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Estimation of therapeutic threshold for tuberculosis using adapted nominal group technique and clinical vignettes in clinical and community settings in Southern Africa
No full textWhen confronted with diagnostic uncertainty and a decision on whether to start treatment or not, clinicians consider the potential harm and benefit of offering versus withholding treatment. Treatment can be offered if the probability of tuberculosis (TB) in the patient is above the “therapeutic threshold” (ThT): the probability of disease at which the expected utility of treating and not treating is the same. We estimated ThT for TB in clinical and community settings in Southern Africa using two methods: an adapted nominal group technique (aNGT), and decisions made based on clinical vignettes (CVs). We enrolled health professionals involved in the routine management of TB patients in South Africa and Lesotho. The participants elicited, discussed and refined the harms of false positive (FP) and false negative (FN) treatment decisions for stable ambulatory patients in the clinical and community settings. They weighed all harms according to their importance in treatment decisions by distributing 100 points. ThT, calculated as the sum of the weights of the harms of the FP decision divided by the total weight, was estimated using a hierarchical Beta regression model. For the CVs, participants were presented with ten hypothetical TB cases in each setting and asked to indicate whether they would offer TB treatment or not. ThT was estimated using the generalized linear model for binary outcomes. We enrolled 138 health professionals (aNGT: 123, CVs: 130 and 115 in both). Using aNGT, the overall ThT was 37.7% (95% credible intervals (95% CrI): 35.8–39.8) and 38.2% (95% CrI: 35.9–40.6) in the clinical and community settings, respectively. Compared to aNGT, CVs produced a significantly lower estimate in the clinical setting (27.7%; 95% CrI: 23.8–31.3) but similar in the community setting (37.7%; 95% CrI: 33.1–41.7). We did not find significant differences across the subgroups defined by the measured covariates. The aNGT produced a reliable estimate of ThT. The difference in the estimates of ThT between the aNGT and CVs may have a limited impact on clinical decisions. Factors influencing ThT and the acceptability of results by healthcare workers will be explored in focus group discussions and in-depth interviews.
What can we learn from Teen MomConnect: a tailored mHealth intervention for improving antenatal care seeking and its determinants among pregnant adolescent girls and young women in South Africa
No full textPoster presented at the Digital Health Africa Conference, 3-4 SeptemberN/
The legacy of TIMSS in shaping policy through engaged research in South Africa
No full textPaper presented the NRF-HSRC Engaged Research Conference, Birchwood Hotel & OR Tambo Conference Centre, Benoni, 22-24 OctoberN/
Borrowed metrics, missed insights: why Africa needs its own STI playbook
No full textAfrica’s innovation story cannot be told with borrowed metrics. While Africa’s mobile money service M-Pesa reshapes finance, and the network organisation AfriLabs supports innovation hubs and fuels grassroots tech, conventional science, technology and innovation (STI) measures overlook these advances. The real task is developing metrics that reflect Africa’s realities—where local innovation that improves lives matters as much as patents. Effective implementation of continental strategies like the Science, Technology and Innovation Strategy for Africa 2034 depends on developing innovation measures and indicators that capture Africa’s unique innovation paradigm.
Understanding how parents deal with the health advice they receive: a qualitative study and implications for the design of message-based health dissemination systems for child health
No full textPaper presented at the Designing Interactive Systems Conference 2024, Copenhagen, Denmark, 1-5 JulyMessage-based health information dissemination systems can potentially improve maternal and child health (MCH). By conveying health information to parents, SMS- and chatbot-based systems can support parents’ learning and empower them to make better health decisions for their children. However, there is limited design advice for creating message-based dissemination systems for MCH. To help address this gap, we conducted 14 participatory workshops with 42 parents from Portugal and South Africa, exploring how parents learned to care for their children’s health. Our findings showed how parents reflected on the health advice they received, by assessing the fit of the advice to their child’s characteristics, their values and beliefs, the advice’s feasibility, or the intention and competence of the advice giver. Based on these insights, we propose four design implications for creating message-based health information dissemination systems tailored to parents and their children.N/
A virtual walkabout through findings and photos of the student movement, violence and wellbeing project
No full textPaper presented at the SARChI Chair in Higher Education and Human Development Research, University of the Free State eSeminar series: re-thinking and re-imagining development in and through higher education, 16 August 2021 (Hybrid
HIV in the Eastern Cape: what the numbers tell us
No full textPaper presented at the South Africa National HIV Prevalence, Incidence, Behavior and Communication Survey (SABSSM VI): 20 years of strategic HIV and public health data: key findings for Eastern Cape, Gqeberha, 8 Septembe
Evaluation of silencing the guns in Africa: issues, challenges and future prospects of violent extremism in Africa
No full textThe Mali phase of the 'Violent Extremism Project' was conducted in Bamako, Mali from 14-29 March 2023This phase of the project was marked by three critical security related issues in the country. The first was the heighten security in the country as a result of frequent terrorist attacks in the northern part of the country. The second, was the handover of military hardware to Force Armee Maliene, FAMA, by the government of Russia. The military hardware will address the heighten insecurity threats in the country, which has witnessed the deployment of the Wagner Group to help the FAMA address the insecurity challenges in the country
Beyond the ballot box: lived experiences of Democracy@30 in Galeshewe and Platfontein
No full textThis chapter aligns with the broader themes of the book (accountability, representation and substantive equality) in that it explores the complexities of democracy in a society marked by historical inequalities and social divisions. By focusing on the experiences of both indigenous minorities and majorities, the chapter sheds light on the ways in which power dynamics may shape access to basic services, development opportunities and political participation. The chapter argues that a nuanced understanding of these dynamics is essential for assessing
the true impact of South Africa’s democratic transition and for identifying the challenges that remain in achieving substantive equality for all citizens.
Evaluating community trust in the South African government: an analysis of community perceptions
No full textThe evolving perceptions of trust within the community about both national and local government have
substantial ramifications for the long-term viability of the nation's democracy and the degree of societal trust. This study sought to evaluate the degree of public trust among South African adults in their national and municipal governments, as well as to analyse the variables influencing this trust. The report underscores considerable scepticism in South African national and local administrations, attributable to performance deficiencies, inadequate service delivery, absence of transparency, and insufficient community participation. Individuals associated with the ANC exhibit comparatively more trust owing to past allegiance. We advocate promoting reforms to restore public trust by enhancing governance processes, increasing transparency, and ensuring efficient service delivery, especially for marginalised areas.