Research Articles (Centre for Development Support)
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Item Open Access Knowledge, attitudes and practices of community treatment supporters administering multidrug-resistant tuberculosis injections: a cross-sectional study in rural Eswatini(Public Library of Science, 2022) Peresu, Ernest; Heunis, J. Christo; Kigozi, N. Gladys; De Graeve, DianaBackground: This study assessed knowledge, attitudes and practices (KAP) of lay community treatment supporters (CTSs) delegated with directly observed treatment (DOT) supervision and administration of intramuscular multidrug-resistant tuberculosis (MDR-TB) injections in the Shiselweni region in Eswatini. Methodology: A cross-sectional survey among a purposive sample of 82 CTSs providing DOT and administering injections to MDR-TB patients was conducted in May 2017. Observations in the patients’ homes were undertaken to verify CTSs’ self-reported community-based MDR-TB management practices. Results: Out of 82 respondents, 78 (95.1%) were female and half (n = 41; 50.0%) had primary education or lower. Over one-tenth (n = 12; 14.6%) had not attended a MDR-TB training workshop, but were administering injections. The overall KAP scores were satisfactory. Good self-reported community-based MDR-TB practices were largely verified through observation. However, substantial proportions of respondents incorrectly defined MDR-TB, were unaware of the treatment regimen, stigmatised patients, and underreported needlestick injuries. There was no statistically significant association between duration administering intramuscular injections, MDR-TB training, knowledge and attitudes, and good community-based MDR-TB management practices. Conclusions: The gaps in the current KAP of CTSs in this setting raise questions about the timing, adequacy, design and content of community-based MDR-TB management training. Nonetheless, with appropriate training, lay CTSs in this region can be an option to complement an overstretched professional health workforce in providing DOT and MDR-TB injections at community level.Item Open Access Housing and child health in South Africa: the value of longitudinal research(University of the Free State, 22-Feb) Chatindiara, Kenneth; Marais, Lochner; Cloete, JanResearch investigating the link between housing and health often produces mixed results. It does not always prove that good housing improves health. The results suggest a complex set of factors play a role, and the findings are sometimes contradictory. Two ways of addressing these concerns are longitudinal research, where the relationship between housing and health is measured in the short and medium terms, and a focus on children. We use the children’s housing and health data from the five waves of the National Income and Distribution Survey (NIDS) survey in South Africa, 2008 to 2017. We investigate the effect that continued living in informal housing over the five waves has had on these children’s health. Our results show a statistically significant relationship between prolonged residence in poor housing and poor health outcomes for some health indicators. The results call for a closer understanding of health issues in housing policy in South Africa.Item Open Access Housing and child health in South Africa: the value of longitudinal research(MDPI, 2022) Chatindiara, Kenneth; Marais, Lochner; Cloete, JanResearch investigating the link between housing and health often produces mixed results. It does not always prove that good housing improves health. The results suggest a complex set of factors play a role, and the findings are sometimes contradictory. Two ways of addressing these concerns are longitudinal research, where the relationship between housing and health is measured in the short and medium terms, and a focus on children. We use the children’s housing and health data from the five waves of the National Income and Distribution Survey (NIDS) survey in South Africa, 2008 to 2017. We investigate the effect that continued living in informal housing over the five waves has had on these children’s health. Our results show a statistically significant relationship between prolonged residence in poor housing and poor health outcomes for some health indicators. The results call for a closer understanding of health issues in housing policy in South Africa.Item Open Access Economic transitions in South Africa's secondary cities: governing mine closures(Cogitatio, 2021) Marais, Lochner; Nel, Verna; Rani, Kholisa; Van Rooyen, Deidre; Sesele, Kentse; Van der Watt, Phia; Du Plessis, LyndonMany South African secondary cities depend on a single economic sector, often mining or manufacturing. This makes them vulnerable to economic change and national decision‐making. We describe change in three secondary cities—Emalahleni, Matjhabeng and Newcastle—all at different phases of economic transition due to imminent mine closure. We investigate the way local governance and planning are dealing with the change. We draw on concepts from institutional economics and evolutionary governance theory, material from strategic planning documents, and approximately 50 key informant interviews. We show how difficult it is to steer economic planning during economic transitions, and we demonstrate how both economic change and governance are path‐dependent. Path dependency in South Africa’s mining towns has several causes: the colonial influence, which emphasised extraction and neglected beneficiation; the dominance of a single sector; the long‐term problems created by mining; and the lack of the skills needed to bring about economic change. The local governments’ continuing reliance on the New Public Management paradigm, which focuses on steering as opposed to building networks, compounds the problem, along with poor governance, inadequate local capacity and inappropriate intergovernmental relations. Of the three towns, only Newcastle has shown signs of taking a new path.Item Open Access State involvement in self-help housing: reflections from the Free State(University of the Free State, 2010) Ntema, John; Marais, LochnerEnglish: When John Turner forwarded his theories on self-help housing, he emphasised the concept of dweller control and argued that the state should not be involved in housing construction processes. Although there was worldwide acknowledgement of his ideas, a large number of self-help programmes developed with a fair amount of state-involvement. South Africa’s self-help programme, called the People’s Housing Process, is no exception in this respect. Although designed to ensure larger degrees of ownership by people, evidence of large-scale government influence is clear. This article assesses the application of self-help housing in the Free State province and argues that a technocratic rather than a people-centred approach (envisaged in policy documents) dominated the People’s Housing Process. The levels of influence by local people in project design, project implementation and housing design remain low, and the housing outcomes do not differ much from the normal project subsidy approach.Item Open Access An evaluation of a family support programme in the southern Free State(University of the Free State, 2012) Marais, Lochner; Ingle, Mark; Skinner, Donald; Sigenu, KholisaEnglish: This article details the evaluation of an NGO Family Support Programme (FSP) that was implemented in the southern Free State’s Kopanong local municipality. The FSP is primarily aimed at strengthening Early Childhood Development (ECD) in what is a very socio-economically deprived environment for small children. The article argues for the critical importance of ECD within the human development paradigm. It then reports on the actual FSP assessment and advances a number of recommendations for how the initiative could be bolstered. It concludes that the FSP methodology is sound in principle and that it warrants replication at scale.