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Introduction Power imbalances within sexual relationships have significant implications for HIV prevention in sub-Saharan Africa. Little is known about how power influences the quality of a relationship, which could be an important pathway leading to healthy behavior around HIV/AIDS. Methods This paper uses data from 448 heterosexual couples (896 individuals) in rural KwaZulu-Natal, South Africa who completed baseline surveys from 2012 to 2014 as part of a couples-based HIV intervention trial. Using an actor-partner interdependence perspective, we assessed: (1) how both partners' perceptions of power influences their own (i.e., actor effect) and their partner's reports of relationship quality (i.e., partner effect); and (2) whether these associations differed by gender. We examined three constructs related to power (female power, male equitable gender norms, and shared power) and four domains of relationship quality (intimacy, trust, mutually constructive communication, and conflict). Results For actor effects, shared power was strongly and consistently associated with higher relationship quality across all four domains. The effect of shared power on trust, mutually constructive communication, and conflict were stronger for men than women. The findings for female power and male equitable gender norms were more mixed. Female power was positively associated with women's reports of trust and mutually constructive communication, but negatively associated with intimacy. Male equitable gender norms were positively associated with men's reports of mutually constructive communication. For partner effects, male equitable gender norms were positively associated with women's reports of intimacy and negatively associated with women's reports of conflict. Conclusions Research and health interventions aiming to improving HIV-related behaviors should consider sources of shared power within couples and potential leverage points for empowerment at the couple level. Efforts solely focused on empowering women should also take the dyadic environment and men's perspectives into account to ensure positive relationship outcomes. [ABSTRACT FROM AUTHOR]

Abstract: This paper contributes to the debate on the precise nature of face as a universal phenomenon, and the cultural variability within it. Specifically, we bring the ‘Southern’ perspective to the debate by discussing the previously neglected African dimension. Recent scholarship suggests that the concept of face and the notion of self in traditional African culture may have more in common with Eastern collectivist cultures than with Anglo-American culture. We examine the interactional management of an encounter between a Zimbabwean English speaker and British English speakers in a community singing group. We argue that, while face needs may be universally relevant in such a situation, the way in which they are oriented to in interaction depends on cultural understandings of which aspects of face are paramount in particular circumstances. Since these assumptions are deep-seated and invisible they are not easily open to explicit negotiation and hence can lead to misinterpretation. By conducting an ethnographic study of the communicative event and combining it with a detailed examination of the co-construction of meaning in this interaction, we show how the participants’ contributions can be related to differing – and potentially conflicting – interpretation frameworks. These frameworks are informed by culture-specific notions of appropriate self-presentation. [Copyright &y& Elsevier]

Abstract: In changing the context regarding the situation of vulnerable children in rural South Africa, understanding the role of communication in the design of community-based child health information systems (HIS) is key. Communication goes beyond language. The importance of translation of terms and concepts used to negotiate between different meanings and logics is explored in this paper. In striving for the ‘ideal speech situation’ [J. Habermas, Structural Transformation of the Public Sphere, The MIT Press, Cambridge, MA, 1989], or, in other words, creating an enabling environment in which people can participate in debate and discussion on equal terms, there is a need to develop a codetermined vision; to understand local meanings of and for childhood illness; to understand communication systems and the context in which they occur; and to connect with networks beyond the localised setting, such as provincial or national health authorities. We provide a theoretical and practical framework in which important aspects of communication related to IS design can be highlighted and against which the implementation of an IS can be reviewed. The South African case study from the UThukela District Child Survival Project in KwaZulu-Natal, illustrates how this approach was used in co-constructing local meanings for child health indicators in a community-based information system. [Copyright &y& Elsevier]

This paper investigates the impact of the Stepping Stones Creating Futures (SSCF) intervention on young women in informal settlements in eThekwini, South Africa. Specifically, whether following participation in the intervention the young women experienced a reduction in intimate partner violence, strengthened agency and shifted gender relations. Where changes occurred, it examines how they occurred, and barriers and enablers to change. SSCF is a gender transformative and livelihoods strengthening intervention using participatory, reflective small groups. Qualitative research was undertaken with fifteen women participating in the SSCF randomised control trial between 2015 and 2018. The women were followed over 18 months, participating in in-depth interviews at baseline, 12- and 18-months post intervention. To supplement these, eight women were involved in Photovoice work at baseline and 18 months and seven were included in ongoing participant observation. Data were analysed inductively. Data revealed many women changed their behaviours following SSCF, including: having more power within relationships, improved communication and relationship skills, increased resistance to controlling partners, shifting relationship expectations, emergence of new femininities and improved livelihoods. Despite these important shifts many women did not report a reduction in IPV. Nonetheless we argue most of the women, following the intervention, became more agentic. Drawing on the notion of 'distributed agency' as developed by Campbell and Mannell (2016), we show that SSCF bolstered the women's distributed agency. Distributed agency recognizes small agentic acts that women take, acts which to them are significant, it further notes that agency is temporal, fluid, dynamic and context specific. Women do not 'either have agency or not', rather being agentic depends on time, context and the particular incident. These findings provide an important contribution to the limited application of distributed agency and femininities work in informal settlements and are critical for policy and intervention science to reduce IPV and support women's agency. • South African informal settlements have high rates of intimate partner violence. • The Stepping Stones Creating Futures intervention strengthened young women's agency. • Women developed new skills, reduced violent confrontations and improved livelihoods. • However, many women remained in violent relationships. • Participatory, group-based, gender transformative interventions can reduce violence. [ABSTRACT FROM AUTHOR]

Abstract: Advocacy, social mobilisation and communication are key components of the successful introduction of new vaccines into childhood immunisation schedules. The development of many new vaccines and the innovation of finance mechanisms, means more efficacious vaccines are becoming available to children in developing countries. At the same time, communication technology is developing at a rapid rate, and with the dramatic decrease in vaccine-preventable diseases over the past few decades, the public have become increasingly exposed to confusing and conflicting information about the need for vaccination. The science of vaccines has become more complex, making effective, clear and consistent communication for healthcare workers and caregivers critical to the uptake of and adherence to life-saving vaccination. The introduction of two new vaccines, the 7-valent pneumococcal conjugate vaccine and the rotavirus vaccine together with the new pentavalent vaccine, which includes inactivated polio vaccine and replaced the former combination vaccine with four antigens, into the South African Expanded Programme on Immunisation over a short period of time, has been met with a number of challenges, some of which led to a lowering of confidence in the Department of Health to deliver on its promises. Had consistent advocacy, social mobilisation and communication efforts not been in place, efforts to make an impact on the burden of disease may not have been as successful. This paper focuses on the lessons learned about effective advocacy with decision makers, social mobilisation, communication with parents and caregivers, and training healthcare workers regarding the introduction of the new vaccines. [Copyright &y& Elsevier]