Drivers of Broad-Spectrum Antibiotic Overuse across Diverse Hospital Contexts—A Qualitative Study of Prescribers in the UK, Sri Lanka and South Africa

South Africa is faced with a huge challenge of addressing the high burden of tuberculosis-human immune virus (TBHIV) co-infection, and this challenge is more pronounced in the province of KwaZulu-Natal which has one of the highest burdens of TB-HIV co-infection in the world. The study explored the experiences of doctors and nurses with regard to the management of tuberculosis and HIV coinfection in a TB-HIV high burden community in northern KwaZulu-Natal, South Africa. The particular focus was to provide insight and to inform policy and programme development for effective management of TB-HIV co-infection in the TB-HIV high burden community of northern KwaZulu- Natal. An interpretivist exploratory qualitative approach was employed through individual semi-structured interviews of 16 participants comprising eight doctors and eight nurses, with a total interview time of 8.95 hours. Purposive sampling was used to select the doctors and nurses from the public and private sector of the TB-HIV high burden community of northern KwaZulu- Natal. Thematic analysis was used to analyse the data. Five key themes emerged from this study and these themes were discussed together with the sub-themes based on the various participant responses. The five key themes were practical experience about the management of TB-HIV co-infection; access to information and training on the management of TB-HIV co-infection; challenges and concerns about the management of TB-HIV co-infection; perception about local beliefs; and knowledge of policies and guidelines. Overall, this study highlights barriers that hamper the effective management of TB-HIV co-infection in northern KwaZulu-Natal. Recommendations of this study point towards an urgent need to scale up the management of TB-HIV co-infection through effective policies, improved capacity and infrastructure, stronger partnerships of all stakeholders, and further research.

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Green Apartheid: Urban green infrastructure remains unequally distributed across income and race geographies in South Africa

10.21504/rur.c.5388203.v1 ◽

2021 ◽

Author(s):

Zander S Venter ◽

Charlie M. Shackleton ◽

Francini Van Staden ◽

Odirilwe Selomane ◽

Vanessa A Masterson

Keyword(s):

South Africa ◽

Low Income ◽

Green Infrastructure ◽

Racial Groups ◽

National Scale ◽

Public And Private ◽

Urban Green ◽

Human Wellbeing ◽

Urban South ◽

Urban Green Infrastructure

Urban green infrastructure provides ecosystem services that are essential to human wellbeing. A dearth of national-scale assessments in the Global South has precluded the ability to explore how political regimes, such as the forced racial segregation in South Africa during and after Apartheid, have influenced the extent of and access to green infrastructure over time. We investigate whether there are disparities in green infrastructure distributions across race and income geographies in urban South Africa. Using open-source satellite imagery and geographic information, along with national census statistics, we find that public and private green infrastructure is more abundant, accessible, greener and more treed in high-income relative to low-income areas, and in areas where previously advantaged racial groups (i.e. White citizens) reside.

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Fig. 2. The frequency distributions of per capita monthly income are plotted, as stacked histograms for each race category (A). Median income values per race are plotted with dashed lines. The relation between monthly income and population density across racial categories is plotted with linear regression lines and 95% confidence interval ribbons (B). Each point is a census district. The frequency distribution of census tracts across proportional racial population composition are plotted in C. P

10.21504/rur.14413571 ◽

2021 ◽

Author(s):

Zander S Venter ◽

Charlie M. Shackleton ◽

Francini Van Staden ◽

Odirilwe Selomane ◽

Vanessa A Masterson

Keyword(s):

South Africa ◽

Low Income ◽

Green Infrastructure ◽

Median Income ◽

Racial Groups ◽

Monthly Income ◽

Public And Private ◽

Frequency Distributions ◽

Racial Categories ◽

Urban South

Urban green infrastructure provides ecosystem services that are essential to human wellbeing. A dearth of national-scale assessments in the Global South has precluded the ability to explore how political regimes, such as the forced racial segregation in South Africa during and after Apartheid, have influenced the extent of and access to green infrastructure over time. We investigate whether there are disparities in green infrastructure distributions across race and income geographies in urban South Africa. Using open-source satellite imagery and geographic information, along with national census statistics, we find that public and private green infrastructure is more abundant, accessible, greener and more treed in high-income relative to low-income areas, and in areas where previously advantaged racial groups (i.e. White citizens) reside.

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Fig. 8. Trajectories in neighborhood greenness (relative to city means) are fitted with linear trend line (solid lines) and generalized additive model lines (dashed) for each race category (A). The distribution of regression line slopes (i.e. slope of linear trend line in A) per census tract are displayed using a violin plot with data medians and interquartile ranges plotted with dots and horizontal bars (B).

10.21504/rur.14413709 ◽

2021 ◽

Author(s):

Zander S Venter ◽

Charlie M. Shackleton ◽

Francini Van Staden ◽

Odirile Sebogoe ◽

Vanessa A Masterson

Keyword(s):

South Africa ◽

Low Income ◽

Green Infrastructure ◽

Linear Trend ◽

Regression Line ◽

Additive Model ◽

Racial Groups ◽

Public And Private ◽

Trend Line ◽

Urban South

Urban green infrastructure provides ecosystem services that are essential to human wellbeing. A dearth of national-scale assessments in the Global South has precluded the ability to explore how political regimes, such as the forced racial segregation in South Africa during and after Apartheid, have influenced the extent of and access to green infrastructure over time. We investigate whether there are disparities in green infrastructure distributions across race and income geographies in urban South Africa. Using open-source satellite imagery and geographic information, along with national census statistics, we find that public and private green infrastructure is more abundant, accessible, greener and more treed in high-income relative to low-income areas, and in areas where previously advantaged racial groups (i.e. White citizens) reside.

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Perceptions, expectations, apprehensions and realities of graduating South African optometry students (PEAR study, 2006)

African Vision and Eye Health ◽

10.4102/aveh.v66i3.241 ◽

2007 ◽

Vol 66 (3) ◽

Author(s):

A. O. Oduntan ◽

A. Louw ◽

V. R. Moodley ◽

M. Richter ◽

P. Von Poser

Keyword(s):

South Africa ◽

South African ◽

Relevant Information ◽

Response Scale ◽

Public And Private ◽

New Graduates ◽

The Future ◽

The Uk ◽

Graduating Students ◽

Optometry Students

The objective of this study was to establish the perceptions, expectations, apprehensions and realities of South Africa optometry students completing their undergraduate studies in 2006. Copies of a questionnaire containing relevant information were distributed to all graduating students at the four Universities offering Optometry. The responses were coded and analyzed. The respondents (N=143), representing 77% of the graduating students included 27.3% males and 72.7% females, aged 20 to 37 years (mean = 23.34 ± 2.75). About a third (32.9%) of the respondents considered opening their own practice as the best way of entering into practice. Also, this mode of practice was considered as providing the greatest fulfilment for their personal (60.8%) and professional (53.8%) goals as well as offering long term financial security (43.7%). Many (56.6%) have secured employment before graduation. Upon graduation, 43.4% would like to join a franchise. Many (79.7%) felt that Government was not offering sufficient opportunities for optometrists. The majority, (70.6%) felt that the South African optometry profession is fastly becoming saturated and this was of great concern to many (31.5%). About half, (50.3%) have plans to go overseas to practice and the most common destinations were the UK (36.1%) and Australia (15%). The mean minimum monthly salary expected as new graduates was between R9 500 and R11 500 in the public and private sectors respectively. On a response scale, the future of optometry in South Africa was scored as 6.59 ± 1.92. Findings in this study may be useful to all stake holders in optometric education in South Africa, as they may reflect the future of the optometry profession in the country.

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Strengthening public financial management in the health sector: a qualitative case study from South Africa

BMJ Global Health ◽

10.1136/bmjgh-2021-006911 ◽

2021 ◽

Vol 6 (11) ◽

pp. e006911

Author(s):

Jodi Wishnia ◽

Jane Goudge

Keyword(s):

South Africa ◽

Service Delivery ◽

Low Income ◽

Financial Management ◽

Boundary Crossing ◽

Multidisciplinary Teams ◽

Health Coverage ◽

Structured Interviews ◽

Public Financial Management

IntroductionEffective public financial management (PFM) ensures public health funds are used to deliver services in the best way possible. Given the global call for universal health coverage, and concerns about the management of public funds in many low-income and middle-income countries, PFM has become an important area of research. South Africa has a robust PFM framework, that is generally adhered to, and yet financial outcomes have remained poor. In this paper, we describe how a South African provincial department of health tried to strengthen its PFM processes by deploying finance managers into service delivery units, involving service delivery managers in the monthly finance meeting, using a weekly committee to review expenditure requests and starting a weekly managers’ ‘touch-base’ meeting. We assess whether these strategies strengthened collaboration and trust and how this impacted on PFM.MethodThis research used a case study design with ethnographic methods. Semi-structured interviews (n=30) were conducted with participant observations. Thematic analysis was used to identify emergent themes and collaborative public management theory was then used to frame the findings. The authors used reflexive methods, and member checking was conducted.ResultsThe deployment of staff and touch-base meeting illustrated the potential of multidisciplinary teams when members share power, and the importance of impartial leadership when trying to achieve consensus on how to prioritise resource use. However, the service delivery and finance managers did not manage to collaborate in the monthly finance meeting to develop realistic budgets, or to reprioritise expenditure when required. The resulting mistrust threatened to derail the other strategies, highlighting how critical trust is for collaboration.ConclusionEffective PFM requires authentic collaboration between service delivery and finance managers; formal processes alone will not achieve this. We recommend more opportunities for ‘boundary crossing’, embedding finance managers in service delivery units and impartial effective leadership.

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Corporate social investment and a company’s image: A case of a CSI initiative in a South African low income community

Corporate Board role duties and composition ◽

10.22495/cbv11i3art10 ◽

2015 ◽

Vol 11 (3) ◽

pp. 130-135

Author(s):

Paul-Francois Muzindutsi ◽

Tshediso Joseph Sekhampu

Keyword(s):

South Africa ◽

South African ◽

Low Income ◽

Quantitative Research ◽

Social Investment ◽

Structured Interviews ◽

Community Members ◽

Corporate Social ◽

A Company ◽

Corporate Social Investment

One of the goals of corporate social investment (CSI) is to ensure that a company becomes a responsible entity which acts as a conscientious citizen within a society. CSI plays an important role in enhancing how a company is perceived within the community it operates in. This paper used a combination of qualitative and quantitative research designs to investigate the effect of a specific CSI initiative on a company’s image within a low income community in South Africa. Semi-structured interviews and survey questionnaire were used to collect data from community members in the township of Bophelong, South Africa. Results show that, if adequately managed, CSI initiatives tend to enhance company’s image as well as its relations with the community it operates in. However, if not adequately managed CSI can created unreachable expectations that can negatively affect a company’s image. Thus, companies better manage their CSI initiatives have an increased opportunity to enhance their reputation within the community they operate in.

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Anti-money laundering in the United Kingdom: new directions for a more effective regime

Journal of Money Laundering Control ◽

10.1108/jmlc-04-2021-0041 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Rafael Pontes ◽

Nick Lewis ◽

Paul McFarlane ◽

Patrick Craig

Keyword(s):

Money Laundering ◽

Structured Interviews ◽

Regulatory Requirement ◽

Public And Private ◽

Content Type ◽

Qualitative Research Design ◽

The United Kingdom ◽

Nuanced Understanding ◽

And Performance ◽

The Uk

Purpose This paper aims to provide a more nuanced understanding of the effectiveness of the anti-money laundering (AML) regime in the UK and explore opportunities to improve policy and performance. Design/methodology/approach Qualitative research design using semi-structured interviews and a focus group with practitioners from both public and private sectors. Findings This paper identifies preventive measures are underfunded by the public sector; there is a disconnect between the regulatory requirement and the regulators’ supervisory approach leading to the ineffective application of the risk-based approach; and authorities have limited ability to stop low-utility reports. Increased collaboration across institutions and sectors, better utilisation of innovative technologies and a sustainable funding plan are needed to drive a collective response to money laundering. Research limitations/implications Few practitioners in the industry have the knowledge and expertise to discuss the topic at a strategic level and participants were limited (n = 8). Practical implications This paper adds to the growing corpus of research showing that the AML regime in the UK is ineffective and needs reform. Social implications This paper encourages practitioners to improve the AML regime, this research contributes to the reform of the existing measures against financial crime. Originality/value This paper presents new data from AML practitioners to provide a better understanding of the limitations of the AML regime in the UK.

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Delivering well-being through the coronavirus pandemic: the role of human resources (HR) in managing a healthy workforce

Personnel Review ◽

10.1108/pr-04-2021-0224 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Kay Lisa Maddox-Daines

Keyword(s):

Human Resources ◽

Well Being ◽

Business Continuity ◽

Physical And Mental Health ◽

Structured Interviews ◽

Effective Response ◽

Public And Private ◽

Content Type ◽

The Public ◽

The Uk

PurposeThis paper examines how human resources (HR) professionals in the UK have supported employee wellbeing during the coronavirus disease (COVID) pandemic. It considers the extent to which HR professionals were prepared for the crisis and their readiness in supporting the wellbeing of their people.Design/methodology/approachSemi-structured interviews were conducted with 15 senior HR professionals working across the public and private sectors in the UK. Using an in-depth interview structure, the research explored how respondents both reacted to and managed the crisis in their respective organisations. Template analysis was used to analyse the data allowing a certain degree of fluidity in the establishment of ordered relationships between the themes.FindingsThis study finds that business continuity plans turned out to be useless during the pandemic because they focussed on data, not people. It highlights the tension between home-working and burn-out as online presenteeism increased due to staff changing their behaviour in response to self-surveillance. The paper emphasises the importance of soft skills and authentic leadership and the tensions in respect of equity.Research limitations/implicationsThe study was conducted with HR professionals in the UK, not internationally. Although the sample did include HR professionals from across the public, private and third sectors, the experience may not be representative of all those working in HR.Originality/valueThis research found that those organisations that had engaged in business continuity planning prior to the pandemic focussed on the retrieval and accessibility of data rather than people. This prioritises staff as a resource rather than emphasising people as an organisation's most valuable asset. Furthermore, the study found that staff worked harder and for longer periods of time as a consequence of self-imposed surveillance. Organisational responses were contradictory as despite implementing well-being strategies to promote physical and mental health, there was little evidence of an effective response to this online presenteeism.

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A Qualitative Research of the Causes of Iranian Female Students Immigration to Developed Countries

Asian Social Science ◽

10.5539/ass.v12n10p167 ◽

2016 ◽

Vol 12 (10) ◽

pp. 167

Author(s):

Sareh Nazari ◽

Fariba Seyedan

Keyword(s):

Low Income ◽

Gender Discrimination ◽

Developed Countries ◽

Female Students ◽

Academic Disciplines ◽

Structured Interviews ◽

Related Factors ◽

University Professors ◽

Discrimination In Employment ◽

The Uk

According to the latest data from United Nations population Fund-UNFPA-in 2015, 244 million people, or 3.3 per cent of the world's population lived outside their country of origin. A number of these migrants are skilled and educated women. This movement usually occurs from developing to developed countries in the world like the US, the UK, Germany, England and so on, to achieve new opportunities and a better life. Iran is a developing country, which is suffering from this serious issue. The aim of this study is to identify the causes of Iranian female students' immigration to developed countries from the perspective of female students of Al-Zahra University. The present qualitative study included 20 master and doctoral female students who were completing their degree programs at this University, through purposive sampling. Data was collected via in-depth, semi structured interviews which were audio-recorded and analyzed by Content analysis method. The main themes and sub-themes were “Economic” (including Unemployment, Low income, Inconsistency between field of education and jobs, Gender discrimination in employment and payments delays), “Educational” (Lack of proper facilities in university, professors' lack of knowledge, lack of public respect for well-educated people in society, and Women’s restrictions in selecting certain academic disciplines), “Socio-political” (Limitation of individual freedom, political pressure, Lack of freedom of speech) and “Personal and Familial” Issues (marriage and parental related factors). The findings present a deeper understanding of the main causes of female migration and why these educated women are less likely to return to Iran.

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