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Health research ethics in Southern Africa: building capacity and cultivating excellence
Get PDFThe health research landscape in southern Africa is becoming increasingly complex as research efforts intensify to address the region's significant disease burden. The increasing volume and complexity of health research in low- and middle-income countries (LMICs) highlights the ongoing need for enhanced research ethics capacity. To supplement a review published in 2014, this paper provides an overview of research ethics capacity-building initiatives supported through substantive long-term competitive awards from the Fogarty International Center of the US National Institutes of Health between 2014 and 2024. These programs aimed to enhance the capabilities of research ethics committees (RECs) and strengthen research ethics capacity throughout Southern Africa, with broader benefits to the African continent and globally as collaborative health research increases. The programs have successfully developed and delivered comprehensive research ethics curricula tailored to research ethics concerns in the region. Trainees and graduates include clinicians, researchers, REC members, REC administrators, lawyers, and ethicists, with focused efforts to ensure gender parity. This increased representivity of scholars has improved the membership on RECs and in skilled research ethics leadership in the region. For the benefit of future planning, this paper also describes some of the many challenges faced in delivering on program goals – including COVID-19. We also describe innovative solutions developed to address these challenges and meet the needs of students, faculty and institutions, while cultivating excellence in health research ethics. The paper concludes by highlighting areas for future research, underscoring the importance of continued diverse global investment in research ethics capacity to protect research participants and maintain and improve ethical standards and practice in health research within the region and globally. This will enable the development of innovative evidence-based global health solutions based on ethical research.
The experiences and perceptions of employed black African men on paternity leave in Gauteng, South Africa
No full textThis article examines the perceptions and experiences of paternity leave among employed Black African fathers in Gauteng, South Africa. Utilising a qualitative research methodology, the study involved in-depth, semi-structured interviews with six participants to gather rich, nuanced data. The findings reveal significant socio-cultural and economic barriers that hinder the uptake of paternity leave, including traditional gender roles and a lack of awareness about paternity leave entitlements. Despite legislative support, some fathers remain uninformed about their rights and the benefits of paternity leave. The study suggests that addressing these barriers through increased awareness, employer resources, and challenging gender norms can create a more supportive environment for fathers. Practical recommendations are provided to guide stakeholders in implementing effective strategies to enhance fathers’ engagement in childcare and family responsibilities.
'n Ondersoek insake die matrikulante van November/Desember 1961 en Maart 1962 as universiteitspotensiaal met inagneming van die opleidingsfasiliteite van die Suid-Afrikaanse residensiele universiteite
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Innovation trends in the financial intermediation sector, 2019-2021
Get PDFThis brief examines how much innovation happened in the financial intermediation sector from 2019 to 2021, including the types of technologies businesses in the sector used, the innovation challenges they faced, and the outcomes of their innovations
Mapping social and human dimensions of One Food to integrate into the One Food Wheel
Get PDFCommissioned by the Department of Science, Technology and Innovation (DSTI), FebruaryThe report categorises the food systems hazards that arise due to people’s behaviours at an individual, group, community, national or global level. It further used a food value chain approach to map where these human and socioeconomic hazards threaten and disrupt sustainability of food systems. The mapping of these hazards is guided by the One Food framework. Socioeconomic hazards can be incorporated in One Food through the One Food Wheel, a visualisation of the One Food approach to conduct multi-hazard risk analysis in food systems. The One Food approach, visualised through the One Food Wheel, aims to mitigate various hazards across food value chains, from production/harvesting to consumption as well as waste management. It emphasises multi-hazard risk analysis and advocates for environmentally friendly diets and sustainable food production practices. This model categorises hazards into natural, human-made, and socioeconomic types, each posing unique problems to food security, safety and attainment of sustainable food systems. As an example, this report identifies hazards like the misuse of agrochemicals, hydrological and meteorological risks, food contamination, and waste mismanagement as central issues that persist across various points of food production and distribution. Further, the report underscores the importance of socioeconomic dynamics in shaping food systems hazards. Human behaviour, whether individual, group-based, or institutional significantly impacts the emergence, spread, and severity of food systems hazards. It provides examples and case studies of how human and socioeconomic issues like poverty, insufficient knowledge and inadequate education are hazards that intensify vulnerabilities within food systems. The report emphasises the potential of the One Food Risk Tool for assessing the impact of hazards to inform policy and practice. The tool can be used to evaluate multiple hazards and inform policy on how to prevent i) harmful human and socioeconomic behaviours and activities, ii) worsening climate damage, iii) loss of biodiversity, and iv) economically, environmentally, and socially unsustainable food systems. This approach has potential provide to solutions that promote protection of vulnerable populations from unstainable food systems while safeguarding biodiversity, human health, and mitigating environmental harm caused by food systems activities. Integrating this model within food systems could lead to a balanced ecosystem where economic, social, and environmental sustainability coexist. The report serves as a call to action, encouraging stakeholders to adopt the One Food framework as a viable solution to the complex challenges facing global food systems today. It ends with recommended questions on further research that could help reduce or remove the human and socioeconomic impediments delaying attainment of sustainability in food systems.N/
Effects of conditional cash transfers and pre-test and post-test tuberculosis counselling on patient outcomes and loss to follow-up across the continuum of care in South Africa: a randomised controlled trial
Get PDFEconomic and behavioural factors lead to poor outcomes in patients with tuberculosis. We investigated the effects of a package of interventions consisting of pre-test and post-test tuberculosis counselling with conditional cash transfers on patient outcomes in adults undergoing investigation for pulmonary tuberculosis.
This pragmatic, open-label, individual randomised controlled trial was done in nine clinics in Johannesburg, South Africa. Participants (aged ≥18 years) undergoing investigation for tuberculosis were randomly assigned (1:1) to the intervention group or control group (standard of care) via permuted block randomisation, stratified by clinic; group assignment was concealed using opaque envelopes. The intervention group received pre-test and post-test tuberculosis counselling, and for participants diagnosed with rifampicin-susceptible tuberculosis, a digital payment (R150; approximately US) at treatment initiation and each monthly treatment visit. Payments were contingent on timely attendance: 14 days from initial sputum sample collection and within 7 days on either side of their scheduled monthly appointment. The primary endpoint was successful patient outcome (patients who were cured or completed treatment) or unsuccessful patient outcome (pretreatment loss-to-follow-up, on-treatment loss-to-follow-up, development of rifampicin-resistant tuberculosis while on treatment, treatment failure [ie, smear or culture positive at 5 months or later after commencing treatment], or death). The primary outcome was analysed in the modified intention-to-treat population, defined as all randomly assigned participants with rifampicin-susceptible tuberculosis confirmed before the commencement of tuberculosis treatment. Weighted outcome prevalence, relative risks (RRs), and risk differences were calculated using a multivariable Poisson model with robust standard errors. This trial is registered with the Pan African Clinical Trials Registry (PACTR202410708311054) and is completed.
A qualitative exploration of sexually transmitted infection (STI) partner notification preferences and practices among women planning for pregnancy and offered HIV pre-exposure prophylaxis in Durban, South Africa
Get PDFSexually transmitted infection (STI) partner notification is key to fostering STI cure and preventing onward STI transmission; this is critical among people planning for pregnancy given the high STI morbidity and mortality among neonates. This qualitative study explores how women planning for pregnancy and considering HIV pre-exposure prophylaxis approach STI partner notification in Durban, South Africa to inform future interventions. We conducted a cohort study evaluating pre-exposure prophylaxis use as a part of safer conception care among adult women (≥ 18 years) without HIV, partnered with a man living with HIV or unknown HIV-serostatus, and planning for pregnancy. As part of an STI-focused sub-study, 25 women who completed etiologic STI screening also completed qualitative interviews exploring participant STI partner notification practices, preferences, and interaction with pregnancy. We used an inductive and deductive approach to generate a codebook, organized our findings according to the Disclosure Processes Model, and identified preliminary themes using content analysis. The median age of sub-study participants was 25 (range 19–33) years, five (20%) were diagnosed with an STI during the study, and 2 (8%) became pregnant during the study. Preliminary themes included 1) Participants’ perceptions of their own and their partner’s additional partnerships affected STI partner notification perceptions and practices; 2) Participants’ asymptomatic presentation and etiologic, laboratory diagnosis supported partner notification; 3) Participants reported male reluctance to engage with healthcare services and a reliance on female participant testing and subsequent partner notification; 4) Participants endorsed provider-assisted STI partner notification; 5) STI diagnoses and partner notification led participants to mistrust their partners and subsequently impacted their condom use during pregnancy planning. We found a lack of partner concurrency and asymptomatic infection to influence STI partner notification with partner notification affecting pregnancy planning and condom use. Since women report having high STI testing and care engagement, they bear a high burden of partner notification and potential subsequent blame and often appreciated provider assistance. Interventions are needed to engage men in STI testing and care and to mitigate the potential harms of STI partner notification.