Households’ Willingness to Pay for Improved Water Services: A Case of Semi-Urban Households in the Lubombo and Lowveld Regions of Swaziland

Management of water resources in an equitable manner by water managers has proved to be a demanding task. Therefore, evaluating domestic water demand behaviours produces an underlying basis for water managers to sustainably and efficiently meet the ever increasing demand for water. Using survey data collected from 314 households in the Lowveld and Lubombo regions of Swaziland, this paper uses the Contingent Valuation Method (CVM) to determine households’ willingness to pay (WTP) for improved water services. In estimating the parametric mean WTP and its determinants, the paper uses both the bivariate probit model and univariate probit model, respectively. The results show that 67% of the households were willing to pay the initial bid for improved water services. The mean WTP for a 20 litre of water was estimated at E0.47[1]. Probit model results show that household income, education, gender, distance and owning a backyard garden positively influence household WTP. However, age, water quality and the initial bid offered deter households WTP for improved water services. This suggests that socioeconomic factors should be considered when setting domestic water tariffs and designing strategies for improved water supply services. Keywords: Willingness to Pay (WTP), Contingent Valuation Method (CVM), Swaziland [1] 1 USD = E13.5 Emalangen

CHARACTERISATION OF MULTIVARIATE TRAITS IN SWAZI INDIGENOUS GOATS

Swazi goats from two different regions in Swaziland kept in communal systems were characterised based on phenotypic measurements. Objective measurements for 200 goats included body weight (BW), abdominal circumference (AC), body length (BL), chest circumference (CC), face length (FL), neck circumference (NC), neck length (NL), rump height (RH) and height at withers (HW), while qualitative traits included coat colour, coat texture and presence or absence of horns. Seven coat colours were observed across both regions. Goats with straight coat texture (82%), short hair length (68%) and with horns (84%) were predominantly more. Goats in Manzini region had the lower BW, AC, BL and CC (51.77±1.32, 61.77±1.32, 62.49±0.66, 57.96±1.18) than Shiselweni goats (53.09±1.01, 71.09±1.00, 73.67±0.94, 53.83±0.90). The study provided a reference for phenotypic and genetic diversity for Swazi goats useful for designing genetic strategies for improved production, food security and sustainable utilisation

Testing the effectiveness of existing psycho-educational material (The Alliance Programme) for patients suffering from schizophrenia in the South African context

Objective:  Key Words:  Schizophrenia; Psycho-education; Participatory communication: comprehension.The objective of this study was to test the effectiveness of the existing psycho-educational material (The Alliance Programme) for patients suffering from schizophrenia in the South African context. Method: A qualitative research approach was used. Fifteen Setswana speaking participants, with a diagnosis of schizophrenia were exposed to the programme. Semi-structured and screening interviews were used to collect demographic and clinical data. The participants were divided into two groups and were exposed to either the Alliance Programme or on adapted version of the programme. Participatory communication instruments including focus groups, were used to assess comprehension and knowledge retention of the material over time. Results: Participants who were exposed to the original Alliance Programme experienced the contents of the programme to be technical, difficult to read or recall. They were unable to relate their previous symptoms to the psycho-education given. Participants who were exposed to the adapted version faired much better, gained more insight and were able to relate better to their illnesses. Participants preferred booklets with examples and illustrations, video clips and films over formal lectures. Conclusion: Psycho-education material given to people suffering from schizophrenia and their caregivers has to be adapted to their context to be effective

Development of a web-based application to improve data collection for antimicrobial point prevalence surveys in the public health care system in South Africa; findings and implications

Background: Surveillance of antimicrobial use is one of the main recommended strategies in combating growing antimicrobial resistance (AMR) rates and a key part of developing pertinent policies and initiatives to reduce growing AMR rates in South Africa and wider. However, determining antimicrobial utilisation at a patient-level among public hospitals in South Africa can be a challenge given personnel and resource constraints. There are also currently no standardized data collection tools. Most countries in Africa currently undertake antimicrobial utilisation surveillance using paper-based data collection tools including point prevalence surveys (PPS). Unfortunately, paper-based systems have disadvantages including the time taken to complete the forms and analyse the findings, increasing costs and manpower hurdles. Electronic tools offer many advantages including mobile and real time data collection and also the opportunity for rapid analytics. Objectives: Develop and test a web-based application (APP) for future PPS studies to successfully address identified challenges. Methods: A web based application (APP) was developed based on previous PPS in Botswana and South Africa using a paper-based data collection tool and tested during July 2017 in a leading public hospital in South Africa. The developed APP was also evaluated for data quality by measuring the number of errors, work flow, and time taken for the survey versus the previous paper-based system. User acceptance was also measured via a questionnaire to the data collectors. Results: A total of 187 patients' files were surveyed in this leading hospital using the APP whilst also documenting the challenges and areas of improvement for the APP. The identified areas of improvement have now been incorporated into the revised APP for future studies. The data collectors agreed that surveying the patients' files took appreciably less time with the APP compared to the paper based tool, and should be used in the future. In addition, data analysis was hastened using the APP. Conclusions: The APP development process has been successful and the APP is a potential tool for future PPS in South Africa and wider. The APP methodology is now being tested in new studies across South Africa to help instigate pertinent educational and other interventions to improve the future use of antimicrobials among public hospitals in South Africa

'This is what is going to help me': Developing a co-designed and theoretically informed harm reduction intervention for mobile youth in South Africa and Uganda

Young migrants in sub-Saharan Africa are particularly vulnerable to HIV-acquisition. Despite this, they are consistently under-served by services, with low uptake and engagement. We adopted a community-based participatory research approach to conduct longitudinal qualitative research among 78 young migrants in South Africa and Uganda. Using repeat in-depth interviews and participatory workshops we sought to identify their specific support needs, and to collaboratively design an intervention appropriate for delivery in their local contexts. Applying a protection-risk conceptual framework, we developed a harm reduction intervention which aims to foster protective factors, and thereby nurture resilience, for youth ‘on the move’ within high-risk settings. Specifically, by establishing peer supporter networks, offering a ‘drop-in’ resource centre, and by identifying local adult champions to enable a supportive local environment. Creating this supportive edifice, through an accessible and cohesive peer support network underpinned by effective training, supervision and remuneration, was considered pivotal to nurture solidarity and potentially resilience. This practical example offers insights into how researchers may facilitate the co-design of acceptable, sustainable interventions

Integration of the Demographic Dividend into Government Plans: A Case of the Kwazulu-Natal Province of South Africa

The Population reference Bureau policy brief, (Gribble and Bremmer, 2012):1) described the demographic dividendas “…the accelerated economic growth that may result from a decline in a country’s mortality and fertility and thesubsequent change in the age structure of the population. With fewer births each year, a country’s young dependentpopulation grows smaller in relation to the working-age population. With fewer people to support, a country has awindow of opportunity for rapid economic growth if the right social and economic policies developed and investments made”. Several South Africa based studies have explored age structure and the prospects of a demographic dividend. These studies range from those that explore timing of the dividend to those that investigate readiness to harness the dividend. Three aspects of the demographic dividend are investigated by this research. Firstly, the paper will explorethe age structure of KwaZulu-Natal population to ascertain the timing of the age-structure (youth bulge) that is a pre-requisite for the dividend. Secondly, demographic, health and education characteristics that are knows to affect the achievement of the dividend will be examined. Lastly, the extent of integration of the demographic dividend into Integrated Development Plans (IDPs) in the province will be explored

Sentinel seroprevalence of SARS-CoV-2 in Gauteng Province, South Africa, August - October 2020

Background. Estimates of prevalence of anti-SARS-CoV-2 antibody positivity (seroprevalence) for tracking the COVID-19 epidemic are lacking for most African countries.Objectives. To determine the prevalence of antibodies against SARS-CoV-2 in a sentinel cohort of patient samples received for routine testing at tertiary laboratories in Johannesburg, South Africa.Methods. This sentinel study was conducted using remnant serum samples received at three National Health Laboratory Service laboratories in the City of Johannesburg (CoJ) district. Collection was from 1 August to 31 October 2020. We extracted accompanying laboratory results for glycated haemoglobin (HbA1c), creatinine, HIV, viral load and CD4 T-cell count. An anti-SARS-CoV-2 targeting the nucleocapsid (N) protein of the coronavirus with higher affinity for IgM and IgG antibodies was used. We reported crude as well as population-weighted and test-adjusted seroprevalence. Multivariate logistic regression analysis was used to determine whether age, sex, HIV and diabetic status were associated with increased risk for seropositivity.Results. A total of 6 477 samples were analysed, the majority (n=5 290) from the CoJ region. After excluding samples with no age or sex stated, the model population-weighted and test-adjusted seroprevalence for the CoJ (n=4 393) was 27.0% (95% confidence interval (CI) 25.4 - 28.6). Seroprevalence was highest in those aged 45 - 49 years (29.8%; 95% CI 25.5 - 35.0) and in those from the most densely populated areas of the CoJ. Risk for seropositivity was highest in those aged 18 - 49 years (adjusted odds ratio (aOR) 1.52; 95% CI 1.13 - 2.13; p=0.0005) and in samples from diabetics (aOR 1.36; 95% CI 1.13 - 1.63; p=0.001).Conclusions. Our study conducted between the first and second waves of the pandemic shows high levels of current infection among patients attending public health facilities in Gauteng Province

Do NO, N2O, N2 and N2 fluxes differ in soils sourced from cropland and varying riparian buffer vegetation? An incubation study

Riparian buffers are expedient interventions for water quality functions in agricultural landscapes. However, the choice of vegetation and management affects soil microbial communities, which in turn affect nutrient cycling and the production and emission of gases such as nitric oxide (NO), nitrous oxide (N2O), nitrogen gas (N2) and carbon dioxide (CO2). To investigate the potential fluxes of the above-mentioned gases, soil samples were collected from a cropland and downslope grass, willow and woodland riparian buffers from a replicated plot scale experimental facility. The soils were re-packed into cores and to investigate their potential to produce the aforementioned gases via potential denitrification, a potassium nitrate (KNO3−) and glucose (labile carbon)-containing amendment, was added prior to incubation in a specialized laboratory DENItrification System (DENIS). The resulting NO, N2O, N2 and CO2 emissions were measured simultaneously, with the most NO (2.9 ± 0.31 mg NO m−2) and N2O (1413.4 ± 448.3 mg N2O m−2) generated by the grass riparian buffer and the most N2 (698.1 ± 270.3 mg N2 m−2) and CO2 (27,558.3 ± 128.9 mg CO2 m−2) produced by the willow riparian buffer. Thus, the results show that grass riparian buffer soils have a greater NO3− removal capacity, evidenced by their large potential denitrification rates, while the willow riparian buffers may be an effective riparian buffer as its soils potentially promote complete denitrification to N2, especially in areas with similar conditions to the current study

Breath-Hold Blood Oxygen Level-Dependent MRI: A Tool for the Assessment of Cerebrovascular Reserve in Children with Moyamoya Disease

BACKGROUND AND PURPOSE: There is a critical need for a reliable and clinically feasible imaging technique that can enable prognostication and selection for revascularization surgery in children with Moyamoya disease. Blood oxygen level-dependent MR imaging assessment of cerebrovascular reactivity, using voluntary breath-hold hypercapnic challenge, is one such simple technique. However, its repeatability and reliability in children with Moyamoya disease are unknown. The current study sought to address this limitation. MATERIALS AND METHODS: Children with Moyamoya disease underwent dual breath-hold hypercapnic challenge blood oxygen level-dependent MR imaging of cerebrovascular reactivity in the same MR imaging session. Within-day, within-subject repeatability of cerebrovascular reactivity estimates, derived from the blood oxygen level-dependent signal, was computed. Estimates were associated with demographics and intellectual function. Interrater reliability of a qualitative and clinically applicable scoring scheme was assessed. RESULTS: Twenty children (11 males; 12.1 ± 3.3 years) with 30 MR imaging sessions (60 MR imaging scans) were included. Repeatability was "good" on the basis of the intraclass correlation coefficient (0.70 ± 0.19). Agreement of qualitative scores was "substantial" (κ = 0.711), and intrarater reliability of scores was "almost perfect" (κ = 0.83 and 1). Younger participants exhibited lower repeatability (P = .027). Repeatability was not associated with cognitive function (P > .05). However, abnormal cerebrovascular reactivity was associated with slower processing speed (P = .015). CONCLUSIONS: Breath-hold hypercapnic challenge blood oxygen level-dependent MR imaging is a repeatable technique for the assessment of cerebrovascular reactivity in children with Moyamoya disease and is reliably interpretable for use in clinical practice. Standardization of such protocols will allow further research into its application for the assessment of ischemic risk in childhood cerebrovascular disease

Improving supply chain performance in the South African healthcare service : a literature based perspective

Abstract: Supply chain performance management plays an imperative role in keeping healthcare organizations sustainable and competitive by handling the storage and efficient distribution of resources in the value chain. Managing the complexity of healthcare demands and the application of improved technologies requires best practice supply chain models. The South African healthcare industry experiences unsatisfactory capacity limitations where there are extreme deficiencies of beds, equipment, facilities and trained healthcare professionals. This study highlights supply chain management strategies that can enhance efficient healthcare accessibility and delivery in South Africa using literature data. The results show that advanced healthcare delivery approaches such as ambulance divert and predictive analytics stand a good chance of improving supply chain management in the country