A Few Good Men in a World of Gangsters: Discourses of Respectability and Risk amongst Student Teachers in the Western Cape, South Africa

This paper considers the concurrent discourses of risk and respectability which are prominent in South  Africa’s Western Cape region and asks how one becomes a ‘respectable’ man in a community which values strong masculine role models and in which there are endemic levels of violence. Through a process of risk ‘mapping’ we explore the means through which a group of young male student teachers consciously ‘locate’ risk in their built environment. We look at the strategies these young men use to negotiate risk in their lives, and the close connection between risk and respectability which they articulate on an ongoing basis.Keywords: discourse; male, risk, respectability, violence, masculinity

The Disaster Management Act 57 of 2002: part panacea or ready recipe for disaster?

Floods, earthquakes, landslides, volcanic eruptions, explosions, runaway fires, and transportation and other accidents are all occurrences with which we are familiar, if only vicariously. These events can presumably all be categorised as ‘disasters’. But can the same be said for the dumping of hazardous waste, ships running aground, farm invasions and large-scale evictions, major traffic accidents and the issue of cross-border or internal refugees? When is an event considered a ‘disaster’, who determines that an event is a ‘disaster’, who can do what to prepare for the ‘disaster‘ and what can be done to alleviate the effects of the disaster after it has happened

Knowledge and awareness of human papillomavirus and intention with regard to human papillomavirus vaccine uptake by female tertiary students in the Eastern Cape province

In 2008, two human papillomavirus (HPV) vaccines, Cervarix and Gardasil, were licensed for use in South Africa. Initial models showed that vaccination could lead to an approximate 70% decline in cervical cancer cases. This paper describes the knowledge, awareness and health beliefs about HPV and the HPV vaccine, and the intentions of female tertiary students with respect of being vaccinated with the latter. An observational, descriptive and analytical cross-sectional survey was conducted among 150 female tertiary students at a university in the Eastern Cape province in this regard. Knowledge and awareness of HPV and the HPV vaccine were poor. Only 22.7% of the students were aware of HPV and that an HPV vaccine was available in South Africa. However, most respondents (80%) reported a willingness to be vaccinated. Being aware of the existence of a Papanicolaou smear, higher knowledge of HPV, higher perceived vaccine effectiveness and higher perceived severity of HPV infection were significantly associated with increased willingness to be vaccinated. There is a need for education on HPV and its vaccination in South Africa. An effective vaccine marketing strategy should emphasise the effectiveness of the vaccine, the susceptibility of women to contracting HPV and the severity of being infected with the human immunodeficiency virus

Knowledge and practice of breast self-examination among rural women in South-West Nigeria: Implications for development of women empowerment programme

Cancer is a major public health concern globally. In Nigeria, over 10 000 cancer deaths and 250 000 new cases of cancer are recorded yearly. It was reported that the number of women at risk of breast cancer increased progressively from 24.5 million in 1990 to about 40 million in 2010. Due to the progressive nature of breast cancer, early detection can improve survival chances of women and reduce death. Breast self-examination (BSE) is a relatively simple and low-cost intervention for women to detect breast cancer before the disease has progressed too far. This paper reports on knowledge and practices of BSE among rural women, living in Iddo Local Government Area (LGA) in south-west Nigeria. A cross-sectional survey was conducted among 345 women, aged 20–60 years, from five selected villages in Iddo LGA, who volunteered to participate in an empowerment programme to promote breast cancer prevention. Data were collected using an interviewer-administered questionnaire and analysed using descriptive and basic inferential statistics. The majority of participating women had low levels of knowledge about BSE (75.1%) and did not practise BSE (76.5%). It was also found that marital status, occupation and income levels were significantly associated with knowledge and practice of BSE. The main reasons offered for not practising BSE were lack of knowledge on the timing of when to do it (85.5%) and not knowing how to do it (87.8%). There is a need to design an intervention programme to educate women on the importance of early diagnosis of breast cancer and to empower them with knowledge on how to practice BSE.DHE

Multimorbidity patterns in South Africa: A latent class analysis

Introduction: South Africa has the largest burden of HIV worldwide and has a growing burden of non-communicable diseases; the combination of which may lead to diseases clustering in ways that are not seen in other regions. This study sought to identify common disease classes and sociodemographic and lifestyle factors associated with each disease class. Methods: Data were analyzed fromthe South AfricanDemographic andHealth Survey 2016. A latent class analysis (LCA) was conducted using nine disease conditions. Sociodemographic and behavioral factors associated with each disease cluster were explored. All analysis was conducted in Stata 15 and the LCA Stata plugin was used to conduct the latent class and regression analysis. Results: Multimorbid participants were included (n = 2 368). Four disease classes were identified: (1) HIV, Hypertension and Anemia (comprising 39.4% of the multimorbid population), (2) Anemia and Hypertension (23.7%), (3) Cardiovascular-related (19.9%) and (4) Diabetes and Hypertension (17.0%). Age, sex, and lifestyle risk factors were associated with class membership. In terms of age, with older adults were less likely to belong to the first class (HIV, Hypertension and Anemia). Males were more likely to belong to Class 2 (Anemia and Hypertension) and Class 4 (Diabetes and Hypertension). In terms of alcohol consumption, those that consumed alcohol were less likely to belong to Class 4 (Diabetes and Hypertension). Current smokers were more likely to belong to Class 3 (Cardiovascular-related). People with a higher body mass index tended to belong to Class 3 (Cardiovascular-related) or the Class 4 (Diabetes and Hypertension). Conclusion: This study a rmed that integrated care is urgently needed, evidenced by the largest disease class being an overlap of chronic infectious diseases and non-communicable diseases. This study also highlighted the need for hypertension to be addressed. Tackling the risk factors associated with hypertension could avert an epidemic of multimorbidity

Factors influencing the choice of child delivery location among women attending antenatal care services and immunization clinic in Southeastern Nigeria

BACKGROUND AND OBJECTIVE: In Nigeria, most deliveries take place at home or with traditional birth attendants (TBAs). This study examined the factors that influenced or determined utilization of healthcare facility delivery services among women who attended antenatal care (ANC) services. METHODS: A cross-sectional survey was conducted with 220 women who registered for ANC at a hospital and delivered within 18 months. Associations between independent variables and choice of healthcare facility delivery were analyzed. Multiple logistic regression was also used to identify the predictors of choice of delivery among women. RESULTS: Of the 220 women who registered for ANC, 75% delivered at a healthcare facility while 15% delivered with a TBA or at home. In the final model, number of children, having planned to deliver at a hospital, labor occurring at night, and labor allowing time for transportation were significant predictors of child delivery location among the women. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: Utilization of the health facilities for childbirth may increase if pregnant women are encouraged to book early for ANC and if during ANC, pregnant women were counseled to detect labor signs early. In addition to focused and intensified counseling for women with more children, support should be provided that includes financial provisions for transportation to the healthcare facility

Conceptualising the factors affecting retention in care of patients on antiretroviral treatment in Kabwe District, Zambia, using the ecological framework

BACKGROUND. HIV remains a major public health challenge in Zambia.The roll-out of antiretroviral treatment (ART) has engendered new challenges in retention in care. OBJECTIVE. To conceptualise the factors affecting retention in care of ART patients at three primary healthcare facilities using the ecological framework. METHOD. Qualitative data were collected through in-depth interviews with 45 ART patients and three focus group discussions with 20 healthcare providers from three primary healthcare facilities in Kabwe district, Zambia, and subjected to thematic content analysis. RESULTS. Individual level barriers to retention in care included side effects, gaining weight, belief in faith healing, and use of herbal remedies and alcohol. Interpersonal barriers such as stigma and nondisclosure of HIV status were reported. At the institutional level, inadequate space in the clinic, long waiting times, long travel distances, and shortage of third-line drugs presented barriers to retention in care. Food shortages and patient mobility were reported as community barriers to retention in care. CONCLUSION.The ecological framework conceptualises the complex and dynamic factors affecting retention inART care and highlights the need formultifaceted interventions that combine health education, disease management, and opportunities for income generation in a socially responsive and accountable environment.Scopu

Aging with HIV: Increased risk of HIV comorbidities in older adults

With improved access to antiretroviral treatment (ART), adults with HIV live longer to reach older age. The number of older adults living with HIV is increasing steadily, giving rise to a new population of interest in HIV research and for invigorated considerations in health service delivery and policy. We analysed the profile of comorbidities in older people (50 years and older) living with HIV in South Africa. We conducted a secondary analysis of all individuals over 15 years who tested HIV positive in the Fifth South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2017. We conducted multivariate logistic regression to determine the factors associated with having HIV comorbidity using Stata 15.0 software. We entered 3755 people living with HIV into the analysis, of whom 18.3% (n = 688) were 50 years or older

A systematic method for comparing multimorbidity in national surveys

Due to gaps in the literature, we developed a systematic method to assess multimorbidity using national surveys. The objectives of this study were thus to identify methods used to defne and measure multimorbidity, to create a pre-defned list of disease conditions, to identify potential national surveys to include, to select disease condi‑ tions for each survey, and to analyse and compare the survey fndings. We used the count method to defne multimorbidity. We created a pre-defned list of disease conditions by examining international literature and using local data on the burden of disease. We assessed national surveys, report‑ ing on more than one disease condition in people 15 years and older, for inclusion. For each survey, the prevalence of multimorbidity was calculated, the disease patterns among the multimorbid population were assessed using a latent class analysis and logistic regression was used to identify sociodemographic and behavioural factors associated with multimorbidity

Rethinking mental health wellness among adolescents living with HIV in the African context: An integrative review of mental wellness components

Adolescents living with HIV (ALHIV) are considered to be at heightened risk for developing mental health problems in comparison to their peers due to the burden of living with a stigmatized condition and managing a chronic condition. Poorer mental health outcomes among ALHIV are associated with lower rates of adherence to anti-retroviral therapy (ART). It is necessary to improve mental wellness among ALHIV as this acts as a buer against developing mental health problems which, if left untreated can evolve into mental health disorders. Research on mental wellness concepts among ALHIV is underdeveloped which is associated with a lack of appropriate measures of mental wellness. We conducted an integrative review to conceptualize mental wellness and consider the critical components for measuring mental wellness in ALHIV