scholarly journals Participant understanding of informed consent in a multidisease community-based health screening and biobank platform in rural South Africa

2020 ◽  
Vol 12 (6) ◽  
pp. 560-566
Author(s):  
Nothando Ngwenya ◽  
Manono Luthuli ◽  
Resign Gunda ◽  
Ntombizonke A Gumede ◽  
Oluwafemi Adeagbo ◽  
...  
Keyword(s):  
South Africa ◽  
Informed Consent ◽  
Economic Status ◽  
Target Population ◽  
Specific Power ◽  
Community Based ◽  
Middle Income ◽  
Biospecimen Collection ◽  
Participant Understanding ◽  
The Impact

Abstract Background In low- and middle-income settings, obtaining informed consent for biobanking may be complicated by socio-economic vulnerability and context-specific power dynamics. We explored participants experiences and perceptions of the research objectives in a community-based multidisease screening and biospecimen collection platform in rural KwaZulu-Natal, South Africa. Methods We undertook semi-structured in-depth interviews to assess participant understanding of the informed consent, research objectives and motivation for participation. Results Thirty-nine people participated (individuals who participated in screening/biospecimen collection and those who did not and members of the research team). Some participants said they understood the information shared with them. Some said they participated due to the perceived benefits of the reimbursement and convenience of free healthcare. Most who did not participate said it was due to logistical rather than ethical concerns. None of the participants recalled aspects of biobanking and genetics from the consent process. Conclusions Although most people understood the study objectives, we observed challenges to identifying language appropriate to explain biobanking and genetic testing to our target population. Engagement with communities to adopt contextually relevant terminologies that participants can understand is crucial. Researchers need to be mindful of the impact of communities’ socio-economic status and how compensation can be potentially coercive.

scholarly journals The impact of illicit drug networks on the effectiveness of law enforcement in South Africa

2022 ◽  
Vol 27 ◽  
pp. 338-360
Author(s):  
Petrus Machethe ◽  
Jacob Tseko Mofokeng
Keyword(s):  
South Africa ◽  
Law Enforcement ◽  
Illicit Drugs ◽  
Illicit Drug ◽  
Economic Status ◽  
Target Population ◽  
Geographical Differences ◽  
Drugs And Crime ◽  
The Impact ◽  
Drug Networks

In the past few years, South Africa has experienced an enormous increase in the amount and types of illicit drug manufacturing, distribution and use. This has resulted in an increase in the burden of crime and health risks in the community. The patterns of drug availability and drug use have been linked to regional and country variations, socio-economic status, racial and geographical differences. Because of the dramatic increase in the availability of various illicit drugs, the United Nations Office on Drugs and Crime World Drug Report (2012) identified South Africa as one of the drug centres of the world. This raises concerns about whether law enforcement agencies perform their functions effectively. This paper focuses on the illicit drug networks that hinder the effectiveness of law enforcement in South Africa. The modus operandi used to produce and smuggle illicit drugs and the challenges experienced by law enforcement to prevent and combat illicit drugs will be discussed. The data was collected through in-depth interviews with experts within the criminal justice system in South Africa. The study conducted in 2017/ 2018 in terms of the scientific measurements, has adopted a qualitative approach. Data was collected from a target population consisting of 11 SAPS drug-related crime experts, including members of the SAPS specialised detectives of the Directorate for Priority Crime Investigation (DPCI), crime intelligence members, border police, the International Criminal Police Organisation (INTERPOL) and commanders at ports of entries. A documentary study was used as a secondary method of data collection. Data obtained from interviews were analysed by identifying common themes from the respondents' descriptions of their experiences.

scholarly journals Is socio-economic status a determinant of HIV-related stigma attitudes in Zimbabwe? Findings from Project Accept

2016 ◽  
Author(s):  
Kudzanai Mateveke ◽  
Basant Singh ◽  
Alfred Chingono ◽  
E. Sibanda ◽  
Ian Machingura
Keyword(s):  
Social Isolation ◽  
Assessment Tool ◽  
Economic Status ◽  
Target Population ◽  
Low Ses ◽  
Voluntary Counseling And Testing ◽  
Socio Economic Status ◽  
Stigma And Discrimination ◽  
Related Stigma ◽  
The Impact

HIV related stigma and discrimination is a known barrier for HIV prevention and care. We aimed to assess the relationship between socio-economic status (SES) and HIV related stigma in Zimbabwe. This paper uses data from Project Accept, which examined the impact of community-based voluntary counseling and testing intervention on HIV incidence and stigma. Total of 2522 eligible participants responded to a psychometric assessment tool, which assessed HIV related stigma and discrimination attitudes on 4 point Likert scale. The tool measured three components of HIVrelated stigma: shame, blame and social isolation, perceived discrimination, and equity. Participants’ ownership of basic assets was used to assess the socio-economic status. Shame, blame and social isolation component of HIV related stigma was found to be significantly associated with medium [odds ratio (OR)=1.73, P<0.01] and low SES (OR=1.97, P<0.01), indicating more stigmatizing attitudes by participants belonging to medium and low SES in comparison to high SES. For HIV related stigma and discrimination programs to be effective, they should take into account the socio-economic context of target population.

scholarly journals Doctors’ Extended Shifts as Risk to Practitioner and Patient: South Africa as a Case Study

2020 ◽  
Vol 17 (16) ◽  
pp. 5853
Author(s):  
Koot Kotze ◽  
Helene-Mari van der Westhuizen ◽  
Eldi van Loggerenberg ◽  
Farah Jawitz ◽  
Rodney Ehrlich
Keyword(s):  
South Africa ◽  
South African ◽  
Medical Practice ◽  
Health And Safety ◽  
Working Hours ◽  
Middle Income ◽  
The Impact ◽  
Safe Working ◽  
Working Hour

Extended shifts are common in medical practice. This is when doctors are required to work continuously for more than 16 h, with little or no rest, often without a maximum limit. These shifts have been a part of medical practice for more than a century. Research on the impact of fatigue presents compelling evidence that extended shifts increase the risk of harm to patients and practitioners. However, where the number of doctors is limited and their workloads are not easily reduced, there are numerous barriers to reform. Some of these include a perceived lack of safer alternatives, concerns about continuity of care, trainee education, and doctors’ preferences. As such, working hour reorganisation has been contentious globally. South Africa, a middle-income country where extended shifts are unregulated for most doctors, offers a useful case study of reform efforts. The South African Safe Working Hours campaign has promoted working hour reorganization through multi-level advocacy efforts, although extended shifts remain common. We propose that extended shifts should be regarded as an occupational hazard under health and safety legislation. We suggest options for managing the risks of extended shifts by adapting the hierarchy of controls for occupational hazards. Despite the challenges reform pose, the practice of unregulated extended shifts should not continue.

scholarly journals What will it cost to prevent violence against women and girls in low- and middle-income countries? Evidence from Ghana, Kenya, Pakistan, Rwanda, South Africa and Zambia

2020 ◽  
Vol 35 (7) ◽  
pp. 855-866 ◽  
Author(s):  
Sergio Torres-Rueda ◽  
Giulia Ferrari ◽  
Stacey Orangi ◽  
Regis Hitimana ◽  
Emmanuelle Daviaud ◽  
...  
Keyword(s):  
South Africa ◽  
Violence Against Women ◽  
National Level ◽  
Cost Data ◽  
Community Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Unit Costs ◽  
Prevention Interventions ◽  
Women And Girls

Abstract Violence against women and girls (VAWG) is a global problem with profound consequences. Although there is a growing body of evidence on the effectiveness of VAWG prevention interventions, economic data are scarce. We carried out a cross-country study to examine the costs of VAWG prevention interventions in low- and middle-income countries. We collected primary cost data on six different pilot VAWG prevention interventions in six countries: Ghana, Kenya, Pakistan, Rwanda, South Africa and Zambia. The interventions varied in their delivery platforms, target populations, settings and theories of change. We adopted a micro-costing methodology. We calculated total costs and a number of unit costs common across interventions (e.g. cost per beneficiary reached). We used the pilot-level cost data to model the expected total costs and unit costs of five interventions scaled up to the national level. Total costs of the pilots varied between ∼US $208 000 in a small group intervention in South Africa to US $2 788 000 in a couples and community-based intervention in Rwanda. Staff costs were the largest cost input across all interventions; consequently, total costs were sensitive to staff time use and salaries. The cost per beneficiary reached in the pilots ranged from ∼US $4 in a community-based intervention in Ghana to US $1324 for one-to-one counselling in Zambia. When scaled up to the national level, total costs ranged from US $32 million in Ghana to US $168 million in Pakistan. Cost per beneficiary reached at scale decreased for all interventions compared to the pilots, except for school-based interventions due to differences in student density per school between the pilot and the national average. The costs of delivering VAWG prevention vary greatly due to differences in the geographical reach, number of intervention components and the complexity of adapting the intervention to the country. Cost-effectiveness analyses are necessary to determine the value for money of interventions.

scholarly journals Intersectoral (in)activity: towards an understanding of public sector department links between water, sanitation and hygiene (WASH) and childhood undernutrition in South Africa

2020 ◽  
Vol 35 (7) ◽  
pp. 829-841 ◽  
Author(s):  
D J Momberg ◽  
P Mahlangu ◽  
B C Ngandu ◽  
J May ◽  
S A Norris ◽  
...  
Keyword(s):  
South Africa ◽  
Public Sector ◽  
Nutritional Status ◽  
Physical Growth ◽  
Human Right ◽  
Poor Child ◽  
Middle Income ◽  
Sanitation And Hygiene ◽  
Nutritional Status Of Children ◽  
The Impact

Abstract Associations between different forms of malnutrition and environmental conditions, including water, sanitation and hygiene (WASH), contribute to poor child health, nutritional status and physical growth. The primary responsibility for the provision of water and sanitation, as a basic service and human right, lies with the State, as such, a number of stakeholders are involved. Despite relatively high levels of WASH infrastructure coverage in South Africa, enteric infections and stunting remain high for a middle-income country. The aim of this study is to elucidate the landscape of WASH in South Africa in relation to nutritional status of children under the age of 5 years in the South African, Gauteng and City of Johannesburg contexts. The authors detailed the national and provincial public sector departments and through purposive sampling proceeded to map the various departments and associated policies that are responsible for the provision of WASH facilities, as well the nutritional status of children. Of the six policies identified for review, three mentioned WASH, nutrition and children; however, none explicitly linked WASH to nutritional status in children. An in-depth review and analysis of these three crucial policy documents was conducted. Finally, a set of expert interviews were conducted and a consensus development conference convened, with experts at the intersection between WASH and nutritional status. The authors found that the public sector would benefit from better integration of the concept of WASH into their policy, planning and implementation frameworks. The WASH sector should emphasize the role in which WASH plans consider the impact of WASH on the nutritional status of children. The various public sector departments involved in WASH service provision, and other WASH stakeholders, including community-based organizations, non-governmental organizations and intergovernmental organizations, should be involved in the decision-making of the nutrition sector.

scholarly journals Non-medical Interventions to Reduce the Burden of Psychosocial and Economic Impacts of COVID-19 Pandemic: A Scope Review

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Sajjad Azmand ◽  
Hassan Joulaei ◽  
Maryam Fatemi
Keyword(s):  
Economic Status ◽  
Target Population ◽  
Developed Countries ◽  
Vital Role ◽  
Vulnerable Groups ◽  
Economic Aspects ◽  
Negative Consequences ◽  
Middle Income ◽  
Medical Interventions ◽  
Middle Income Countries

Context: COVID-19, like the other pandemics, apart from its impacts on peoples' health, has had diverse huge impacts on psycho-socio-economic aspects of societies globally. Hence, applying appropriate interventions to reduce the indirect burden of this pandemic is as important as patients’ care. Objectives: In this study, we aimed to review the main interventions against the economic and psychosocial impacts of the COVID-19 pandemic. Method: This scope review was conducted to determine what measures have been taken by governments against different non-medical (economic and psychosocial) consequences of the COVID-19 pandemic. The authors reviewed the relevant articles published from December 2019 to December 2020 through three databases of PubMed/MEDLINE, Scopus, and Google Scholar. The interventions in three areas of economic, social, or psychological were exerted, and in the review of the articles, the country and the target population were considered. Finally, the results were categorized and presented descriptively. Results: Regarding the negative consequences of the COVID-19 pandemic in psychosocial and economic aspects of societies, governments, especially in developed countries, have established measures to reduce the burdens of these consequences. Apart from interventions related to the general population, at-risk and vulnerable groups and also those with low socio-economic status are specific target populations for interventions. Conclusions: The future of the COVID-19 pandemic is uncertain and unpredictable. Governments and their decisions will play a vital role in determining the trend of the pandemic. Therefore, it is the responsibility of governments, especially in lower-middle-income countries (LMICs), to support vulnerable people and protect them against the devastating socio-economic and psychological effects of this pandemic using all their capacity.

scholarly journals Why do people continue to live near polluted sites? Empirical evidence from Southwestern Europe

2021 ◽  
Author(s):  
Pierre Levasseur ◽  
Katrin Erdlenbruch ◽  
Christelle Gramaglia
Keyword(s):  
Affordable Housing ◽  
Unobserved Heterogeneity ◽  
Economic Status ◽  
Location Choices ◽  
Middle Income ◽  
Original Dataset ◽  
The Us ◽  
Residence Location ◽  
Pollution Exposure ◽  
The Impact

Abstract Poverty is a major determinant for pollution exposure, according to the US location choice literature. In this paper, we assess the impact of socio-economic status on location choices in the European context. Our analysis relies on an original dataset of 1194 households living in polluted and non-polluted areas in three European countries: Spain, Portugal and France. We use instrumental variables strategies to identify the socioeconomic causes of location choices. We show that low education, wealth and income are main reasons for living in polluted areas. We provide several robustness checks testing for the exogeneity of selected instruments. We observe that unobserved heterogeneity tends to understate the impact of socioeconomic status on residence location. Interestingly, we highlight that an important proportion of intermediate social groups (especially young couples) are living in polluted areas, probably because of place attachment and affordable housing facilities. Similarly, we show that middle-income households have lower move-out intentions than other income groups. These latter results contrast the linear vision of environmental inequalities found in the US.

scholarly journals The epidemiology of musculoskeletal injuries in trail runners in the eThekwini Municipality of KwaZulu-Natal

2019 ◽  
Author(s):  
◽  
Maxine-Lee Millar
Keyword(s):  
Risk Factors ◽  
South Africa ◽  
Statistical Analysis ◽  
Informed Consent ◽  
Musculoskeletal Injuries ◽  
Informed Consent Form ◽  
Kwazulu Natal ◽  
Associated Risk Factors ◽  
The Impact ◽  
Trail Running

AIM: The aim of this study was to determine the point and period prevalence of musculoskeletal injuries, the injury profile, associated risk factors and the impact of musculoskeletal injuries on trail runners who participated in selected trail races in the eThekwini municipality of KwaZulu-Natal. SUBJECTS: Participants from various trail running races volunteered to participate in the study after the completion of a trail race. METHODOLOGY: Participants were approached individually following the completion of a minimum of a 10 kilometre trail race. Each participant read a letter of information and signed an informed consent form before completing the questionnaire. A total of 197 completed informed consent and post-pilot questionnaires were collected and placed in separate sealed ballot boxes. A code was allocated to each questionnaire before data was captured on a spreadsheet for statistical analysis. RESULTS: In total, 145 questionnaires were statistically analysed. The results revealed that only ethnicity and how often the participant's trail ran per month were significant predictors of developing an injury. White participants were five times more likely to be injured compared to African participants and those who ran more than 10 times a month were 4.65 times more likely to be injured than those who ran less than five times a month. The most common past injuries sustained by trail runners was shown to be predominantly due to trauma, and were located in the knee, ankles and ITB regions. Current injuries were shown to be equally due to trauma and overuse, with predominant location being in the same anatomical regions as past injuries. CONCLUSION: The majority of the data collected was in line with the literature on running; however, most of those studies were done on road runners. The findings of this study were unique to trail runners in KwaZulu-Natal. Further studies are required on trail runners in other regions of South Africa to determine a clearer injury profile.

scholarly journals Bridging the digital divide with data-free platforms to reach families with young children during the COVID-19 pandemic (Preprint)

2020 ◽  
Author(s):  
Linda Marleine Richter ◽  
Sara Naomi Naicker
Keyword(s):  
South Africa ◽  
Young Children ◽  
Online Survey ◽  
Survey Methodology ◽  
Immediate Feedback ◽  
Middle Income ◽  
Family Outcomes ◽  
Containment Measures ◽  
Social Media Platforms ◽  
The Impact

BACKGROUND The COVID-19 pandemic and containment measures have severely affected families around the world. It is frequently assumed that digital technologies can supplement and perhaps even replace services for families. This is challenging in conditions of high device and data costs as well as poor internet provision and access, raising concerns about widening inequalities in availability of support and consequent effects on child and family outcomes. Very few studies have examined these issues, including in low- and middle-income countries. OBJECTIVE The main aim of the study was to gather data on the impact of COVID-19 on families of young children using an online survey. A secondary aim was to assess the feasibility of using a data-free online platform to conduct regular surveys and, potentially, to provide support for parents and families of young children in South Africa. METHODS We used a data-free mobile messenger platform to conduct a short digital survey of the impact of COVID-19 on caring for young children in South Africa. RESULTS More than 16,000 people consented to the short survey within 96 hours of it being launched. Respondents were predominantly from lower- and lower-middle classes, representing the majority of the population, with residential locations roughly proportionate to national patterns. Mothers comprised 70% of respondents and fathers 30%. Using RedCAP, we made aggregate findings in the form of bar graphs, available to participants to view and download once they had completed the survey. Participants were also able to download contact details for support and referral services at no cost. CONCLUSIONS Data-free survey methodology breaks new ground and demonstrates potential not previously considered. Reach is greater than achieved through phone surveys and some social media platforms, men are not usually included in parent surveys, costs are lower than phone surveys, and the technology allows for immediate feedback to respondents. These factors suggest that zero-rated services could provide a feasible, sustainable and equitable basis for ongoing interactions with families of young children.

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