Inequality of opportunity: the plight of foreign workers in South Africa

Migration can be a hazardous venture, particularly if carried out clandestinely. Evidence indicates that foreigners working without formal authorisation, i.e. 'irregular migrant workers', are in a particularly vulnerable position primarily because of their irregular immigration status. They are more likely to be subjected to exploitative and unsafe employment practices in terms of benefits and conditions. This study examines the protection available to this category of migrant workers in South Africa, particularly their right of access to work-related social protection. South Africa is a major migrant-receiving country in Southern Africa because of its relatively stronger economy and political stability. However, the employment of foreign nationals without work permits, or foreigners working contrary to visa requirements, raises a series of policy issues. These issues, against the background of fairness and equity discourses pertaining to socio-economic entitlements, become exacerbated. This study examines the adequacy of domestic, constitutional and legislative frameworks that offer work-related social protection to foreign workers in South Africa. In the context of international, continental, and regional instruments that provide similar protection to irregular migrants, it could be argued that South Africa's restrictive legislative framework compromises equality in the right of access to social protection for some migrants. Although effective migration management depends on careful juxtaposition of myriad policies, emerging evidence suggests conflicting interplay between key South African policies intended to manage the rights of workers specifically and labour migration in the country generally. Critical analysis of relevant national immigration, labour, and social security laws indicates inconsistency with international human rights principles concerning the equality of opportunity or treatment of irregular migrants vis-àvis regular migrants and nationals regarding social protection. Yet, inequalities in the actual processes or opportunities (means) embedded in these policies disentitle many vulnerable foreign workers from important constitutionally entrenched fundamental rights because their presence and/or employment violates existing immigration laws. The study concludes by recommending policy interventions that may help remedy these problems

Safeguarding the illegal rethinking the interface between labour and immigration laws

Includes bibliographical references.The rendering of work by foreigners without the authorization to work is a contentious issue in South Africa. South Africa possesses one of the most progressive Constitutions, yet many are left at the fringes of the economy with little protection. Despite constitutional entrenchment of fundamental labour rights, many well-deserving workers are disentitled from important labour protections because their employment contract violates immigration laws. Unauthorized workers are formally excluded from access to certain legal institutions and economic benefits as most of the protective labour laws are centred on an existing employer-employee relationship

A review of pharmacological effects of xylopic acid

Xylopic acid (15β-acetyloxy-kaur-16-en-19-oic acid) is a kaurene diterpene that can be obtained from various Xylopia spp. Xylopic acid has demonstrated several pharmacological activities in vitro and in vivo. The compound has shown promising effect as a potent analgesic, anti-inflammatory and anti-allergic agent. Xylopic acid is a CNS depressant and was able to ameliorate anxiety-like symptoms in mice in addition to its neuroprotective effects. Deleterious effects of xylopic acid on the reproductive system of mice have been well documented but extensive toxicity study detailing effect of the acid upon chronic exposure needs to be determined. Due to the heavy consumption of X. aethiopica fruits, it is recommended that the pharmacokinetics of xylopic acid be determined to ascertain the possible food-drug interaction that may occur when conventional drugs are taken together with foods containing xylopic acid

Being ready, willing and able: understanding the dynamics of family planning decision-making through community-based group discussions in the Northern Region, Ghana

Regional contraceptive use differentials are pronounced in Ghana, with the lowest levels occurring in the Northern Region. Community-based health services, intended to promote maternal and child health and family planning use, may have failed to address this problem. This paper presents an analysis of qualitative data on community perspectives on family planning “readiness,” “willingness,” and “ability” compiled in the course of 20 focus group discussions with residents (mothers and fathers of children under five, young boys and girls, and community elders) of two communities each in two Northern Region districts that were either equipped with or lacking direct access to community health services. The study districts are localities where contraceptive use is uncommon and fertility is exceptionally high. Results suggest that direct access to community services has had no impact on contraceptive attitudes or practice. Widespread method knowledge is often offset by side-effect misperceptions. Social constraints are prominent owing to opposition from men. Findings attest to the need to improve the provision of contraceptive information and expand method choice options. Because societal acceptance and access in this patriarchal setting is critical to use, frontline worker deployment should prioritize strategies for outreach to men and community groups with prominent attention to social mobilization themes and strategies that support family planning

Spectrum of anxiety and depression reported in reproductive-aged women diagnosed with gynaecological disorders at a tertiary healthcare facility in Ghana

Background: Patients with gynaecological disorders often suffer from psychological disorders including anxiety and depression. Although depression and anxiety have been studied in Ghana, data regarding the prevalence of these disorders in patients with gynaecological disorders is non-existent. The aim of the study was to investigate the prevalence of anxiety and depression in reproductive-aged women diagnosed with gynaecological disorders.Methods: Cross-sectional observational study was conducted at the Gynaecology Clinic of Korle-Bu Teaching Hospital, a tertiary health facility in Accra, Ghana. Patients of reproductive age seeking gynaecological care at the facility from December 2018 to January 2019 were assessed for anxiety and depression using the Generalized anxiety disorder (GAD) questionnaire and the Beck depression inventory (BDI) respectively. Sociodemographic and clinical information was gathered as well.Results: Of the 120 patients interviewed (mean age 34.33±0.66), 36.7% were depressed while 51.6% were reported anxiety disorders. Patients aged 35-45 years had the highest prevalence of anxiety (24.58%) and depression (29.18%). Again, prevalence rates were highest among respondents with senior high school as the highest educational qualification, (anxiety (22.15%); depression (24.20%). Patients suffering from pelvic floor disorder recorded the highest prevalence of anxiety (11.40%) and depression (13.77%). There was a significant association between depression and gynaecological disorders [χ2(25) =53.915, p=0.001, CI=95%], but there was not enough evidence of an association between anxiety and gynaecological disorders [χ2(15) =22.791, p=0.089, CI=95%].Conclusions: Anxiety and depression are prevalent amongst women in their reproductive age diagnosed presenting with gynaecological disorders and there is a significant association between gynaecological disorders and the prevalence of depression

Research capacity building integrated into PHIT projects: leveraging research and research funding to build national capacity

Background: Inadequate research capacity impedes the development of evidence-based health programming in sub-Saharan Africa. However, funding for research capacity building (RCB) is often insufficient and restricted, limiting institutions’ ability to address current RCB needs. The Doris Duke Charitable Foundation’s African Health Initiative (AHI) funded Population Health Implementation and Training (PHIT) partnership projects in five African countries (Ghana, Mozambique, Rwanda, Tanzania and Zambia) to implement health systems strengthening initiatives inclusive of RCB. Methods: Using Cooke’s framework for RCB, RCB activity leaders from each country reported on RCB priorities, activities, program metrics, ongoing challenges and solutions. These were synthesized by the authorship team, identifying common challenges and lessons learned. Results: For most countries, each of the RCB domains from Cooke’s framework was a high priority. In about half of the countries, domain specific activities happened prior to PHIT. During PHIT, specific RCB activities varied across countries. However, all five countries used AHI funding to improve research administrative support and infrastructure, implement research trainings and support mentorship activities and research dissemination. While outcomes data were not systematically collected, countries reported holding 54 research trainings, forming 56 mentor-mentee relationships, training 201 individuals and awarding 22 PhD and Masters-level scholarships. Over the 5 years, 116 manuscripts were developed. Of the 59 manuscripts published in peer-reviewed journals, 29 had national first authors and 18 had national senior authors. Trainees participated in 99 conferences and projects held 37 forums with policy makers to facilitate research translation into policy. Conclusion: All five PHIT projects strongly reported an increase in RCB activities and commended the Doris Duke Charitable Foundation for prioritizing RCB, funding RCB at adequate levels and time frames and for allowing flexibility in funding so that each project could implement activities according to their trainees’ needs. As a result, many common challenges for RCB, such as adequate resources and local and international institutional support, were not identified as major challenges for these projects. Overall recommendations are for funders to provide adequate and flexible funding for RCB activities and for institutions to offer a spectrum of RCB activities to enable continued growth, provide adequate mentorship for trainees and systematically monitor RCB activities. Electronic supplementary material The online version of this article (10.1186/s12913-017-2657-6) contains supplementary material, which is available to authorized users

Data-driven quality improvement in low-and middle-income country health systems: lessons from seven years of implementation experience across Mozambique, Rwanda, and Zambia

Well-functioning health systems need to utilize data at all levels, from the provider, to local and national-level decision makers, in order to make evidence-based and needed adjustments to improve the quality of care provided. Over the last 7 years, the Doris Duke Charitable Foundation’s African Health Initiative funded health systems strengthening projects at the facility, district, and/or provincial level to improve population health. Increasing data-driven decision making was a common strategy in Mozambique, Rwanda and Zambia. This paper describes the similar and divergent approaches to increase data-driven quality of care improvements (QI) and implementation challenge and opportunities encountered in these three countries

Research capacity building integrated into PHIT projects: leveraging research and research funding to build national capacity

Background: Inadequate research capacity impedes the development of evidence-based health programming in sub-Saharan Africa. However, funding for research capacity building (RCB) is often insufficient and restricted, limiting institutions’ ability to address current RCB needs. The Doris Duke Charitable Foundation’s African Health Initiative (AHI) funded Population Health Implementation and Training (PHIT) partnership projects in five African countries (Ghana, Mozambique, Rwanda, Tanzania and Zambia) to implement health systems strengthening initiatives inclusive of RCB. Methods: Using Cooke’s framework for RCB, RCB activity leaders from each country reported on RCB priorities, activities, program metrics, ongoing challenges and solutions. These were synthesized by the authorship team, identifying common challenges and lessons learned. Results: For most countries, each of the RCB domains from Cooke’s framework was a high priority. In about half of the countries, domain specific activities happened prior to PHIT. During PHIT, specific RCB activities varied across countries. However, all five countries used AHI funding to improve research administrative support and infrastructure, implement research trainings and support mentorship activities and research dissemination. While outcomes data were not systematically collected, countries reported holding 54 research trainings, forming 56 mentor-mentee relationships, training 201 individuals and awarding 22 PhD and Masters-level scholarships. Over the 5 years, 116 manuscripts were developed. Of the 59 manuscripts published in peer-reviewed journals, 29 had national first authors and 18 had national senior authors. Trainees participated in 99 conferences and projects held 37 forums with policy makers to facilitate research translation into policy. Conclusion: All five PHIT projects strongly reported an increase in RCB activities and commended the Doris Duke Charitable Foundation for prioritizing RCB, funding RCB at adequate levels and time frames and for allowing flexibility in funding so that each project could implement activities according to their trainees’ needs. As a result, many common challenges for RCB, such as adequate resources and local and international institutional support, were not identified as major challenges for these projects. Overall recommendations are for funders to provide adequate and flexible funding for RCB activities and for institutions to offer a spectrum of RCB activities to enable continued growth, provide adequate mentorship for trainees and systematically monitor RCB activities. Electronic supplementary material The online version of this article (10.1186/s12913-017-2657-6) contains supplementary material, which is available to authorized users

Understanding the problem: A South African policy reflection on the social protection of unauthorised migrant workers

Abstract Social protection is a fundamental human right; yet a great proportion, about 80 percent, of the world's working-age population (and their families) has no access to social security. This trend is undoubtedly worse when observed in individual countries. In South Africa specifically, there appears to be a social protection gap. Domestically, work-related social protection coverage is concentrated in the formal economy (i.e. on formal sector workers) and when it is not, nationality or residency is a key requirement for access. Such restrictive provisions unfavourably impact on the social security rights of many foreign workers in the country. The situation is particularly severe for unauthorised or irregular migrants as they are categorically precluded from any legal coverage owing to their precarious legal status. The exclusionary nature of the welfare policy highlights a complex interplay between immigration, labour and social security laws when considered in the context of clandestine labour migration. Research suggests that the level of social and labour protection that a foreigner can enjoy is directly related to his/her immigration status. Thus, the more tenuous one's immigration status is the more barriers to access to social protection. The legal disparity in access to social protection raises issues of serious human rights concerns; especially considering the fact that the main purpose of social protection is to protect the most vulnerable members of a society. Short of completely eroding the power of policy makers, it is important to ensure that immigration, labour, and social security laws are carefully juxtaposed so as to ensure that while the state is exercising its territorial right, it will still ensure that everyone's right to access fundamental social and labour rights are given effect. A fair balance of these laws needs to be struck if we are to manage migration effectively to the benefit of all stakeholders. The paper argues in favour offers a pragmatic argument for promoting the rights of unauthorised migrant based on a structural analysis of clandestine migration trend