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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]

The burden of malnutrition experienced globally, coupled with the increasing rate of micronutrient deficiencies, compromises the health and well-being of women during their reproductive years. Obesity places young South African women at particular risk during pregnancy, and increases obesity risk for their offspring. To address these risks, the Bukhali trial is being implemented in Soweto, South Africa with 18–28-year-old women, as part of the Healthy Lifestyle Trajectory Initiative. A dietitian is part of the Bukhali intervention team (community health workers) to provide nutritional support for overweight/obese trial participants, making use of the International Federation of Gynaecology and Obstetrics (FIGO) Nutrition Checklist. This paper reflects on the experiences and lessons learned by the Bukhali dietitian, including the use of the FIGO Nutrition Checklist and Healthy Conversation Skills to facilitate conversations about making healthy dietary behaviour changes. Identified challenges that influence nutrition and behaviour are discussed, including lack of food affordability, cultural and social influences on healthy food choices, unsupportive environments and food insecurity. Strategies to optimise this nutritional support are also mentioned. The Bukhali trial is showing that introducing additional nutrition support by a dietitian for at-risk participants has the potential to encourage young women to prioritise nutrition and health, even in the midst of contextual challenges to both nutrition and health. [ABSTRACT FROM AUTHOR]

This paper presents findings from a study on blindness discourses found in South African non-profit organisations that provide rehabilitation services to visually impaired adults. The paper investigates what the public relations materials of these organisations communicate about blindness. It also considers the ideological assumptions that blindness discourses reinforce and embed in rehabilitation practice. The primary focus is a discourse analytic review conducted on a sample of organisation public facing material. The findings comprise three clusters of assumptions, with concomitant enactments in practice. These are i) third-person alliances around the blind subject and a resulting objectification of service users ii) 'journey discourse' which prohibits the expression of complex disability experiences and iii) polarised blindness fantasies which promote othering and prescribe acceptable ways of being for blind subjects. This paper questions what might be imparted to blind persons at a symbolic level through rehabilitative practices. This article explores the ways that blindness and blind persons are represented on the websites of organisations that provide visual impairment rehabilitation services in South Africa. These representations affect the way that society views visually impaired people, and the way that visually impaired people feel about themselves. Organisation websites describe visually impaired people in ways that make it seem as though they play little active role in the rehabilitation process. The idea that rehabilitation is a journey from dependence and depression to independence and self-acceptance might make it difficult for rehabilitation service users to express ongoing feelings of grief and loss. There is a need for more focus on interdependence in rehabilitation services. Rehabilitation organisations must think carefully about what their public relations materials communicate to society about blindness and blind persons. [ABSTRACT FROM AUTHOR]

Purpose: Legacies of colonialism continue to influence the profession of speech-language pathology (SLP) around the world. While there is some literature on ways in which we can decolonise the profession, there is little written on these issues in relation to research and practice in the field. In this paper, we discuss how qualitative approaches can be useful particularly in post-colonial contexts to transform research and practice in the profession. Method: Using a reflective framework, we draw on examples from several of our own research and teaching experiences that have embraced a variety of qualitative approaches, conducted across various contexts in the post-colonial South African context. Result: Qualitative approaches can play a central role in achieving transformation goals because they offer opportunities for highlighting the voices of marginalised communities and they are flexible and adaptable to the needs of particular contexts. We reflect on how qualitative approaches can be linked to SLP curricula, practice and research, and consider innovative ways in which such approaches can be embraced within the profession. Specifically focussing on research, we explore issues of access, representation and inclusion, the use of contextually relevant methods, and ethical considerations when working in post-colonial contexts. Conclusion: Many of the points raised in this article are important for all contexts. Embracing qualitative approaches offers opportunities for the SLP profession to transform and meet our mandate of providing culturally safe, appropriate, effective care. [ABSTRACT FROM AUTHOR]

This paper evaluates a South African rural telecentre that may serve as a ‘best practice’ model. The paper first provides a brief literature review of telecentres and the role of information and communication technology in economic development. A qualitative evaluation of a case study is presented within the context of sustainability considerations and development outcomes; that is, showing how the telecentre has improved the lives of the rural community at Thabina. Some of the observed economic development impacts are listed in the paper and an attempt is made to capture the essence of the vital links between the use of information and communication technology (technology transfer), human development, education and economic development. [ABSTRACT FROM PUBLISHER]

Background:Indigenous health matters have largely been neglected in the speech-language pathology literature and have particular import for the aphasia clinician. The influence of culture on people’s experiences and expectations after an event such as stroke can vary widely and there is a need to understand the impact of context on assessment and therapy. Standard approaches may not be adequate or relevant, nor always ethical to apply. Examination of aphasia in contexts with Indigenous populations provides an opportunity to explore methods and approaches with socially complex and marginalised communities and to expand our understanding of the lived experience of aphasia. Aims:The goal of this paper is to explore the role of culture in aphasia in Indigenous populations and drawing from a body of emerging research, highlight relevant dimensions of understanding and practice for the aphasia clinician. Main Contribution:A series of qualitative studies undertaken with Indigenous people with aphasia in two separate contexts – Australia and South Africa – will be described and their findings considered along several dimensions. A consideration of methods of approach and understanding will be provided, followed by discussion of some central constructs. A series of conceptual and clinical propositions for culturally safe research and practice in aphasia will be derived from this evidence. Models of collaboration are derived which are decolonising and potentially transformative and supplement models of knowledge and intervention in a local community. Particular attention is paid to temporal and spatial issues, the role of family, identity and community, the notion of resilience in such communities and addressing some of the specific challenges that may be involved such as working with cultural brokers. A series of recommendations is provided which allows for a critical engagement with interdisciplinary frameworks of understanding aphasia in context. Conclusion:As a reflective piece, this paper has enabled a collation of knowledge about aphasia in two Indigenous cultures and has helped consolidate some novel principles and insights and the need for expanded skills, attitudes, insights, explanations and methodologies – ones that acknowledge and accommodate diversity and difference, and that are relevant to Indigenous communities. Language difficulties are only one cause of social exclusion and issues such as poverty and identity make a huge impact on the lives of our clients and their families, and on the approach we adopt. A shift from the primary framework of our profession is required to accommodate the central role of culture in communication. [ABSTRACT FROM PUBLISHER]

Concise and effective business English communication underpins successful organisations. During the 4th Industrial Revolution (4IR) much of the working day is spent in some form of communication, usually e-mails. This paper examines the effectiveness of English communication between integral parts of a business operation during the 4IR. A mixed methods approach utilising a non-experimental design was used to investigate effective business communication using e-mails in English in a medium sized organisation in South Africa. A questionnaire consisting of 10 Likert type scale questions and 5 open ended questions was used. Purposive sampling was utilised as the population was small (150 employees, final sample 55) thus results cannot be generalised. Certain barriers to communication were identified which were considered important. For instance, many staff members were second language English speakers and often misunderstand e-mails. As a result, they reported that they felt frustrated in their working life and were demotivated. It was concluded that many e-mails were challenging to staff and needed to be written in everyday English not business language. The authors recommended that workshops and initial training in business language skills when people enter the organisation should be undertaken. Human Resources could also audit the use of appropriate English. [ABSTRACT FROM AUTHOR]

Background: Providing aphasia care in multilingual and multicultural settings necessitates increased attention in light of current migration and globalisation patterns. Delivering care that is meaningful and appropriate for people living with aphasia becomes challenging in cases where speech-language therapists are not able to speak the languages of people with aphasia, and in instances where there is a shortage of therapeutic resources. Traditional approaches to aphasia management thus require rethinking. The South African context embodies some of these challenges, with a lack of sufficient speech-language therapists and many unable to speak the languages of the majority population. Aims: Drawing from a framework of Ethics of Care and extending it to include the notion of community, this paper proposes a model of what a "community of care" might look like for people living with aphasia in diverse contexts. Several examples from a synthesis of qualitative studies conducted in the diverse South African context are used to illustrate and expand on a model of community of care. This work has explored communication opportunities and social activities across a range of community and residential care settings, incorporating the perspectives of people with aphasia, speech-language therapists and community members involved in caring for people with aphasia. Main contribution: A "community of care" perspective involves a broader conceptualisation of the care team and its contributors, including people such as employed caregivers who can potentially play an important role in the rehabilitation process. Similarly, a broader view of context is required, in particular its role in facilitating or inhibiting communication opportunities through focusing on aspects such as community activities, place of abode, and contextual nuances. "Care" needs to be considered as extending beyond the therapy room or rehabilitation centre, and group therapy may play a particular role in contributing to a sense of community for people with aphasia and meeting cultural needs. Tools such as narrative and ethnographic approaches may facilitate a stronger focus on the lifeworld of the person with aphasia and thus also strengthen a community of care perspective. Conclusions: A community of care perspective builds on existing approaches to aphasia management that consider the broader context and community. The potential role of the speech-language therapist in enabling a community of care for people with aphasia in multicultural settings is considered. [ABSTRACT FROM AUTHOR]

Over the past decade, there has been increased focus on targeting couples in HIV prevention efforts, particularly in sub-Saharan Africa where HIV transmission primarily occurs through heterosexual contact, in the context of intersecting alcohol use and intimate partner violence (IPV). However, little is known about couples' general relationship functioning. This understanding is needed to augment couple-based HIV prevention programs and address risk for IPV. This paper presents data on domains of relationship functioning with 300 South African couples who were recruited for an HIV prevention study. Exploratory and confirmatory factor analyses were conducted to determine the relevance of 17 individual items, as well as the overall factor structure of the questions. Results revealed three independent factors of relationship functioning: relationship satisfaction, arguing, and open communication; an overarching construct of relationship functioning for these three domains was not observed in the data. Results provide insight into the structure of relationship functioning questions and subscales that can be used to assess South African adult romantic relationships. This may allow for a greater focus on aspects of relationships within couple-based HIV prevention programs going forward. [ABSTRACT FROM AUTHOR]

This paper focuses on the role of codeswitching (CS) by isiZulu (Zulu) native language (NL) junior secondary learners in English first language (EL1) multilingual classrooms in South Africa. In spite of the educational transformation in South Africa, and the recognition of CS (by education policy documents) as a means of fulfilling pedagogical objectives, the use of CS in the classroom, more particularly in the EL1 classroom, is mostly prohibited. Nevertheless, the research, from which this paper is drawn, reveals that learners resort to English-NL CS when interacting among themselves, both in and outside the classroom. Using a qualitative study, I explore the language(s) of learners during group-work in the language, literacy and communication: English (LLCE) classroom, and show how their use of CS contributes to the achievement of the specific outcomes of this learning area within the outcomes-based education curriculum. I argue that even though CS is mostly prohibited in the classroom, its strategic use by learners serves as a means of fulfilling both social and pedagogical functions. [ABSTRACT FROM AUTHOR]

In this article, I examine the case study of a secret communication infrastructure developed as part of Operation Vula and operational from 1988 to 1991 during the final years of the South African liberation struggle. The purpose of Vula was to bring key leaders back from exile to steer from the ground the machinery of mass movement against the apartheid regime. To make Vula a reality in a highly militarised South Africa in the late 1980s a whole infrastructure of covered resistance (physical, technical, and people-based) was necessary. I propose the concept of fugitive infrastructure to understand this form of resistance. I suggest that the secret Vula mission and its communication system can be interpreted as a fugitive infrastructure whereby the system comprised not only an instrument for coordinating resistance to the apartheid regime but also a materialisation, at the level of infrastructure, of a potential alternative future for South Africans. Methodologically, this paper is based on mixed data collection methods including empirical and archival materials collected and analysed during my Ph.D. research. [ABSTRACT FROM AUTHOR]

Various health promotion strategies have been implemented in South Africa aiming to encourage young people to talk about issues of sexuality and HIV with their parents/caregivers. Although parent/caregiver sexual communication may be an effective method of influencing sexual behaviour and curbing the incidence of HIV, very little is known about how young people with disabilities in South Africa communicate about these traditionally difficult subjects with their parents/caregivers. Based on findings from a participatory study conducted amongst 15–20-year-old Zulu-speaking youth with physical and visual disabilities, this paper explores how they perceive youth–parent/caregiver communication about sexuality and HIV. Using Foucauldian discourse analysis, the paper outlines how disabled youth–parent/caregiver sexual communication is governed by cultural customs, sexual secrecy and constructs of innocence. It also argues that the experiences and perceptions of young people with disabilities are critical to the development of future interventions to assist parents/caregivers develop communication strategies that help disabled young people make sense of sexual behaviour. [ABSTRACT FROM PUBLISHER]

Objectives: This study investigated to what extent South African dietitians make use of social media and electronic communication and their compliance with the ethical guidelines set by the Health Professions Council of South Africa (HPCSA). Design: Cross-sectional descriptive design. Setting: South Africa. Subjects: Registered South African dietitians. Methods: Data were collected using an online survey (N = 125) and an observational checklist for selected digital platforms (N = 135). Both parts assessed demographic characteristics, usage of digital platforms and awareness or adherence to ethical guidelines. Results: Most participants used Instagram (45.5%) and Facebook (31.6%) as these platforms were regarded as user friendly, quick and suitable for their target audiences. Barriers to social media usage included time constraints (53.0%) and being unfamiliar with some platforms (37.3%). Enablers to social media usage included better reach of target population (61.4%) and ease of use (56.6%). The majority of survey participants were aware of the HPCSA Ethical Guidelines for Good Practice (n = 68/75, 90.7%). Overall compliance with the HPCSA guidelines was observed, yet nearly half (37/89, 41.6%) of the dietitians who shared information on digital platforms never provided references. Forms of touting/canvassing were observed on 20.7% (n = 28/135) of the platforms, while 15.6% of dietitians (n = 21) sold products on their websites, mostly meal-plans and supplements. Conclusion: South African dietitians actively engage with digital platforms to a varied extent, highlighting the importance of being cognisant of, and applying, the HPCSA Ethical Guidelines for Good Practice. The study can be useful in guiding future research on this unexplored, emerging topic. [ABSTRACT FROM AUTHOR]

South African schools are tasked with providing sexuality education through the Life Orientation curriculum as a means of challenging continued high rates of HIV, unwanted pregnancy and gender-based violence. While in theory schools are well positioned to provide appropriate knowledge for reproductive health and navigating sexual challenges within a gender justice framework, research on sexuality education in South African schools indicates that this is not the reality in practice. This paper draws on a growing body of qualitative studies, with both educators and learners in South African schools, to understand the issues undermining the goal of a critical and social justice pedagogy of sexuality in Life Orientation classrooms. We argue that sexuality education has been deployed to regulate and discipline young sexualities, reinforce and perpetuate gender binarisms and heteronormativity, re-establish global northern family values of the nuclear family within a pro-family discourse, and represent continued assumptions of adult authority in a civilising mission over young people. We suggest that the failure to make critical use of Life Orientation is linked to the dominance of 'expert'-based didactic pedagogy, and argue the possibilities of sexuality education as a productive space for young people's active participation and agency in making meaning of gender and sexualities. [ABSTRACT FROM AUTHOR]

Both risk analysis and risk management are required for answering today's challenging construction project demands. The targeted result of combining risk analysis with risk management is a successful project, which satisfies the expectations of its stakeholders. This paper aims to assist geotechnical professionals with extending from traditional risk analysis towards risk management, by presenting some experiences and guidelines. These are derived from geotechnical practice and ongoing geotechnical risk management research, which actually takes place in The Netherlands. It also integrates professional experiences from a number of other countries, such as China, the United States, the United Kingdom and South Africa. The paper starts by defining and describing the concepts of risk analysis and risk management, while stressing that both complement each other. Risk analysis and risk management are blended in one geotechnical risk management framework: the GeoQ risk management process. The anticipated (financial) benefits of applying risk management are also highlighted. Next, some common barriers are presented, which may prevent geotechnical professionals from extending their activities to risk management. These barriers can be lowered, and under certain circumstances can even be eliminated. However, this will require the professional's motivation to apply risk management and the availability of at least some risk management tools. In addition, it is likely that some kind of training will be needed for gaining the attitude and skills for applying risk management. Non-geotechnical decision makers turn up in any construction project and they ultimately determine the amount of resources, such as money and time, to be allocated to geotechnical activities. By gaining risk management skills, in addition to in-depth geotechnical expertise, geotechnical professionals may become even better positioned to effectively communicate and implement their precious geotechnical expertise in any construction project. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge 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.)

Communication has evolved into a cornerstone of central bank design and policy implementation. The South African Reserve Bank has been proactive in this regard as well – most notably with the adoption of inflation targeting in 2001. Using novel text-mining techniques, we evaluate the communication of the SARB, as presented via public speeches and monetary policy committee (MPC) statements, in the context of historical developments from 1994 to 2020. Our analysis focuses on the volume, complexity, scope, and sentiment of communication. We conclude that MPC statements are consistently and narrowly focused on the mandate, whereas speeches capture more detail about how the thinking of SARB policy makers evolves over time. In both cases, communication serves as a channel to reduce uncertainty and build credibility in the public domain. [ABSTRACT FROM AUTHOR]

Purpose: Based on the bioecological model by Bronfenbrenner, this paper will provide a broad perspective on factors that need to be taken into account in order to facilitate communication and participation in preliterate children making use of electronic Augmentative and Alternative Communication (AAC) systems accessed through eye gaze. Method: Two case studies of children who have been provided with the technology described are presented. The case studies were analysed using the four nested systems of the ecology as a framework to describe not only the environment, but also the processes and interactions between the persons and their context. Results: Risk and opportunity factors are evident at all levels of the ecology. Conclusions: While a good fit between the person and the technology is an essential starting point, additional factors pertaining to the partner, the immediate environment as well as meso-, exo- and macrosystemic issues (such as societal attitudes and funding sources) have a significant influence on benefits derived. In resource-limited environments, the lack of support at more distal levels of the ecology (meso-, exo- and marosystemic levels) seems to be a factor that differentiates these environments from more resourced ones. [ABSTRACT FROM AUTHOR]

Background: Improving the quality of health care is central to the proposed health care reforms in South Africa. Nursing unit managers play a key role in coordinating patient care activities and in ensuring quality care in hospitals. Objective: This paper examines whether the activities of nursing unit managers facilitate the provision of quality patient care in South African hospitals. Methods: During 2011, a cross-sectional, descriptive study was conducted in nine randomly selected hospitals (six public, three private) in two South African provinces. In each hospital, one of each of the medical, surgical, paediatric, and maternity units was selected (n=36). Following informed consent, each unit manager was observed for a period of 2 hours on the survey day and the activities recorded on a minute-by-minute basis. The activities were entered into Microsoft Excel, coded into categories, and analysed according to the time spent on activities in each category. The observation data were complemented by semistructured interviews with the unit managers who were asked to recall their activities on the day preceding the interview. The interviews were analysed using thematic content analysis. Results: The study found that nursing unit managers spent 25.8% of their time on direct patient care, 16% on hospital administration, 14% on patient administration, 3.6% on education, 13.4% on support and communication, 3.9% on managing stock and equipment, 11.5% on staff management, and 11.8% on miscellaneous activities. There were also numerous interruptions and distractions. The semi-structured interviews revealed concordance between unit managers' recall of the time spent on patient care, but a marked inflation of their perceived time spent on hospital administration. Conclusion: The creation of an enabling practice environment, supportive executive management, and continuing professional development are needed to enable nursing managers to lead the provision of consistent and high-quality patient care. [ABSTRACT FROM AUTHOR]

Background: Lay health workers (LHWs) are critical in linking communities and primary healthcare (PHC) facilities. Effective communication between facilities and LHWs is key to this role. We implemented a mobile health (mHealth) system to improve communication and continuity of care for chronically ill clients. The system focused on requests from facility staff to LHWs to follow up clients and LHW referrals of people who needed care at a facility. We implemented the system in two rural and semi-rural sub-districts in South Africa. Objective: To assess the feasibility of the mHealth system in improving continuity of care for clients in PHC in South Africa. Method: We implemented the intervention in 15 PHC facilities. The clerks issued recalls to LHWs using a tablet computer. LHWs used smartphones to receive these requests, communicate with clerks and refer people to a facility. We undertook a mixed-methods evaluation to assess the feasibility of the mHealth system. We analysed recall and referral data using descriptive statistics. We used thematic content analysis to analyse qualitative data from semi-structured interviews with facility staff and a researcher fieldwork journal. Results: Across the sub-districts, 2,204 clients were recalled and 628 (28%) of these recalls were successful. LHWs made 1,085 referrals of which 485 (45%) were successful. The main client group referred and recalled were children under 5 years. Qualitative data showed the impacts of facility conditions and interpersonal relationships on the mHealth system. Conclusion: Using mHealth for recalls and referrals is probably feasible and can improve communication between LHWs and facility staff. However, the low success rates highlight the need to assess facility capacity beforehand and to integrate mHealth with existing health information systems. mHealth may improve communication between LHWs and facility staff, but its success depends on the health system capacity to incorporate these interventions. [ABSTRACT FROM AUTHOR]

This paper aims to evaluate the impacts of four communication programs on promoting HIV testing behavior among sexually active individuals in South Africa. The four programs, implemented by Johns Hopkins Health and Education in South Africa, are aimed to promote HIV prevention behaviors, as well as gender-based violence prevention, tuberculosis screening and treatment, and reduction of alcohol consumption. Launched between 2009 and 2010, they all promoted HIV testing. Data came from the population-based Third National AIDS Communication Survey 2012; 6004 men and women who had sex within the last 12 months were included in the analysis. Multiple causal attribution analysis is used to justify causal reference and estimate the impact of communication programs. Findings indicate significant direct and indirect effects of the programs on HIV testing behavior. Indirect effects worked through increasing one's likelihood of perceiving that their friends were tested and the probability of talking about HIV testing with sex partners and friends, which in turn increased the likelihood of HIV testing. Findings suggest multiple angles from which communication programs can promote HIV testing. The study also demonstrates the use of multiple statistical techniques for causal attribution in a post-only design, where randomization is not possible. [ABSTRACT FROM AUTHOR]

The vocabulary needs of individuals who are unable to spell their messages continue to be of concern in the field of augmentative and alternative communication (AAC). Social validation of vocabulary selection has been suggested as one way to improve the effectiveness and relevance of service delivery in AAC. Despite increased emphasis on stakeholder accountability, social validation is not frequently used in AAC research. This paper describes an investigation of the social validity of a vocabulary set identified in earlier research. A previous study used stakeholder focus groups to identify vocabulary that could be used by South African adults who use AAC to disclose their experiences as victims of crime or abuse. Another study used this vocabulary to create communication boards for use by adults with complex communication needs. In this current project, 12 South African adults with complex communication needs who use AAC systems used a 5-point Likert scale to score the importance of each of the previously identified 57 vocabulary items. This two-step process of first using stakeholder focus groups to identify vocabulary, and then having literate persons who use AAC provide information on social validity of the vocabulary on behalf of their peers who are illiterate, appears to hold promise as a culturally relevant vocabulary selection approach for sensitive topics such as crime and abuse. [ABSTRACT FROM AUTHOR]

Globally, communication plays an integral role in public health strategies, from infectious diseases to diseases related to lifestyles. The evolution of the field of social and behaviour change communication (SBCC), combined with the need for evidence based practice and multi-level interventions to promote health, and human resource gaps in sub-Saharan Africa have led to the imperative to standardise and formalise the field. Moreover, current practitioners come from different disciplinary backgrounds underlining the need to define common core skills and competencies. This paper describes the partnership between the Wits School of Public Health and the Soul City Institute for Health and Development Communication and how the partners responded to this need. It highlights the factors influencing sustainable institutional capacity to provide quality assured, accredited training. We describe an unexpected positive response from a number of practitioner organisations that have chosen to send multiple staff members for training, specifically to build a critical mass within their organisations. Finally, we note the interest from (mostly) southern-based academic institutions in setting up similar programmes and postulate that south-south collaborations can contribute to building sustainable context specific and evidence-informed SBCC programmes in the global south. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge 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.)

This paper reports on the writing of grade seven learners in English as an additional language at four differently resourced schools in the Eastern Cape Province, South Africa. Because grade seven is the start of the senior phase of schooling, it is vital that learners achieve grade-level competence in the language used as medium of instruction. Learning outcome five, which states that 'the learner will be able to use language to think and reason, as well as access, process and use information for learning', is particularly relevant. The primary research question asked what the writing practices in grade seven additional languages were, and how these contribute to the development of learners' writing. The findings were that literacy practices at all four schools privilege grammar exercises and personal, expressive writing. In terms of Cummins's constructs of basic interpersonal communicative skill and cognitive academic language proficiency, learners' written competencies are mainly conversational (basic interpersonal communicative skill). The personal expressive texts that predominate in learners' writing have done little to develop a formal, impersonal academic register (cognitive academic language proficiency). Learners need to become familiar with the more abstract impersonal factual genres associated with disciplinary-based knowledge. [ABSTRACT FROM AUTHOR]

The article explores some issues related to the process of a systemic intervention using our experience in three projects in the Information and Communications Technologies (ICT) sector carried out in South Africa between 1997 and 2002. The projects served as a testing ground for exploring some theoretical and practical aspects associated with the process of facilitating the intervention. The paper presents reflections on some of the lessons learned regarding the process in each of the three cases associated with complex developmental decision-making issues. [ABSTRACT FROM AUTHOR]

'Lavender linguistics' in South Africa experienced a recent breakthrough with Cage's pioneering 2003 publication of 'Gayle - the language of kinks & queens'. What is however still lacking is research into the indigenous African gay speech variety that Cage identified as the 'black' equivalent to Gayle, namely isiNgqumo. In this paper we take up the task of introducing isiNgqumo while interrogating the following questions: If we trust the data collected thus far which suggests that there is a linguistically identifiable gay black South African variety which is an African equivalent to the English-based Gayle, which linguistic term shall be used to best identify this variety? Second, there is the question of description: How is it possible to provide sound and comprehensive lexical and grammatical analyses and descriptions of the 'language'? To find answers to these two central research questions, we draw from empirical findings based on data collection in KwaZulu- Natal, while relying on selected theoretical approaches to sociolinguistic and queer terminology. This paper presents a first discussion of isiNgqumo as a linguistic variety thus far ignored in South African research and argues that from a sociological perspective it constitutes a 'language' for most of its speakers. [ABSTRACT FROM AUTHOR]

This paper sets out the case of a gifted and innovative individual, Alexius Buthelezi, who was part of a talented team of black radio producers, scriptwriters, actors and announcers at the SABC in the 1960s. All worked in the section of the SABC known as Radio Bantu, a structure set up to implement the apartheid ideology of control of the lives and mindsets of the black subjects of the South African state. I argue that within this unpromising media environment, Buthelezi attempted, with his colleagues, to create a different notion of ‘home’. He did so by producing vibrant and eclectic new forms, such as that exemplified in the musical uNokhewzi . These were modern, expansive, myth-making, and incorporated rather than jettisoned older art forms such as the ingenkwane , oral narrative. The attempt at a kind of dissident modernist renaissance through the medium of radio, right under the nose of the ideologues of apartheid, was a brave attempt to ‘sup with the devil’. [ABSTRACT FROM AUTHOR]

Effective interpersonal communication is critically important in the design phase of a building project if a successful design brief is to be formulated and appropriate cost advice prepared. This paper explores the latter process in the context of communication theory, using structured interview surveys of building clients, architects and quantity surveyors in South Africa. [ABSTRACT FROM AUTHOR]

Limited clinical and research evidence is available to support healthcare practitioners in the communication assessment and intervention of persons who are minimally conscious. This study placed a specific focus on the multimodal communication strategies familiar caregivers of persons who are minimally conscious observed, as well as the verbal and the nonverbal communication strategies they employed to build communication capacity. This may inform clinical practice as it provides valuable autobiographical information as well as familiar stimuli that may elicit responses from persons in a minimally conscious state. A descriptive qualitative design employing in-depth semi-structured interviews with familiar caregivers was utilised to address the purpose of the study. Familiar caregivers reported that they used both nonverbal and verbal communication strategies to obtain a response from persons who are minimally conscious. These caregivers also reported that these persons appeared to rely on nonverbal communication strategies to express 36 different communication functions. Based on the findings of this study, it is clear that caregivers can be beneficial to persons who are minimally conscious, if they are able to observe and capitalise on naturally occurring multimodal communication strategies and functions. This study emphasises that familiar caregivers respect and value the dignity of persons who are minimally conscious and want to improve their communication capacity, but often lack confidence in their own communication skills. [ABSTRACT FROM AUTHOR]

Research regarding South African caregivers' protective parenting behaviors that can improve youth well-being in early adolescence is limited. Therefore, this study explored the affective and protective aspects of adult caregiving that influence mental health and possible engagement in sexual situations among Black South African early adolescents. Structural Equation Modeling was employed using baseline data from 577 youth to examine caregiver communication's mediating effect on the relationship between child-report of caregiver attunement, child depressive symptoms, and possible engagement in sexual situations. The findings suggested that Black South African caregivers can provide a protective role in reducing the risk of engagement in sexual situations while improving child mental health. Therefore, caregiver communication and attunement are vital mechanisms that build family resilience and child well-being. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a global public health concern amongst young people. Consequently, prevention efforts in the form of participatory interventions have been implemented, mainly in face-to-face settings. However, in recent years, there has been a growing interest to deliver participatory IPV prevention interventions online, and this has been exacerbated by COVID-19 imposed limitations. There remain concerns, however, about the impact social contexts may have on transformative communication in participatory interventions online. We conducted semi-structured interviews with 18 learners (14–19 years) from Eastern Cape province, South Africa, to understand the possibilities and limitations that social contexts impose on online participatory IPV prevention interventions. Access to devices, reliable internet, and privacy in homes provided opportunities for online IPV prevention interventions, while limited privacy, safety, concentration, and familiarity with some apps online challenged young people's interest in online IPV prevention interventions. We also found that young people's greatest concern was around achieving trust, privacy and safety online. More evidence is needed on how trust, privacy, and safety, supportive of transformative communication, can be achieved online. Further, young people are active and strategic in their engagements online and their potential to generate creative relevant solutions to address these challenges is highlighted. [ABSTRACT FROM AUTHOR]

The HIV response in the African continent over past decades demonstrates the potency that the words and actions of political leaders have in either expediting or impeding the implementation and adoption of preventive measures at the individual and community levels. The article explores the health communication approaches employed by two South African past presidents (Thabo Mbeki and jacob Zuma) in responding to the HIV epidemic, and contrasts these with the communicative approach of President Cyril Ramaphosa during the COVID-19 pandemic. Approached from this understanding, this article provides a comparative analysis of the communication approaches of these three presidencies across the two pandemics, and considers the variously trusted sources of top-down, government-driven and bottom-up, community-informed approaches to health communication. Critical lessons that emerged in South Africa during the HIV epidemic regarding the need to include communities in communicating about risks and behaviour change have not been adopted into the COVID-19 response. Political leaders are not best placed to communicate about these issues, and, in the context of pandemics, there is a clear need to reconsider top-down communication approaches that are designed without the participation of communities and ignore the interconnected nature of health and other social determinants of health. [ABSTRACT FROM AUTHOR]

Advertisements are intended to persuade the addressees to buy a particular product or service. In order to achieve this communicative purpose, text producers make use of various strategies. Apart from directly appellative speech acts like recommendations, requests or invitations, they use referential, expressive and phatic utterances as an indirect means of persuasion. The phatic function, which, according to Jakobson (1960), provides the appropriate channel for communication, is of particular importance in this respect. If the channel does not work properly, the persuasive function will never fulfil its aim. In the following paper, a small corpus of English, Spanish and German advertising texts is analysed in order to find the indicators of the phatic function, which is instrumental in making persuasion work. [ABSTRACT FROM AUTHOR]

During food-borne disease outbreaks, people get most of their information about food safety and risk from the news media. Best practice in risk messaging requires the rapid sharing of information to minimise harm, while expressing empathy, accountability, and commitment. The journalistic processes through which news is shaped can prioritise information differently, potentially limiting informed decision-making. The South African listeriosis outbreak (2017–2018) was the biggest in global history and generated considerable media attention. Using 'social attenuation of risk theory' and 'gatekeeping theory', combined with 'crisis and emergency risk communication best practices' as guiding principles, in this study we aimed to analyse which components of risk message content and which news factors were prioritised by news media during the outbreak. Content analysis of 91 listeriosis-related newspaper articles revealed that the most common risk messaging practices included were information about 'what is known' and 'which foods to avoid'. News factor analysis indicated 'relevance' was omnipresent, and 'controversy' was the second most frequently encountered factor. Overall, our findings suggest that only some best practices featured in the risk message media content, while others were mostly absent. This should be considered when developing future risk communication strategies related to food safety. [ABSTRACT FROM AUTHOR]

In this paper we give an outline of a corpus planning project which aims to develop linguistic resources for the nine official African languages of South Africa in the form of corpora, more specifically spoken language corpora. In the course of the article, we will address issues such as spoken language vs. written language, register vs. activity and normative vs. non-normative approaches to corpus planning. We then give an outline of the design of a spoken language corpus for the nine official African languages of South Africa. We consider issues such as representativity and sampling (urban-rural, dialects, gender, social class and activities), transcription standards and conventions as well as the problems emanating from widespread loans and code switching and other forms of language mix characteristic of spoken language. Finally, we summarise the status of the project at present and plans for the future. [ABSTRACT FROM AUTHOR]

Availability of HIV self-testing may increase HIV testing frequency among men who have sex with men (MSM). It is unclear, however, if self-testing may impact HIV-related sexual behaviors among MSM, including HIV status disclosure and condom use. We conducted a mixed methods analysis of changes in HIV-related behaviors after HIV self-testing introduction, using data from 110 MSM participating in a feasibility and acceptability study of HIV self-testing in Mpumalanga Province, South Africa. We found increased HIV status disclosure from study participants to sexual partners after HIV self-testing introduction, from 61.8% at baseline to 75.5% at 6-month follow-up (p = 0.04), but decreased condom use with female partners (p = 0.03). Qualitative interviews reveal that some participants used test results to inform condom use. Distribution of self-testing kits can improve mutual disclosure, but should be accompanied by information stressing that the tests may not detect early HIV infections or other sexually transmitted infections. [ABSTRACT FROM AUTHOR]

Breast cancer is a titanic health problem. It was once prevalent mainly in Developed countries. However, new cases are rapidly being diagnosed in the Developing world. In South Africa, it is the most common type of cancer amongst women. Further, Black women have a lower chance of surviving breast cancer than their White counterparts. This is partially due to economic and communication constraints. Consequently, in this article I explore the breast cancer communication strategy of a prominent hospital in Kwa Zulu Natal (KZN), South Africa. I conducted 30 semi-structured interviews with Black, Zulu women at this institution. My findings demonstrate that the hospital practices a banking style of communication, which encumbers the patients' capacity to acquire breast cancer information. Thus, I propose a participatory communication approach. This will equip the patients with vital knowledge which can be disseminated to their communities. Gradually, the threat of breast cancer can be conveyed throughout KZN. [ABSTRACT FROM AUTHOR]

In the absence of a gold standard, this study illustrates the process involved in the cross-cultural translation and adaptation of the FOCUS© and its shortened version, FOCUS-34© (the Parent Form and Instruction Sheet, as well as the Clinician Form and Instruction Sheet), while also determining the social validity and clinical applicability of the translated measure. The target language used as example was Afrikaans, one of the 11 official languages of South Africa. A two-phase cross-cultural translation model was employed in which Phase 1 (comprising a six-step blind back-translation procedure) was sequentially followed by Phase 2 (social validation and clinical applicability of the measure, using focus groups with stakeholders). The extensive process followed in Phase 1 resulted in a clear and appropriate translation acceptable to both stakeholder groups (parents and speech-language pathologists). Both groups questioned the meaning of certain concepts, explored cultural differences and requested the extension of some items. Parents also shared their emotional reactions towards assessment, while therapists focussed on editorial changes to the measures. A framework is proposed for cross-cultural translation and adaptation of assessment measures with suitability in the speech-language pathology discipline. [ABSTRACT FROM AUTHOR]

Health workforce cohort studies are uncommon in low-and middle-income countries (LMICs), especially those in sub-Saharan Africa. Describe the methodology and lessons learned from establishing and maintaining the WiSDOM (Wits longitudinal Study to Determine the Operation of the labour Market among its health professional graduates) health professional cohort study in South Africa. WiSDOM is a prospective longitudinal cohort study that commenced in 2017. The cohort focuses on the eight professional groups of clinical associates, dentists, doctors, nurses, occupational therapists, oral hygienists, pharmacists and physiotherapists. Annual, electronic follow-up surveys have been conducted in 2018, 2019 and 2020 with informed consent. Key steps in establishing the WiSDOM cohort include consultation, communication and marketing, stakeholder feedback, resources and infrastructure. Retention strategies consist of an electronic database, detailed cohort contact information, cohort engagement, communication and feedback, short survey tools, and appropriate incentives. We obtained an overall response rate of 89.5% at baseline in 2017, 79.6% in 2018, 68.3% in 2019 and 72.8% in 2020. The largest decline in response rates is for medical doctors: 66.0% response rate in 2018, 53.2% in 2019 and 58.2% in 2020. However, for each of the three follow-up surveys, we have obtained response rates in excess of 80% for clinical associates, dentists, nurses, oral hygienists, pharmacists and physiotherapists. Since baseline, the outright refusals have remained very low at 4.7%. The multiple logistic regression analysis showed that self-identified race was the only significant socio-demographic difference between medical doctor respondents and non-respondents. Black African doctors and Indian doctors were 2.0 and 2.6 times more likely respectively to respond than White doctors (p < 0.05). Other LMICs can learn from WiSDOM's lessons of establishing and maintaining a health professional cohort that aims to generate new knowledge for health system transformation. [ABSTRACT FROM AUTHOR]

Caregivers determine the level of care adolescents with mental issues receive; however, caregivers' own needs are often unmet. Communication technology can be tailored to address these challenges, especially in a rural environment. This study aimed to explore caregivers' interest in using communication technology to provide support to address challenges. This study involved a visual-based narrative inquiry that gathered data through the Mmogo-method®. Three (n = 3) groups were held with rural caregivers (n = 17) of adolescents with mental health issues in a rural area in the Free State province of South Africa during 2017. Three themes captured challenges confronting caregivers, namely, psychosocial, social resources, and informational challenges. Interest in communication technology was captured in a fourth theme. The findings indicate that communication technology can address caregivers' challenges by providing support and information to caregivers in rural areas. Communication technology, including mobile phones, electronic devices, and the Internet, has transformed healthcare services and proved to be valuable in resource constraint environments. [ABSTRACT FROM AUTHOR]

The purpose of the current study was to explore the challenges experienced by hearing parents when parenting a child with hearing loss. Using a qualitative purposive sampling design, interviews were conducted with 13 parents (9 mothers, 4 fathers) residing in Cape Town, South Africa. Four salient themes emerged, namely: 1) communication is difficult, hard, and frustrating; 2) lack of knowledge and information about hearing loss makes it difficult to parent; 3) little or no support makes for a lonely journey; and 4) support identified by parents for parents. The findings of the study have important implications for collaboration and partnerships between parents and health and family practitioners within South Africa for the design and development of supportive interventions for parents parenting a child with hearing loss. [ABSTRACT FROM AUTHOR]

This article explores the question of how organizations can transform constructively and positively towards the Fourth Industrial Revolution (4IR). It presents insights into the state of the art on 4IR, positive psychology movements PP1.0 and PP2.0 and particularly on German organizations in the 4IR within the South African context. The study uses a qualitative research approach and presents findings from a study conducted with 16 managers across top, middle and lower management levels in a German engineering organization, based in South Africa, operating in Southern Africa. Findings, discussion, conclusions and recommendations provide insights into emerging themes on the 4IR from perspectives that take the context of discourses on the 4IR in developed and developing countries into account. Findings show the importance of five main themes when transforming into the 4IR: (1) Employee management; (2) Innovative technological and systemic change; (3) Work organization; (4) Environment and (5) Network and cooperation. Human communication and connectivity and a balanced human–machine interaction seem to build the core framework for constructive socio-technological change and a meaningful work environment. Thereby, a focus on the positive transformation requires working through the challenges and dark sides of the 4IR as well as a contextual and culture-specific approach to finally create a meaningful, healthy and optimal functioning work environment for the employees. [ABSTRACT FROM AUTHOR]

The bureaucratic and academic nature of higher education institutions (HEIs), coupled with their complex organisational structures, extensive vertical hierarchies and large numbers of staff in need of communication, are believed to often hamper their internal communication processes. This is, to a great extent, also the case in the South African higher education arena. This article reports on a study that aimed to undertake research that would direct the development of a framework for improving internal communication at South African multi-campus universities. The framework would not only boast of features which are regarded as good practice by companies in the corporate sector, but also features based on the recommendations and suggestions of communication executives from seven multi-campus universities in South Africa. A mixed methods research design was employed. The research indicates that communication should be established as a core business value, and be advocated on all levels. The findings also suggest that management should be evaluated on their communication skills; regular monitoring of the effectiveness of communication at main and distance campuses should take place; whilst communication channels for feedback should be established. The internal communication framework outlined in the article may aid multi-campus universities to attain higher levels of excellence, which will subsequently result in greater business impact and more funding opportunities. [ABSTRACT FROM AUTHOR]

Background: Health care workers play an integral role in the rehabilitation and care of people living with HIV who face multiple impairments and often disabilities. The aim of the article was to understand the perceptions and attitudes of health care workers towards caring for people living with HIV, and experiencing disability. Methods: Fifteen health care workers offering care to people living with HIV were interviewed using a semi-structured guide. These health care workers included doctors, a social worker, a pharmacist, a dietician, an occupational therapist, a physiotherapist, and nurses and HIV couPnsellors who were employed at a public health care facility in KwaZulu-Natal. Data from the interviews were transcribed and analysed using conventional content analysis. Results: Four themes emerged from semi-structured interviews with the health care workers: a holistic disability framework, a multidisciplinary team dynamic, organisational barriers and recommendations by health care workers. Conclusion: Health care workers perceived a shift from a biomedical perspective of disability to a bio-psychosocial interpretation that is influenced by contextual and environmental barriers imposed by communities on people living with HIV. Barriers included stigmatisation that leads to attitudinal barriers and social exclusion of people living with HIV and experiencing disabilities within communities. Lack of resources, including of equipment, and a shortage of health care staff also posed barriers to the care offered to people living with HIV and experiencing disabilities. Participants agreed that improved communication in the multidisciplinary health care team, as well as continuing education and training, would enable health care workers to offer improved, integrated care to people living with HIV who experience disabilities. [ABSTRACT FROM AUTHOR]

Lack of condom use by married or cohabiting couples in populations with high rates of HIV infection has become a significant public health issue. This study investigated whether an HIV risk-reduction intervention (RRI) would increase condom use when delivered to serodiscordant couples as a unit. Of the 62 couples that were screened, 30 serodiscordant couples were enrolled in the study, and randomized 2:1 to an immediate intervention-waitlist control study. The 12-week intervention focused on communication, problem-solving, and negotiation skills. Participants were assessed at baseline, three and six months after the intervention. The main outcome measures were consistent condom use, HIV seroconversion and fidelity to the programme. The use of condoms increased for both the intervention and control groups after receiving a 12-week RRI. Group comparisons showed a significant difference at three months, with a significantly higher mean proportion of condom-protected sex acts (p = 0.0119) between the control and intervention groups, the later showing an increase in condom use. No seroconversion was detected, and the overall retention rate of participants was 83.33%. Counselling heterosexual couples as a unit prompted an increase in condom use, but sustained condom use remains a challenge. [ABSTRACT FROM AUTHOR]

Background: There is global emphasis on quality universal health coverage (UHC) that is responsive to the needs of vulnerable communities, such as migrants. Objective: Examine the perceptions of migrants on health system responsiveness (HSR) and their satisfaction with health workers in public health facilities of a South African Province. Method: We conducted a cross-sectional study in 13 public health facilities. Following informed consent, we used a semi-structured questionnaire to collect sociodemographic information, patient perceptions of HSR and their satisfaction with health workers. Two open-ended questions gave patients the opportunity to comment on the health facility visit. We applied descriptive and multivariate analyses to our data, and thematic analysis to the qualitative responses. Results: A total of 251 migrant patients participated in the study, giving a response rate of 80.7%. The majority of patients were female (81.1%), and the mean age was 31.4 years. 30.0% of patients reported that they waited too long; 94.3% that the consulting nurse or doctor listened to them; and 89.4% that they received information about their condition. However, 81.7% said they did not know the name of the consulting nurse or doctor. The mean scores on patients' satisfaction with health workers ranged from 7.0 (95% CI 6.42–7.63) for clerks, 7.7 (95% CI 7.4–8.0) for security guards, 7.4 (95% CI 7.1–7.6) for nurses and 8.3 (95% CI 7.93–8.63) for doctors. The predictors of patient satisfaction with nurses were being given information about their condition; polite treatment, time spent in facility, whether they received prescribed medicines; and stating that they would refer the health facility to family/friends. Four overlapping themes emerged: health workers' attitudes; time waited at the health facility, communication difficulties; and sub-optimal procedures in the health facility. Conclusion: UHC policies should incorporate migrant patients' perceptions of HSR and the determinants of their satisfaction with health workers. [ABSTRACT FROM AUTHOR]

Diagnostic assistance using mobile technology is instrumental to timely and adequate care in resource-scarce settings, particularly for acute burns. Little is known, however, as regards to how remote diagnostic consultation in burns affects the work process. This article reviews a doctoral thesis on this topic based on four studies conducted in the Western Cape, South Africa prior to and in a very early phase of the implementation of an app for burn remote diagnostic assistance. The aim was to increase knowledge on how remote diagnostic assistance for burn injuries can influence the role and work of medical experts in a resource-poor setting. The congruence model was used as a reference framework to study the 'input' (study 1), 'tasks' (studies 2 and 3) and 'people' (study 4) involved. The results show higher burn incidence in young children (75.4 per 10 000) and gender differences primarily among adults. The quality of images was considered by experts as better when viewed on smartphones and tablets than on computers. The accuracy of burn size assessments was high overall but low for burn depth (ICC = 0.82 and 0.53 respectively). Experts described four positions pertaining to remote consultations: clinical specialist, gatekeeper, mentor and educator. They perceived images as improving accuracy of consultation and stressed the need for verbal communication among clinicians during critical situations. In conclusion, experts are satisfied with the quality of images seen on handheld devices and can accurately assess burn size using these, yet burn depth assessment is more challenging without additional clinical information. mHealth for diagnostic assistance can benefit current image-based consultation by systematising information quality, introducing enhanced security and improved access to experts. Remaining challenges include the necessity of verbal communication in some instances and replacing existing informal organisational practices. [ABSTRACT FROM AUTHOR]

Concurrent sexual partnerships have been identified as a potential driver in the HIV epidemic in Southern Africa. This study utilised an innovative approach to explore perceptions of why Malawians may engage in these relationships, and their suggestions for reducing the practice among a select population of radio listeners. Using radio listener feedback in the form of text messages, we analysed approximately 1 000 text messages sent by individuals who listened to a reality radio programme that included real stories, told by Malawians, on topics related to HIV/AIDS. Listeners suggested that lack of satisfaction with one’s partner was the overarching reason why individuals had concurrent sexual partnerships. Within the context of lack of satisfaction, listeners cited alcohol use, poor communication and gendered norms as factors related to satisfaction. Listeners suggested that couple communication could increase satisfaction, which, in turn, could reduce concurrent sexual partnerships. Prevention efforts should consider how to utilise couple communication to improve satisfaction as an approach to reduce HIV risk in Southern Africa. [ABSTRACT FROM AUTHOR]

In the era of widespread access to antiretroviral therapy, people living with HIV survive; however, this comes with new experiences of comorbidities and HIV-related disability posing new challenges to rehabilitation professionals and an already fragile health system in Southern Africa. Public health approaches to HIV need to include not only prevention, treatment and support but also rehabilitation. While some well-resourced countries have developed rehabilitation approaches for HIV, resource-poor settings of Southern Africa lack a model of care that includes rehabilitation approaches providing accessible and comprehensive care for people living with HIV. In this study, a learning in action approach was used to conceptualize a comprehensive model of care that addresses HIV-related disability and a feasible rehabilitation framework for resource-poor settings. The study used qualitative methods in the form of a focus group discussion with thirty participants including people living with HIV, the multidisciplinary healthcare team and community outreach partners at a semi-rural health facility in South Africa. The discussion focused on barriers and enablers of access to rehabilitation. Participants identified barriers at various levels, including transport, physical access, financial constraints and poor multi-stakeholder team interaction. The results of the group discussions informed the design of an inclusive model of HIV care. This model was further informed by established integrated rehabilitation models. Participants emphasized that objectives need to respond to policy, improve access to patient-centered care and maintain a multidisciplinary team approach. They proposed that guiding principles should include efficient communication, collaboration of all stakeholders and leadership in teams to enable staff to implement the model. Training of professional staff and lay personnel within task-shifting approaches was seen as an essential enabler to implementation. The health facility as well as outreach services such as intermediate clinics, home-based care, outreach and community-based rehabilitation was identified as important structures for potential rehabilitation interventions. [ABSTRACT FROM PUBLISHER]