Ethical challenges in assessment centres in South Africa

Abstract: Assessment Centres (ACs) are used globally for the selection and development of candidates. Limited empirical evidence exists of the ethical challenges encountered in the use of ACs, especially in South Africa (SA). Research purpose: Firstly, to explore possible ethical challenges related to ACs in SA from the vantage point of the practitioner and, secondly, to search for possible solutions to these. Motivation for the study: Decisions based on AC outcomes have profound implications for participants and organisations, and it is essential to understand potential ethical challenges to minimise these, specifically in the SA context, given its socio-political history, multiculturalism, diversity and pertinent legal considerations. Research design, approach and method: A qualitative, interpretative research design was chosen. Data were collected by means of a semi-structured survey that was completed by 96 AC practitioners who attended an AC conference. Content analysis and thematic interpretation were used to make sense of the data. The preliminary findings were assessed by a focus group of purposively selected subject-matter experts (n = 16) who provided informed insights, which were incorporated into the final findings. The focus group suggested ways in which specific ethical challenges may be addressed..

Knowledge and skills of midwives on antenatal care in Livingstone district,Southern province,Zambia

THESIS MSCLivingstone District in Southern Province of Zambia has a high number of maternal deaths. This study was exploring midwives’ knowledge and skills on antenatal care (ANC). A descriptive cross-sectional study comprising 89 respondents conveniently sampled from Livingstone Central Hospital and six (6) urban clinics was conducted. The data was collected using a self-administered questionnaire and clinical structured observational skills checklist and processed and analyzed using Statistical Package for Social Sciences (SPSS) version 23. Descriptive statistics was used to describe data. Chi-square test was used to test associations between the outcome variables (knowledge and skills) and other independent variables (midwives’ characteristics; work organization and environment; and job satisfaction). The significant level was set at 0.05 with confidence interval of 95%. Knowledge levels on first ANC were high 65 (73%). Surprisingly, 55 (61.8%) did not have the required clinical skills to offer ANC. Additionally, 62 (70%) of the respondents had received supervision within the last 6 months prior to data collection. However, less than half, 37 (41.6%), had undergone in-service training in reproductive health. Possible enhancements include good and prompt ANC as an important activity that should be rendered to all pregnant mothers. The study revealed that the knowledge levels of midwives were high compared to the skills levels. The implications are that the midwives have more knowledge on ANC than the skills which can make them not to detect early the pregnancy related complications which leads to high numbers of maternal deaths. These include pre-eclampsia and ante partum haemorrhage. Intensive onsite supportive mentorship and supervision to midwives should be strengthened to improve knowledge and skills so that they offer quality ANC by prompt identification, treatment and referral of any abnormality detected. Key words: Antenatal, Antenatal care, Midwife, Knowledge, Skill

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Costs of eye care services: prospective study from a faith-based hospital in Zambia.

PURPOSE: To estimate the mean costs of cataract surgery and refractive error correction at a faith-based eye hospital in Zambia. METHODS: Out-of-pocket expenses for user fees, drugs and transport were collected from 90 patient interviews; 47 received cataract surgery and 43 refractive error correction. Overhead and diagnosis-specific costs were determined from micro-costing of the hospital. Costs per patient were calculated as the sum of out-of-pocket expenses and hospital costs, excluding user fees to avoid double counting. RESULTS: From the perspective of the hospital, overhead costs amounted to US$31 per consultation and diagnosis-specific costs were US$57 for cataract surgery and US$36 for refractive error correction. When including out-of-pocket expenses, mean total costs amounted to US$128 (95% confidence interval [CI] US$96--168) per cataract surgery and US$86 (95% CI US$67--118) per refractive error correction. Costs of providing services corresponded well with the user fee levels established by the hospital. CONCLUSION: This is the first paper to report on the costs of eye care services in an African setting. The methods used could be replicated in other countries and for other types of visual impairments. These estimates are crucial for determining resources needed to meet global goals for elimination of avoidable blindness