249 research outputs found
Antiretroviral Therapy in Primary Health Care: Experience of the Khayelitsha Programme in South Africa
The limits of capitalists reform in South Africa
Until a few years ago, it was widely held that, ‘apartheid cannot be reformed, it can only be destroyed’. Today, all participants in the negotiation process are agreed that one fundamental characteristic of the social order must be preserved: the new South Africa is to be a capitalist society; the productive wealth of the country will be the private property of a small number of capitalists, and the vast majority will try to sell their labour for a wage to capitalists who will buy it only when that labour can contribute to their profits. There is still disagreement about how small or large the number of capitalists will be; about the colour of their skins; about who they will appoint to manage their mines, banks, factories and farms for them; about the rules that will govern disputes over wages; and above all about the use that the state will make of the taxes paid from their profits. There is also disagreement about the extent to which capitalism can afford to meet popular needs. But all of these disagreements take place within the framework of a common belief that the future is capitalist. The aim of this seminar series, held by the Marxist Theory Seminar at the University of the Western Cape in April/May 1993, was to pose the question: What are the limits of social reform in a capitalist South Africa? Can the fundamental needs and aspirations of the vast majority of South Africans be met within a capitalist framework? Very often these questions are brushed aside with the argument that, given the present balance of local and international forces, there is no alternative to capitalism in SA today. Even if this argument is correct, it still remains necessary to ask what can be achieved within the framework of the capitalist society to which there is no alternative. If that question is not posed in the most rigorous way, all kinds of illusions will be created about what the future holds in store for us. The question of the limits of capitalist reform in SA is posed as it concerns five different areas; democracy, education, economic growth and employment, land and the oppression of women. What will democracy mean in a new SA which depends on foreign investment and capitalist profitability? Can the education crisis be resolved while meeting the needs of capitalist growth? Will economic growth take place in a capitalist SA, and will this lead to the creation of jobs and a higher standard of living for the majority? Can land be restored to the dispossessed, the virtual slavery of millions of farm workers ended, and land used in a way that produces food for all? What are the prospects of ending the oppression of women in a capitalist South Africa? MTS does not believe that there are simple answers to these questions. Certainly, these questions cannot be answered by a general condemnation of the inequality and inhumanity of capitalism. In each case, it is necessary to give clear answers to such questions as: Has capitalism served historically to support the struggle for democracy or to oppose it? How has it affected education in SA? What are the present interests of the capitalists in solving the land question, or giving women control of their lives? To what extent can capitalism be forced to make concessions - to provide jobs, for example - by the struggles of the oppressed? In the past, capitalism has shown itself to be much more flexible than its critics have supposed. That does not mean that capitalism can do anything it likes, nor that the working class can force it to meet whatever demands it has. One of the indispensable insights of Marxism is that processes of social change are not determined by the intentions or integrity of political leaders, but rather by the fundamental relationships of society and the ability of the major classes to pursue their interests created by these relationships. We hope that the publication of this seminar series contributes to making this insight available to a wider audience.Marxist theory semina
AZASO: tribute to women
As women in South Africa, it is important for us to understand the nature of our oppression, for it is only after understanding it, can we identify the target of our attack and plan the appropriate strategy and tactics for our struggle. Black women in South Africa suffer three types of oppression. 1. Political oppression, which is common to all blacks in South Africa, ie. the denial of rights to vote for or choose the type of government we want, and the denial of rights as a people in South Africa. 2. Economic oppression as black workers in South Africa. Black women workers are even more exploited than men workers. They are paid lower wages for the same job, are treated as temporary staff and can be fired at anytime especially if they fall pregnant. 3. Social oppression which stems from the idea that women are born inferior to men and therefore have to play an inferior role in society. The socialization process starts at birth and women and men are geared towards certain roles in society. Men most often towards leadership positions and professional jobs and women towards household duties and secretarial jobs. This socialization process continues throughout ones life such that most people accept it as a natural phenomenon and a way of life. Having understood the forms of oppression, we can see that the struggle is not between men and women, where men are seen as the source of our oppression. Nor is it a struggle for mechanical equality between men and women ie. being paid the same wages as men, and having equal status as men in society, because this will mean equality within the present status quo. Our struggle is a struggle between womenand the existing social order. It is a struggle of the oppressed against oppression. Our main weapons in the struggle for liberation are UNITY and ORGANISATION. Unity is realised through common effort, links are forged through collective work and study, through criticism and self-critcism and through action against opression. Organization can be achieved through women's groups and organization. A women's group's first demand should be the clarification of our ideas, to get rid of miscosepts and erroneous ideas concerning the role and liberation of women. A women's group usually tackles the question of social oppresion, but more important, it must be seen as a stepping stone towards involvement in the broader struggle can we destroy the foundations of exploitative society and rebuild society on new foundations. Foundations built on the demands of the FREEDOM CHARTER. “The fundamental struggle is for national liberation of the oppressed people of South Africa, and any women's organization that stands outside this struggle must stand apart from the mass of women. What was realised by the Federation of South African Women was that it would be impossible for women to achieve their rights as women in a society in which so many fundamental rights are denied to both men and women by virtue of their colour and their class. Therefore just as there can be no revolution without the liberation of women, the struggle for women's emancipation cannot succeed without the victory of the revolution"
The Rural poor, the private sector and markets: changing interactions in southern Africa
One of the central tenets of much current development thinking in southern Africa is that market-oriented strategies and private sector involvement must be the basis for future economic growth. This has underpinned structural adjustment and economic policy reform policies in the region over the last decade or more. It also underlies the argument for encouraging external foreign direct investment (FDI) as a motor for growth. However growing evidence suggests that such a strategy has not paid off. Economic growth rates have been disappointing, private, and particularly foreign, investment has been limited, and employment in the formal sector has fallen dramatically.1 Structural adjustment and market liberalisation have clearly not delivered the developmental benefits claimed of them, and people's livelihood opportunities have, ft seems, declined over the same period and their levels of vulnerability have increased. The increasing recognition that the standard neo-liberal prescriptions were not having the expected benefits, especially for poor people, has resulted in some rethinking about how best to redirect the benefits of globalisation and economic reform towards the poor, and how to offset some of the losses. Thus ‘pro-poor growth strategies’, ‘making markets work for the poor’ and ‘growth for redistribution' have become well-worn slogans. However, the practical and policy measures required, whereby the benefits of an engagement with a globalised economy, investment by the private sector and liberalisation privatisation measures can result in poverty reduction, remain vague.A number of issues arise. For the sceptics, questions are raised about the degree to which the turn to a 'pro-poor' markets approach is simply rhetorical gloss, added to the discredited neo-liberal paradigm, or actually a genuinely new policy perspective in its own right. It is important to differentiate between broad economic policy reform objectives (which, with some nuances, remain largely in the standard neo-liberal form) and sectoral policies which contain explicitly pro-poor elements. While retaining the argument that market liberalisation and external investment are key, such policies may include some strategic elements of state- directed intervention which boost the access of the poor to new markets and investment opportunities. It is this stance, where the state intervenes to improve access and for particular groups of people, redressing to some extent the imbalances caused by the lack of level playing fields of existing markets, which potentially sets a pro-poor perspective apart
"Not Just a Journal Club - It's Where the Magic Happens": Knowledge Mobilization through Co-Production for Health System Development in the Western Cape Province, South Africa.
BACKGROUND: The field of Health Policy and Systems Research (HPSR) views researchers as active participants in processes of knowledge mobilization, learning and action. Yet few studies examine how such processes are institutionalized or consider their health system or wider impacts. This paper aims to contribute insights by presenting a South African experience: the Western Cape (WC) HPSR Journal Club (JC). METHODS: The paper draws on collective reflection by its authorial team, who are managerial and academic JC participants; reflective discussions with a wider range of people; and external evaluation reports. The analysis has been validated through rounds of collective engagement among authors, and through comparison with the wider sets of data, documentation and international literature. It considers impacts using a framework drawn from the co-production literature. RESULTS: Since 2012, the JC has brought together provincial and local government health system managers and academics to discuss complex systems' and social science perspectives on health system development. The JC impacts encompass the trusting relationships (group micro-level) that have not only strengthened personal confidence and leadership skills (individual micro level), but also led to organizational impacts (meso level), such as practice and policy changes (practitioner organizations) and strengthened research and post-graduate teaching programs (academic organizations). Macro-societal impacts are, finally, judged likely to have resulted from new health system practices and policies and from academic post-graduate training activities. This set of impacts has been enabled by: the context of the JC; aspects of the JC design that underpin trusting relationships and mutual learning; the sustained participation of senior health system managers and academic managers who are able to translate new ideas into practice in their own organizational environments; and our individual and collective motivations - including the shared goal of health system development for social justice. Our challenges include risks and costs to ourselves, and the potential exclusion of challenging voices. CONCLUSION: The principles and practice of the JC approach, rather than the JC as a model, offer ideas for others wishing to mobilize knowledge for health system development through embedded and co-production processes. It demonstrates the potential for productive human interactions to seed long-lasting systemic change
A retrospective evaluation of the impact of a dedicated obstetric and neonatal transport service on transport times within an urban setting
OBJECTIVE:To determine whether the establishment of a dedicated obstetric and neonatal flying squad resulted in improved performance within the setting of a major metropolitan area.DESIGN AND SETTING:The Cape Town metropolitan service of the Emergency Medical Services was selected for a retrospective review of the transit times for the newly implemented Flying Squad programme. Data were imported from the Computer Aided Dispatch programme. Dispatch, Response, Mean Transit and Total Pre-hospital times relating to the obstetric and neonatal incidents was analysed for 2005 and 2008. RESULTS: There was a significant improvement between 2005 and 2008 in all incidents evaluated. Flying Squad dispatch performance improved from 11.7% to 46.6% of all incidents dispatched within 4 min (p < 0.0001). Response time performance at the 15-min threshold did not demonstrate a statistically significant improvement (p = 0.4), although the improvement in the 30-min performance category was statistically significant in both maternity and neonatal incidents. Maternity incidents displayed the greatest improvement with the 30-min performance increasing from 30.3% to 72.9%. The analysis of the mean transit times demonstrated that neonatal transfers displayed the longest status time in all but one of the categories. Even so, the introduction of the Flying Squad programme resulted in a reduction in a total pre-hospital time from 177 to 128 min. CONCLUSION: The introduction of the Flying Squad programme has resulted in significant improvement in the transit times of both neonatal and obstetric patients. In spite of the severe resource constraints facing developing nations, the model employed offers significant gains
Preparing for national elections: workbook: a civic education programme
Today Namibia is at the crossroads of its independence. The agony of death and destruction that the Namibians have endured for the past 105 years of colonial oppression is about to come to an end and freedom is in sight. The process of transition to independence has already started. On 1 November 1989, the Namibian people will exercise their long-denied right to self-determination by electing their own leaders who. by virtue of being elected by the masses will have the sovereign right to draft the constitution of independent Namibia. This will bring about a new political and socio-economic order. The task before the Namibian people is to seize this historic opportunity and ensure that they join hands to safeguard the revolutionary gains we have made in bringing our country to the threshold of independence. Seizing this opportunity means, first, to register as a voter, and second, to vote and send to the Constituent Assembly men. and women with a revolutionary will, honourable record, vision for a better future, integrity, experience and proven ability to fight for the interests of the broad masses of the Namibian people. Such men and women are to be found in SWAPO. SWAPO has stood tall in the face of formidable odds over the last twenty-nine years of its struggle to free Namibia. Because of this fact. SWAPO had participated in the formulation of Resolution 435 and fought bravely for the last 11 years for its implementation. The motivating force behind this struggle has always been to guarantee that power is given to the Namibian people to decide the future of our country' through free and fair elections. Now that Resolution 435 is being implemented, the Central Committee of SWAPO has the honour to place before the people of Namibia its concrete programme of action in the form of SWAPO’s policy positions on a broad spectrum of political, economic, social and cultural issues. Together, these policy'positions form SWAPO's Election Manifesto.sponsored by the Centre for Development Studies, University of the Western Cape & the National Democratic Institute for International Affairs, November 6-16, 199
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