understood in relation to the various social! political! ethnical! cultural! religious and security dimensions of the (I)/"I* or post+(I)/"I* situation. :C "ny substantial progress in peace+building and social development has to be inclusive and allow for participatory processes! one of the prere>uisites for this is women literacy. The recent national human development report on "fghanistan emphasises the potential of education and women literacy programmes to significantly improve human security. These programmes raise not only the levels of women literacy but also have a host of positive externalities ranging from improved household health management! to expanded decision+making capabilities! more informed resource management 1UG*6! 2339 bF2384. (owever! until the full deployment of this potential will be possible! others will have taken the decision+making positions in the society thereby increase the risk of excluding and disempowering the largely illiterate "fghan population which is Kstill struggling for physical survival and coming to terms with its losses. 6.= Acce.. #% He!#5c!"e !&( H%)e M!&!*e)e&# %7 HIV In one study it was shown that nearness to health care site reduces fatality outcome to (I) since prompt treatment to (I) prevents the development of complications and fatal outcomes. %onse>uently the concept of home management of (I) was investigated. ?irstly studies had to be conducted to demonstrate that mothers who are the caretakers in "frican communities can diagnose fever or (I) in their children. 5esults from this study showed that over 7<; of mothers can diagnose (I) in their children. Gext carefully packaged anti (I) with directive for administration based on movement of the sun were distributed to mothers to use for the treatment of (I) in their offspring. This trial also showed that a large number of rural women could correctly administer anti (I) to their sick children. This endeavor has significantly reduced (I) morbidity and particularly mortality in young children living in difficult to reach communities or where health facilities are very distant from settlement areas. "n improvement to this strategy was the education of mothers in the use of rectal anti (I) to sick children for whom oral medication was impossible due to vomiting. In this instance! mothers administered rectal anti (I) until the child was stable and it was convenient for her to visit a health facility. It is evident from this submission that the identification of preventive 1bed nets! chemoprophylaxis in pregnancy4 and therapeutic measures 1home treatment4 against (I) when communicated in a user friendly manner to the :7 grass root has the potential of reducing disease fre>uency and mortality. The outcome is an improvement of the health status of the community and family finances or poverty alleviation. 6.> I&7%")!#$%& L$#e"!cy %& HIV/AIDS P"e-e&#$%& %7 T"!&.)$..$%& (I)/"I* is one of the major public health problems in "frica. ub aharan "frica harbours the highest burden of the (I)/"I* disease with country prevalence rates ranging between :; to over 83;. -omen are the most vulnerable including commercial sex workers! truck drivers and other mobile populations and military personnel. Transmission is mainly heterosexual with the most infected age group being :<R9D years old. %ontrol of this pandemic has been hinged on "bstinence! ?idelity in relationships and Use of a preservative 1protections4 if the first two strategies are unlikely. In several studies conducted in %ameroon! it was observed that knowledge on prevention strategies increased with level of formal education in both sexes. $essage packaging for delivery to the grass root that included means of transmission of the virus! voluntary counseling and testing sites and available treatment options was shown to adversely affect incidence in some communities. %ommunication for change of behaviour and social mobili0ation for greater use of health care services also had a positive impact on the (I) status of the communities. In ensuring that (I)/"I* prevention reaches every household in the community! the %ameroon #overnment created .ocal "I* %ontrol %ommittees which comprised of mapped geographical areas! elites! community elders and elected representatives of households or streets. The mandate of this committee was to deliver user friendly message packages 1posters! flyers! bill boards4 on (I)/"I* and exually Transmissible Infections 1TIs4 prevention! care of patients living with (I)/"I*! available (I)/"I* counseling and screening facilities to the communities so as to reduce the transmission of the (I) or cater for those who are already infected. -ith regards to (I)/"I* my presentation on information literacy and the disease will focus on prevention of mother+to+child transmission 1(I)/"I*4 of the virus. := 6.A L$#e"!cy %& P"e-e&#$%& %7 HIV/AIDS -omen who are infected with (I) are usually counseled to avoid unwanted pregnancies since it has been documented that close to :<; of children born to (I) infected mothers also get infected either in utero! during birth or through breast milk. Thus (I) positive partner1s4 who need a child can be counseled on safe procedures to adopt towards reducing the risk of infecting their baby. %onse>uently focal points for the implementation and evaluation of (I)/"I* strategies have been created in almost all health districts. %hildren occupy an important position in a typical "frican family and therefore (I)/"I* activities should be fully implemented to avoid the embarrassing situation of overburdening the health care system with (I) infected newborns since couples will always want children irrespective of their status. 5isk reduction in (I) transmission to the offspring is feasible and involves a collaborative effort between the health care provider and the expectant mother/partner. #ood or safe delivery practices will eliminate the contamination of the newborn during delivery thus leaving the mother to make the wisest informed decision on the feeding option to adopt. "n infected mother has the choice to make whether to infect her baby or not. *uring antenatal enrolment! it is currently the procedure to counsel and screen all pregnant women for (I) amongst others. Information is usually made available to the (I) infected mothers during post testing counseling on the available options that will prevent her baby from becoming infected. ?irstly the mother is counseled to deliver in a health care center where delivery facilities are optimal that ensures the newborn is not infected during delivery. econdly the (I) seropositive mother is given different feeding options with varying risks of infecting the baby. These include in order of increasing risk exclusive bottle feeding 1safest option4! breastfeeding for the first four months and then bottle feeding thereafter! or exclusive breastfeeding throughout infancy. In our community! we observed that the majority of women prefer the second optionF breastfeeding for 8+9 months and then bottle feeding which exposes their baby to some risk of (I) infection. This was associated with stigma since exclusive bottle feeding raises eyebrows in the community and reveals the (I) status of the mother. It is however! difficult to understand why a mother will choose an option that exposes her child to being infected instead :D of making the decision to prevent her baby from (I) infection. Is this due to lack of information or stigma, This observation inspired us to brainstorm and asked several research >uestions. It was evident from field data obtained from different sites that men are reluctant to participate in (I)/"I* of (I) activities either due to the Jmale egoE or fear of stigma or other unknown reasons. The >uestion arises therefore on how we can educate men to increase their participation in (I)/"I* programmes, -e are interested in identifying barriers that hinder men from participating in antenatal care with their partners. 5esults from this study will provide the necessary support women need to make a wise family decision on delivery and feeding options that protect the child from being infected with the (I). There is the absolute need to educate men on the need to support their partners in making the right decisions towards protecting their offspring thus reducing the number of infected newborns and subse>uently improve on the finances of the family. -e also observed that most (I) positive women prefer to breastfeed their babies for between 8 to 9 months before switching to bottle feeding. The >uestion is why a mother will choose this option when there is a safer option for the newbornEs protection. -e plan to investigate how stigma! availability of resources and messaging affect a womanEs decision to comply (I) interventions. -e will identify barriers that prevent women from making informed decisions regarding (I)/"I* interventions 1relating to delivery at hospital and choice of infant feeding options4. Information from this study will be packaged for delivery to (I) seropositive mothers in the community in order to empower them make informed decisions on their childEs welfare. 6.23 T5e I),!c# %7 L$#e"!cy !&( #5e HIV/AIDS C%&#"% In the United tates! an estimated 83 million people over the age of :C read no better than the average elementary school child. -orldwide! nearly =33 million adults are illiterate in their native languages@ two+thirds of them are women. Iet the ability to read and write is the basis for all other education@ literacy is necessary for an individual to understand information that is out of context! whether written or verbal. .iteracy is essential if we are to eradicate poverty at 23 home and abroad! improve infant mortality rates! address literacy ine>uality! and create sustainable development. -ithout literacy skills the abilities to read! to write! to do math! to solve problems! and to access and use technology todayOs adults will struggle to take part in the world around them and fail to reach their full potential as parents! community members! and employees. .earning to read begins long before a child enters school. It begins when parents read to their children! buy their children books! and encourage their children to read. The research is clearF parents who are poor readers donEt read as often to their children as do parents who are strong readers@ children who are not read to enter school less prepared for learning to read than other children. Understanding a doctorEs orders! calculating how much medicine to take! reading disease+prevention pamphlets all are ways adults can keep themselves and their families healthy. Aut millions of adults lack these essential health literacy skills. The study aimed at finding out basic understanding of (I) infection! degree of awareness regarding the ongoing treatment and reasons behind irregular follow+up visits of our (I) patients who attend Q.&. -ood outpatient clinic of 6ennsylvania (ospital! 6hiladelphia for treatment of (I)/"I*. 6.23.2 U.$&* $#e"!cy #% ,"%#ec# !*!$&.# HIV $&7ec#$%& *espite the absence of a medical vaccine against (I) infection! society has at its disposal a Nsocial vaccineO! the vaccine of literacy 1)andemoortele and *elamonica 23334. In Sambia! for instance! the decline in the prevalence rate for :<+to+:D+yearold women in .usaka was more marked for those with secondary and higher levels of literacy than for those who had not proceeded beyond the primary level 1?ylkesnes et al.! :DDD4. This finding is in striking contrast to earlier evidence from Sambia and several other severely affected countries. This evidence suggested that levels of (I) infection were higher among the more educated and well+off. It pointed to a positive correlation not only between levels of literacy and the probability of engagement in high+risk sexual behaviour but also of actual infection 1"insworth and emali! :DD=@ (argreaves and #lynn! 23334. The subjects whose behaviour was documented in these studies had all! however! become sexually active in the comparatively early stages of the epidemic when the behavioural correlates of (I)/"I* 2: infection were less understood and relevant information was less widely available. Information about the behaviour of people who have become sexually active in more recent times! such as those in the .usaka study! suggests that the more educated are now less vulnerable to (I) infection. *oes literacy protect against (I) infection through the health skills and disease+ related information it transmits to learners! or is there something inherent in the very process of becoming more educated that helps people protect+ themselves against infection, )andemoortele and *elamonica 123334 note that existing evidence does not allow us to draw exact conclusions about how the Oliteracy+vaccineO against (I) works. -hile they are clearly right to argue that the increased knowledge! information and awareness that literacy provides are important protectors against infection! we believe the general impact of literacy in and of itself may be the most significant factor. This conclusion is supported by the change in the positive correlation between levels of literacy and (I) infection or high+risk behaviour even among those whose formal literacy included little! if any! health skills and "I* literacy. Indeed! few of those attending school prior to the mid+:DD3s were exposed to (I)/"I* literacy programmes. *uring this period! life+skills and reproductive health programmes were implemented on a sporadic basis@ teacher knowledge! understanding and commitment were limited@ and literacyal strategies reflected little sensitivity to the real experiences of young people 1#achuhi! :DDD@ /ippax! mith and "ggleton! 2333@ UG&%"! 23334. Gonetheless! the infection rates for individuals educated during this period are declining. Improved literacyal programmes and materials as well as revised teacher preparation systems now becoming more widespread will undoubtedly accelerate this favourable trend. Aut literacy itself tends to enhance the potential to make discerning use of information and to plan for the future and to accelerate favourable socio+cultural changes. 6.22 S+))!"y %7 L$#e"!#+"e ?rom a literacy perspective! this discourse is particularly interesting. ?irstly! the interviewee had to be prompted for more input about personal change. It seemed as if she did not want to say these positive things about herself! as if it were inappropriate! or could possibly be 22 construed as boasting. (er discomfort shows in the >uestioning of her suggestion 1her last4 of leadership! in her halting flow of speech when she is otherwise so fluent and articulate! and in her laughing. ?inally! she even >uestions the relevance of her comment To return this discussion to the impact of globali0ation on literacy and social change raised at the outset! as the evidence above attests! globali0ation involves the institutionali0ed construction of the individual! such that literacy roles tend to embrace cultural and traditional dichotomies! such as JcommunalE for women and JagenticE for men 15idgeway and %orrell 23394. The hybridi0ation effect of globalisation has meant that literacy and culture have become increasingly salient and fluid. (owever! as many of the above examples from the data show! despite the progress made towards literacy e>uity! the core structure of literacy beliefs has not changed. " life lived between cultures will result in hybrid traditions and some of this was evident as respondents in this study struggled! due to hegemonic cultural beliefs! to situate themselves within new structures and with new identities. ?inally! in response to the >uestions on literacy raised by the study! the impact of an overseas education was different for men than for women! particularly in terms of empowerment. -hile there was greater literacy e>uity at the level of the family! this was often only when the male did not feel he was being evaluated! that is! within the home. Aetter family relationships were often developed in "ustralia! but could not always be maintained in Indonesia due to the situation! greater workloads of both partners and hegemonic literacy beliefs. In both the community and the workplace! men benefited to a greater extent in terms of opportunities to participate in the public sphere! greater respect and decision making responsibilities! and leadership and mentoring roles. In contrast! women referred to ine>uality in terms of cultural and social workload! (I) control in terms of opportunities for promotion or leadership roles and a constrained self perception. *espite considerable social change resulting from their overseas education and the hybridisation effects of globalisation! considerable literacy bias and ine>uality still persist as a result of hegemonic cultural beliefs about literacy. 28 CHAPTER THREE: RESEARCH DESI/N AND METHODOLO/Y 8.3 I&#"%(+c#$%& This %hapter presents the methodology used in the study. It includes the description of the study area! research design! and target population! sampling procedures! development of research instruments! and administration of research instruments! data collection and data analysis. 8.2 Re.e!"c5 De.$*& The research design employed in this study was a descriptive survey study! generally >ualitative in nature. To achieve the objectives of the study! survey research design was adopted and the focus of this study was cross+sectional. The survey approach was used! because it has its own advantages of identifying attributes of a large population from a small group of individuals! the economy of the design and the rapid approach in data collection 1Aabbie! :DD3@ ?owler et. al.! :DD<4. In addition it will greatly increase the researcherEs knowledge about what happens in the study context and itEs a strategy perceived as authoritative by people in general and is both comparatively easy to explain and to understand. 8.6 T5e S#+(y A"e! The study was carried out at selected community health centres in &ldoret Town. &ldoret is a town in western /enya and the administrative centre of Uasin #ishu *istrict of 5ift )alley 6rovince. .ying south of the %herangani (ills. It has a population of about 233!333 people and is among the fastest growing town in /enya. The town is now home to a large market! $oi University and &ldoret International "irport. It is also known for its cheese factory. $ajor industries include textiles! wheat! pyrethrum and corn. The town has a number of factories. &ldoret is also home to number nationally recognised manufacturing industries like 5aiplywoods! /en+/nit! .ochab Arothers! and /andola and onEs. "ll these industries were set up and developed by some of the oldest Indian origin families in the rift valley region namely The 5aiEs! The /andolaEs! The hahEs! The .ochabEs and The 6atelEs. 29 8.8 T!"*e# P%,+!#$%& The total population is approximately 7893 employees of the surveyed community health centres. This also consisted of those who in one way or another have experienced the conflicts management and resolutions process. 8.: S!),e S$Be !&( S!),$&* Tec5&$C+e. The participants in this study were :878 192; females! and <=; males4 from selected community health centres in the entire &ldoret town. The study targeted a cross section of employees from various departments across all levels and areas of work. The participants were asked to voluntarily participate in the survey by answering a >uestionnaire during their free time. The employees were assured confidentiality and anonymity! as well as told they had the choice to refuse to participate in the survey without penalty. $ost employees in each organisation who were asked did agree to participate. The study targeted the human resources managers of the community health centres mentioned. The total number of sample selected for the study consisted of one hundred managers. The convenience sampling was used to get the views of the managers selected for the study. The study used :D.28; of the target population thus the sample si0e of :878 respondents out of the 7:93 who were sampled. The group was selected because it comprised of the vital group with information about effects of conflicts on (5$ in organi0ational settings. -here there is no estimate of the sample proportion in the target population assumed to have the characteristics of interest! <3; of target population should be used! ?isher et. al. 123334. If target population is less than :3! 333 the re>uired sample si0e will be smaller hence final sample si0e of at least :3; was suitable 1?isher et. al. 23334. imple 5andom sampling was used to select the D< subordinate staff while purposive sampling was used to descriptively identify the five administrators who are to be interviewed. 2< T!'e 8.2: S!),$&* F"!)e P%,+!#$%& C!#e*%"y N% %7 Pe".%&. Pe"ce&#!*e S!),e S!),e S$Be &ldoret (ospital :283 :7.28; 287 5eale (ospital :2<3 :7.<3; 293 t. .uke (ospital 7C3 :3.C<; :9C ?amily (ealthcare :3:3 :9.:<; :D9 &lgonveiw (ospital :333 :9.33; :D2 $oi Teaching and 5eferral (ospital C<3 3D.:3; :2< $ediheal (opspital :293 :7.87; :2D T%#! =2:3 233.33D 28=8 8.; D!#! C%ec#$%& P"%ce(+"e The researcher distributed the >uestionnaires randomly! which were clarified and explained ade>uately to the respondents. The >uestionnaires were collected on agreed dates. This ensured :33; return rates. "s for the interview schedules! the researcher interviewed the "dministrators on the agreed dates. This ensured convenience to the "dministrators who operate on a busy schedule. 8.< D!#! C%ec#$%& I&.#"+)e&#. The instrument used to collect data in this research study was a survey titled Literacy Issues Survey and was based on prior research 1%arr! et. al.! 2333@ 23384. The instrument was >uantitative and included the following topical areas of >uestioning specific to the present studyF literacy discrimination of self! literacy discrimination of others! response of self and demographic information. The instrument provided a definition of literacy discrimination derived from a review of the literature as literacy+based behaviors! policies! and actions that adversely affect a personEs work by leading to une>ual treatment or the creation of an intimidating environment because of oneEs literacy. .iteracy discrimination occurs when employers make decisions such as selection! evaluation! promotion! or reward allocation based on an individualEs literacy.L 5espondents were asked to indicate to what extent literacy would impact their own careers in ways such as career success! advancement! professional opportunity! networking! mentoring! time for career! pay! and expectations of others using a < point .ikert+type scaleF never 1:4! 2C rarely 124! possibly 184! probably 194! and likely 1<4. The measures were adapted from previous research that suggests these factors to be common outcomes of literacy discrimination in the workplace 1%arr! et. al.! 2333@ 23384. The respondents were then asked to indicate to what extent literacy would affect the careers of others! specifically women! in these same areas. 5espondents were asked to indicate to what extent the experience of literacy discrimination would affect their professional career in terms of personal confidence! career advancement! job satisfaction! organi0ational commitment! and career commitment. These measures were adapted from previous research on this topic. The survey concluded with eight demographic >uestionsF literacy! race! classification! work experience! age! and political viewpoint. 8.<.2 Q+e.#$%&&!$"e This is a collection of items to which a respondent is expected to react in writing@ designed >uestions in form format were distributed to the respondents. This method collects a lot of information over a short period of time. The method is suitable when the information needed can be easily described in writing and if time is limited. In this study! the respondents were given enough time to complete the >uestionnaires before returning them back for analysis of the collected data. The >uestionnaires included both structured and semi structured >uestions. This allowed the respondents to give their opinions where necessary. The .ikert scale was useful in analy0ing data in >uestions that directly involve the feelings and attitudes of the respondents. "nother method that was used was cross tabulation! an essential techni>ue in tabulating fre>uencies and occurrences of some variables. -hen analy0ing >ualitative data! especially from observation and interviews! the >uasi+judicial method was crucial because it offers a systematic procedure! which uses rational argument to interpret empirical evidence 1$ugenda and $ugenda :DDD4. 5espondents were assured confidentiality that their identities were secured and collection of information was from the point of view of the respondents. 8.= P$%# S#+(y The survey was pre+tested with approximately :33 employees to ensure that the respondents would understand the meaning of the >uestions and could answer the >uestions appropriately. 27 The concerns raised during the pre+test were minimal@ however! modifications were made to the instrument based on the feedback 1clarified item wording! shortened the survey4. The researcher was carried out a preliminary survey of a similar population to the target population of this study. This was done before the main study is carried out. The researcher identified a group to pre test the instruments and this group did not participate in the actual survey and make preliminary observations of the target groups. 'bservations during the survey were useful in making provisional impressions about the situations prevailing in this setting. The >uestionnaires were administered to two members in each group. "long with >uestionnaires there were interview schedules that were conducted to verify the reliability of its use in the main study. 8.=.2 V!$($#y %7 #5e I&.#"+)e&#. )alidity of an instrument refers to the degree to which an instrument measures what it is suppose to measure. It therefore involves asking the right >uestions formed in the least ambiguous ways notes! 1Aest and /ahn! :D=D4. To establish the validity of the instruments! the researcher will carry out pre+test study in a population group similar to the one selected for the actual study. This will reveal the validity of the two instruments of data collections. 8.=.6 Re$!'$$#y %7 #5e I&.#"+)e&#. 5eliability is defined by Aest and /ahn 1:D=D4 as the degree of consistency that an instrument or a procedure demonstrates. 6rior to conducting the research the instruments will be piloted in a population group with the same features like those found in the population to participate in the actual study where a sampling of C3 >uestionnaires will be administered within an interval of two weeks. The researcher used a test+re+test method to draw this sample population for the pilot study. 8.> D!#! A&!y.$. *ata captured from the >uestionnaires forms were examined by the researcher before being summari0ed coded and classified into categories. imple descriptive statistics including tables 2= were used. The data was organi0ed! presented! analy0ed and interpreted using descriptive methods of data analysis. It used tables! charts! percentages! and chi s>uare was also be used in analysis the .ikert scaled data. ?rom the analysis! data was used to carry out a test on the >uestions to determine whether the objectives could be accepted or not. *escriptive statistics 1fre>uencies! means! standard deviations! and correlations4 were produced for all of the survey >uestions using 6. %ross tabulations were run on the literacy discrimination survey >uestions as dependent variables against the independent demographic variables of literacy and level of management. %ross tabulations were also run on the response of self to literacy discrimination survey >uestions against the same demographic variables. Independent sample t+tests were conducted to determine the statistical significance of responses based on literacy and level of management. CHAPTER FOUR: DATA PRESENTATION0 ANALYSIS AND INTERPRETATION :.3 I&#"%(+c#$%& 2D This chapter contains the analysis of >uestionnaire used in answering the research objective on the effects of conflicts on (5$ in organisations. The researcher administered >uestionnaires for data collection. "fter data collection the researcher dealt specifically with data analysis of the collected data. The data collected was organi0ed! classified and keyed in computer using statistical package for social sciences 164. :.2 De)%*"!,5$c I&7%")!#$%& In this section the researcher present the background information of the respondents covered by the study. The main variables used to get clearly background information of the respondents were the age bracket! literacy! academic >ualification! marital status! and occupation. The demographic characteristics of the respondents helped the researcher to determine the way the respondents perceived certain opinions. These features were also used to provide a base for further analysis of the specific research objectives and their findings using descriptive statistics! tables! fre>uency and percentages. *emographic analysis was critical to a considerable extent! since demographic phenomena affect respondentsE social! political and economic behaviour of the variables of this research. These demographic characteristics are presented in the section that followsF This study also sought to discover if demographic variables such as literacy and race impacted employeesE perceptions of literacy issues in the workplace. ?urther! this study sought to discover whether employees were more or less likely to foresee the potential impact of (I) on themselves as compared to other similarly situated persons. This study assessed both the personal and group targets of (I) based on prior research which shows a discrepancy between perceptions of (I) control against self and perceptions of (I) control against others. :.2.2 L$#e"!cy %7 Re.,%&(e&#. T!'e :.2: L$#e"!cy D$.#"$'+#$%& %7 Re.,%&(e&#. 'y /e&(e" 83 L$#e"!cy F"eC+e&cy Pe"ce&#!*e $ale C<D 9=; ?emale 7:9 <2; T%#! 28=8 233D Table 9.: indicates that <2; 17:94 were female! and 9= ;1C<D4 males. This is an indication that there are many female respondents than male ones. The literacy effects is a factor as it shows majority of those who would be affected by (I). :.2.6 Re.,%&(e&#. A*e D$.#"$'+#$%& T!'e :.6: Re.,%&(e&#. A*e D$.#"$'+#$%& A*e Eye!".F F"eC+e&cy Pe"ce&#!*e 23+2D 27< 23; 83+8D 9:2 83; 93+9D :87 :3; <3+<D 9:2 83; C3+"bove :87 :3; T%#! 28=8 233D Table 9.2 shows that of the respondents those aged between 23+2D years represented 23;! the age bracket of 83+8D years old accounted for 83;. The least reported was age bracket of :3;. This is an indication that majority of respondents are aged 83+8D and <3+<D years of age. The mean age of the participants was 23 years! with a range of :7 to 7: years. :.2.8 Re.,%&(e&#. M!"$#! S#!#+. T!'e :.8: D$.#"$'+#$%& %7 Re.,%&(e&#. M!"$#! S#!#+. M!"$#! S#!#+. F"eC+e&cy Pe"ce&#!*e $arried <D3 98; ingle 9D9 8C; eparated/*ivorced :29 3D; -idowed :C< :2; 8: T%#! 28=8 233D The table 9.8 states of the respondentsE married represented 98; of respondents! single was 8C;! separated/divorced 3D; while widowed :2; of sampled population total. This means that many of the respondents were married. :.2.: Re.,%&(e&#. E(+c!#$%&! Le-e T!'e :.:: D$.#"$'+#$%& %7 Re.,%&(e&#. Le-e %7 E(+c!#$%& Le-e %7 E(+c!#$%& F"eC+e&cy Pe"ce&#!*e 6rimary/econdary C<D 23; %ollege *iploma <22 8=; *egree 297 :=; $asters #raduate :29 3D; 6h* *egree 33 33 'thers 23C :<; T%#! 28=8 233D The results showed that 23; of respondents had primary or secondary level of education! 8=; college diploma! :=; degree! 3D; had masters degree! :<; had other >ualifications while 6h* degree had 33;. This means that the respondents mainly college diploma residents. (ence it is possible to experience high rate of (I). :.2.; Re.,%&(e&#. Le&*#5 %7 S#!y $& #5e De,!"#)e&# T!'e :.;: Le&*#5 %7 S#!y $& #5e De,!"#)e&# Le&*#5 %7 S#!y EYe!".F F"eC+e&cy Pe"ce&#!*e 3+9 9:2 83; <+D 98D 82; :3+:9 27< 23; :<+:D :29 3D; 23+and $ore :29 3D; T%#! 28=8 233D The table above shows that 82; of respondents have stayed in the department for a period of <+ D years! 83; 3+9 years! 23; :3+:9 years! D; :<+:D years and only D; has taken 23 and above 82 years. This means that there is rapid movement and relocation of settlement areas by the respondents since majority of respondents have spent only between <+D years. :.6 P"e.e&#!#$%& %7 /e&e"! I&7%")!#$%& The study also sought to obtain the general information related to the effects of conflicts on human resource management in organi0ational settings. Thirty hundred >uestionnaires were distributed to managers in each company. "ll the 83 >uestionnaires were returned by the respondents which accounts to :33;. The >uestions were grouped into six variables with similar characteristics. These variables included whether employees have been involved in conflict! causes of organisational conflict! and types of (I)! impacts and strategies to resolve conflicts. :.8 K&%?e(*e %& HIV/AIDS T"!&.)$..$%& It is evident in the literature that knowledge on (I)/"I* in /enya is almost universal particularly with regard to modes of transmission. The result showed that all the respondents interviewed 1:33;4 knew that sexual intercourse with an infected person is the main way through which (I)/"I* can be spread. 'ther transmission routes mentioned included sharing sharp piercing instruments 179;4! transfusion of infected blood 1C8;4 and mother to child transmission 192;4 as illustrated in Table 9.C. T!'e :.<: K&%?e(*e %& HIV/AIDS T"!&.)$..$%& T"!&.)$..$%& "%+#e F"eC+e&cy Pe"ce&#!*e ex with infected person 287 DD.C haring sharp piecing instruments :7= 79.= Transfusion with infected blood :<3 C8.3 $other to child transmission :3: 92.9 Use of un+sterili0ed needles C: 2<.C "ccident 9< :=.D Areast+feeding 29 :3.: 'ther 37 2.D Totals may exceed 100% due to multiple responses :.: S%+"ce. %7 $&7%")!#$%& %& HIV/AIDS "ll the respondents interviewed in the survey were asked their main sources of information about (I)/"I*. "s illustrated in Table 9.7! the most prominent sources of (I)/"I* 88 information among respondents are the radio 1=8;4! newspapers 1C:;4! seminars and workshops 19<;4 and health facilities 187;4. The others were television 189;4! books 18:;4 friends 12=;4! posters and leaflets 1:D;4 and drama 1:2;4. T!'e :.=: S%+"ce. %7 I&7%")!#$%& %& HIV/AIDS S%+"ce F"eC+e&cy Pe"ce&#!*e 5adio :DD =2.C Gewspaper :9C C3.C eminars/workshops :3= 99.= (ealth facility D3 87.8 T) =2 89.3 Aooks 7< 8:.: ?riends/other respondents C= 2=.2 (I)/"I* school program <3 23.7 6osters/leaflets/brochures/banners 9< :=.7 *rama 2= ::.C 5eligious leaders 29 :3.3 G#' 2: =.7 Internet 3D 8.7 Totals may exceed 100% due to multiple responses :.; K&%?e(*e %& HIV/AIDS P"e-e&#$%& 5espondents exhibited high knowledge levels regarding (I)/"I* prevention with majority 1=D;4 reporting abstinence from sex! followed by faithfulness 17<;4 and use of protections 178;4 as indicated in Table 9.=. T!'e :.>: K&%?e(*e %& HIV/AIDS P"e-e&#$%& Me#5%(. F"eC+e&cy Pe"ce&#!*e "bstain from sex 2:3 ==.C Sero gra0ing/be faithful :7= 7<.: Use of protections :79 78.9 "void sharing sharp piercing instruments 72 83.9 "void getting injections from none >ualified medical staff 99 :=.C (I) %ounselling and Testing 1(%T4 88 :8.D "void blood transfusions 2D :2.2 Totals may exceed 100% due to multiple responses 89 5espondents were also asked about their most preferred source of information about (I)/"I* and as presented in Table 9.D! the radio emerged as their most preferred source of information about (I)/"I* accounting for 2C;! followed by workshops and seminars and health facilities/health workers 1:7;4! books 1:3;4 and newspapers 1=;4. T!'e :.A: Re.,%&(e&#.G M%.# Re7e""e( S%+"ce %7 I&7%")!#$%& %& HIV/AIDS S%+"ce F"eC+e&cy Pe"ce&#!*e 5adio C8 2C.: (ealth facilities/health worker 93 :C.C eminars/workshops 93 :C.C Aooks 29 :3.3 Gewspaper := 7.< ?riends :: 9.C T) :3 9.: (I)/"I* school program 3D 8.7 6osters/leaflets/brochures/banner 3D 8.7 *rama 37 2.D Internet 32 3.= :.< I),!c# %7 HIV/AIDS %& #5e E(+c!#$%& Sec#%" !&( Re.,%&(e&#. $& P!"#$c+!" (I)/"I* emerged as one of the common health problems affecting respondents. *uring the survey many of the schools/institutions visited had either lost a teacher to the pandemic or had a teacher living with (I)/"I*. 5esults revealed that D2; of the respondents said that (I)/"I* has affected them either directly or indirectly. Table 9.:3 shows ways in which (I)/"I* has affected respondents. These includeF increased absenteeism 179;4! time lost caring for the sick 17:;4! inefficiency in teaching 1<:;4 and reduction in salary 18<;4. 'ther effects reported include@ indiscipline 129;4! stigma/ discrimination 123;4 and dismissal from school 1:8;4. T!'e :.23: I),!c# %7 W%)e& L$#e"!cy %& HIV/AIDS C%&#"% W!y. F"eC+e&cy Pe"ce&#!*e Increased rate of absenteeism :89 78.C Time lost caring for sick people :83 7:.9 Inefficiency in teaching D2 <3.< .oss/ reduction of salary C9 8<.3 Indiscipline 99 29.2 8< tigma T discrimination 7C :D.= *ismissal from workplaces 28 :2.C Totals may exceed 100% due to multiple responses :.= Re.,%&(e&#.G C%,$&* Mec5!&$.). The survey investigated ways through which 5espondents are coping with the effects of (I)/"I*. "s illustrated in ?igure 9.:! <:; of the respondents reported increased involvement in (I)/"I* sensiti0ation! 2C; reported that respondents seek (I) counseling and testing services! D; psychosocial support groups and only 9; reported an uptake of "5)s. F$*+"e :.2: Re.,%&(e&#.G C%,$&* Mec5!&$.). 0 10 20 30 40 50 60 Increased sensitization Seeking counselling Join psychosocial groups ARs !aking on "ore #ork A$stain %eing &aith&ul !aking on less #ork m e a n s
o f
c o p i n g :.> Pe"ce&#!*e ($.#"$'+#$%& %7 "e.,%&(e&#. 'y !*e !&( 4&%?e(*e %7 HIV #"!&.)$..$%& 8C "mong the -omen .iteracy who was aged less than 23! about <2; have no knowledge of (I) transmission. -hile :D; and D.<; of -omen literacy who were aged between 2: and 83 and more than 83 years respectively did not have knowledge of (I) transmission 1Table 9.::4. ?urther only 3.8; of youngest -omen literacy knew five ways of (I) transmission compare to 29.<; and D.<; of those aged 2: to 83 years and those more than 83 years of age respectively. The association is between the age of -omen literacy and their knowledge scores is highly significant 1pU 3.33:4 indicating that younger -omen literacy have less knowledge about the (I) transmission. T!'e :.22: Pe"ce&#!*e ($.#"$'+#$%& %7 "e.,%&(e&#. 'y !*e !&( 4&%?e(*e %7 HIV #"!&.)$..$%& ENHA3>F A*e *"%+, $& ye!". K&%?e(*e %7 HIV/AIDS #"!&.)$..$%& E$& ,e"ce&#!*eF T%#! 3 2 6 8 : ; U23 years 1nH2D24 <2.: :7.< =.2 :9.7 7.2 3.8 :33 2: to 83 years1nH<924 :D.3 2D.8 :9.= 29.9 C.< C.3 :33 V83 years 1nH794 D.< 8:.3 :C.2 29.8 D.< D.< :33 C5$ .C+!"e H26<.A>: (7H230 ,I3.332 "mong the 5espondents who were aged less than 23! about <2; have no knowledge of (I) transmission. -hile :D; and D.<; of 5espondents who were aged between 2: and 83 and more than 83 years respectively did not have knowledge of (I). ?urther only 3.8; of youngest 5espondents knew five ways of (I) transmission compare to 29.<; and D.<; of those aged 2: to 83 years and those more than 83 years of age respectively. The association is between the age of 5espondents and their knowledge scores is highly significant 1pU 3.33:4 indicating that younger 5espondents have less knowledge about the (I) transmission. 87 :.A Pe"ce&#!*e ($.#"$'+#$%& %7 "e.,%&(e&#. 'y e(+c!#$%& !&( 4&%?e(*e %7 HIV #"!&.)$..$%& T!'e :.26: Pe"ce&#!*e ($.#"$'+#$%& %7 "e.,%&(e&#. 'y e(+c!#$%& !&( 4&%?e(*e %7 HIV #"!&.)$..$%& ENH>A6F A*e *"%+, $& ye!". K&%?e(*e %7 HIV/AIDS #"!&.)$..$%& E$& ,e"ce&#!*eF T%#! 3 2 6 8 : ; Go education 1nH7224 8:.2 2<.< :8.9 23.: C.C 8.2 :33 &ducation 1nH:734 :=.2 2C.< D.9 27.: =.2 :3.C :33 C5$ .C+!"e H8<.>6> (7H;0 ,I3.332 "mong 5espondents who did not go to school! 82; had no knowledge about (I) transmission! while only :=; had no knowledge among those who attended school. &ducation is significantly associated 1pU 3.33:4 with the knowledge scores of (I) transmission of the respondent. The result indicates that knowledge level is higher among the 5espondents who attended school than those who never attended school. "mong -omen literacy that did not go to hospital! 82; had no knowledge about (I) transmission! while only :=; had no knowledge among those who attended hospital 1Table 9.:24. &ducation is significantly associated 1pU 3.33:4 with the knowledge scores of (I) transmission of the respondent. The result indicates that knowledge level is higher among the -omen literacy who attended hospital than those who never attended hospital. :.23 Pe"ce&#!*e ($.#"$'+#$%& %7 "e.,%&(e&#. 'y (+"!#$%& !&( 4&%?e(*e %7 HIV #"!&.)$..$%& T!'e :.28: Pe"ce&#!*e ($.#"$'+#$%& %7 "e.,%&(e&#. 'y (+"!#$%& !&( 4&%?e(*e %7 HIV #"!&.)$..$%& ENHA3>F L$#e"!cy D+"!#$%& K&%?e(*e %7 HIV/AIDS #"!&.)$..$%& E$& ,e"ce&#!*eF T%#! 3 2 6 8 : ; U: years 1nH:CC4 72.8 :3.= 8.7 :3.2 8.3 3.3 :33 : to < years1nH8<74 29.C 8:.D :9.C :D.D C.7 2.2 :33 8= C to :3 years 1nH2<D4 :<.: 27.3 :9. 7 2C.C :3.3 C.C :33 V:3 years 1nH:2C4 ::.D 29.C :<.D 2=.C ::.: 7.D :33 C5$ .C+!"e H62>.:<6 (7H2;0 ,I3.332 There was a statistically significant relationship between how long the -omen literacy worked in this profession and knowledge about (I) transmission 1pU3.33:4. "mong the -omen literacy who had worked less than one year! 72; had no knowledge! while among those who had worked between one and five years! 2<; had no knowledge 1Table 9.:84. ?urther! :< and :2 ; of those who had worked between six to ten years and over ten years respectively had no knowledge. Those who had greatest (I) transmission knowledge were those who had worked in the industry the largest. :.22 Pe"ce&#!*e ($.#"$'+#$%& %7 "e.,%&(e&#. 'y !.# ?ee4G. $&c%)e !&( 4&%?e(*e %7 HIV #"!&.)$..$%& T!'e :.2:: Pe"ce&#!*e ($.#"$'+#$%& %7 "e.,%&(e&#. 'y !.# ?ee4G. $&c%)e !&( 4&%?e(*e %7 HIV #"!&.)$..$%& I&c%)e *"%+, !cc%"($&* #% !.# ?ee4G. $&c%)e K&%?e(*e %7 HIV/AIDS #"!&.)$..$%& E$& ,e"ce&#!*eF T%#! 3 2 6 8 : ; U/shs.<333 1nH<234 22.7 2<.2 :9.3 28.= =.: C.2 :33 V/shs.<3331nH8C24 87.= 27.D :3.< :C.C C.C 3.C :33 C5$ .C+!"e H:8.3:A (7H;0 ,I3.332 Table 9.:< shows that 22.7; of the -omen literacy who have below average income had no (I) transmission knowledge and only C.2; knew five ways of (I) transmission. 'n the other hand! 8=; of the -omen literacy who were earning more than the -omen literacy average income did not know about (I) transmission and less than :; knew five ways of (I) transmission. The relationship between knowledge about (I) transmission and last weekEs income was significant 1pU 3.3:4. The result indicates that knowledge is less among those earning more than those earning less. :.26 Pe"ce&#!*e ($.#"$'+#$%& %7 "e.,%&(e&#. 'y !"e! !&( 4&%?e(*e %7 HIV #"!&.)$..$%& 8D T!'e :.2;: Pe"ce&#!*e ($.#"$'+#$%& %7 "e.,%&(e&#. 'y !"e! !&( 4&%?e(*e %7 HIV #"!&.)$..$%& ENHA3>F /e%*"!,5$c! !"e! ?5e"e #5e $&.#$#+#$%& $. %c!#e( K&%?e(*e %7 HIV/AIDS #"!&.)$..$%& E$& ,e"ce&#!*eF T%#! 3 2 6 8 : ; %entral 1nH<D34 2=.3 28.2 :2.2 28.9 7.9 <.= :33 'utskirts of town 1nH8:=4 83.< 83.2 :8.= :7.8 7.D 3.8 :33 C5$ .C+!"e H6:.8<A (7H;0 ,I3.332 "mong the -omen literacy in the central region! 2=; did not have knowledge about (I) transmission and <.=; knew the five ways of (I) transmission. 'n the other hand! about 8:; -omen literacy in the southwest region did not have knowledge and U:; knew five ways of transmission. /nowledge level is highly associated 1pU 3.3:4 with location of the respondents. The -omen literacy of central region was more knowledgeable than those of the southwest region. :.28 Pe"ce&#!*e ($.#"$'+#$%& %7 "e.,%&(e&#. ?$#5 ,!"#$c$,!#$%& $& !c#$-$#y %7 HIV ,"e-e&#$%& ,"%*"!) 'y 4&%?e(*e %7 HIV/AIDS T!'e :.2<: Pe"ce&#!*e ($.#"$'+#$%& %7 "e.,%&(e&#. ?$#5 ,!"#$c$,!#$%& $& !c#$-$#y %7 HIV ,"e-e&#$%& ,"%*"!) 'y 4&%?e(*e %7 HIV/AIDS ENHA3;F P!"#$c$,!#$%& $& !c#$-$#y %7 HIV ,"e-e&#$%& ,"%*"!) K&%?e(*e %7 HIV/AIDS #"!&.)$..$%& E$& ,e"ce&#!*eF T%#! 3 2 6 8 : ; Ies 1nH:D74 9.: :7.= D.C 88.3 28.D ::.C :33 Go 1nH73=4 8<.D 27.= :8.C :=.3 2.8 2.9 :33 C5$ .C+!"e H622.<; (7H;0 ,I3.332 "mong those who participated in (I) prevention program! only 9; the -omen literacy did not have knowledge about (I) transmission and :2; knew five ways of transmission 1Table 9.:C4. (owever among those who had not participated in the (I) prevention program! 8C; of the -omen literacy did not have knowledge and 2.9; knew five ways of (I) transmission. The relationship between knowledge and participation in (I) prevention program was highly significant 1pU 3.33:4. 93 :.2: Pe"ce&#!*e ($.#"$'+#$%& %7 "e.,%&(e&#. 'y .e7 ,e"ce$-e( "$.4 !&( 4&%?e(*e %7 HIV #"!&.)$..$%& T!'e :.2=: Pe"ce&#!*e ($.#"$'+#$%& %7 "e.,%&(e&#. 'y .e7 ,e"ce$-e( "$.4 !&( 4&%?e(*e %7 HIV #"!&.)$..$%& Pe"ce$-e( "$.4 K&%?e(*e %7 HIV/AIDS #"!&.)$..$%& E$& ,e"ce&#!*eF T%#! 3 2 6 8 : ; Go risk 1nH8CC4 C<.D :<.3 C.8 :3.9 :.D 3.< :33 5isk 1nH<874 8.< 82.= :7.8 2=.7 ::.< C.2 :33 C5$ .C+!"e H:2A.63> (7H;0 ,I3.332 "mong the -omen literacy who believed that they had no risk of contacting (I)! CC; had no (I) transmission knowledge 1Table 9.:74. "mong this group half of one percent knew of five ways of (I) transmission. 'n the other hand! among the -omen literacy who thought that they were at risk of ac>uiring (I)! 8.<; had no knowledge about (I) transmission! while C.:; knew of five ways of (I) transmission. (ere self perceived risk is tested for association with knowledge level. The result showed a highly significant association 1pU 3.33:4 between the two variables indicating that those who think that they are at risk of ac>uiring (I) will have more knowledge about (I) transmission than those who do not perceived that they are at risk. :.2; A..%c$!#$%& 'e#?ee& .!7e.e@ ,"!c#$ce !&( .%c$%(e)%*"!,5$c c5!"!c#e". "mong the socio+demographic characters of the -omen literacy last weekEs income 1pU3.33:4 and duration in the profession 1pU3.33<4 were statistically associated with safe sex practice. "mong the -omen literacy were earned less than their average! 2C; used protections consistently with last client! while among those who earned more than average only :9.:; of the (I)/"I* control used protections consistently with last client 1Table 9.:=4. Those who had been in the sex industry less than one year were the least likely to use protections consistently with last client. 'nly :8; of them did so. There was no association of practicing safe sex with age of the -omen literacy! their educational background and where their s were situated. 9: :.2<: Pe"ce&#!*e ($.#"$'+#$%& %7 .!7e .e@ ,"!c#$ce %7 W%)e& $#e"!cy 'y .%c$% (e)%*"!,5$c 7!c#%".0 ,"%*"!))!#$c 7!c#%".0 ,.yc5%1.%c$! 7!c#%". !&( 4&%?e(*e %7 HIV #"!&.)$..$%& T!'e :.2>: Pe"ce&#!*e ($.#"$'+#$%& %7 HIV/AIDS C%&#"% Le-e. %7 W%)e& $#e"!cy 'y S%c$% De)%*"!,5$c F!c#%".0 ,"%*"!))!#$c 7!c#%".0 ,.yc5%1.%c$! 7!c#%". !&( 4&%?e(*e %7 HIV #"!&.)$..$%& I&(e,e&(e&# -!"$!'e De,e&(e&# -!"$!'e E.!7e .e@F T%#! S#!#$.#$c. S%c$%(e)%*"!,5$c 7!c#%" N% Ye. A*e *"%+, 1nH=D34 U23 years 77.9 22.C :3312=74 W 2 H3.CC< pU3.3< 2:+83 years 7D.9 23.C :331834 V83 years =3.= :D.2 :331784 E(+c!#$%& 1nH=794 Go &ducation 7=.= 2:.2 :3317374 W 2 H3.C77 pU3.33: (ave education =3.2 :D.= :331:C74 I&c%)e 1nH=C94 U/shs.<333 79.: 2<.D :331<3D4 W 2 H:7.C<= pU3.33: V/shs.<333 =<.D :9.: :3318<<4 L$#e"!cy D+"!#$%& 1nH=D34 U: years =7.: :2.D :331:C84 W 2 H::.7== pU3.33< : to < years 79.< 2<.< :3318C84 C to :3 years 7=.3 22.3 :3312<94 V:3 years =2.< :7.< :331:234 /e%*"!,5$c! !"e! 1nH=D34 %entral 7=.< 2:.< :331<=24 W 2 H3.:27 pU3.3< 'utskirts of town 7D.< 23.< :33183=4 P"%*"!))e 7!c#%" HIV ,"e-e&#$%& ,"%*"!) ,!"#$c$,!#$%& 1nH=D34 Ies C2.= 87.2 :331:DC4 W 2 H8D.<39 pU3.3< Go =8.< :C.< :331CD94 Se7 ,e"ce$-e( "$.4 1nH=D34 Go risk =8.C :C.9 :3318<D4 W 2 H7.DD: pU3.33< (ave risk 7<.7 29.8 :331<2C4 I&#e")e($!#e -!"$!'e K&%?e(*e %7 HIV #"!&.)$..$%& core 3 =<.7 :9.8 :3312<D4 W 2 H93.C:C pU3.33: core : =9.3 :C.3 :33122D4 92 1nH=D34 core 2 79.C 2<.9 :331::94 core 8 7C.8 28.7 :331:D34 core 9 <8.3 97.3 :331C=4 core < 79.8 2<.7 :3318<4 *espite the existing empirical evidence! many employees and young professionals believe (I) no longer exists or is rare in organi0ational settings. This is evidenced by comments made in the classroom and/or during training sessions when incidents/cases are discussed. "dditionally! these individuals perceive that if (I) were to occur it would most likely not happen to them. "s such! the purpose of this study was to explore the perceptions of employees about literacy issues in the workplace! specifically (I)! and to identify gaps! if they exist! in employeesE perceptions and the realities of (I) in todayEs workplace. This study asked employees to indicate how likely it is that they will experience (I) in the workplace! how likely it is that others will experience (I) in the workplace! and to also indicate the extent to which (I)! if it does occur! would impact their careers. exual harassment issues are also explored in the survey! however these will be analy0ed in future work. 98 CHAPTER FIVE: DISCUSSIONS0 CONCLUSIONS AND RECOMMENDATIONS ;.3 I&#"%(+c#$%& The organi0ation of this chapter involves the discussion of research findings covering the following research objectives. It then draws conclusions and highlight recommendations to the study. The sub headings were described as below. ;.2 D$.c+..$%&. %7 F$&($&*. In the light of the growing epidemic! safe sex practice is crucial to prevent (I). "mong the elements of safe sex practice! consistent protection use has been widely approved as an appropriate (I) preventive measure particularly for the 5espondents. (owever! T*/(I) prevention education for 5espondents has been ignored. 6revention of (I) for 5espondents has traditionally focused on increasing protection use. -hile this is clearly the proximate determinant of diminished risk! achieving this goal is not easy. The constraints on the lives of 5espondents are great. 'n the other hand! poorly conceived efforts to rehabilitate the victims over past few years! have played havoc with the lives of these women. Increased empowerment and organi0ational growth among these highly marginali0ed and stigmati0ed persons can only threaten the status >uo and may be responsible for increased reports of violence by men such as police and gangsters. 'ne important advantage of workplace based health education is that health education programs can touch the population directly. Therefore! medical personal and health educator 99 should go to the service sectors to co+operate with the owners of the services sectors in considering government policies related to commercial sex. -orkplace based health education should focus on safe sex education among the 5espondents in order to enhance their ability to protect themselves. The study has shown that educationally disadvantaged women were not able to access information on (I)/"I* control due to socio+economic pressures. Therefore a total of =9; of the respondents indicated some level of education which means the average literacy level of these patients is relatively high. This explains the strong impact of a lower literacy level on the tendency for the respondents to miss taking their "5)s. Therefore literacy level 1W 2 H :<.93! df H=! p H 3.3<4 is one of the factors that determine optimal adherence to "5)s. This study indicated that there was a relationship between a women literacy on respondentsE tendency to miss their "5) doses 1W 2 H 2C.<=! df H =! p H 3.33:4. The survey consistently identified difficulties in communications as the key factor in blocking womenEs access to (I)/"I* information. Understandably! radio is not a source of information for the women population. -hile =<; of women respondents claimed literacy! the low rate of newspaper and maga0ine readership among the women group may in fact! reflect lower reading proficiency within this population. This is consistent with international findings of poorer educational standards for women populations. The sources from which the women and the vulnerable population is getting their information are also of concern. 6osters and bill boards do not contain in depth information and tend to be in &nglish! which is taught only in secondary schools! rather than in the local language. Television was reported as a source of information by CC; of the women and the vulnerable individuals. The amount of factual information on (I)/"I* available to women and the vulnerable audiences! based on visual interpretations of television programming! is open to >uestion and deserves further investigation. ;.6 C%&c+.$%&. 9< Though (I)/"I* is weld disease! prevention of the disease is far more difficult to achieve yet. The number of people living with (I) and the death toll from "I* are increasing everyday. The disease was spread or transmission at the beginning. Therefore! women and the vulnerable groups are considered to play an important role in the (I) epidemic and contribute disproportionately to the spread of (I) due to their large number of sexual partners 16eter! 233:4. These high+risk populations may not have sufficient knowledge to prevent themselves. (owever! knowledge of "I* alone may not be sufficient to prevent (I) infection. There are other factors such as socio+demographic factors including individual perceptions! attitudes! and behaviors! which influence the (I) infection 1$ann.Q et al.! :DD24. /nowledge! attitude! and beliefs about (I) transmission play an important role in preventing (I)/"I*. If sex workers know about (I) transmissions and have positive attitudes towards protection use! they are more likely to engage in safe sexual behavior. If sex workers view protection as an effective way to prevent (I) transmission! they would accept using protections with their clients. /nowledge about "I* and the conse>uence of (I) infection indeed play an important role in motivating proper management and control of (I)/"I*. The results of the survey clearly indicated a significant gap in knowledge about (I) prevention among women. The /enya women are already keenly aware of this discrepancy. %omments from women respondents included the need for more information about how (I)/"I* was transmitted and how it can be prevented. "lmost universally! respondents felt the greatest need is for information and health services to be available! in order to facilitate their ability to ac>uire information! ask >uestions and discuss the issues surrounding (I)/"I* prevention and care. The study hypothesi0ed that the gap in communication about (I)/"I* leads members of the women to feel less able to negotiate safer lifestyles. " reduced ability to recogni0e symptoms of (I)/"I* by members of the women may delay appropriate care and management of the infection. $oreover! once a women individual does seek treatment from a healthcare facility! his or her privacy may be compromised. (ealthcare staff is also reported to be largely unaware that women individuals may be sexually active and this may further deter women individuals 9C from seeking help. -omen surveyed in this study report being turned away at (I) testing sites by clinic staff who assume that they could not be (I) positive. This assumption is not uni>ue to women individuals. It has been widely reported for individuals with all types of disabilities! and this lack of awareness on the part of (I)/"I* experts appears to be a major barrier to the inclusion of these populations in (I)/"I* outreach efforts. ;.8 Rec%))e&(!#$%&. ?irstly! more effective measure should be taken to ensure and subsidi0e female adolescents to finish twelve years of compulsory educations@ this will not only reduce women entering in to commercial sex but will increase protection use among 6rotections and their clients. Therefore! it is recommended that policy makers should consider legal reforms and investments out side the health sectors as "I* control strategies. econdly! educational reform! such as developing vocational education could help young women adapt to socio+economic development. It can teach the young women and 6rotections different kinds of working skills so that they can have more opportunity to find jobs outside commercial sex. In addition! night school or day school in urban areas can also be organi0ed in order to train female who are vulnerable to entering into sex work. ?urthermore! provision for vocational training for 6rotections will increase their sense of future and self+esteem! which in turns motivates the 6rotections to practice better (I)/"I* control mechanisms. ;.: S+**e.#$%&. 7%" 7+"#5e" S#+($e. ?irst! due to time limitation! this study was carried out on secondary data collected by the Aehavioral urveillance urvey 1A 23334. "ll the variables of interest were not available according to researcherEs will as well as the variables were collected on >uantitative models. Therefore! further studies among 5espondents in the brothels can be carried out with >ualitative variables and in depth investigation on the reasons for low protection use. econdly! 5espondents in /enya have many faces+ brothel based! street! hotel based! and non+ professional 5espondents. 5esearchers did not identify the large proportions of the 5espondents regularly! while these groups contribute a large proportion of unprotected sexual 97 act. Therefore! studies should be performed on these groups 5espondentsF on their high+risk behavior! psychosocial factors including their self+perceived risk and selfesteem! and impact of program on their practice. "ccording to the findings of the study! it is recommended that (I) preventive functions of protections should be emphasi0ed. In order to increase regular protection use among 5espondents! the contents of safe sex education should include how to use protection correctly and how to negotiate protections use with clients effectively. Re7e"e&ce. "insworth and emali! :DD=@ (argreaves and #lynn! 2333@ &ducational attainment and (I) infection in developing countriesF a review o f the published literature. .ondon! Infectious *isease &pidemiology Unit! *epartment of Infectious and Tropical *iseases! .ondon chool of (ygiene and Tropical $edicine "rcher and %ottingham! :DDC! -ho is most likely to die of "I*, ocioeconomic correlates of adult deaths in /agera region! Tan0ania "0erbaijani+$oghadam! .! 233:! %onfronting "I*F evidence from the developing world. Arussels! &uropean %ommission@ -ashington! *%! -orld Aank Aabbie! :DD3@ ?owler *elamonica! &.! :DD<. The Neducation vaccineO against (I). %urrent issues in comparative education 1Gew Iork! GI4! vol. 8! no. :. 'nline versionF www.tc.colum+ bia.edu/cice . Aaker! *.-.! 6arker! 5.$.! -illiams! $.).! T %lark! -.. 1:DD=4. (ealth literacy and the risk of hospital admission. Journal of General Internal Medicine Ahola! :D=9! managing the impact of (I)/"I* on the education sector in outh "frica. 6aper commissioned by United Gations &conomic %ommission for "frica 1UG&%"4 in preparation for the "frica *evelopment ?orum 2333. "ddis "baba! Aush! /./ altarelli! *.! 2333@ The impact o f (I)/"I* on education systems in the eastern and southern "frica region and the response of education systems to (I)/"I*F life skills programmes. 6aper presented to the "ll ub+aharan "frica %onference on &ducation for "ll 2333! Qohannesburg! *ecember %enter for (ealth %are trategies. 1n.d.4. Impact of low health literacy scores on annual health care expenditures. 5etrieved *ecember :D! 2338! from httpF//www.chcs.org/resource/pdf/hl8.pdf 9= %hwedyk! 6. 12338! ?all4. )ital signsF *iabetes health literacy board hopes to close patient education gaps. Minority Nurse, 9. ?elecia #. -ood! *G! 5G! 123334! (&".T( .IT&5"%I IG " 5U5". %.IGI%! 'nline Qournal of 5ural Gursing and (ealth %are ?reire! :D72@ the socioeconomic correlates of sexual behaviourF a summary of results from an analysis of *( data ?ylkesnes! /.! et al. :DDD. ?avorable changes in the (I) epidemic in Sambia in the :DD3s. 6aper presented at eleventh International %onference on "I* and T*s in "frica! .usaka! eptember #achuhi! :DDD@ /ippax! mith and "ggleton! 2333@ UG&%"! 2333! "I* in "frica! country by country. #eneva! UG"I*. /alichman! .%.! 5amachandran! A.! T %at0! . 1:DDD4. "dherence to combination antiretroviral therapies in (I) patients of low health literacy. Journal of General Internal Medicine, !! 2C7+278. /irsch! I..! Qungeblut! ".! Qenkins! ..! T /olstad! ". 1:DD84. "dult literacy in "merica# " first loo$ at the results of the National "dult Literacy Survey. -ashington! *%F Gational %enter for &ducation tatistics! U.. *ept. of &ducation. .ind! :DD<! %onfronting "I*F evidence from the developing world! p. D<+:3D $ontalto! G.Q.! T piegler! #.&. 1233:4. ?unctional health literacy in adults in a rural community health center. %est &ir'inia Medical Journal, 9(! :::+::9 5idgeway and %orrell 2339! 6lanning for education in the context of (I)/"I*. 6aris! International Institute for &ducational 6lanning chillinger! *.! #rumbach! /.! 6iette! Q.! -ang! ?.! 'smond! *.! *aher! %.! et al. 123324. "ssociation of health literacy with diabetes outcomes. Journal of the "merican Medical "ssociation, )**! 97<+9=2 United Gations &conomic %ommission for "frica. 2333. (I)/"I* and education in &astern and outhern "frica. The leadership challenge and the way forward. ynthesis 5eport for "frica *evelopment ?orum 2333! "ddis "baba! *ecember. "ddis "baba! "frica *evelopment ?orum ecretariat! &conomic %ommission for "frica. United Gations &ducational! cientific and %ultural 'rgani0ation. 2333. -orld &ducation ?orum! *akarF final report. 6aris! UG&%'. UG&%'. :D97. +undamental ,ducation# -ommon Ground for "ll .eoples. 5eport of a pecial %ommittee to the 6reparatory %ommission. 6aris! UG&%'. 9D X. :DDC. Learnin'# /he /reasure %ithin. 5eport to UG&%' of the International %ommission on &ducation for the Twenty+fi rst %entury. 6aris! UG&%' X. 2333. %orld ,ducation 0eport# /he 0i'ht to ,ducation, /owards ,ducation for "ll /hrou'hout Life. 6aris! UG&%' X. 2333. Literacy for "ll# " 1nited Nations Literacy 2ecade. " *iscussion 6aper. 6aris! UG&%' UGIT&* G"TI'G #&G&5". "&$A.I. "/5&/<</2:3 of ?ebruary 233:. Implementation of the +irst 1nited Nations 2ecade for the ,radication of .overty 399(4)5567 X. "/5&/<C/82C of C eptember 233:. 0oad Map /owards the Implementation of the 1nited NationsMillennium 2eclaration X. "/5&/<C/::C of := Qanuary 2332. 1nited Nations Literacy 2ecade# ,ducation for "ll. X. "/5&/<7/2:= of :C Quly 2332. 1nited Nations Literacy 2ecade# ,ducation for "ll# International .lan of "ction.)andemoortele! Q.@ *elamonica! &. 2333. The Neducation vaccineO against (I). %urrent issues in comparative education 1Gew Iork! GI4! vol. 8! no. :. 'nline versionF www.tc.colum+bia.edu/cice UG"I* 1:DD74F 6reventing (I)/"I*F UG"I* point of view@ 8+9. UG"I* 123324F 5eport on the #lobal (I)/"I* &pidemics!F 93+9:. UG"I* 123324F TI/(I)F :33; condo use program for sex workers accessed online at www.unaids.org/bestpractice/digest/files/html. -eiss! A.*. 1&d.4. 1:DDD4. )5 common pro8lems in primary care. Gew IorkF $c#raw (ill UG&%".2333b. /eeping the education system healthyF managing the impact of (I)/"I* on education in outh "frica. %urrent issues in comparative education 1Gew Iork! GI4! 'nline versionF www.tc.columbia.edu/cice )andemoortele and *elamonica 2333! outh "fricaF sexual violence rampant in schools! harassment and rape hampering girlsO education. Gew Iork! (uman 5ights -atch -illiams! $.).! Aaker! *.-.! (onig! &.#.! .ee! T.$.! T Gowlan! ". 1:DD=4. Inade>uate literacy is a barrier to asthma knowledge and self+care. -hest, !! :33=+:3:<. -illiams! $.).! Aaker! *.-.! 6arker! 5.$.! T Gurss! Q.5. 1:DD=4. 5elationship of functional health literacy to patientsE knowledge of their chronic disease. "rchives of Internal Medicine, 9*! :CC+:72 -orld Aank. Adolescents and Youth with Disability: Issues and Challenges International 6olicy and 6rograms. -ashington! -orld Aank! 2338 <3 A,,e&($@: Q+e.#$%&&!$"e S!),e Q+e.#$%&&!$"e SECTION A: PERSONAL DATA :. #ender $ale 14 ?emale 14 2. "ge bracket 23+2D 1 4 83+8D 1 4 93+9D 1 4 <3+<D 1 4 C3+"bove 1 4 8. $arital tatus $arried 1 4 ingle 1 4 eparated/*ivorced 1 4 -idowed 1 4 9. &ducational .evel 6rimary/econdary 1 4 %ollege *iploma 1 4 *egree 1 4 $asters #raduate 1 4 6h* *egree 1 4 'thers 1 4 <. .ength of tay in the *epartment 3+9 1 4 <+D 1 4 :3+:9 1 4 <: :<+:D 1 4 23+and $ore 1 4 SECTION B: /ENERAL INFORMATION C. *epartmental #ender *istribution of &mployees *epartment $ale employees ?emale employees "dministration "ccounting and ?inance 6rocurement/6urchases 6roduction/ales (uman 5esources 'rganisational 6lanning 5eception and ecretarial 7. 6ercent %hange in %onstant+hillings $onthly &arnings! by &ducational "ttainment and ex! 2333R23:3 H$*5e.# E(+c!#$%& Le-e 6ercent %hange in %onstant+hillings $onthly &arnings per #ender $en -omen AachelorEs *egree and (igher ome %ollege or "ssociate *egree (igh chool! no %ollege .ess than a (igh chool *iploma =. *istribution of ?ull+Time -age and alary &mployment! by ex and $ajor 'ccupation #roup! 23:3 "nnual "verages Occ+,!#$%& Ty,e Pe"ce&#!*e %7 T%#! Me& W%)e& $anagement! Ausiness! and financial 'perations 6rofessional and 5elated ervice ales and 5elated 'ffice and "dministrative upport Gatural 5esources! %onstruction and $aintenance 6roduction! Transportation and $aterial+moving D. 6ercent of .iterate 6opulation 'ver ix Iears 'ld A"e! 2A>A 2AAA 633A M!e Fe)!e M!e Fe)!e M!e Fe)!e &ast -est Gort h %A* <2 :3. "ctivity and unemployment rates by gender and age group 1;4 in 23:3 A*e EY".F M!e. Fe)!e. U&e),%y)e&# "!#e Ac#$-$#y "!#e U&e),%y)e&# "!#e Ac#$-$#y "!#e :<RC9 :<R29 2<R89 8<R99 9<R<9 <<RC9 ::. &mployment and Un+&mployment 5ates for -omen "ged :<RC9 1;4! by &ducational .evel! 23:3 &ducation .evel &mployment Unemployment Go &ducation 6rimary .ower econdary Upper econdary Tertiary :2. .ikelihood of gender bias against self 1negative responses4 #ender Gever 5arely 6ossibly 6ercentage 1negative4 $ale ?emale :8. .ikelihood of gender affecting opportunities of advancement #ender Gever 5arely 6ossibly 6ercentage negative4 $ale ?emale :9. .ikelihood of gender affecting opportunities for networking 1negative responses #ender Gever 5arely 6ossibly 6ercentage 1negative4 $ale ?emale :<. .ikelihood of gender affecting opportunities for mentoring 1negative responses4 #ender Gever 5arely 6ossibly 6ercentage 1negative4 $ale ?emale <8 :C. .ikelihood of gender affecting pay 1negative responses4 #ender Gever 5arely 6ossibly 6ercentage 1negative4 $ale ?emale :7. .ikelihood of gender discrimination outcomes based on gender of respondents #ender Impact of #* on self confidence Impact of #* on career advancement Impact of #* on job satisfaction Impact of #* on organi0ational commitment Impact of #* on career commitment $ale ?emale :=. .ikelihood of gender discrimination outcomes based on $anagement level of respondents .evel of $anagement Impact of #* on self confidence Impact of #* on career advancement Impact of #* on job satisfaction Impact of #* on organi0ational commitment Impact of #* on career commitment Top and $id .ower <9