The status quo of research on South Africa’s water resource management institutions

The South African water resource management institutional landscape has seen some dramatic changes since the new dispensation came into power in 1994. Not only have legislation and policies changed, but there has also been a significant increase in the number of non-state actors in the policy development process. Water resource governance has therefore become more complex and its regulatory component is being implemented by a number of legislative institutions: catchment management agencies, water user associations, irrigation boards, and international water management bodies. Policy development is influenced by a myriad of non-state actors, scientists included. A comprehensive literature review of research on water resource management institutions published between 1997 and 2011 shows that scientists are focusing predominantly on catchment management agencies and aspects regarding their institutionalisation and organisational functionality. There is much less of a focus on other entities, such as advisory committees, international water management bodies, irrigation boards, the water tribunal and water user associations. What the review has also revealed is that research on water resource management institutions has been conducted predominantly by scientists from the natural sciences. There is therefore an evident need for a research focus on water resource management institutions other than catchment management agencies. In addition, there should be a focus on informal aspects of water resource governance and new theoretical developments, also from disciplines other than the natural sciences, in the fields of water resource governance and politics.Keywords: Water resource management institutions, literature review, catchment management agencies,water user associations, legislation, irrigation boards, catchment forums, international water management bodie

Patterns of disease on admission to children’s wards and changes during a COVID-19 outbreak in KwaZulu-Natal Province, South Africa

Background. Major causes of under-5 child deaths in South Africa (SA) are well recognised, and child mortality rates are falling. The focus of child health is therefore shifting from survival to disease prevention and thriving, but local data on the non-fatal disease burden are limited. Furthermore, COVID-19 has affected children’s health and wellbeing, both directly and indirectly.Objectives. To describe the pattern of disease on admission of children at different levels of care, and assess whether this has been affected by COVID-19.Methods. Retrospective reviews of children’s admission and discharge registers were conducted for all general hospitals in iLembe and uMgungundlovu districts in KwaZulu-Natal Province, SA, from January 2018 to September 2020. The Global Burden of Disease framework was adapted to create a data capture sheet with four broad diagnostic categories and 37 specific cause categories. Monthly admission numbers were recorded per cause category, and basic descriptive analysis was completed in Microsoft Excel.Results. Overall, 36 288 admissions were recorded across 18 hospital wards, 32.0% at district, 49.8% at regional and 18.2% at tertiary level. Communicable diseases, perinatal conditions and nutritional deficiencies (CPNs) accounted for 37.4% of admissions, non-communicable diseases (NCDs) for 43.5% and injuries for 17.1%. The distribution of broad diagnostic categories varied across levels of care, with CPNs being more common at district level and NCDs more common at regional and tertiary levels. Unintentional injuries represented the most common cause category (16.6%), ahead of lower respiratory tract infections (16.1%), neurological conditions (13.6%) and diarrhoeal disease (8.4%). The start of the local COVID-19 outbreak coincided with a 43.1% decline in the mean number of monthly admissions. Admissions due to neonatal conditions and intentional injuries remained constant during the COVID-19 outbreak, while those due to other disease groups (particularly respiratory infections) declined.Conclusions. Our study confirms previous concerns around a high burden of childhood injuries in our context. Continued efforts are needed to prevent and treat traditional neonatal and childhood illnesses. Concurrently, the management of NCDs should be prioritised, and evidence-based strategies are sorely needed to address the high injury burden in SA

The preventive misconception: experiences from CAPRISA 004.

CAPRISA, 2014.Abstract available in pdf

Project Masihambisane: a cluster randomised controlled trial with peer mentors to improve outcomes for pregnant mothers living with HIV

Abstract Background Pregnant women living with HIV (WLH) face daily challenges maintaining their own and their babies' health and mental health. Standard Prevention of Maternal to Child Transmission (PMTCT) programs are not designed to address these challenges. Methods/Design As part of a cluster randomized controlled trial, WLH are invited to attend four antenatal and four postnatal small group sessions led by a peer WLH (a Peer Mentor). The WLH and their babies are assessed during pregnancy and at one week, six months, and twelve months post-birth. Mobile phones are used to collect routine information, complete questionnaires and remain in contact with participants over time. Pregnant WLH (N = 1200) are randomly assigned by clinic (N = 8 clinics) to an intervention program, called Masihambisane (n = 4 clinics, n = 600 WLH) or a standard care PMTCT control condition (n = 4 clinics; n = 600 WLH). Discussion Data collection with cellular phones are innovative and effective in low-resource settings. Standard PMTCT programs are not designed to address the daily challenges faced by WLH; Peer Mentors may be useful in supporting WLH to cope with these challenges. Trial registration ClinicalTrials.gov registration # NCT0097269

Assessing the impact of the 'skills revolution' among women in South Africa

Commissioned by the PWMSAThis study sought to examine the extent to which there is/has been a skills revolution in South Africa, the extent to which such a revolution targets/has targeted women and the extent to, and ways in which such skills revolution benefits/has benefitted women, particularly those who have been historically disadvantaged. In essence, the study examined the nature of opportunities available to South African women as a result of the skills revolution and the factors that impede their use of these opportunities

A study of clinical performance of nurses who recently completed the comprehensive basic nursing course

A study was conducted to assess clinical performance of registered nurses who had recently completed the new comprehensive basic nursing course. This regional project was undertaken because of controversy surrounding clinical competence of the graduates/diplomates of the new regulation course. Senior qualified nurses gave their views according to Likert Scale statements and open-ended questions. Findings were that the sample was of the opinion that clinical performance of the new graduates/diplomates falls short of expectations

Gender and poverty reduction: voice, dialogue and targeting

Commissioned by Department of Science and Technology's (DST) Unit on Technology for Social ImpactThis study examined the gendered dimensions of poverty in South Africa and their implications for poverty reduction interventions in South Africa. The study identifies and analyses national approaches to understanding and addressing poverty and their integration of gender. It also identifies and analyses approaches to understanding and addressing poverty and their integration of gender in three countries: Chile, Brazil and India. From these understandings, the study develops recommendations for developing integrated approaches to understanding poverty and its links to gender inequality and for developing and implementing ameliorative strategies. The research questions, in particular included: * What are the gendered dimensions of poverty and their implications for poverty reduction interventions in South Africa? * What poverty reduction policy and interventions exist to change the material realities of women and men's lives in South Africa? * How have other (selected) countries understood and addressed poverty, and how do their strategies aim to change the gendered lives of women and men

Neutralizing Carbapenem Resistance by Co-Administering Meropenem with Novel β-Lactam-Metallo-β-Lactamase Inhibitors

Virulent Enterobacterale strains expressing serine and metallo-β-lactamases (MBL) genes have emerged responsible for conferring resistance to hard-to-treat infectious diseases. One strategy that exists is to develop β-lactamase inhibitors to counter this resistance. Currently, serine β-lactamase inhibitors (SBLIs) are in therapeutic use. However, an urgent global need for clinical metallo-β-lactamase inhibitors (MBLIs) has become dire. To address this problem, this study evaluated BP2, a novel beta-lactam-derived β-lactamase inhibitor, co-administered with meropenem. According to the antimicrobial susceptibility results, BP2 potentiates the synergistic activity of meropenem to a minimum inhibitory concentration (MIC) of ≤1 mg/L. In addition, BP2 is bactericidal over 24 h and safe to administer at the selected concentrations. Enzyme inhibition kinetics showed that BP2 had an apparent inhibitory constant (Kiapp) of 35.3 µM and 30.9 µM against New Delhi Metallo-β-lactamase (NDM-1) and Verona Integron-encoded Metallo-β-lactamase (VIM-2), respectively. BP2 did not interact with glyoxylase II enzyme up to 500 µM, indicating specific (MBL) binding. In a murine infection model, BP2 co-administered with meropenem was efficacious, observed by the >3 log10 reduction in K. pneumoniae NDM cfu/thigh. Given the promising pre-clinical results, BP2 is a suitable candidate for further research and development as an (MBLI)