Private TVET in Africa: Understanding the Context and Managing Alternative Forms Creatively!

Since the 1990s, there has been a growing sense from both national policymakers and international agencies of the importance of private Technical and Vocational Education and Training and skills provision in all regions.  This pri-VET sector both through traditional apprenticeship forms and more formal sector oriented approaches have become an essential feature of the contemporary landscape. It is, however, a sector that is largely undocumented and its regulation is thus based on a less than nuanced understanding of its contribution to both the education and training system in general and as a complement to public TVET provisioning. The paper will seek to identify key features of the key trends of what is known about private TVET provision in Africa with a view to understanding the complexity of provision forms and its current importance in the region. It is argued that for this ‘unconventional education and training’ form to take its place in national systems, there is a need for more rigorous research of the sector to ensure that it is able to take its rightful place in national systems. It is expected that this will enable a more thorough examination of regulatory mechanisms used by governments

Public and private Further Education and Training in South Africa: a comparative analysis of the quantitative evidence

Publ ic and private provision of vocational education and training (or FurtherEducation and Training in the South African usage) exist in a relationship witheach other but are rarely cons idered togethe r. An analysis is provided of recent quantitative evidence on both sectors in South Africa in order to advance the case for further po licy and res earch work on the inter-connectivities of the two sectors. This particularly emphasises the need for better conceptions of quality and a more serious focus on equity in both sectors

Private technical and vocational education and training (TVET) and national development : The South African reality

This thesis examines the extent to which the private Technical and Vocational Education and Training (TVET) Sector in South Africa is responsive to national development. National development is understood as associated with a range of socio-economic imperatives which include challenges of poverty, unemployment, inequality, the ravages of the HIV/AIDS pandemic and its associated impacts. In addition to these, the educational component of national development is to ensure access, redress and equity, which are necessary to undo the impacts of an apartheid-related skills regime. Skills development is considered a crucial means to respond to these challenges. Without skills for formal and informal labour markets, as well as productive self-employment, South Africa’s capacity to respond to the new globalised era is likely to be considerably stunted and will negatively affect its developmental trajectory. The methodology used in this study included a mix of quantitative and qualitative strategies to obtain the size, shape and nature of provision. The quantitative component, undertaken in the course of 2002, was supplemented by randomly chosen qualitative case studies. Together, they provided the basis for unravelling a sector distinct in nature, form and content. Developing a comprehensive typology provides important insight into responsiveness of a sector characterised by wide-ranging provision forms. The typology of provider type based on profitability and form, i.e. ‘for-profit’, ‘non-profit’ and ‘in-house’ providers, was replaced with a multi-dimensional model. Learner type, as a primary typological category, includes the ‘pre-employed’, ‘unemployed’, the employed ‘self-funded employee’ and the ‘corporate client’. Provider types responding to these learner types are distinguished on the basis of location, delivery patterns and programming. The various provider forms include ‘multi-providers’, ‘specialist providers’, ‘consultants’, ‘in-house’ and ‘non-profit’ providers. Provider purposes include those responding to employment, either formal labour market or self-employment, and self-development, including leisure-related skilling and lifelong learning. Learner types and training purpose determine the manner, form and characteristics of provision. This understanding of a widely divergent and heterogeneous sector provides the context for assessing its contribution to national development in South Africa. The notions of responsiveness and receptiveness are used as conceptual devices to assess the role of the sector. Responsiveness describes specific labour market purpose, while receptiveness refers to the social development and educational imperatives of access, redress and equity. The sheer size of the sector suggests an important demand-led element of provision and represents an important measure of receptiveness to national development prerogatives. The conservative estimate of 706 884 learners, located at 4178 sites for 864 providers that pre-registered with the Department of Education in 2001, provide the basis for serious consideration of the sector. The sector adequately responds to the immediate short-term needs of employers. Programmes offered for corporate providers respond more deliberately to their immediate short-term skill requirements and which has made it possible for them to outsource a considerable proportion of their training. In addition, there is no other education and training form flexible enough to provide for the training needs of employees, and sometimes the customers of corporate concerns, as in product upgrading and support, at times and locations suitable to their requirements. Private providers did not necessarily have more linkages with the formal labour market than do public providers and are not necessarily able to secure more effectively employment opportunities for their pre- and unemployed learners With respect to receptiveness, the sector comprises learner patterns consistent with national demographics. The sector is associated with an older, employed learner type, typically enrolled in shorter-term courses. This demonstrates the sector’s accessibility. In comparison with their public counterparts, costs were not prohibitive and programme structure allowed adequate flexibility to enable learners to weave in and out of the system. Variable admission requirements also allowed learners to slot into appropriate levels. The absence of data makes comparative judgements of throughput, and quality, with public institutions difficult to make. The current need to regulate all providers equally may not be the most efficient way of dealing with the sector. In light of the national development prerogative to protect those most vulnerable from the risk of market failure, there is need to grant support to those providers most responsive to this group - in this instance, those ‘full time’ providers responding to the pre- and unemployed learner set. The market adequately regulates providers responding to the employed and corporate client groups

Knowing and doing vocational education and training reform: evidence, learning and the policy process

Much of VET policy internationally draws on a toolkit that has been seriously questioned for its logic, international relevance and effectiveness by considerable amounts of academic research. Reflecting primarily on our experiences of leading a complex, multi-country policy study, we develop an account that seeks to explore ways in which the apparent incommensurability between academic and policy knowledge can be addressed. This leads on to a broader discussion of key issues of contestation in the debates about knowledge for policy as they relate to international education and development more generally. We consider three key turns in the discourse of international education policy and research: to "governing by numbers", "what works" and policy learning, and ask what happens when these discursive trends travel to Southern and VET contexts. We suggest that this analysis implies that policymakers need both to be more modest and reflexive in their expectations of what knowledge can be mobilised for policy purposes and more serious in their commitment to supporting the generation of the types of knowledge that they claim to value. For international and comparative educators, we stress the importance of being clearer in seeking to shape research agendas; more rigorous in our approaches to research; and better in our external communication of our findings. Given the particular focus of this special issue on VET, we end by reiterating the particular challenge of reawakening research on VET-for-development from twenty years of slumbers

Access to Labour Market Equity: Advancing the Case for National Development in South African Higher Education

Abstract The responsibilities of higher education and training (HET) institutions include, but are not limited to, preparing students for absorption and productive participation in the labour market. Although the post-1994 period has witnessed a rapid expansion in enrolment into tertiary institutions in South Africa by black people who were previously excluded, this has not resulted in transforming the South African labour market. Although increased black graduate production has resulted in more black people emerging from the university system, the labour market outcomes of black graduates and those emerging from previously black tertiary institutions (referred to as previously disadvantaged institutions) is less than consistent. While this must reflect on the reality of a racialised labour market selection process that favours white rather than black students or their 'traditional' institutions, it is necessary for supply side institutions to respond appropriately. The role of universities in this process is considered critical. This article argues for a more responsive higher education system that provides a bridge between the worlds of the institution and work

Dolutegravir twice-daily dosing in children with HIV-associated tuberculosis: a pharmacokinetic and safety study within the open-label, multicentre, randomised, non-inferiority ODYSSEY trial

Background: Children with HIV-associated tuberculosis (TB) have few antiretroviral therapy (ART) options. We aimed to evaluate the safety and pharmacokinetics of dolutegravir twice-daily dosing in children receiving rifampicin for HIV-associated TB. Methods: We nested a two-period, fixed-order pharmacokinetic substudy within the open-label, multicentre, randomised, controlled, non-inferiority ODYSSEY trial at research centres in South Africa, Uganda, and Zimbabwe. Children (aged 4 weeks to <18 years) with HIV-associated TB who were receiving rifampicin and twice-daily dolutegravir were eligible for inclusion. We did a 12-h pharmacokinetic profile on rifampicin and twice-daily dolutegravir and a 24-h profile on once-daily dolutegravir. Geometric mean ratios for trough plasma concentration (Ctrough), area under the plasma concentration time curve from 0 h to 24 h after dosing (AUC0–24 h), and maximum plasma concentration (Cmax) were used to compare dolutegravir concentrations between substudy days. We assessed rifampicin Cmax on the first substudy day. All children within ODYSSEY with HIV-associated TB who received rifampicin and twice-daily dolutegravir were included in the safety analysis. We described adverse events reported from starting twice-daily dolutegravir to 30 days after returning to once-daily dolutegravir. This trial is registered with ClinicalTrials.gov (NCT02259127), EudraCT (2014–002632-14), and the ISRCTN registry (ISRCTN91737921). Findings: Between Sept 20, 2016, and June 28, 2021, 37 children with HIV-associated TB (median age 11·9 years [range 0·4–17·6], 19 [51%] were female and 18 [49%] were male, 36 [97%] in Africa and one [3%] in Thailand) received rifampicin with twice-daily dolutegravir and were included in the safety analysis. 20 (54%) of 37 children enrolled in the pharmacokinetic substudy, 14 of whom contributed at least one evaluable pharmacokinetic curve for dolutegravir, including 12 who had within-participant comparisons. Geometric mean ratios for rifampicin and twice-daily dolutegravir versus once-daily dolutegravir were 1·51 (90% CI 1·08–2·11) for Ctrough, 1·23 (0·99–1·53) for AUC0–24 h, and 0·94 (0·76–1·16) for Cmax. Individual dolutegravir Ctrough concentrations were higher than the 90% effective concentration (ie, 0·32 mg/L) in all children receiving rifampicin and twice-daily dolutegravir. Of 18 children with evaluable rifampicin concentrations, 15 (83%) had a Cmax of less than the optimal target concentration of 8 mg/L. Rifampicin geometric mean Cmax was 5·1 mg/L (coefficient of variation 71%). During a median follow-up of 31 weeks (IQR 30–40), 15 grade 3 or higher adverse events occurred among 11 (30%) of 37 children, ten serious adverse events occurred among eight (22%) children, including two deaths (one tuberculosis-related death, one death due to traumatic injury); no adverse events, including deaths, were considered related to dolutegravir. Interpretation: Twice-daily dolutegravir was shown to be safe and sufficient to overcome the rifampicin enzyme-inducing effect in children, and could provide a practical ART option for children with HIV-associated TB

Neuropsychiatric manifestations and sleep disturbances with dolutegravir-based antiretroviral therapy versus standard of care in children and adolescents: a secondary analysis of the ODYSSEY trial

BACKGROUND: Cohort studies in adults with HIV showed that dolutegravir was associated with neuropsychiatric adverse events and sleep problems, yet data are scarce in children and adolescents. We aimed to evaluate neuropsychiatric manifestations in children and adolescents treated with dolutegravir-based treatment versus alternative antiretroviral therapy. METHODS: This is a secondary analysis of ODYSSEY, an open-label, multicentre, randomised, non-inferiority trial, in which adolescents and children initiating first-line or second-line antiretroviral therapy were randomly assigned 1:1 to dolutegravir-based treatment or standard-of-care treatment. We assessed neuropsychiatric adverse events (reported by clinicians) and responses to the mood and sleep questionnaires (reported by the participant or their carer) in both groups. We compared the proportions of patients with neuropsychiatric adverse events (neurological, psychiatric, and total), time to first neuropsychiatric adverse event, and participant-reported responses to questionnaires capturing issues with mood, suicidal thoughts, and sleep problems. FINDINGS: Between Sept 20, 2016, and June 22, 2018, 707 participants were enrolled, of whom 345 (49%) were female and 362 (51%) were male, and 623 (88%) were Black-African. Of 707 participants, 350 (50%) were randomly assigned to dolutegravir-based antiretroviral therapy and 357 (50%) to non-dolutegravir-based standard-of-care. 311 (44%) of 707 participants started first-line antiretroviral therapy (ODYSSEY-A; 145 [92%] of 157 participants had efavirenz-based therapy in the standard-of-care group), and 396 (56%) of 707 started second-line therapy (ODYSSEY-B; 195 [98%] of 200 had protease inhibitor-based therapy in the standard-of-care group). During follow-up (median 142 weeks, IQR 124–159), 23 participants had 31 neuropsychiatric adverse events (15 in the dolutegravir group and eight in the standard-of-care group; difference in proportion of participants with ≥1 event p=0·13). 11 participants had one or more neurological events (six and five; p=0·74) and 14 participants had one or more psychiatric events (ten and four; p=0·097). Among 14 participants with psychiatric events, eight participants in the dolutegravir group and four in standard-of-care group had suicidal ideation or behaviour. More participants in the dolutegravir group than the standard-of-care group reported symptoms of self-harm (eight vs one; p=0·025), life not worth living (17 vs five; p=0·0091), or suicidal thoughts (13 vs none; p=0·0006) at one or more follow-up visits. Most reports were transient. There were no differences by treatment group in low mood or feeling sad, problems concentrating, feeling worried or feeling angry or aggressive, sleep problems, or sleep quality. INTERPRETATION: The numbers of neuropsychiatric adverse events and reported neuropsychiatric symptoms were low. However, numerically more participants had psychiatric events and reported suicidality ideation in the dolutegravir group than the standard-of-care group. These differences should be interpreted with caution in an open-label trial. Clinicians and policy makers should consider including suicidality screening of children or adolescents receiving dolutegravir