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Government expenditure and health, education and housing outcomes: empirical analysis from South Africa
No full textThis study analyses the relationship between government expenditure on health, education, and housing and their corresponding outcomes across nine provinces in South Africa. Notwithstanding considerable public investment in these vital areas, South Africa persists in confronting serious difficulties, such as elevated infant and TB mortality rates, enduring HIV prevalence, inadequate educational achievement, and a substantial housing deficit. These challenges prompt enquiries into the efficiency and efficacy of public expenditure and its congruence with developmental aims. The study utilised panel data from nine provinces between 2004 and 2019, employing fixed and random effects models to examine the influence of government expenditure on sector-specific outcomes. The findings indicate that health expenditure has a positive, statistically insignificant impact on health outcomes, such as infant mortality, TB mortality, and HIV prevalence. Conversely, education expenditure had a negative and statistically significant correlation with educational outcomes, as indicated by senior certificate results, learner-school ratios, and educator-school ratios, underscoring potential inefficiencies and mismatched fiscal objectives. Housing expenditure was determined to have a positive and statistically significant effect on housing outcomes, particularly the total quantity of housing units supplied. The findings indicate that although government investment in housing produces concrete advantages, inefficiencies in health and education funding obstruct the achievement of intended objectives. The study findings highlight the necessity for improved resource allocation, focused interventions, and enhanced monitoring systems to ensure public spending result in substantial advancements in societal well-being
A critical examination of the humanitarian visa as a complementary pathway in ameliorating the plight of “climate displaced persons” in Eastern Africa.
Get PDFEastern Africa has grappled with increasing numbers of displaced persons in the past 20 years because of flooding, tropical storms, landslides, and prolonged seasons of drought. Although there is widespread recognition of the impact of climate change on populations in this region, persons displaced across borders due to climate-related disasters still face challenges in finding protection. This is the case because of their unclear legal status under regional and international law as a unique category of refugees, with scholars arguing over their legitimacy in the international humanitarian landscape. In Eastern Africa, regional economic blocs such as the Intergovernmental Authority for Development (IGAD) have recognised the need to safeguard persons fleeing due to climate change-related disasters. This has been attempted using soft law regional policy frameworks to fill the legal vacuum in recognising human mobility because of climate change disasters. Within this afrocentric context, this thesis adopts a systematic qualitative research methodology, utilizing document analysis, policy review, and case studies to explore complementary pathways for climate-displaced persons in Eastern Africa. The study conducts an in-depth examination of key international and regional frameworks, including UN reports, the Global Compacts on Refugees and Migration, UNHCR's Climate Action Reports, and the IPCC Assessment Reports. It assesses regional instruments and policies relevant to climate-induced displacement to provide a comprehensive understanding of existing legal and policy gaps. Through a critical review of these documents and case studies, the research evaluates the effectiveness of current protection mechanisms, if any and identifies potential solutions to enhance the legal status and rights of climate-displaced individuals. In particular, the thesis proposes humanitarian visas as a practical complementary pathway and legally sound approach to addressing protection gaps, offering a structured pathway for displaced persons facing climate-related threats
Longitudinal latent class and joint modelling of antiretroviral adherence
Get PDFThis dissertation investigates the relationship between antiretroviral therapy (ART) adherence and viral outcomes in people living with HIV in South Africa using advanced statistical modeling techniques. Utilizing data from the ADD-ART study, a prospective cohort of 238 adults on ART in Cape Town, the research employs survival analysis, joint modeling, and longitudinal latent class analysis to compare di↵erent adherence monitoring tools and examine heterogeneity in adherence behaviors. Key findings include: Electronic Adherence Monitoring (EAM) and tenofovir diphosphate levels in dried blood spots were more strongly associated with viral non-suppression than self-reported adherence; joint modeling revealed a stronger association between EAM adherence and viral outcomes compared to traditional survival models, with each additional missed dose in the preceding 30 days associated with an 81% increase in the hazard of viral non-suppression; longitudinal latent class analysis identified five distinct adherence trajectory groups, with poorer or declining adherence groups experiencing significantly higher rates of viral non-suppression; baseline viral load and prior tuberculosis exposure were significant predictors of subsequent viral non-suppression, even after accounting for adherence. The results highlight the importance of using objective adherence measures, the value of advanced statistical techniques in HIV research, and the need for personalized adherence support strategies. Limitations include potential violations of model assumptions and generalizability constraints
The impact of mobile money on Rwandan household consumption
Get PDFResearch on consumption patterns in developing countries shows that precautionary savings behaviour is common. This is driven by high-risk exposure to natural and economic shocks, and a lack of formal insurance mechanisms among rural farming households. The spread of mobile phones has introduced mobile money, which offers new financial opportunities to marginalized groups. This study examines mobile money's impact on consumption in Rwanda, using data from the Rwanda FinScope 2020 Survey. It applies probabilistic models and an instrumental variable approach to explore the relationship between mobile money use and consumption. The study finds that mobile money is financially inclusive and increases the likelihood of higher consumption among households. Remittances, representing financial flows between households, are key to this increased consumption smoothing. The findings suggest further research is needed to investigate whether household welfare improvements align with positive consumption patterns
Engagement/involvement of staff from public medical Institutions with pregnant women experiencing intimate partner violence - a systematic review of African & South African literature
Get PDFThis study explores how staff at public health care institutions respond to intimate partner violence (IPV) experienced by pregnant women living in South Africa and Africa. This study aimed to investigate what protocols/pathways staff at public health care institutions (PHCI) use to identify, screen, report, record and refer instances of IPV. The motivation for this study was to bring awareness of IPV during pregnancy. Since learning the high statistics of IPV during pregnancy, the researcher was prompted to investigate what PHCI are doing to identify, screen, report, record and refer cases of IPV. In addition, the researcher hopes that this research can facilitate policy development for staff at PHCI on how best to respond to pregnant women experiencing IPV. The methodology used in this study was a systematic literature review, that reviewed 14 qualitative journal articles. PICo was used to identify the study participants, the Cochrane systematic review methodology was used and the PRISMA flow diagram. Using thematic analysis, the researcher used Dey and Tesch to analyse the data. The findings indicate that there are no pathways/protocols for identifying, screening, reporting recording and refereeing instances of IPV in South Africa or Africa. There were also no direct policies or frameworks established at PHCI to manage intimate violence during pregnancy. The research identifies some of the main barriers/challenges to IPV enquiry which are lack of privacy at public health care institutions, training and awareness of IPV during pregnancy, staff agency, staff safety and cultural beliefs. These results contribute to the research regarding how PHCI in South Africa and Africa respond to IPV. Thus shifting focus away from the criminal justice system and more toward PHCI as IPV during pregnancy has grave health implications. This study provides new insights on how to build and improve protocol/pathways at PHCI. This study highlights the daily challenges that staff at PHCI face when enquiring about IPV. It concludes by discussing how The National Council on Gender-Based Violence Femicide can use information on the challenges/barriers to enquiry to achieve the goals and aims set out in The National Strategy Plan addressing gender-based violence and femicide in South Africa and Africa
Corporate governance and financial performance of asset managers in South Africa
Get PDFCorporate governance plays an important role in the creation of long-term value and the protection of shareholders and other stakeholders' interests. This research study examines the influence of corporate governance characteristics (board size, board independence, board chairman independence, audit committee independence, and audit committee financial expertise) on the financial performance of asset management firms in South Africa. The proxy for financial performance is Return on Assets. The study employed the fixed and random effects panel regression techniques to estimate a panel data of 11 asset management firms in South Africa from 2012 to 2023. The results of the analysis show a positive and significant relationship between Return on Assets, board chairman independence, and audit committee financial expertise. While the relationship between board independence and Return on Assets is observed to be positive, it is not statistically significant. By contrast, board size and audit committee independence ratio showed no significant relationship with Return on Assets. Therefore, this study recommends the appointment of an independent non-executive chairman on the board of directors to achieve enhanced directorship independence and improved monitoring and supervisory responsibilities within the organisation. Furthermore, South African asset management firms should consider drafting more members with financial expertise into the audit committee and, in particular, directors with a background in accounting, audit, regulation, compliance, internal controls, and enterprise risk management
Technology assessment of green hydrogen in South Africa
No full textThis study investigated the sustainability indicators for green hydrogen in South Africa's Northern Cape Province to inform investment and policy decisions. Using an exploratory sequential mixed-method approach, the study first conducted a systematic literature review to identify relevant sustainability indicators. This was followed by a stakeholder survey of 16 individuals representing 11 stakeholder groups to validate and rank these indicators in the context of the Northern Cape. The stakeholders' responses on the relative importance of each of the identified sustainability indicators were registered using a 5-point Likert scale, and a weighted mean score was computed to rank each indicator. This study identified 28 sustainability indicators across environmental, economic, and social dimensions. Environmental indicators were ranked highest in importance, with water use, biodiversity impact, and human toxicity potential as the top concerns. Social indicators were ranked second, with employment and skills development emerging as critical factors. Economic indicators were ranked third, with energy efficiency, local procurement, energy supply security, and economic development as the primary considerations. The study also revealed differences in priorities between public and private sector stakeholders, with the former placing more importance on social indicators and the latter on environmental indicators, thus highlighting the need for a balanced energy technology sustainability assessment approach. Based on the findings, this study recommended a comprehensive energy technology sustainability assessment for green hydrogen be conducted that considers the diverging stakeholder views of and incorporates the key sustainability indicators established in this study. The assessment may provide results relevant to policymakers and investors alike in decision-making, thus ensuring that capital is mobilised and aligned with sustainable energy technologies, such as green hydrogen. This study contributed to the broader fields of energy technology assessment and sustainable investment and provided sustainability indicators that researchers, policymakers and investors can consider in South Africa's emerging green hydrogen economy, with a specific focus on the Northern Cape. These findings can inform sustainable development strategies and guide future research in this field
An investigation of the rehabilitation needs, development, and preliminary outcomes of an education and exercise self-management intervention for breast cancer survivors
Get PDFAn investigation of the rehabilitation needs, development, and preliminary outcomes of an education and exercise self-management intervention for breast cancer survivors. The central premise of this thesis was that breast cancer (BC) survivors face debilitating long-term side effects (LTSEs) after completing their medical cancer treatment (MCT), such as chronic pain and upper limb dysfunction, cancer-related fatigue, a reduction in health-related quality of life (HRQoL), reduced physical function, weight gain, and lymphoedema. It was hypothesised that BC survivors may not receive education and support to manage these and other LTSEs. It was also hypothesised that LTSEs of BC treatment can be improved by an education and exercise self-management intervention (SMI). Firstly, a qualitative study using focus group discussions was conducted to investigate the lived experience of LTSEs of BC treatment and the rehabilitation needs of survivors, in a semi-urban region of South Africa (SA)(n = 23). The findings of the qualitative study revealed that survivors were affected by LTSEs of MCT. These impacted their daily lives, and in some cases, the ability to provide for their families. Participants were unable to self-manage their symptoms as they had not been provided with information or rehabilitation for these sequelae of their cancer. Furthermore, many participants lacked support from cancer support organisations, and felt isolated. Transportation and financial challenges were identified, and survivors lived in geographically diverse areas. Attitudes towards and perspectives of participating in a rehabilitation intervention including an exercise component, were positive. However, specific exercise and rehabilitation preferences varied between participants. For example, some participants preferred to exercise in a group, while others preferred to exercise alone, or with a family member. Some participants preferred to receive survivorship information via email or through printed material, while others preferred to receive talks. Second, a systematic review and meta-analysis was conducted to determine the effectiveness of SMIs including an exercise component, to improve LTSEs and physical activity, in BC survivors following the completion of MCT. The systematic review and meta-analysis presented in this thesis (n = 10 studies) found that, as an alternative to supervised on-site interventions, SMIs including an exercise component are effective to improve LTSEs and increase physical activity, in early-stage BC survivors following MCT. Third, the results of the qualitative study and the systematic review were used to inform the content and structure; and the Medical Research Council (MRC) guidelines for intervention development were used to inform the process of developing an education and exercise SMI. As patient-centred SMIs based on cognitive behavioural and self-management principles have shown promise in previous chronic disease management programmes, the new intervention ‘Survive and Thrive' was informed by the abovementioned principles. Content validation was established by obtaining feedback from a multidisciplinary team of five South African clinical BC experts and refining the intervention accordingly. An acceptability evaluation was conducted through a small qualitative study including three BC survivors. Alterations were made to the intervention according to the results of this study. The final phase was a single-group, pre-test-post-test study (n = 33) to determine the feasibility, safety, and preliminary outcomes of the newly developed intervention, in early-stage BC survivors who had completed their MCT. The baseline findings of the intervention study suggest that prevalence and levels of pain and cancer-related fatigue were high, and HRQoL index scores and physical activity levels were low at baseline, compared to previous studies of BC survivors conducted in high-income countries. The intervention was feasible and safe to implement in this study. Furthermore, significant improvements were demonstrated post-intervention in terms of pain and fatigue prevalence, severity, and interference, HRQoL, self-efficacy, and exercise participation. The findings of this thesis revealed that physical LTSEs were a significant problem for South African BC survivors, and that they were largely unaddressed by the standard of care. Further, the findings demonstrated that a resource-efficient SMI was feasible, safe, and potentially effective to improve patient-reported outcomes in South African BC survivors
Learning to resist: exploring habitus (trans)formation of critical teacher-activists before 1994
Get PDFThis study aims to understand the enabling conditions for the emergence of teacher activism before South Africa's democratic transition in the 1990s. It does so by examining the life experiences of four teacher activists that became politically active in their childhood and youth, and who entered the field of teaching during apartheid. The study contributes to a growing body of literature about the lives of teachers during apartheid, while offering theoretical insight into the emergence of teacher activism under apartheid. Four teachers were selected for the study, all of whom were classified as ‘coloured' males under apartheid. All four identify as socialists and all four participated in the anti apartheid struggle and held various positions of leadership. While they began their teaching careers at different times and the length of their teaching careers differ for various reasons, including banning, imprisonment and dismissal, they embodied in their own ways what it means to be critical teachers. Methodologically, this study critically analyses life-stories, drawing from in-depth narratives produced through semi-structured interviews. This approach allowed for an engagement with rich data on personal perspectives and recollections, as well as broader social influences in the lives of the teachers in this study. The primary concern of the study is to understand the enabling conditions for the emergence of teacher activism during apartheid, which it explores through an analysis of the accounts of the four designated teachers. Treating memory as a repository of precious knowledge, the goal is to offer a variety of insights that serve as a heuristic framework to think about the arguable absence of teacher social movements in South Africa in the contemporary period. Leveraging conceptual resources drawn from Bourdieu, the insights which this study has produced demonstrate that the emergence of activism may be better understood by considering how times of crisis produce conditions under which taken-for-granted assumptions can be contested. Crisis produces discordance within the field between hegemonic social visions and the reality of the crisis, which renders plausible resistance discourses. Such times of crisis can be experienced at the level of the individual in moments that are referred to in this study as critical incidents, and they are also experienced collectively at the broader societal level, as Bourdieu has suggested. In the above regard, the primary contribution of the study lies in its engagement with the role of imagination as a form of intellectual labour at moments of crisis, where machinations of power are made more explicit but where imagining a more hopeful future is also catalysed. Both of these processes are necessary in converting crises into catalytic events capable of mobilising people, and that then spurs different forms of activism. A further contribution emerges from the study's engagement with different collective processes of organisation such as trade unions, history societies, or sports clubs that offer spaces that promote the acquisition of two forms of capital, namely critical capital and organising capital, and that create places where counter-hegemonic imaginations can be cultivated. The study shows how changing situations in the lives of different teacher activists simultaneously constrain possibilities for change and produce contradictions (or contradictory conditions) that provide the required room for activist intervention. These lessons, it is argued, offer important insights into how teacher activism is constituted and how, perhaps, it can arguably be revived in the contemporary period
A qualitative exploration of high school dropout and retention among adolescent girls and young women (AGYW) in South Africa
Get PDFIn South Africa high school attrition and disengagement rates have been problematic for the past decade with adolescent girls and young women (AGYW) more likely to dropout of school than their male counterparts, especially those AGYW from socio-economically disadvantaged communities. Increased levels of education, a social determinant of health, strongly correlates with better health outcomes for youth. The disengagement and dropout of AGYW in high school is a public health concern. AGYW are at a greater risk of HIV infection and other sexually transmitted infection (STI) due to biological, cultural, religious, socio-economic and structural factors, and efforts to increase their retention and completion of high school, a protective factor, will increase the likelihood of better health outcomes in this population group. This study was a qualitative analysis of AGYW and stakeholders across five provinces from urban, semi-urban and rural districts. The transcripts were thematically analysed to explore the perceptions of and attitudes to high school completion and dropout and the factors which may contribute to either. Findings revealed that AGYW valued their high school education and associated it with future success and independence but several context specific factors on the individual, interpersonal and institutional levels influenced their retention and likelihood of dropping out of high school. An understanding of the multiple factors which influence high school dropout and retention, as indicated on the different levels of the socio-ecological model, may inform more target specific interventions to increase the retention and completion of high school of AGYW in South Africa