Migration theories and Zimbabwean migrant teachers as reflected in a south african case study

Neo-classical and neo-Marxist theories oppose each other in terms of explaining motivation for migration and its development impact. Neo-classical theories posit that migration occurs because of economic considerations: higher incomes and economic gain. Neo-Marxist theories emphasize that migration occurs because of unequal and structural levels of development between developed and developing countries, regions or areas. In sub-Saharan Africa, South Africa is relatively economically developed compared to other countries in the region and, according to neo-Marxist philosophy, exploits the labour from other poorer countries. In this case study, the focus is on migrant teachers from Zimbabwe. According to neo-Marxist- theories, migrants exist in an exploitative relationship with their host regions and/or countries. Apart from neo-classical and neo-Marxist theories, pluralist theories have evolved from these distinctive schools of thought that emphasize that migration is the result of a conscious family decision aimed at diversifying their resource base when faced with crises and/or scarcity, asserting that migration does indeed bring about development. This paper contends that neo-classical theories do apply to the case of Zimbabwean migrant teachers because they satisfactorily explain why these teachers came to South Africa, whereas neo-Marxist theories have limited relevance. Pluralist theories, however, through their emphasis on remittances, add meaning to people’s motivations for, and the consequent impact of development related to this particular aspect of migration

African migrant traders’ experiences in Johannesburg inner city : towards the migrant calculated risk and adaptation framework

Abstract: Globally, migrants face numerous socio-economic and institutional impediments that hinder their participation in the labour market of host cities and/or countries. This motivates them to join the informal economic sector to make a living. Applying the concept of tactical cosmopolitanism to understand the social and economic agency of African migrants, this article reports on an explorative analysis of the experiences of informal African migrant street traders (African migrant traders) operating in Johannesburg inner city, Gauteng, South Africa. The study revealed that African migrant traders left their countries of origin to secure better opportunities and to escape hostile conditions in their home countries. Despite the host city turning out to be more hostile and xenophobic, making life and finding formal employment opportunities more challenging, the thought of the more difficult life conditions in their home countries has led them to trading on the streets..

TRAPPED IN A GARDEN OF GREENER PASTURES: THE EXPERIENCES OF ZIMBABWEAN TEACHERS IN SOUTH AFRICA

 Most immigrants from African countries choose Johannesburg as a migration destination. They all perceive it to be location with many opportunities that would enable them to make a fresh start to a life outside their home country, and Zimbabweans are no exception. In South Africa, Johannesburg has a large percentage of foreigners at any given time, hence its inner city was chosen as a suitable location to investigate the extent and manner in which the experiences of migrant Zimbabwean teachers matched their expectations. The results revealed a paradox of economic satisfaction accompanied by fear and social unhappiness in the lives of these Zimbabwean teachers in South Africa. The Zimbabwean migrant teachers have two juxta-positioned problematic situations: wanting the money, their initial reason for migrating and motivation to continue working; and feeling imprisoned, unsafe and unwanted, an incongruous reality, in South Africa. This paper examines the dynamics of these contradictions by presenting the two-pronged dilemma from both an economic and a social point of view. They want to be and not to be in South Africa at the same time – they are trapped in a contradictory existence, in a city and country to which they chose to migrate.

MIGRATION THEORIES AND ZIMBABWEAN MIGRANT TEACHERS AS REFLECTED IN A SOUTH AFRICAN CASE STUDY

Neo-classical and neo-Marxist theories oppose each other in terms of explaining motivation for migration and its development impact. Neo-classical theories posit that migration occurs because of economic considerations: higher incomes and economic gain. Neo-Marxist theories emphasize that migration occurs because of unequal and structural levels of development between developed and developing countries, regions or areas. In sub-Saharan Africa, South Africa is relatively economically developed compared to other countries in the region and, according to neo-Marxist philosophy, exploits the labour from other poorer countries. In this case study, the focus is on migrant teachers from Zimbabwe. According to neo-Marxist- theories, migrants exist in an exploitative relationship with their host regions and/or countries. Apart from neo-classical and neo-Marxist theories,  pluralist theories  have evolved from these distinctive schools of thought that emphasize that migration is the result of a conscious family decision aimed at diversifying their resource base when faced with crises and/or scarcity, asserting that migration does indeed bring about development. This paper contends that neo-classical theories do apply to the case of Zimbabwean migrant teachers because they satisfactorily explain why these teachers came to South Africa, whereas neo-Marxist theories have limited relevance. Pluralist theories, however, through their emphasis on remittances, add meaning to people’s motivations for, and the consequent impact of development related to this particular aspect of migration

Rapid urine-based screening for tuberculosis in HIV-positive patients admitted to hospital in Africa (STAMP): a pragmatic, multicentre, parallel-group, double-blind, randomised controlled trial.

BACKGROUND Current diagnostics for HIV-associated tuberculosis are suboptimal, with missed diagnoses contributing to high hospital mortality and approximately 374 000 annual HIV-positive deaths globally. Urine-based assays have a good diagnostic yield; therefore, we aimed to assess whether urine-based screening in HIV-positive inpatients for tuberculosis improved outcomes. METHODS We did a pragmatic, multicentre, double-blind, randomised controlled trial in two hospitals in Malawi and South Africa. We included HIV-positive medical inpatients aged 18 years or more who were not taking tuberculosis treatment. We randomly assigned patients (1:1), using a computer-generated list of random block size stratified by site, to either the standard-of-care or the intervention screening group, irrespective of symptoms or clinical presentation. Attending clinicians made decisions about care; and patients, clinicians, and the study team were masked to the group allocation. In both groups, sputum was tested using the Xpert MTB/RIF assay (Xpert; Cepheid, Sunnyvale, CA, USA). In the standard-of-care group, urine samples were not tested for tuberculosis. In the intervention group, urine was tested with the Alere Determine TB-LAM Ag (TB-LAM; Alere, Waltham, MA, USA), and Xpert assays. The primary outcome was all-cause 56-day mortality. Subgroup analyses for the primary outcome were prespecified based on baseline CD4 count, haemoglobin, clinical suspicion for tuberculosis; and by study site and calendar time. We used an intention-to-treat principle for our analyses. This trial is registered with the ISRCTN registry, number ISRCTN71603869. FINDINGS Between Oct 26, 2015, and Sept 19, 2017, we screened 4788 HIV-positive adults, of which 2600 (54%) were randomly assigned to the study groups (n=1300 for each group). 13 patients were excluded after randomisation from analysis in each group, leaving 2574 in the final intention-to-treat analysis (n=1287 in each group). At admission, 1861 patients were taking antiretroviral therapy and median CD4 count was 227 cells per μL (IQR 79-436). Mortality at 56 days was reported for 272 (21%) of 1287 patients in the standard-of-care group and 235 (18%) of 1287 in the intervention group (adjusted risk reduction [aRD] -2·8%, 95% CI -5·8 to 0·3; p=0·074). In three of the 12 prespecified, but underpowered subgroups, mortality was lower in the intervention group than in the standard-of-care group for CD4 counts less than 100 cells per μL (aRD -7·1%, 95% CI -13·7 to -0·4; p=0.036), severe anaemia (-9·0%, -16·6 to -1·3; p=0·021), and patients with clinically suspected tuberculosis (-5·7%, -10·9 to -0·5; p=0·033); with no difference by site or calendar period. Adverse events were similar in both groups. INTERPRETATION Urine-based tuberculosis screening did not reduce overall mortality in all HIV-positive inpatients, but might benefit some high-risk subgroups. Implementation could contribute towards global targets to reduce tuberculosis mortality. FUNDING Joint Global Health Trials Scheme of the Medical Research Council, the UK Department for International Development, and the Wellcome Trust

AICCRA leveraging on networks to communicate climate information and climate smart agriculture to smallholder farmers in Zambia

AICCRA Zambia supports networks and community responses through programs on climate innovation and agribusiness, leveraging on media and communication channels. Interventions are designed to stimulate networks of actors at multiple levels (macro, meso, micro) that catalyse dissemination of climate information and climate smart products and services to smallholder farmers. At project level, communication and outreach strategies that support networks and linkages within and across the networks can also contribute to achieving impact. Network strengthening and media communications can provide an important bridge for research, development, climate and agri-business to achieve their targets of enhancing uptake of climate information and climate smart agriculture. Assessment tools are being developed to identify what networks, partnerships and strategic stakeholders the media can leverage on and start working with. Assessing value creation stories with key stakeholders will show how communication and outreach activities of the AICCRA project have resulted in stimulating response by intermediaries and end-users and improved program performance and impact on smallholder farmers. Providing feedback on how good the media interventions were, how they contributed to local impact pathways, and what new opportunities for partnerships were discovered, supports monitoring and evidencing achievements in accordance with the project results framework

Impact of CSA technology packages on smallholder farmers under the accelerator program in Zambia

The primary goal of this report is to provide evidence on the impact of CSA technology packages on smallholder farmers under the accelerator programme in in Zambia. The AICCRA Zambia accelerator program tested various CSA technology packages, designed and implemented through agribusiness partnerships, SME bundles. The SME bundles were selected through a competitive process for the packages to address major challenges for CSA in Zambia and covering major agricultural production systems in Zambia. Each bundle was supported by a 50,000-USD grant

Tuberculosis in Hospitalized Patients With Human Immunodeficiency Virus: Clinical Characteristics, Mortality, and Implications From the Rapid Urine-based Screening for Tuberculosis to Reduce AIDS Related Mortality in Hospitalized Patients in Africa.

BACKGROUND: Tuberculosis (TB) is the major killer of people living with human immunodeficiency virus (HIV) globally, with suboptimal diagnostics and management contributing to high case-fatality rates. METHODS: A prospective cohort of patients with confirmed TB (Xpert MTB/RIF and/or Determine TB-LAM Ag positive) identified through screening HIV-positive inpatients with sputum and urine diagnostics in Malawi and South Africa (Rapid urine-based Screening for Tuberculosis to reduce AIDS Related Mortality in hospitalized Patients in Africa [STAMP] trial). Urine was tested prospectively (intervention) or retrospectively (standard of care arm). We defined baseline clinical phenotypes using hierarchical cluster analysis, and also used Cox regression analysis to identify associations with early mortality (≤56 days). RESULTS: Of 322 patients with TB confirmed between October 2015 and September 2018, 78.0% had ≥1 positive urine test. Antiretroviral therapy (ART) coverage was 80.2% among those not newly diagnosed, but with median CD4 count 75 cells/µL and high HIV viral loads. Early mortality was 30.7% (99/322), despite near-universal prompt TB treatment. Older age, male sex, ART before admission, poor nutritional status, lower hemoglobin, and positive urine tests (TB-LAM and/or Xpert MTB/RIF) were associated with increased mortality in multivariate analyses. Cluster analysis (on baseline variables) defined 4 patient subgroups with early mortality ranging from 9.8% to 52.5%. Although unadjusted mortality was 9.3% lower in South Africa than Malawi, in adjusted models mortality was similar in both countries (hazard ratio, 0.9; P = .729). CONCLUSIONS: Mortality following prompt inpatient diagnosis of HIV-associated TB remained unacceptably high, even in South Africa. Intensified management strategies are urgently needed, for which prognostic indicators could potentially guide both development and subsequent use

Cost-effectiveness of urine-based tuberculosis screening in hospitalised patients with HIV in Africa: a microsimulation modelling study.

BACKGROUND: Testing urine improves the number of tuberculosis diagnoses made among patients in hospital with HIV. In conjunction with the two-country randomised Rapid Urine-based Screening for Tuberculosis to Reduce AIDS-related Mortality in Hospitalised Patients in Africa (STAMP) trial, we used a microsimulation model to estimate the effects on clinical outcomes and the cost-effectiveness of adding urine-based tuberculosis screening to sputum screening for hospitalised patients with HIV. METHODS: We compared two tuberculosis screening strategies used irrespective of symptoms among hospitalised patients with HIV in Malawi and South Africa: a GeneXpert assay (Cepheid, Sunnyvale, CA, USA) for Mycobacterium tuberculosis and rifampicin resistance (Xpert) in sputum samples (standard of care) versus sputum Xpert combined with a lateral flow assay for M tuberculosis lipoarabinomannan in urine (Determine TB-LAM Ag test, Abbott, Waltham, MA, USA [formerly Alere]; TB-LAM) and concentrated urine Xpert (intervention). A cohort of simulated patients was modelled using selected characteristics of participants, tuberculosis diagnostic yields, and use of hospital resources in the STAMP trial. We calibrated 2-month model outputs to the STAMP trial results and projected clinical and economic outcomes at 2 years, 5 years, and over a lifetime. We judged the intervention to be cost-effective if the incremental cost-effectiveness ratio (ICER) was less than US$750/year of life saved (YLS) in Malawi and$940/YLS in South Africa. A modified intervention of adding only TB-LAM to the standard of care was also evaluated. We did a budget impact analysis of countrywide implementation of the intervention. FINDINGS: The intervention increased life expectancy by 0·5-1·2 years and was cost-effective, with an ICER of $450/YLS in Malawi and$840/YLS in South Africa. The ICERs decreased over time. At lifetime horizon, the intervention remained cost-effective under nearly all modelled assumptions. The modified intervention was at least as cost-effective as the intervention (ICERs $420/YLS in Malawi and$810/YLS in South Africa). Over 5 years, the intervention would save around 51 000 years of life in Malawi and around 171 000 years of life in South Africa. Health-care expenditure for screened individuals was estimated to increase by $37 million (10·8$261 million (2·8%), respectively. INTERPRETATION: Urine-based tuberculosis screening of all hospitalised patients with HIV could increase life expectancy and be cost-effective in resource-limited settings. Urine TB-LAM is especially attractive because of high incremental diagnostic yield and low additional cost compared with sputum Xpert, making a compelling case for expanding its use to all hospitalised patients with HIV in areas with high HIV burden and endemic tuberculosis. FUNDING: UK Medical Research Council, UK Department for International Development, Wellcome Trust, US National Institutes of Health, Royal College of Physicians, Massachusetts General Hospital