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Background: Rapid reviews have emerged as an approach to provide contextualized evidence in a timely and efficient manner. Three rapid review centers were established in Ethiopia, Lebanon, and South Africa through the Alliance for Health Policy and Systems Research, World Health Organization, to stimulate demand, engage policymakers, and produce rapid reviews to support health policy and systems decision-making. This study aimed to assess the experiences of researchers and policymakers engaged in producing and using rapid reviews for health systems strengthening and decisions towards universal health coverage (UHC). Methods: Using a case study approach with qualitative research methods, experienced researchers conducted semi-structured interviews with respondents from each center (n = 16). The topics covered included the process and experience of establishing the centers, stimulating demand for rapid reviews, collaborating between researchers and policymakers, and disseminating and using rapid reviews for health policies and interventions and the potential for sustaining and institutionalizing the services. Data were analyzed using thematic analysis. Results: Major themes interacted and contributed to shape the experiences of stakeholders of the rapid review centers, including the following: organizational structural arrangements of the centers, management of their processes as input factors, and the rapid reviews as the immediate policy-relevant outputs. The engagement process and the rapid review products contributed to a final theme of impact of the rapid review centers in relation to the uptake of evidence for policy and systems decision-making. Conclusions: The experiences of policymakers and researchers of the rapid review centers determined the uptake of evidence. The findings of this study can inform policymakers, health system managers, and researchers on best practices for demanding, developing and using rapid reviews to support decision- and policymaking, and implementing the universal healthcare coverage agenda. [ABSTRACT FROM AUTHOR]

Background: Low- and middle-income countries (LMICs), including South Africa, are currently experiencing multiple epidemics: HIV and the rising burden of non-communicable diseases (NCDs), leading to different patterns of multimorbidity (the occurrence of two or more chronic conditions) than experienced in high income settings. These adversely affect health outcomes, increase patients' perceived burden of treatment, and impact the workload of self-management. This paper outlines the methods used in a qualitative study exploring burden of treatment among people living with HIV/NCD multimorbidity in South Africa. Methods: We undertook a comparative qualitative study to examine the interaction between individuals' treatment burden (self-management workload) and their capacity to take on this workload, using the dual lenses of Burden of Treatment Theory (BoTT) and Cumulative Complexity Model (CuCoM) to aid conceptualisation of the data. We interviewed 30 people with multimorbidity and 16 carers in rural Eastern Cape and urban Cape Town between February-April 2021. Data was analysed through framework analysis. Findings: This paper discusses the methodological procedures considered when conducting qualitative research among people with multimorbidity in low-income settings in South Africa. We highlight the decisions made when developing the research design, recruiting participants, and selecting field-sites. We also explore data analysis processes and reflect on the positionality of the research project and researchers. Conclusion: This paper illustrates the decision-making processes conducting this qualitative research and may be helpful in informing future research aiming to qualitatively investigate treatment burden among patients in LMICs. [ABSTRACT FROM AUTHOR]

Purpose: There is a growing call both globally and nationally for integrated multisectoral and multidisciplinary systems of care to be implemented for children's needs in the foundation stages of their growth to be met. Extant literature shows that historical, structural, epidemiological, political and social factors create many adversities for South African children both in the short and in the long term. South Africa's fragmented and weak service delivery compounds the situation. In this paper, the authors describe the lessons learnt from a multisectoral and multidisciplinary community of practice established to strengthen social systems to ensure child wellbeing outcomes. Design/methodology/approach: A qualitative research design was used, drawing on data collected over a two-year period. Data included meeting minutes, focus group discussions, and email communications between project partners. Focus group discussions were audio-recorded and transcribed verbatim. Data was analysed thematically. Findings: Findings show that having a shared goal, establishing supportive, mutually beneficial relationships and contributing to services that enhance child wellbeing outcomes enabled the community of practice, while differing organizational mandates and heavy workloads constrained the partnership. Research limitations/implications: The study shows the effectiveness of a Community of Practice (CoP) in integrating services across sectors for children's well-being and promoting collaborative learning and intersectoral work. However, this success also depends on the presence of strong leadership and efficient coordination.Limitation: Despite its benefits, the CoP model presents challenges, including securing active participation and buy-in from stakeholders, managing time and resource constraints, and dealing with issues in the existing service delivery system. Questions about long-term sustainability and the practicalities of scaling and institutionalizing the model need to be addressed. Originality/value: Through this paper, the authors contribute to a nascent area of research in the Global South, critically reflecting on the lessons the authors learnt from implementing an integrated community of practice approach to strengthen social sector systems toward the enhancement of children's wellbeing. [ABSTRACT FROM AUTHOR]

Migration to South Africa is motivated by the pursuit of employment, safety, and improved living conditions. However, immigrants encounter significant challenges, such as restricted access to essential services, which were exacerbated by the COVID-19 pandemic. This paper investigates the impact of the COVID-19 pandemic on Malawian immigrants in South Africa, addressing the lack of attention given to this immigrant population by highlighting their vulnerabilities. Using a qualitative exploratory and descriptive approach, in-depth interviews were conducted with 24 Malawi immigrants who were over 18 years old and had established residency in South Africa before the onset of the COVID-19 pandemic. Five key stakeholders were also interviewed for additional perspectives and to ensure triangulation and improve data reliability. The interviews were transcribed verbatim and analyzed using thematic analysis strategies and coding with Nvivo12 software. The study highlighted the exacerbated struggles of Malawian immigrants in South Africa amid the COVID-19 pandemic, uncovering systemic discrimination in healthcare, marked by longer wait times and reluctance from health workers to treat undocumented immigrants. The study also revealed a dire security situation, with immigrants living in high-crime areas and feeling particularly targeted due to their foreign status, a situation worsened by the pandemic's economic effects. Additionally, the economic downturn induced by COVID-19 significantly impacted employment opportunities, with many immigrants facing prolonged unemployment and job losses, especially in sectors where they traditionally found work. The detailed accounts of participants highlight not only the multifaceted challenges imposed by the pandemic but also the critical need for inclusive policies and support systems that ensure healthcare access, safety, and economic resilience for immigrants, particularly during global health emergencies. Future research should focus on effective interventions for socioeconomic integration and well-being, particularly for immigrants from other African countries. [ABSTRACT FROM AUTHOR]

Although delivery of services in South Africa is the responsibility of all spheres of government, the provision of basic services lies at the doorstep of local municipalities. Local municipalities have, for many reasons, frequently been unable to live up to this mandate despite the fact that some of the challenges that they face can be addressed by using IT. This paper assesses factors enabling and inhibiting the efficient deployment and integration of IT in local municipalities. The technological, organizational and environmental (TOE) framework was deployed to assess the factors. A multiple case study in which semi-structured interviews were conducted produced qualitative data and thematic analysis was carried out. This paper suggests that effective deployment and integration of IT is not solely dependent on technological factors but that organizational and environmental factors also influence the outcomes to a significant extent. [ABSTRACT FROM AUTHOR]

Purpose: Globally, mobile technology is a significant factor influencing how libraries are changing the ways of delivering services to today's users. This paper aims to explore academic librarians' perceptions of the usefulness of mobile technology in delivering library services and the efforts required for its successful adoption. Design/methodology/approach: The study was conducted within an interpretive paradigm. The research objectives were underpinned by the unified theory of acceptance and use of technology as a theoretical framework. Data were collected through semi-structured interviews and analyses using NVIVO for thematic analysis. Findings: Results show that, in general, academic librarians support the use of mobile technology to provide services such as access to eBooks and Journals, Online Public Access Catalogue, Bookmyne application, information literacy consultations and training. Library managers, fellow librarians and users were identified as encouraging the adoption of mobile technology to enhance library services. The paper further confirms that the successful adoption of mobile technology requires some effort. However, due to some of the challenges presented in the study, a majority of respondents felt that their libraries are not yet ready to fully embrace mobile technology the way it is envisioned in today's world. Practical implications: The study endeavours to address the divergence between students and academic librarians' viewpoints regarding the application of mobile technology in the provision of library services. Originality/value: This paper highlights numerous ways that academic librarians could adopt and embrace mobile technology, which can benefit both academic libraries and other institutions of higher learning. The knowledge presented in this paper could assist academic librarians in assessing their institutions' vulnerabilities, challenges and strengths in using mobile technologies to provide library services. [ABSTRACT FROM AUTHOR]

In some regions, the role of women is still relegated to the kitchen and raising children. The notion of a career woman still needs to be entirely accepted and embraced. However, the rapid interconnectedness of the global world has opened numerous opportunities for women, especially within the political sphere. With this continuing trend of women empowerment, is the era of women marginalization over? Can we say the tide has turned, where women are now recognized as political leaders? Can we confidently conclude that those women now play a constructive role in community development and consolidate democracy, law, and legislation through political involvement? To engage these questions, the article undertakes a literature examination. It compares how women empowerment initiatives in Rwanda, South Africa, and Senegal concerning political inclusion have resulted in more and more women participating in politics. As a point of departure, the article argues that there has been a considerable increase in the percentage of women participating in African politics. However, there are still challenges in terms of gender equality within society at large. The findings from this paper were analyzed using thematic content analysis to answer these fundamental questions underpinning the paper. [ABSTRACT FROM AUTHOR]

Background: Community health worker programmes have the potential to contribute critically towards universal health coverage. However, CHWs globally have often continued to operate on the periphery of the health care system, viewed as a non-essential cadre. This results in a workforce that often remains disempowered and under-supported. This paper presents evidence from a study conducted in a rural part of South Africa, to better understand issues of CHW prioritisation, integration, and empowerment. Methods: We applied an analytical lens based on empowerment theory and conducted a secondary analysis of qualitative data emerging from a sub-study of a cRCT evaluating the effectiveness of supportive supervision for CHWs within a large-scale national CHW programme. The cRCT was conducted between 2017 and 2022, and 39 CHWs were included in the study. Results: We organised our findings across the four domains of structural empowerment; information, resources, support, and opportunity, and mapped these domains against the domains of psychological empowerment. Our findings show how CHWs are still working in the periphery of the healthcare system. Without sufficient prioritisation, high level-support from national and district governments, and sufficient investments in programmatic domains—such as training, equipment, and supportive supervision—it is likely that the CHW cadre will continue to be seen as informal health care workers. Conclusions: CHW empowerment could be a lever to potentially transform the current health system towards universal coverage; however, this process can only happen with sufficient high-level prioritization and investment. [ABSTRACT FROM AUTHOR]

The proliferation of mobile phones across the world has contributed to the rise of mHealth interventions as a complementary means for improving health outcomes in areas where health facilities are limited. However, community members who do not own or have access to mobile devices feel excluded from such interventions. In this paper, we seek to understand and explore engagement strategies that support the inclusion of non-mobile phone owners in mHealth interventions. We conducted a review of mHealth and community engagement literature to gauge the strategies different studies have employed to engage non-mobile phone owners and users. We further reflected on two Southern African case studies from health and citizen engagement sectors to gain insights on ways non-mobile phone owners may feel included in mHealth interventions. Through a process of thematic analysis, we have identified three areas that mHealth implementers could draw from when designing more inclusive mHealth interventions. These strategies include the need for sensitising communities, using multi-stakeholder and multi-sectoral collaboration, and embracing a braided approach to communication technologies. We hope that this paper will inform mHealth project implementers on different strategies they can use to include community members, regardless of whether they own mobile phones or not. [ABSTRACT FROM AUTHOR]

Purpose: The rapidly emerging digital work system, accentuated by technological innovation, has dramatically changed the nature of skill-sets required for employees to perform their tasks effectively at the workplaces. This paper aims to examine the skills development strategies that organizations in South Africa are adopting in the transitioning of their respective workforces to fit the skills dynamics of the emerging work system. Design/methodology/approach: The paper uses the interpretive qualitative research strategy to draw evidence from semi-structured interviews conducted on 38 respondents, using the thematic analytical process to derive themes embedded in the data set. Findings: Based on the strength of data analysis, this paper identified two broad themes and six sub-themes that are critical for the transformation and transition of existing pool of skills for the emerging work system in South Africa. Research limitations/implications: The research lacks ability to be generalized, which is a methodological limitation that is inherently associated with cross-sectional design and qualitative strategy in terms of causality and generalizability of findings. Originality/value: The main value-add of this paper is the development of evidence-based research outcomes that provide both theoretical and practical framework for skills development and transition initiatives that are imperative for policy formulation. The paper responded to, and advanced the respective works of Hirschi (2017), Sharma et al. (2021) and Barley et al. (2017), by establishing the following strategic themes that are critical for skills development and transition mechanisms in the emerging work system: stakeholder relationship, media and public perception, learning organization, higher education system, continuous skills development and technology and job losses. [ABSTRACT FROM AUTHOR]

Community reintegration of offenders is one of South Africa's methods of rehabilitating offenders who have served a portion of their sentence in a correctional centre. However, overcrowding in the rural correctional facilities that have limited resources have exposed the correctional officials to enormous work-related challenges. This paper discusses the work-related challenges experienced by correctional officials at Rooigrond Correctional Centre, a rural correctional centre in North West Province in South Africa. This study employed a qualitative research approach and a descriptive research design to capture the challenges experienced by correctional officials during reintegration of offenders at Rooigrond Correctional Centre. Due to the different ranks of the correctional officials who participated in the study, a quota sampling technique was used to involve ten correctional officials in face-to-face interviews. Thematic data analysis was used, which showed that correctional officials experience a plethora of challenges which have an impact on work and personal levels. This paper makes significant conclusions and recommendations to improve the work-related experiences of the correctional officials in overcrowded, low-resourced rural correctional facilities. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic necessitated that speech–language therapists (SLTs) make a radical change to provide services to their clients safely via telepractice. For many practitioners, telepractice was an unfamiliar mode of practice that had to be implemented under emergency conditions. Limited literature on SLTs' experiences of implementing telepractice in the Global South during this time is available. Aims: To explore the experiences of South African SLTs (N = 45) who implemented telepractice services during the COVID‐19 pandemic. Methods & Procedures: SLTs across the country were invited via professional bodies to participate in an online qualitative survey distributed in 2021. Data were analysed using thematic analysis principles. Outcomes & Results: We describe participants' reports of their current telepractices, discuss their perspectives on accessibility to telepractice for SLTs, clients and caregivers, and working with specific diagnoses, and consider the support needs of SLTs to enhance telepractice services. Most participants work in private practice or school settings with primarily paediatric caseloads. They reported telepractice as a positive experience and felt it was effective, although they judged that some clients were not well served by telepractice. SLTs felt underprepared for the rapid switch to telepractice and the flexibility required, especially given the limited availability of guidelines given the pandemic crisis. Greater preparation is required for telepractice sessions and more attention needs to be paid to supporting caregiver involvement online. Conclusions & Implications: Telepractice involves various barriers and facilitators, many of which seem common across Global North and South contexts. Support is required to enhance current telepractices in terms of computer literacy, technical education, different telepractice methods and caregiver coaching. Our findings have the potential to enable the development of support, training and guidelines to improve SLTs' confidence in providing telepractice whilst delivering quality services in an accessible and safe manner. WHAT THIS PAPER ADDS: What is already known on the subject: Many SLTs had to transition quickly to telepractice service provision during COVID‐19, with limited existing guidelines and support. Although there is some literature available on SLTs' experiences of implementing telepractice in the Global North, perspectives from the Global South during this time are limited. It is important to understand experiences, barriers and facilitators to telepractice provision to provide tailored support to practitioners. What this paper adds to existing knowledge: Telepractice provides a viable alternative to in‐person therapy for specific clients and contexts. Telepractice presents both benefits and barriers for effective clinical practice across Global North and South contexts. Greater preparation is required for telepractice sessions and more attention needs to be paid to enhancing caregiver involvement online, especially since many practitioners are likely to continue offering telepractice services post‐pandemic. What are the potential or actual clinical implications of this work?: Clinicians felt underprepared for the rapid switch from service delivery mode to telepractice. Greater support, training and guidelines for students and practitioners are required to enhance current practices and ensure practitioners are equipped to provide effective telepractice in the future. In particular, support should cover technological aspects, caregiver coaching and online assessment options, especially for paediatric clients. [ABSTRACT FROM AUTHOR]

Background/Aims: Extensive research focuses on the advantages and disadvantages of various positions throughout active second stage labour, but there is limited focus on midwives' practice. This study aimed to explore midwives' practice of maternal positions throughout the active phase of second stage labour. Methods: An integrative review of three databases was carried out for research papers published between 2015 and 2022. Thematic analysis was used for data analysis and synthesis. Results: Five eligible research papers were included. There were four key findings: maternal positions practised by midwives, midwives as the prime decision maker, midwives' personal convenience and comfort, and barriers to practising maternal positions. Conclusions: Midwives were seen as prime decision makers, who hindered informed decision making on maternal positions during active second stage labour. Inadequate knowledge, skills and confidence were barriers to practice and attributed to midwives adopting positions that were convenient and comfortable for themselves. Strategies are needed to enhance practice through review and evaluation of current clinical settings, regular updates to evidence-based practice and refreshing essential midwifery skills. [ABSTRACT FROM AUTHOR]

Background: Literature shows that in South Africa there are insufficient resources to meet mental healthcare needs. At general or district hospital level, the non-specialist doctor is often responsible for the holistic assessment and management of mental health service users. Such situations inevitably increase doctors' care load as they are required to treat across disciplines. We highlight the particular challenges faced by a community service (CS) doctor in this context. Methods: The presented case study formed part of a larger project that investigated public mental healthcare provision in the Eastern Cape province. Data were collected through a once-off semi-structured interview with the participant. The interview was transcribed and data analysed by utilising thematic analysis to yield results. Results: The study suggests that the CS doctor experiences being overloaded with duties, and feels overwhelmed in a healthcare context that lacks resources needed for service provision, which may lead to inadequate mental healthcare provision to public health service users. Conclusion: Healthcare facilities in rural parts of the Eastern Cape province are in need of assistance. This in-depth account highlighted the consequences of working on the front line of a disadvantaged and under-resourced health system. The presented account can be interpreted as a cry for help by CS doctors for relevant authorities to improve access and provision of mental healthcare in the area. Contribution: The paper provides an exploration of the circumstances wherein mental healthcare is provided in rural parts of South Africa. [ABSTRACT FROM AUTHOR]

Background: COVID‐19 necessitated emergency telepractice for student‐led speech‐language therapy clinical practicals in training institutions, with limited preparation and evidence‐based guidelines. Beyond the pandemic, practitioners and university training sites are likely to continue to offer telepractice necessitating thorough preparation for telepractice services underpinned by a comprehensive understanding of the complexities involved in online therapy. Aims: Adopting realist evaluation principles, our aim in this paper was to explore broadly what works and does not work in a set of student‐led telepractice sessions in a diverse, resource‐limited context. The broader goal of this project was to provide evidence‐based support to enhance the efficiency and success of telepractice sessions in student clinical training contexts. Methods & Procedures: We used qualitative observational methods with reflexive thematic analysis to analyse 28 video recordings and 61 observation notes of student‐led paediatric telepractice sessions from a South African university clinic as part of a pilot study. Outcomes & Results: We identified four overarching considerations for student‐led telepractice: (1) additional, specific preparation is required, (2) with greater management of technology and adaptation of tasks, especially during times of poor connectivity; (3) telepractice relies heavily on caregiver input and collaboration; and (4) promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical skills that are complicated by the lack of face‐to‐face contact. Conclusions & Implications: Our findings indicate that telepractice pedagogy needs to be explicitly taught and students require practical assistance as they learn how to use this service delivery approach effectively. There are some aspects peculiar to telepractice that require unique consideration and planning, especially in contexts where service providers and users may be unfamiliar with this form of service provision. The findings of this pilot study can be used by clinical educators and student clinicians to enhance clinical training opportunities involving telepractice. WHAT THIS PAPER ADDS: What is already known on this subject: Many speech‐language therapy (SLT) student clinicians had to transition quickly to telepractice service provision during COVID‐19 with limited existing guidelines and support, especially in contexts where teletherapy is typically non‐existent or difficult to access. Although there is some literature available on experiences of telepractice, there is very little evidence‐based research which explores the mechanics of such sessions in real‐time and which offers practical support to student clinicians and clinical educators engaging in this mode of service delivery. What this study adds: This pilot study examined video‐recorded, student‐led, paediatric, speech‐language teletherapy sessions to understand challenges and considerations involved in using telepractice as a clinical training tool. Findings show that additional preparation for telepractice sessions is required, particularly in contexts of poor digital literacy; students must learn to manage technology, especially when connectivity poses a challenge, and adapt therapy tasks for online work with clients; telepractice relies heavily on caregiver input and collaboration, more so than in in‐person consultations, and this relationship requires careful management; and promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical yet challenging skills in telepractice. What are the potential or actual clinical implications of this work?: Our findings highlight a need to teach telepractice pedagogy explicitly and support students practically in learning how to provide therapy effectively via this mode of service delivery. Observational methods for studying practices in recorded telepractice sessions can be used as part of a reflective approach to clinical training. Using already available data allowed us to unpack the 'messy reality' of clinical training using telepractice. [ABSTRACT FROM AUTHOR]

Whilst traditionally, participation in bullying was understood to refer to being a victim, a bully or a bystander, studies have shown that the prevalence of learners who are both a bully and a victim known as bully-victims is also prevalent both locally and internationally. The aim of the study was to explore and explain reasons why some learners assume the dual roles of victim and perpetrator. A cross-sectional explanatory mixed-method design was used for the study. In the first phase, the Illinois Bully Scale was used to screen for bullying behaviour on a sample of 460 learners, aged 11 to 20 years, with a mean age of 15 years, who attended high schools in a Tshwane District township, Gauteng Province. The learners were categorised as bullying perpetrators, victims, both, or not involved in bullying, based on the scores from the Illinois Bully Scale. A phenomenological hermeneutical method was then used to collect and analyse data from 25 of those with high scores in any of the three categories, namely perpetrators, victims or both as determined using the Illinois Bully Scale. NVivo 14 software was used to conduct a thematic analysis of the data. The focus of this paper is on the perpetrator-victim category, a category of learners that screened positively for being both the perpetrators and victims of bullying. The study found that bullying victims tend to bully those whom they perceive to be weaker than them. Being both a perpetrator and a victim of bullying was found to be as a result of a belief that being a victim of bullying makes one less respectable and bullying others brings back the lost respect. Victims also feel the need to make others suffer the pain of being bullied that they are going through so as not to suffer alone. Victims also bully others as a form of self-protection and defence against being bullied. Furthermore, victims bully those who are weaker than them to get some relief from ethe emotions of anger and frustration that build up as a result of being bullied by a stronger bully against whom they cannot defend themselves. Bullying creates a perpetual cycle of violence as victims view bullying others as justified as it is "paying forward the pain" that they themselves have been subjected to. Early identification and interventions to prevent and manage bullying in schools are required to break the victim-perpetrator cycles. [ABSTRACT FROM AUTHOR]

Collaboration between midwives and traditional birth attendants for maternal and child healthcare is a challenge in rural South African communities due to the absence of a guiding framework. To address this, this study sought to develop and validate an inclusive framework informed by the Donabedian structure–process–outcome (SPO) framework for collaboration between these healthcare professionals. Method: Key stakeholders were invited to participate in a co-creation workshop to develop the framework. Twenty (20) participants were purposively sampled based on their maternal and child healthcare expertise. A consensus design using the nominal group technique was followed. Results: Participants identified the components needed in the framework, encompassing (i) objectives, (ii) structures, (iii) processes, and (iv) outcomes. Conclusion: This paper will contribute to the development of an inclusive healthcare framework, providing insights for stakeholders, policymakers, and practitioners seeking to improve maternal and child healthcare outcomes in resource-constrained, rural settings. Ultimately, the proposed framework will create a sustainable and culturally sensitive model that optimises the strengths of midwives and TBAs and fosters improved healthcare delivery to rural South African communities. [ABSTRACT FROM AUTHOR]

Civic space constitutes the substratum for women to be able to organise, communicate and participate in democratic processes, including claiming their rights, as well as influencing the trajectory of the political and socioeconomic structures around them. With the proliferation of the recognition and participation of women in political processes, their attempts to occupy the civic space have also intensified. While the civic space is theoretically open for women's civic participation, structural violence and cyber-violence have militated against women's civic space visibility. This has culminated in the shrinking of the civic space for women's articulation of political and socio-economic issues; especially in the African context. Against this backdrop, the objective of this paper is to examine the constraints women in Namibia, South Africa and Zimbabwe experience in operating in these spaces and the strategies they deploy to deal with these constrictions. Having said this, the paper intends to examine the manner in which physical, cyber and structural violence against Namibian, South African and Zimbabwean women manifests and affects their participation in civic spaces. Moreover, it explores the strategies deployed by women to counter the various forms of violence and other stumbling blocks inherent in the civic space. Data for this paper were generated from both primary and secondary sources and thematic analysis was used to analyse the data. [ABSTRACT FROM AUTHOR]

Background: Gender equality remains an outstanding global priority, more than 25 years after the landmark Beijing Platform for Action. The disconnect between global health policy intentions and implementation is shaped by several conceptual, pragmatic and political factors, both globally and in South Africa. Actor narratives and different framings of gender and gender equality are one part of the contested nature of gender policy processes and their implementation challenges. The main aim of this paper is to foreground the range of policy actors, describe their narratives and different framings of gender, as part exploring the social construction of gender in policy processes, using the Adolescent Youth Health Policy (AYHP) as a case study. Methods: A case study design was undertaken, with conceptual underpinnings combined from gender studies, sociology and health policy analysis. Through purposive sampling, a range of actors were selected, including AYHP authors from government and academia, members of the AYHP Advisory Panel, youth representatives from the National Department of Health Adolescent and Youth Advisory Panel, as well as adolescent and youth health and gender policy actors, in government, academia and civil society. Qualitative data was collected via in-depth, semi-structured interviews with 30 policy actors between 2019 and 2021. Thematic data analysis was used, as well as triangulation across both respondents, and the document analysis of the AYHP. Results: Despite gender power relations and more gender-transformative approaches being discussed during the policy making process, these were not reflected in the final policy. Interviews revealed an interrelated constellation of diverse and juxtaposed actor gender narratives, ranging from framing gender as equating girls and women, gender as inclusion, gender as instrumental, gender as women's rights and empowerment and gender as power relations. Some of these narrative framings were dominant in the policy making process and were consequently included in the final policy document, unlike other narratives. The way gender is framed in policy processes is shaped by actor narratives, and these diverse and contested discursive constructions were shaped by the dynamic interactions with the South Africa context, and processes of the Adolescent Youth Health Policy. These varied actor narratives were further contextualised in terms of reflections of what is needed going forward to advance gender equality in adolescent and youth health policy and programming. This includes prioritising gender and intersectionality on the national agenda, implementing more gender-transformative programmes, as well as having the commitments and capabilities to take the work forward. Conclusions: The constellation of actors' gender narratives reveals overlapping and contested framings of gender and what is required to advance gender equality. Understanding actor narratives in policy processes contributes to bridging the disconnect between policy commitments and reality in advancing the gender equality agenda. [ABSTRACT FROM AUTHOR]

As part of the rehabilitation of offenders, South Africa has emerged as one of the countries in the world that uses programmed reintegration of offenders into the communities. However, overcrowding in correctional facilities has implications for correctional officials' work in the reintegration of offender's programmes. This paper discusses overcrowding at Rooigrond Correctional Centre in the North West Province in South Africa and the implications it has for the work of correctional officials at the facility. The study applied a qualitative approach and a descriptive research design to capture the experiences of the correctional officials on the implication of overcrowding on the reintegration of offenders. Using the quota sampling method and semi-structured face-to-face interviews, ten correctional officials of different ranks participated in the study. Thematic data analysis employed showed that overcrowding in a correctional facility affects negatively the reintegration programmes at Rooigrond Correctional Centre making the rehabilitation process difficult and less effective. To enable and facilitate the successful reintegration of offenders into the communities, the study makes significant recommendations for consideration by correctional officials. [ABSTRACT FROM AUTHOR]

Background: South Africa presents one of the riskiest patterns of alcohol consumption, with per capita consumption above the African regional average. Globally, there has been an increased focus on the potential of appointing lay counsellors to administer alcohol intervention strategies in resource-limited contexts. Given the increasing need for relevant and efficient intervention strategies in response to high-risk alcohol consumption, screening instruments such as the AUDIT-C have gained increased attention. Methods: This paper explores the experiences of 15 lay counsellors in response to the training received on how to administer the AUDIT-C instrument, as well as provide interventions such as brief advice or an appropriate referral, in the resource-limited South African township of Alexandra, Johannesburg. A focus group was facilitated for this purpose and, thereafter, a thematic content analysis was applied to identify the themes most central to the lay counsellors' experiences. Results: The research findings suggest that the lay counsellors perceived the training to be adequate in preparing them for administrating the AUDIT-C and for providing any relevant interventions, and that their confidence in administering the instrument developed as the project progressed. However, recruitment and administration challenges were experienced in primary healthcare and community settings, and lay counsellors perceived home visits to be more appropriate with respect to issues related to confidentiality and stigmatisation. Conclusion: Overall, while lay counsellors feel that the training they received on the tool and the tool itself is useful for effectively implementing the AUDIT-C in low-resource communities, the availability and efficiency of alcohol treatment services in Alexandra Township need to be improved. [ABSTRACT FROM AUTHOR]

The aim of this paper is to explore the livelihood concerns of the proposed fracking on the amaZizi community. There is little research to explicitly draw on when establishing the likely effects that fracking will have on people's livelihoods in South Africa. We take an ethical position drawing on Environmental Justice as the theoretical underpinning. The data used in this paper is drawn from an empirical case study. A qualitative interpretive research approach was used to explore the livelihood concerns of the proposed fracking on the amaZizi community, South Africa. Thematic analysis was employed and the findings indicate that despite the prospective job opportunities that are touted by the government, community members oppose fracking. Community members articulated the potential negative effects of fracking on their livelihoods which will compromise their traditional pursuits, agricultural lifestyles, businesses and resources. The study recommends that the local community's concerns about their livelihoods should be explored in depth with NGOs and independent researchers' contributions given the deficiencies of the Environmental Impact Assessment, before fracking can be considered as an energy option in this heritage site. This study further informs government and fracking investors about the need for extensive community consultations/participation and approval before any 'top-down energy' option can be pursued to ensure environmental justice for the amaZizi. [ABSTRACT FROM AUTHOR]

Purpose: In South Africa, the majority of the population struggles to access care and support for mental health challenges. Drawing on challenges faced by asylum seekers and refugees in the urban margins of Johannesburg, this paper aims to explore the relationship between migration and mental health through a lens of heightened vulnerability, precarious urban spaces and unmet basic needs. Design/methodology/approach: Remote interviews were conducted with respondents working in the mental health-care sector (public and private) and with migrant communities in Johannesburg. Respondents were identified via purposive sampling and interviews were conducted in English. Key findings were identified using thematic analysis. Findings: Effective responses to asylum seekers and refugees facing mental health challenges are based on an understanding of context, of crisis and of the need to meet basic needs such as paying rent, finding employment and providing for families. These "daily stressors" not only compound "extreme traumatisation" but are a form of trauma in and of itself. Originality/value: This paper shows how alternative responses determined by an understanding of context, of crisis and of the need to meet basic needs provide critical and potentially far-reaching interventions. Locating trauma in the unmet needs, precarious urban spaces and marginalisation opens up space to further question the ways that migration and mental health shape and reshape one another. [ABSTRACT FROM AUTHOR]

Deaf learners are among the most disadvantaged when it comes to educational outcomes in South Africa. The aim of this paper, therefore, is to explore the educational needs of learners who are deaf and use the findings as a basis from which to strengthen their education. This research employed a qualitative research design, drawing on interviews with deaf learners, teachers, school management team members (SMTs) and parents. Data were analysed using thematic analysis. Findings reveal that deaf learners have significant difficulty in communicating with their teachers, and that teachers of the deaf in South Africa are not sufficiently trained to understand the educational needs of their learners. Recommendations regarding the strengthening of training for teachers of the deaf are made. [ABSTRACT FROM AUTHOR]

Background: A disability studies approach seeks to understand and address political and social issues that affect disabled individuals. Disability studies scholars employ various models of disability to address and oppose the oppression and discrimination of disabled individuals. A disability studies approach, however, has largely been absent in studies that have investigated the lived experiences of people who stutter. Aim: To examine the understandings young adult South African men who stutter hold of whether, and in what way, stuttering may be considered to be a disability. Methods & Procedures: A total of 15 men who stutter, aged 20–39 years, participated in the study. Semi‐structured interviews and two focus groups discussions were conducted to collect data for the study. The data were analysed according to a phenomenological approach and the affective turn in social research. Outcomes & Results: The results indicated that some men in this study understood stuttering as a speech disorder that can be controlled, while other men constructed stuttering as a disability, subjectively positioning themselves either as disabled or non‐disabled men. Conclusions & Implications: This article emphasizes the importance of adopting a disability studies approach when examining the lived experiences of people who stutter and enhancing intervention strategies to adequately address the disabled needs of such individuals. WHAT THIS PAPER ADDS: What is already known on the subject?: The past few decades have seen researchers investigating the personal and social experiences of people who stutter. However, empirical studies exploring the disabling experiences of people who stutter have been absent from the existing body of knowledge. What this paper adds to existing knowledge?: This research aimed to provide comprehensive insight into the disabling experiences of people who stutter. The results gave an insight into the oppression and disablism experienced by people who stutter. More specifically, the findings demonstrated how individuals who stutter are disabled by oppressive communication practices that dominate spaces of education and employment. What are the potential or actual clinical implications of this work?: Several men in this study attended speech therapy to gain control over their stuttering. For a number of participants, speech therapy proved a valuable experience, while others saw speech therapy as being out of touch with their lived reality of stuttering. Speech and language therapists are encouraged to employ a disability studies approach in order to enhance intervention strategies to adequately address the disabling needs of people who stutter. [ABSTRACT FROM AUTHOR]

Although nuances around the definitions and contextualization of social cohesion subsist, this paper views social cohesion through the lens of social cooperation and togetherness within a collective in geopolitical terms, expressed in the attitudes and behaviours of its members. In many countries, including South Africa, social cohesion remains an ideal to strive for and achieve. Extant studies suggest that trust is one of the key factors in building social cohesion. As such, this paper aims to explore trust in the context of social cohesion. This study attempts to address the knowledge gaps regarding the views, feelings, and experiences around trust and also make a contribution to the qualitative inquiry of trust in the context of social cohesion in rural communities of South Africa. Accordingly, the perceptions and experiences of people in two rural communities (Lambert's Bay and Philippolis) regarding trust in the context of social cohesion were explored. A qualitative methodology was employed in order to gain a deeper understanding of the perceptions of trust. A total of 19 participants were interviewed, comprising of community stakeholders and parents. A semi-structured interview schedule was used to collect data in face-to-face interviews with participants. Data collected were analysed using Braun and Clark's thematic analysis. The study found that trust among community members in both Lambert's Bay and Philippolis was limited. In instances where there was trust, it was mainly amongst participants who know each other compared to individuals who do not know each other. Thus, in both communities, generalised trust continues to be a challenge. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Rural Medicine (Wolters Kluwer India Pvt Ltd) is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mental health care in many low to middle-income countries like South Africa is often under resourced. Many individuals in these countries have access to the internet and often use this as a first source to search for information. Hence the possibility for online screening of mental health holds the promise of early detection and intervention. However, there are no clear guidelines for the ethics of online screening for mental health. This study aims to explore the literature in an attempt to explore existing guidelines on online screening with a view to formulating recommendations for a more universally applicable standard for online screening of mental health. A systematic review method was used to explore the literature. Articles were obtained from six electronic databases from 1970 to 2019. Through the use of the PRISMA method 12 articles met the inclusion criteria. There was only one article that made specific reference to ethical considerations regarding online screening instruments, whilst the remaining 11 made reference to some pertinent ethical considerations for online screening of mental health. Using a thematic analysis, six core themes were identified across the articles which covered online screening, namely modes of tests, psychometric properties of the tool, issues of consent, accuracy of results, feedback and test security. These were aspects that needed to be addressed over those already in place for pen-and-paper screening tools. The results are used to provide recommendations for ethical guidelines for the online screening of mental health. [ABSTRACT FROM AUTHOR]

Within the framework of the current drive to transform psychology in South Africa, this paper highlights "other" axes of identity that are arguably largely overlooked within the field. The conversation exposes the discipline of psychology – specifically within the South African context – and its many unexamined assumptions concerning "expected" identities of psychologists – specifically, those along heterosexual and able-bodied lines. By engaging in an autoethnographic conversation, the two authors, both "other", practising psychologists – one queer, one disabled – share and reflect on some of their experiences of feeling othered in their chosen profession. Drawing on parts of queer theory, critical disability literature, as well as the theoretical framework of biopolitical power, we start to make sense of our experiences of difference, deviance, and defiance. How the field of psychology marginalises "other" psychologists, and the impacts on those who bear the oppressions, is exposed; and a conversation is begun in which the discipline's assumptions around compulsory forms of identity – straight, not disabled, among others – are disrupted in productive ways. [ABSTRACT FROM AUTHOR]

Background: Patients with chronic diseases (PWCDs) were severely affected by the coronavirus disease 2019 (COVID-19) pandemic, as they were prevented from making the necessary visits to health facilities for medical review and to collect their medication. The emergence of the health crisis and inadequate access to quality care affected chronic care management. The perspectives of PWCDs are not known, and therefore the research on which this paper is based sought to investigate the lived experiences of these patients during the COVID-19 pandemic. Methods: A qualitative phenomenological design was used to obtain the lived experiences of PWCDs identified for participation in the study by means of purposive sampling. Patients' experiences were obtained during individual structured interviews, and a checklist was used to gather patient characteristics from their files. Results: Three themes emerged from the study findings, namely poor healthcare services, the socio-economic impact of the COVID-19 pandemic, and the psychological impact of the COVID-19 pandemic. The COVID-19 pandemic had devastating effects on PWCDs, in that they experienced barriers to accessing quality chronic care services and suffered psychological and financial difficulties that affected their health, life, needs and expectations. Conclusion: Policymakers should consider PWCDs when responding to a public health concern in the future. Contribution: The study findings may have an impact on future policies regulating the management of chronic diseases during epidemics, in order to improve patient health outcomes and satisfaction with healthcare services and the chronic care model based on the experiences of PWCDs. [ABSTRACT FROM AUTHOR]

Purpose: This paper examined supply chain disruptions in the manufacturing industry in South Africa and how additive manufacturing technology was used to help deal with disruptions encountered. Design/methodology/approach: The study adopted a qualitative research approach in order to meet the objectives of the study. A total of ten (10) managers of conventional manufacturing firms and ten (10) managers of 3D printing firms in Free State, South Africa participated in the study through the use of a purposive sampling technique. Interview guides were used in the collection of data. Data transcriptions and thematic analysis were used to analyze data gathered from the interviews. Findings: The results of the study showed that 3D printing contributed positively in dealing with manufacturing disruptions that were encountered by manufacturing firms in Free State, South Africa through the production of components and spare parts that were broken down in manufacturing machinery/plants. From the study, the researchers recommend that 3D printing technology should be adopted by manufacturing firms because of its practicality in providing manufacturing support and production continuity even in supply chain disruptive experiences caused by pandemics such as Covid-19. Originality/value: The study proves that due to the versatility of the 3D printing technology it could be used to minimize the effect of supply chain disruption during cries such as the Covid-19 pandemic. One of the unique contributions of the current study is the realization that additive manufacturing was not of much relevance to the generic supply chain challenges encountered in supply chain activities, but rather very relevant in helping to prevent disruptions of the manufacturing process by improvising spare parts at the peak of the Covid-19 pandemic. [ABSTRACT FROM AUTHOR]

Although the Constitution of the Republic of South Africa (1996) provides a normative framework for upholding the fundamental human rights of its citizens, day labourers represent one of the most disenfranchised and marginalised sectors of the South African economy and remain entirely at the mercy of prevailing market forces. This paper is based on a qualitative study that was conducted in the city of East London in the Eastern Cape province of South Africa to develop a comprehensive understanding of the precarious circumstances in which day labourers are obliged to eke out a meagre subsistence through short-term employment. A person-in-environment framework was used to evaluate the findings from a thematic analysis of the data that was obtained from individual interviews with eighteen day labourers who had no other forms of income. The findings were used to formulate recommendations for social work practice, specifically with respect to the role of social workers in the formulation and implementation of policies to include day labourers among the vulnerable segments of the population whose well-being the profession is dedicated to improving. [ABSTRACT FROM AUTHOR]

In response to the COVID-19 pandemic, South Africa implemented a national lockdown including a ban on the sale of alcohol. This paper describes adults' perspectives on this alcohol ban, focusing on whether they support or oppose this regulation. As part of a longitudinal study that documents South African's experiences of the COVID-19 lockdown, qualitative data were collected from 49 adults and analyzed thematically. Perspectives are framed around the overarching theme of "lives versus livelihoods," presented as support and/or opposition to the ban. Participants who endorsed the ban, as preserving "lives," thought that it facilitated social distancing and therefore limited the spread of COVID-19. Those who opposed the ban suggested that it undermined the "livelihoods" of South Africans, in the context of an already-strained economy. Our findings show that decisions around whether to support or oppose the alcohol ban were informed by critical reflections on the wider socio-behavioral and health implications of such regulations. Further implications are discussed. [ABSTRACT FROM AUTHOR]

English First Additional Language (EFAL) is one of the prescribed subjects in South Africa. However, it is a has proven to be difficult, especially the reading part of the it. On the other hand, the integration of Information Communication Technology (ICT) can mitigate the challenges and promote effective pedagogy in this subject. Unfortunately, there is evidence that the implementation of ICT is not easy to achieve in some South African schools. This scholarly piece, which is guided by the theory of connectivity, has its focus on those impediments that hinder the effective implementation of ICT in EFAL classrooms. This is because contextual factors must be faced head-on to achieve success in a school environment. The study was informed by interpretive practices, resulting in the use of participant observations and semi-structured interviews to collate the data. Thematic analysis of the data revealed the following: limited time for collaborative practices; lack of ICT expertise; issues of power; poor reading competence among the learners; limited pedagogical knowledge; workload; lack of resources; network issues; and safety issues. Despite all these conundrums, this paper proposes that intermediate phase EFAL teachers should still try to learn how ICT can assist the improvement of reading competence. For the integration of ICT to happen effectively, managers at all levels should also provide the necessary support to the teachers. [ABSTRACT FROM AUTHOR]

Graduate unemployment is one of the major socio-economic development problems in South Africa and many other developing countries. Previous research has described various factors causing graduate unemployment, one of which is a lack of relevant work experience. Internships are increasingly supported to address this problem. However, internships have been criticised for being exploitative, illegal, and unjust. This paper seeks to present a new perspective on internships. It seeks to examine the perspectives on the impact of stipend level on graduate intern work productivity. Thus, the objectives of this study are to: explore the impact of stipend level on the work productivity of graduate interns; explore the exploitative nature of internship as perceived by participants; and explore the concerns of graduate interns over compensation. This study is qualitative and exploratory in nature. Fifty semi-structured interviews were conducted with interns, mentors, and HR managers at eThekwini municipality, Durban, South Africa, to address these research objectives. Data from interviews was analysed through thematic analysis. The results indicate that there is a relationship between the level of stipend earned by interns and their work productivity. This study found that low pay is associated with low work productivity. Therefore, work compensation is the primary motivator of productivity, not only for full-time employees but also for graduate interns. [ABSTRACT FROM AUTHOR]

Background: In South Africa, children with cerebral palsy are nested within a family setting by immediate relatives, particularly in the rural areas. These immediate relatives are regarded as caregivers and are not trained with regard to providing care to children with special needs. Therefore, they have to find ways to adapt to their new roles of caregiving using the available resources. The aim of this paper is to present the challenges encountered by caregivers of children with cerebral palsy in rural areas of South Africa. Methods: This qualitative, explorative, descriptive, and contextual study included 10 caregivers for children with cerebral palsy who were purposively recruited from the three respective hospitals in Vhembe District within Limpopo Province. Data were collected through individual in-depth interviews and analysed using a thematic approach. Ethical considerations and measures to ensure trustworthiness were upheld throughout the study. Results: Four themes emerged from the study, namely economic problems facing caregivers; health problems encountered by caregivers; maltreatment of caregivers by community members, as well as access to transport for caregivers and children. Conclusion: Participants narrated that caring for a child with cerebral palsy is not an easy task for the caregiver, particularly in the rural areas of South Africa. They encounter various challenges as they strive to provide quality care to the children that they are caring for. An investigation is recommended concerning the kind of model which should be developed to support caregivers in caring for children with cerebral palsy in the rural areas. [ABSTRACT FROM AUTHOR]

The demanding and complex training of learner nurses in clinical practices requires various occupational health and safety measures to curb occupational health hazards among learner nurses. This paper aimed to explore learner nurses' experiences concerning occupational health and safety during clinical learning. A qualitative descriptive, contextual and exploratory design study was conducted. A total of 31 learner nurses were selected using purposive sampling. Data were collected by semi-structured interviews and analysed using Tesch's open coding method. Two themes emerged from this study: "The experiences of learner nurses concerning their health and safety during clinical learning" and "The measures to be taken to promote occupational health and safety during clinical learning." Highlighting challenges and measures to mitigate occupational health hazards among learner nurses in the South African context, Limpopo province, would be beneficial. The findings can assist stakeholders in developing specific precautionary guidelines for learner nurses. Effective and innovative occupational health and safety training programmes for learner nurses can be developed despite constrained environmental resources. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Occupational Therapy / Cadernos Brasileiros de Terapia Ocupacional is the property of Cadernos de Terapia Ocupacional da UFSCar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Contemporary literature reveals that there is significant growth in scholarly attention on fracking globally. This paper draws from an interpretivist study that explored the potential impacts of fracking on communities in the Drakensberg Mountains, an area where fracking will consume excesses of water in a water stressed region. The research was carried out amongst the amaZizi community in the Drakensberg Mountains. A qualitative case study research approach was utilized for data generation by the researchers. The researchers utilized the Sustainable Livelihoods Approach coupled with the Asset Based Community Development approach that served as a theoretical to guide. Data were generated using three tools: semi-structured interviews, mini-focus group discussions and participatory observations. Thematic analysis was used by the researchers to identify emerging themes that were used to present and analyse the findings. Central to the findings was the contention that there was a lack of engagement with the communities about fracking and no active participation and collective decision-making with the amaZizi community in the Drakensberg Mountains. The study recommends that the government, its representatives, and fracking companies engage in extensive community consultations and include the traditional leadership in rural areas to ensure understanding of the process and its impacts for the amaZizi people. We recommend that there is the potential to avert a foreseeable challenge when fracking commences. [ABSTRACT FROM AUTHOR]

Background: Speech–language therapists and audiologists (SLT&As) may encounter difficulties when confronted with patient death and dying, which may conflict with their moral beliefs and result in moral injury. Furthermore, South African SLT&As practice in a country with a high mortality rate, which may add to the complexity of their experience. Moreover, they may be influenced by African philosophies promoting care, which might conflict with their experiences of patient death and dying. Aims: To explore the moral injury experienced by South African SLT&As in patient death and dying, and how they overcame the injury. Methods & Procedures: This article forms part of a larger qualitative study that explored SLT&As' experiences of patient death and dying in South Africa. Thematic analysis was conducted on the transcripts of 25 episodic narrative interviews conducted with South African SLT&As on their experiences of patient death and dying. Outcomes & Results: Findings suggest that South African SLT&As experienced helplessness, guilt and anger in patient death and dying. However, with support from the allied team, engaging in self‐reflection and religious practices, they reported alleviation of moral injury. Conclusions & Implications: In order to mitigate moral injury in South African SLT&As, they require professional education, self‐care strategies, guidelines and support from the teams in which they work and their supervisors. Research is needed that explores how SLT&As' biographical characteristics and interactions with significant others of dying and deceased patients, may result in moral injury. What this paper adds?: What is already known on this subject?: Moral injury and measures used to overcome the injury have been explored in military personnel, doctors and nurses, but not in SLT&As. However, studies that explored the perceptions of SLTs and/or audiologists regarding providing palliative care and of death and dying, particularly that by Rivers et al. in 2009, suggested that these professionals may be at risk of experiencing emotional trauma due to patient death, particularly when not receiving undergraduate education on this subject. However, the extent of this trauma and the support needed to overcome it is unknown because the participants in these studies may have not experienced patient death, and were only students or just SLTs. What this article adds?: This article highlights the complexity of speech–language therapy and audiology practice when confronted with patient death and dying. South African SLT&As may have to make decisions that conflict with their morals and professional practice standards, especially as the helping nature of their profession is characterized by African philosophies that promote care, which may result in moral injury. Clinical implications of this article: This article indicates that in addition to undergraduate education on patient death and dying, SLTs and audiologists require continuous professional education on this topic, self‐care strategies, support from the teams in which they work, and their supervisors and guidelines for when they encounter patient death and dying. [ABSTRACT FROM AUTHOR]

Background: HIV and sub-optimal infant feeding practices remain important threats to child growth, development, and survival in low- and middle-income countries. To our knowledge, few studies have explored health service users' perspective of infant feeding in the context of WHO Option B+ policy to prevent vertical HIV transmission (PMTCT). This paper is a sub-analysis of qualitative data from a mixed-methods multi-level process evaluation of Option B+ implementation in South Africa (SA). In this study we explored health facility users' infant feeding knowledge, perceptions, and practices one year after SA adopted the 2016 updated World Health Organization prevention of mother-to-child transmission of HIV Option B+ infant feeding guidelines. Methods: Nineteen focus group discussions (FGDs) were held with six groups of men and women whose infants were aged < 6 months. Participants were attending randomly selected primary health care facilities within six purposively selected priority districts. The six groups included in the FGDs were: (i) adolescent girls and young women living with HIV (WHIV), (ii) adolescent girls and young women not living with HIV (WNHIV), (iii) older postnatal WHIV (iv) older postnatal WNHIV (v) pregnant women, and (vi) men. Data collection took place between April and December 2018. Data analysis involved coding and thematic framework analysis. Results: Women and men have suboptimal knowledge of the recommended breastfeeding duration and exclusive breastfeeding, especially for HIV-exposed infants. Most women received sub-optimal infant feeding counselling and mixed messages from health care workers. Fewer WHIV initiated breastfeeding at birth compared to WNHIV. Most parents believed that HIV-exposed infants should be breastfed for 6 months and many postnatal women on antiretroviral drugs and younger mothers lacked confidence to breastfeed beyond 6 months. Mixed feeding was predominant among all women due to individual, family, and socio-structural barriers. Many men were supportive on infant feeding; however, they lacked the appropriate information and skills to influence their partners' infant feeding decisions. Conclusions: Differences in breastfeeding practices between WHIV and WNHIV are highly influenced by the lack of knowledge of infant feeding policy recommendations. Multiple-level factors deter many mothers from adhering to recommended guidelines. Appropriate ongoing infant feeding counselling and breastfeeding support are required for women and their partners. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Several studies explore and describe the role of family dynamics in dementia care.However, few focus specifically on the diversity of family relationships that influence family caregivers' experiences of providing care to a relative with dementia.The role of family caregivers engaging in unpaid care of relatives with dementia is becoming more and more critical as the numbers of people living with dementia increase across the globe.Family caregivers are a diverse group of people as there are different categories of kinship relations and thus cannot be viewed as a single collective.They are linked intricately to their family and social support systems, however, they often experience limited family support, and tensions between family members can be a major source of stress.Hence, health professionals need to deepen their understanding of family relationships to enable them to provide effective advocacy and clinical support to family caregivers. What the paper adds to existing knowledge?: This study is unique in that it focuses on a range of family relationships in which a person with dementia finds themselves. It highlights that this network of complex connections influences the caregiving process.The study demonstrates the important role that siblings can play in sharing the caregiving load. However, this sharing is rarely balanced or fair and there is always someone in the family who carries the heaviest load.Communication between family members is frequently a challenge, with family members experiencing denial or an inability to understand the challenges encountered by the family caregiver.Most studies focus on the relationship between the family caregiver and the relative with dementia alone, rather than the family network of the family caregiver and how it influences the caregiving process.This study is unique as it focuses on family dynamics and the family network, particularly the range of family relationships in which family caregivers and their relative with dementia find themselves.Other studies tend to focus on a specific kinship category and the family network, such as an adult child, caring for their parent, but this study presents a wide variety of kinship categories to demonstrate the diversity of family caregiving contexts.The family caregivers in this study all highlighted the need or desire for effective support from the family network.Challenges of communication between family members and the caregiver were also evident and were framed within the existing family dynamic of each family. What are the implications for mental health nursing?: The findings suggest the need for communication (training and therapeutic) interventions between family caregivers and other family members (secondary caregivers). Mental health nurses are often well positioned to offer the family caregiver the option to undertake such an intervention.The findings emphasize the diversity of family caregiving situations and argue that mental health nurses can assess the nature of the care situations and work with families on how best to address the needs of the relative with dementia and the main caregiver.However, tensions frequently exist between family members, some of which existed prior to the relative acquiring dementia and other tensions as a consequence of the relative acquiring dementia. Mental health nurses could assist as a mediator between family members in order to assist families to become more cohesive. Introduction: This article explores the diverse nature of family caregivers, focusing on the different categories of kinship relations. Family caregivers are linked intricately to their families, but often experience limited family support, causing stress and tension between family members. Aim: The article aims to explore the family relationships of family members caring for relatives with dementia in order to provide an insight into the role of such relationships on the caregiver relative with dementia dyad. Method: A phenomenological, exploratory‐descriptive design was used. Eight participants took part and data were obtained using collages and semi‐structured interviews. Results: A range of family relationship patterns was highlighted including sibling involvement in the caregiving process; spousal involvement in supporting a caregiver of a parent; and spousal involvement in caring for their spouse. Discussion: The family caregivers highlighted the need or desire for effective support from the family network. Challenges of communication between family members and the caregiver were also evident and were framed within the existing family dynamic of each family. Implications for Practice: Mental health nurses need to deepen their understanding of family relationships to enable them to provide effective advocacy and clinical support to family caregivers and assist families to become more cohesive. [ABSTRACT FROM AUTHOR]

Youth disengagement is a growing concern globally, yet little research has been done to explore participatory approaches that can engage youth as co‐creators of community programs that improve their resilience. The primary objective of the study is to report on the results of an innovative participatory approach used in the Eastern and Western Cape provinces, South Africa, to engage vulnerable youth in needs ranking. Data for this paper were collected in three phases. Using information gleaned from the literature review (Phase I), authors compiled a list of core needs on separate cards. In Phase II, youth discussed and ranked each need in terms of importance for their community. In Phase III, youth participated in focus group discussions on the ranked needs as part of a broader discussion on youth risk behaviours. Thematic analysis was used for qualitative data. Needs ranking data were analysed using descriptive statistics. Although expressed priority needs differed amongst communities, combined data revealed the top expressed priorities as further education (priority 1; 85%), skills development (priority 2; 74%) and career development and training (priority 3; 68%). Differences between critical needs as discussed in the literature and those perceived by youth were noted. Focus group data validated the expressed priority needs and highlighted that vulnerable youth felt valued through the needs ranking activity. Involving youth in the assessment of their needs can improve the value of information obtained, which in turn can facilitate better allocation of community resources. [ABSTRACT FROM AUTHOR]

The use of drugs amongst adolescents and youth has become a global phenomenon and South Africa is no exception. This paper aims to explore the familial contexts and childhood experiences leading up to the drug-taking pathways of young drug users. A qualitative approach was utilized to gather demographic from a purposive sample of 41 young (14–19 years) drug users, at five drug treatment centres in the Western Cape of South Africa. Additionally, participants could agree to participate in an in-depth interview or to provide a written life history account. A thematic data analysis was applied, and the results uncovered a range of family-related risk factors such as family structure (single motherhood and absent fatherhood), and other negative family functioning and practices such as troubled parent-child relationships, poor family communication/interactions, parental/family substance abuse, and conflict-ridden, stressful and often violent and abusive family situations. The findings suggest that prevention initiatives should focus on strengthening family functioning by reducing high conflict, stress, violent and abusive family situations, as well as aim to enhance the caregiver-child relationship. Prevention strategies should encourage live-in and non-live-in fathers to be actively involved in the lives of their children and should aim to reduce parental/caregiver substance abuse. [ABSTRACT FROM AUTHOR]

The social work profession has become critical in assisting victims of violent crime at social service agencies in South Africa. Social workers have been spearheading efforts to help trauma victims at the expense of their mental health. For Black South African social workers, the mental burden of working with victim collides with historical trauma to create new ways of experiencing mental health challenges. The study aimed to explore the experiences of social workers working with victims of violent crime at select social service agencies in Johannesburg. The study was qualitative in nature and a case study design was used. Data was collected using in-depth interviews. The researchers used purposive sampling and data was analyzed using thematic analysis. Results from the study showed that Black South African social workers working in the field of violent crime face challenges such as prolonged sadness, emotional exhaustion and vicarious trauma. All these psychological problems are amplified by the fact that social workers in South Africa work under strenuous conditions. This increases the impact of psychological problems on social workers. Therefore, this paper argues that when the psychological effects of working with victims of violent crime, intersect with historical trauma, it produces unique ways of experiencing trauma for Black South African social workers. This study has strong implications for research about the health and wellbeing of social work practitioners working with trauma victims. The study exposes the need to prioritize the wellbeing of social workers especially those working in contexts with a traumatic past. [ABSTRACT FROM AUTHOR]

Mothering in the context of a South African high-risk community has undue complexities. Apart from the compounding risks for families and the reality of many "poverty traps," when mothers' personal and parenting competencies within this context are compromised, then the entire family suffers. There is a need for the development and evaluation of a wellness program for mothers living in high-risk communities in the South African context. Moreover, scholars argue for a contextual understanding of structural conditions and, particularly, for the inclusion of a participatory and social justice approach to such program development. The aim of the program described in this paper was to strengthen the personal and parenting abilities of mothers living in a South African high-risk low-income community. We describe our modus operandi in combining research-generated academic information with contextual data obtained via participatory processes to inform the content and focus of the program. Additionally, thematic analysis of data obtained via a focus group discussion with social worker participants was used to identify prerequisite skills and competencies for this program to enhance mothers' well-being as well as appropriate parenting skills. We describe the content of the wellness program comprising concept mapping of four modules called Mattering; Mothering; Managing; and, Mentoring located within the theoretical framework of Community Psychology. Guidelines from various parenting programs were incorporated as best practices toward effective implementation. [ABSTRACT FROM AUTHOR]

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In South Africa, community participation has been embraced through the development of progressive policies to address past inequities. However, limited information is available to understand community involvement in priority setting, planning and decision-making in the development and implementation of public services. This narrative review aims to provide evidence on forms, extents, contexts and dynamics of community participation in primary health care (PHC) and water governance in South Africa and draw cross-cutting lessons. This paper focuses on health and water governance structures, such as health committees, Catchment Management Agencies (CMA), Water User Associations (WUAs), Irrigation Boards (IBs) and Community Management Forums (CMFs). Articles were sourced from Medline (Ovid), EMBASE, Google Scholar, Web of Science, WHO Global Health Library, Global Health and Science Citation Index between 1994 and 2020 reporting on community participation in health and water governance in South Africa. Databases were searched using key terms to identify relevant research articles and grey literature. Twenty-one articles were included and analysed thematically. There is limited evidence on how health committees are functioning in all provinces in South Africa. Existing evidence shows that health committees are not functioning effectively due to lack of clarity on roles, autonomy, power, support, and capacity. There was slow progress in establishment of water governance structures, although these are autonomous and have mechanisms for democratic control, unlike health committees. Participation in CMAs/WUAs/IBs/CMFs is also not effective due to manipulation of spaces by elites, lack of capacity of previously disadvantaged individuals, inadequate incentives, and low commitment to the process by stakeholders. Power and authority in decision-making, resources and accountability are key for effective community participation of marginalized people. Practical guidance is urgently required on how mandated participatory governance structures can be sustained and linked to wider governance systems to improve service delivery. [ABSTRACT FROM AUTHOR]

Purpose: Machine learning (ML) in new-generation hearing aid technology presents a beneficial opportunity for development in audiology. It is, however, important to balance new applications against the audiologist's professional ethics to protect the client from any harm. This study aimed to identify the key ethical concerns related to the latest digital hearing aid technology that incorporates ML that could potentially impact the client and/or the audiologist. Method: A nominal group technique was conducted with the audiologist to generate and prioritize a list of key ethical concerns related to human data interaction, with specific focus on hearing aids. Results: Five categories were identified in relation to the potential impact on the client: (a) privacy and confidentiality, (b) relationship and trust, (c) nonmaleficence, (d) informed decision making, and (e) financial gain. An additional five categories were identified in relation to the potential impact on the audiologist: (a) privacy and confidentiality, (b) professional responsibility, (c) relationship and trust, (d) financial gain, and (e) trust technology. Privacy and confidentiality were ranked as the highest priority that should be considered when supplying clients with the latest hearing aid technology. Conclusions: Hearing aid technology has evolved considerably, and audiologists need to keep abreast of and master the general technological developments and the associated ethical challenges that may arise. Discussions on the ethics related to ML and hearing aid fittings will help identify the key ethical concerns involved and, thereby, enhance the ethical sensitivity of the profession. [ABSTRACT FROM AUTHOR]

Job insecurity is a widespread workplace stressor that has been extensively investigated using quantitative approaches. With the use of a critical organisational psychology framework, we conducted a meta‐synthesis of 20 qualitative studies to investigate the experience of job insecurity among vulnerable employee groups (i.e., women and immigrants). The qualitative meta‐synthesis results suggest that there are meaningful differences. Specifically, whereas women were more concerned with and exposed to deteriorating working conditions, men experienced job insecurity as a threat to their identity. Among immigrants, the experience of job insecurity is viewed as largely intersecting with the legal system, impacting their ability to remain in their country and making them feel powerless. Thematic evidence also emerged regarding individual actions that participants use to attain security in contrast to corporate strategies that enhance job insecurity. We contribute to the critical organisational psychology literature by discussing how these results test common academic theories and neoliberal assumptions pervasive within the job insecurity literature: We highlight how organisations manufacture job insecurity, question the existence of harmonious social exchanges, discuss the use of job insecurity as a form of worker control, consider the role of the legal context in aiding worker exploitation and argue for an intersectional view of job insecurity. [ABSTRACT FROM AUTHOR]