The curriculum tracker: A tool to improve curriculum coverage or just a tick-box exercise?

Research on teacher professional development generally states that teachers do not take new innovations on board easily. The study reported on here focused on the uptake of a curriculum tracker tool designed to improve curriculum coverage by mathematics teachers. The tool formed part of the Jika iMfundo (JiM) programme launched by the KwaZulu-Natal Department of Education and a partner organisation. The purpose of this study was to explore the extent to which secondary mathematics teachers and heads of department (HoDs) used the tools for their intended purposes. The study was carried out with teachers and department heads from 14 schools located in 2 districts of KwaZulu-Natal. Data were generated by 21 interviews, supplemented by secondary data sourced from responses to previous surveys conducted by JiM. The findings show that most teachers considered the tool as a tick-box activity, instead of using it to guide their planning in a meaningful manner. Furthermore, there was misalignment between planning undertaken by the provincial education department and JiM. It is crucial that teachers on the ground are consulted first in order to jointly identify how certain problems can be addressed before any professional development activity is implemented

Young Men’s Experiences of Being Fathered and Absent Father’s Experience: A Case Study from Urban Informal Settlements in South Africa

This is the final version. Available on open access from Springer via the DOI in this recordThe impact of absent fathers can be a significant challenge for young people, but particularly for young men. Our study drew on 19 in-depth interviews with young men living in urban informal settlements in South Africa, to understand how they understood the impact of biological father absence. Young men described an idealized fatherhood role in which biological fathers provided economic support, active fathering (including emotional support), and social recognition of children. Young men described biological father absence in very emotional terms, including the exclusion from family networks, and having negative economic and educational impacts. Furthermore, men saw biological father absence as impacting on their current situation, and as part and parcel of their wider social marginalization in South Africa. Social fathers — alternative male role models as they grew up — while described as existing, were not felt to be adequate in replacing biological fathers, despite the economic support and guidance some described receiving. Engaging with young men around the repercussions of biological father absence is important for supporting young, poor men in South Africa.South African Medical Research CouncilUKR

Impact of South Africa’s April 2022 floods on women and men’s lives and gender relations in low-income communities: A qualitative study

This is the final version. Available on open access from Elsevier via the DOI in this recordIn 2022, South Africa faced devastating flooding which resulted in the loss of at least 425 lives and widescale destruction of property. Using qualitative methods, we describe the gendered impact of the floods on homes and lives of women and men from very low-income housing areas. We conducted 16 in-depth interviews with women, and eight single-sex narrative group discussions and with 35 women and 15 men from flood-affected areas. The women were research participants in a project that commenced prior to the floods, and the men were recruited for this study. The floods were described by many as ‘heart-breaking’, as neighbouring homes collapsed, children were swept away, and people known to them lost their lives. However, other participants asserted that the floods ‘didn’t affect them much’, before describing considerable, impact on their houses, families, possessions, neighbourhoods, jobs, and other aspects of their lives. After the initial struggle to secure their homes, and rescue family and possessions from the floods, participants were faced with extensive interruption to water supply and electricity, which severely exacerbated stress, especially for women. We describe how the impact of the flooding unfolded and largely followed the contours of gender relations, rather than disrupting them. Most women did not describe violence against women (VAW) as escalating after the floods, but for those who did, the pathway followed the impact of the floods on men’s access to the central tenets of successful masculinity, notably the provider/protector role, and lashing out response. Participants also emphasised that their lives continued much as before once the immediate aftermath of floods was past, and in so doing demonstrated significant resilience, which is not described in existing models of disaster impact on VAW.South African Medical Research Counci

Challenges and opportunities in coproduction: reflections on working with young people to develop an intervention to prevent violence in informal settlements in South Africa

This is the final version. Available on open access from BMJ Publishing Group via the DOI in this recordData availability statement: No data are available. Not applicable.Coproduction is widely recognised as essential to the development of effective and sustainable complex health interventions. Through involving potential end users in the design of interventions, coproduction provides a means of challenging power relations and ensuring the intervention being implemented accurately reflects lived experiences. Yet, how do we ensure that coproduction delivers on this promise? What methods or techniques can we use to challenge power relations and ensure interventions are both more effective and sustainable in the longer term? To answer these questions, we openly reflect on the coproduction process used as part of Siyaphambili Youth (‘Youth Moving Forward’), a 3-year project to create an intervention to address the social contextual factors that create syndemics of health risks for young people living in informal settlements in KwaZulu-Natal province in South Africa. We identify four methods or techniques that may help improve the methodological practice of coproduction: (1) building trust through small group work with similar individuals, opportunities for distance from the research topic and mutual exchanges about lived experiences; (2) strengthening research capacity by involving end users in the interpretation of data and explaining research concepts in a way that is meaningful to them; (3) embracing conflicts that arise between researchers’ perspectives and those of people with lived experiences; and (4) challenging research epistemologies through creating spaces for constant reflection by the research team. These methods are not a magic chalice of codeveloping complex health interventions, but rather an invitation for a wider conversation that moves beyond a set of principles to interrogate what works in coproduction practice. In order to move the conversation forward, we suggest that coproduction needs to be seen as its own complex intervention, with research teams as potential beneficiaries.Medical Research Council (MRC

Conducting sexualities research: an outline of emergent issues and case studies from ten Wellcome-funded projects [version 1; peer review: awaiting peer review]

This letter seeks to synthesise methodological challenges encountered in a cohort of Wellcome Trust-funded research projects focusing on sexualities and health. The ten Wellcome Trust projects span a diversity of gender and sexual orientations and identities, settings; institutional and non-institutional contexts, lifecourse stages, and explore a range of health-related interventions.  As researchers, we originate from a breadth of disciplinary traditions, use a variety of research methods and data sources. Despite this breadth, four common themes are found across the projects: (i) inclusivity, representations and representativeness, (ii) lumping together of diverse groups, (iii) institutions and closed settings (iv) ethical and governance barriers

Conducting sexualities research: An outline of emergent issues and case studies from ten wellcome-funded projects [version 1; peer review: 3 approved]

© 2019 Kneale D et al. This letter seeks to synthesise methodological challenges encountered in a cohort of Wellcome Trust-funded research projects focusing on sexualities and health. The ten Wellcome Trust projects span a diversity of gender and sexual orientations and identities, settings; institutional and non-institutional contexts, lifecourse stages, and explore a range of health-related interventions. As researchers, we originate from a breadth of disciplinary traditions, use a variety of research methods and data sources. Despite this breadth, four common themes are found across the projects: (i) inclusivity representations and representativeness, (ii) lumping together of diverse groups, (iii) institutions and closed settings (iv) ethical and governance barriers

Health-related quality of life among people living with HIV in the era of universal test and treat: Results from a cross-sectional study in KwaZulu-Natal, South Africa

Background: The World Health Organization’s (WHO) key population-based strategy for ending the human immunodeficiency virus (HIV) epidemic is universal HIV test and treat (UTT) along with pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Despite the successful scale-up of the UTT strategy in sub-Saharan Africa, the quality of life (QoL) of people living with HIV (PLHIV) remains sub-optimal. Poor quality of life in PLHIV may threaten the UNAIDS 95-95-95 programme targets. Monitoring QoL of PLHIV has become a key focus of HIV research among other outcomes so as to understand health-related quality of life (HRQoL) profiles and identify interventions to improve programme performance. This study aimed to describe HRQoL profiles and identify their predictors in PLHIV in KwaZulu Natal, South Africa. Methods: We conducted a secondary data analysis of a cross-sectional survey conducted between May and June 2022 among PLHIV (n=105) accessing HIV services at an outpatient clinic in KwaZulu-Natal, South Africa. Socio-demographic, HRQoL (EQ-5D-5L index scores), clinical data, depressive symptoms (CES-D-10) and viral load data were collected from all participants. We examined predictors of HRQoL using generalised linear models controlling for age and sex. Results: The mean age of the participants was 45 years (SD= 13). The proportion of participants with disabilities and comorbidities was 3% and 18%, respectively. Depressive symptoms were present in 49% of the participants. Participant’s mean EQ-5D-5L index score was 0.87 (SD= 0.21) and ranged from 0.11 to 1.0. The mean general health state (EQ-VAS) was 74.7 (SD= 18.8) and ranged from 6 to 100. Factors that reduced HRQoL were disability (β=-0.607, p<0.001), comorbidities (β = - 0.23, p<0.05), presence of depressive symptoms (β = -0.10, p<0.05) and old age (β = -0.04, p<0.05). Factors that increased HRQoL were a good perceived health state (β = 0.147, p<0.001) and availability of social support (β = 0.098, p<0.05). Conclusion: A combination of old age (60 years and above), any disability and comorbidities had a considerable effect on HRQoL among PLHIV. Our findings support the recommendation for an additional fourth UNAIDS target that should focus on ensuring that 95% of PLHIV have the highest possible HRQoL. Psycho-social support interventions are recommended to improve the HRQoL of PLHIV

Adaptation and pre-test of a shortened Stepping Stones and Creating Futures intervention focused on HIV for young men in rural South Africa

This is the final version. Available on open access from Public Library of Science via the DOI in this recordData Availability: All data are available via the AHRI data repository: https://data.ahri.org/index.php/home with access based on their guidelines.Men’s engagement in HIV prevention and treatment is suboptimal, including in South Africa. We sought to address this through adapting an evidence-based intervention, Stepping Stones and Creating Futures (SSCF), to strengthen its HIV content and provide a more scalable (shorter) intervention in rural South Africa. We then conducted a mixed methods pre-test of the intervention among young men aged 18–35 years. To adapt SSCF, we reviewed the current evidence base and worked with male Peer Navigators to update the SSCF theory of change (ToC) and manual. The revised intervention was ~45 hours (9 sessions) as opposed to ~63 hours and included a greater focus on HIV prevention and treatment technologies. Overall, 64% (n = 60) of men approached agreed to participate in the intervention, uptake (attending one session) among those who agreed was n = 35(58%) and retention (attending 6 or more sessions) was n = 25(71%). Qualitative data emphasized the intervention was acceptable, with young men describing it as something they liked. The qualitative data also broadly supported the intervention ToC, including the normalization of HIV in men’s lives, and the importance of health for men in achieving their life goals. However, it also highlighted the need to focus more on HIV-related stigma and fear, and the importance of HIV self-testing kits in encouraging testing. We revised the ToC and manual in light of this data. The adapted SSCF is acceptable and supports the ToC. Next steps is an evaluation to look at effectiveness of the intervention.Medical Research Council (MRC)Wellcome TrustNational Institutes of Health (NIH)South African Medical Research Counci

Examining oral pre-exposure prophylaxis (PrEP) literacy among participants in an HIV vaccine trial preparedness cohort study

Background: PrEP literacy is influenced by many factors including the types of information available and how it is interpreted. The level of PrEP literacy may influence acceptability and uptake. Methods: We conducted 25 in-depth interviews in a HIV vaccine trial preparedness cohort study. We explored what participants knew about PrEP, sources of PrEP knowledge and how much they know about PrEP. We used the framework approach to generate themes for analysis guided by the Social Ecological Model and examined levels of PrEP literacy using the individual and interpersonal constructs of the SEM. Results: We found that PrEP awareness is strongly influenced by external factors such as social media and how much participants know about HIV treatment and prevention in the local community. However, while participants highlighted the importance of the internet/social media as a source of information about PrEP they talked of low PrEP literacy in their communities. Participants indicated that their own knowledge came as a result of joining the HIV vaccine trial preparedness study. However, some expressed doubts about the effectiveness of the drug and worried about side effects. Participants commented that at the community level PrEP was associated with being sexually active, because it was used to prevent the sexual transmission of HIV. As a result, some participants commented that one could feel judged by the health workers for asking for PrEP at health facilities in the community. Conclusion: The information collected in this study provided an understanding of the different layers of influence around individuals that are important to address to improve PrEP acceptability and uptake. Our findings can inform strategies to address the barriers to PrEP uptake, particularly at structural and community levels. Trial registration: https://clinicaltrials.gov/ct2/show/NCT04066881