Southern African Journal of Gerontology, volume 2, number 1, April 1993

The second number of SAJG again presents knowledge on ageing and the aged which can be useful in the development of better practices and the formulation of better policies in southern African countries. A focus of the articles in this number is on housing and living arrangements. Nyanguru and Peil writing on Zimbabwe give a finely detailed description of the housing situation of the elderly population using survey material. They draw on comparisons with other developing contexts to place the Zimbabwean housing situation in perspective. At the outset, the authors note that the impact of disability on the elderly is directly related to the nature and quality of housing. In conclusion to their overview of urban and rural housing circumstances. they recommend a more appropriate housing policy for the elderly which makes provision for home maintenance and home-help services to assist the elderly to stay in their homes. Moller re-analyses data collected for South Africa's baseline study of the elderly to explore the possible benefits for South Africa's elderly when they live with adult children. Her comparative case studies are based on the assumption that black elders might prefer to live with sons as traditional custom dictates and whites would usually choose to live independently according to Western custom. Chen systematically explores the question of which children co-reside with elderly parents in Taiwan using a large national database and sophisticated multivariate analyses. He also raises the question whether filial piety is on the decline when children no longer co-reside with their parents. The last article in this issue picks up a subject relating to quality of life-a topic introduced in an article in the first issue of SAJG. Authors Gillespie and Louw wish to re-open the debate on activity and quality of life. They pose the provocative question: Does a decline in activity in the elderly really dampen morale? Preliminary results from the pilot study undertaken by the authors reported in the article yielded inconclusive results. However the pilot study involved only a small sample and is presented to make the point and whet our appetite for further research and debate. In support of Gillespie and Louw's call to re-open the debate on the activity question we contribute further South African evidence which allows for various interpretation

Southern African Journal of Gerontology

Professor Monica Ferreira, Retired Director of the Institute of Ageing in Africa, Faculty of Health Sciences, University of Cape Town, was the founding editor of the journal (SAJG) and Emeritus Professor Valerie Møller was the associate editor for all nine volumes. The journal was SAPSE accredited. Publication of the journal ceased in 2000. With this letter permission is granted for making SAJG available online on the Rhodes Digital Commons

TB treatment initiation and adherence in a South African community influenced more by perceptions than by knowledge of tuberculosis

Background. Tuberculosis (TB) is a global health concern. Inadequate case finding and case holding has been cited as major barrier to the control of TB. The TB literature is written almost entirely from a biomedical perspective, while recent studies show that it is imperative to understand lay perception to determine why people seek treatment and may stop taking treatment. The Eastern Cape is known as a province with high TB incidence, prevalence and with one of the worst cure rates of South Africa. Its inhabitants can be considered lay experts when it comes to TB. Therefore, we investigated knowledge, perceptions of (access to) TB treatment and adherence to treatment among an Eastern Cape population. Methods. An area-stratified sampling design was applied. A total of 1020 households were selected randomly in proportion to the total number of households in each neighbourhood. Results. TB knowledge can be considered fairly good among this community. Respondents' perceptions suggest that stigma may influence TB patients' decision in health seeking behavior and adherence to TB treatment. A full 95% of those interviewed believe people with TB tend to hide their TB status out of fear of what others may say. Regression analyses revealed that in this population young and old, men and women and the lower and higher educated share the same attitudes and perceptions. Our findings are therefore likely to reflect the actual situation of TB patients in this population. Conclusions. The lay experts' perceptions suggests that stigma appears to effect case holding and case finding. Future interventions should be directed at improving attitudes and perceptions to potentially reduce stigma. This requires a patient-centered approach to empower TB patients and active involvement in the development and implementation of stigma reduction programs

Socio-economic status and self-reported tuberculosis: A multilevel analysis in a low-income township in the eastern cape, South Africa

Few studies have investigated the interplay of multiple factors affecting the prevalence of tuberculosis in developing countries. The compositional and contextual factors that affect health and disease patterns must be fully understood to successfully control tuberculosis. Experience with tuberculosis in South Africa was examined at the household level (overcrowding, a leaky roof, social capital, unemployment, income) and at the neighbourhood level (Gini coefficient of inequality, unemployment rate, headcount poverty rate). A hierarchical random-effects model was used to assess household-level and neighbourhoodlevel effects on self-reported tuberculosis experience. Every tenth household in each of the 20 Rhini neighbourhoods was selected for inclusion in the sample. Eligible respondents were at least 18 years of age and had been residents of Rhini for at least six months of the previous year. A Kish grid was used to select one respondent from each targeted household, to ensure that all eligible persons in the household stood an equal chance of being included in the survey. We included 1,020 households within 20 neighbourhoods of Rhini, a suburb of Grahamstown in the Eastern Cape, South Africa. About one-third of respondents (n=329; 32%) reported that there had been a tuberculosis case within the household. Analyses revealed that overcrowding (P≤0.05) and roof leakage (P≤0.05) contributed significantly to the probability of a household tuberculosis experience experience, whereas higher social capital (P≤0.01) significantly reduced this probability. Overcrowding, roof leakage and the social environment affected tuberculosis prevalence in this economically disadvantaged community. Policy makers should consider the possible benefits of programs that deal with housing and social environments when addressing the spread of tuberculosis in economically poor districts

Systems analysis approach to the design of efficient water pricing policies under the EU Water Framework Directive

Economic theory suggests that water pricing can contribute to efficient management of water scarcity. The European Union (EU) Water Framework Directive (WFD) is a major legislative effort to introduce the use of economic instruments to encourage efficient water use and achieve environmental management objectives. However, the design and implementation of economic instruments for water management, including water pricing, has emerged as a challenging aspect of WFD implementation. This study demonstrates the use of a systems analysis approach to designing and comparing two economic approaches to efficient management of groundwater and surface water given EU WFD ecological flow requirements. Under the first approach, all wholesale water users in a river basin face the same volumetric price for water. This water price does not vary in space or in time, and surface water and groundwater are priced at the same rate. Under the second approach, surface water is priced using a volumetric price, while groundwater use is controlled through adjustments to the price of energy, which is assumed to control the cost of groundwater pumping. For both pricing policies, optimization is used to identify optimal prices, with the objective of maximizing welfare while reducing human water use in order to meet constraints associated with EU WFD ecological and groundwater sustainability objectives. The systems analysis approach demonstrates the successful integration of economic, hydrologic, and environmental components into an integrated framework for the design and testing of water pricing policies. In comparison to the first pricing policy, the second pricing policy, in which the energy price is used as a surrogate for a groundwater price, shifts a portion of costs imposed by higher water prices from low-value crops to high-value crops and from small urban/domestic locations to larger locations. Because growers of low-value crops will suffer the most from water price increases, the use of energy costs to control groundwater use offers the advantage of reducing this burden.The authors would like to thank the Danish Research School of Water Resources (FIVA) for financial support. Three anonymous reviewers made helpful suggestions that were incorporated into the revised version.Riegels, N.; Pulido-Velazquez, M.; Doulgeris, C.; Sturm, V.; Jensen, R.; Moller, F.; Bauer-Gottwein, P. (2013). Systems analysis approach to the design of efficient water pricing policies under the EU Water Framework Directive. Journal of Water Resources Planning and Management. 139(5):574-582. doi:10.1061/(ASCE)WR.1943-5452.0000284S574582139

How does subjective well-being evolve with age? A literature review

This literature review provides an overview of the theoretical and empirical research in several disciplines on the relation between ageing and subjective well-being, i.e., how subjective well-being evolves across the lifespan. Because of the different methodologies, data sets and samples used, comparison among disciplines and studies is difficult. However, extant studies do show either a U-shaped, inverted U-shaped or linear relation between ageing and subjective well-being