Out-migration in the context of the HIV/AIDS epidemic: evidence from the Free State province

This paper investigates the characteristics and determinants of out-migration in the context of the HIV/AIDS epidemic, using data from a panel designed to investigate the household impact of the epidemic. Departure models show that individual attributes, notably age and gender, play an important role in explaining out-migration from households that have not experienced morbidity or mortality. In affected households, a number of household-level variables, notably the gender of the household head, place of residence, family structure, the dependency ratio, human capital and household size, feature as important determinants of out-migration. Health shocks in the form of increased mortality, which characterises the impact of the epidemic, independently explain part of observed differences in out-migration from affected households, the out-migration of ill persons from affected households, and the out-migration of orphaned children from affected households. Thus, migration represents an important strategy for poorer households having to cope with the HIV/AIDS epidemic, both as an economic survival strategy and as a social strategy aimed at accessing support from the extended family

The role of social grants in mitigating the socio-economic impact of HIV/AIDS: evidence from the Free State Province

This paper investigates the role of social grants in mitigating the socioeconomic impact of HIV/AIDS using data from a panel designed to investigate the household impact of the epidemic. The child support, disability and foster care grants play an important role in mitigating the impact of HIV/AIDS, given that eligibility for these grants is driven largely by the increasing burden of chronic illness, the mounting orphan crisis and the impoverishment of households associated with the epidemic. Yet, take-up of these grants remains low and much scope remains to improve take-up rates. Social grants also play an important role in alleviating poverty in affected households, resulting in significant declines in the severity of poverty. Income received from social grants also saw expenditure on food increase in affected households, while oldage pensions saw household expenditure on education increase. Given that many orphaned and other children live in households headed by their grandparents, these transfers targeted at the elderly benefit children indirectly. This raises the question as to whether or not grants aimed at benefiting children should rather be administered via the education system in order to ensure that these transfers benefit children in a more direct way

Reconstruction of an extensive midfacial defect using additive manufacturing techniques

Malignant peripheral nerve sheath tumours are extremely rare tumours arising in peripheral nerves. Only 17 cases involving the trigeminal nerve have ever been reported. These tumours have a very poor prognosis and very high rates of recurrence and metastases. Their recommended treatment involves complete tumour resection followed by radiation. This can be problematic in the head and neck region. We present a clinical case involving a 33 year old female patient presenting with a slow growing exophytic mass of the anterior maxilla. Incisional biopsy and subsequent histological examination revealed a diagnosis of a malignant peripheral nerve sheath tumour. Surgical resection involved a complete maxillectomy, rhinectomy, and resection of the upper lip and aspects of the left and right cheeks. Reconstruction of the subsequent defect incorporated the placement of 4 zygomatic oncology implants to aid in retention of a facial prosthesis. These implants, however, were subsequently lost so it was decided to manufacture an anatomical model of the hard tissues via 3D printing. This model was used to design and manufacture a titanium frame (customised implant) for the patient, which was then fixated and secured intra-operatively with 21 cortical screws. A maxillary denture and silicone facial prosthesis were also made to fit onto this frame. This is the first known case where additive manufacturing, via the use of rapid prototyping and 3D printing, was employed to manufacture a facial prosthesis.The South African National Research Foundation and Materialise (Leuven, Belgium).http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1532-849X2017-10-31hb2016Maxillo-Facial and Oral SurgeryProsthodontic

Incentivising the Social Discounting Task: A laboratory experiment

Altruism is one of the single most important social preferences driving human behaviour. In Psychology experiments, the Social Discounting Task is employed as a measure of altruism. A conventional laboratory experiment was conducted with 117 undergraduate students, with students randomly assigned to complete an incentivized and un-incentivized Social Discounting Task. In accordance with the 1/d law of giving, the results exhibit the expected inverse relationship between social distance and altruism. There is weak evidence that incentivizing the Social Discounting Task impacts the measurement of altruism in a student population. More specifically, subjects are more altruistic when incentivized, possibly due to enforced reciprocity. At the same time, making payments real influence the identity of the target recipients: paying makes subjects more likely to choose people who are physically and psychologically close at high ranks, and more likely to report greater physical and psychological distance to subjects at lower ranks. Further research is required to verify the robustness of this result. The study also shows that among students family members are more altruistic toward each other as are those exhibiting greater intergenerational solidarity. Preferences for altruism in this student population is no different from WEIRD subject populations.JEL Classification Codes: C91, D64http://www.grips.ac.jp/list/jp/facultyinfo/munro_alistair

Who is accessing public-sector anti-retroviral treatment in the Free State, South Africa? An exploratory study of the first three years of programme implementation

<p>Abstract</p> <p>Background</p> <p>Although South Africa has the largest public-sector anti-retroviral treatment (ART) programme in the world, anti-retroviral coverage in adults was only 40.2% in 2008. However, longitudinal studies of who is accessing the South African public-sector ART programme are scarce. This study therefore had one main research question: who is accessing public-sector ART in the Free State Province, South Africa? The study aimed to extend the current literature by investigating, in a quantitative manner and using a longitudinal study design, the participants enrolled in the public-sector ART programme in the period 2004-2006 in the Free State Province of South Africa.</p> <p>Methods</p> <p>Differences in the demographic (age, sex, population group and marital status) socio-economic (education, income, neo-material indicators), geographic (travel costs, relocation for ART), and medical characteristics (CD4, viral load, time since first diagnosis, treatment status) among 912 patients enrolled in the Free State public-sector ART programme between 2004 and 2006 were assessed with one-way analysis of variance, Bonferroni post-hoc analysis, and cross tabulations with the chi square test.</p> <p>Results</p> <p>The patients accessing treatment tended to be female (71.1%) and unemployed (83.4%). However, although relatively poor, those most likely to access ART services were not the most impoverished patients. The proportion of female patients increased (<it>P </it>< 0.05) and their socio-economic situation improved between 2004 and 2006 (<it>P </it>< 0.05). The increasing mean transport cost (<it>P </it>< 0.05) to visit the facility is worrying, because this cost is an important barrier to ART uptake and adherence. Encouragingly, the study results revealed that the interval between the first HIV-positive diagnosis and ART initiation decreased steadily over time (<it>P </it>< 0.05). This was also reflected in the increasing baseline CD4 cell count at ART initiation (<it>P </it>< 0.05).</p> <p>Conclusions</p> <p>Our analysis showed significant changes in the demographic, socio-economic, geographic, and medical characteristics of the patients during the first three years of the programme. Knowledge of the characteristics of these patients can assist policy makers in developing measures to retain them in care. The information reported here can also be usefully applied to target patient groups that are currently not reached in the implementation of the ART programme.</p

Gender Differences in Intra-Household Financial Decision-Making: An Application of Coarsened Exact Matching

Most studies that explore collective models of intra-household decision-making use economic outcomes such as human capital, earnings, assets, and relative income shares as proxies of the relative distribution of bargaining power. These studies, however, fail to incorporate important measures of control over and management of the economic resources within households. In the current study, a direct measure of financial decision-making power within the household is used to directly assess the distribution of bargaining power. Coarsened exact matching, an identification strategy not yet applied in studies of this nature, is applied to couple-level observational data from South Africa’s longitudinal National Income Dynamics Study. The influence of gender differences in intra-household decision-making on resource allocations to per capita household expenditure is assessed. In the case of greater financial decision-making power in couples being assigned to wives rather than husbands, per capita household expenditure on education increases significantly. The empowerment of women with financial decision-making power therefore holds the promise of realizing the benefits of investments in human capital

The measurement of economic development : alternative composite indices

Thesis (PhD)--Stellenbosch University, 2000.ENGLISH ABSTRACT: The success of policies aimed at economic development cannot be monitored and evaluated without development indicators. These indicators are also crucial in comparing levels of development across time and space so as to come a greater understanding of the development process. Yet, economic development does not mean the same thing to everyone. As a result, there exists a variety of indicators of economic development. Five main classes of development indicators are distinguished on the basis of the shift over time in our understanding of economic development (Chapter 1). A distinction is drawn between indicators of national income and economic growth (Chapter 3), employment, unemployment and underemployment (Chapter 4), and poverty and inequality (Chapter 5). Social indicators (Chapter 6) and composite indices (Chapter 7) of economic development represent two futher classes of development indicators. These indicators differ in terms of their content, method and technique, comparative application, simplicity, clarity, focus, availability and flexibility. These main classes of development indicators are evaluated with reference to these dimensions of measurement which are described in detail in Chapter 2. There is no one indicator that can be described as an ideal, all encompassing measure of economic development, at least not in terms of its performance on these dimensions of measurement. Hence, the measurement of development remains imperfect, but nonetheless makes an invaluable contribution to the study of economic development. In fact, development studies will be impossible without access to such a variety of development indicators. Given the importance of development indicators in development studies, two new composite indices of development are presented here to address two specific gaps in indicator research. Indices of Human Security (HSIs) and Inefficiency ratios are developed to determine the extent to which countries have made progress on human security as defined by the UNDP (Chapter 8). Progress is assessed in terms of both effort and outcomes, as well as the extent to which efforts are actually translated into outcomes. Indices of Reconstruction and Development (RDIs) are employed to measure the extent to which the nine provinces of South Africa have made progress on the development objectives described in the Reconstruction and Development Programme (RDP) (Chapter 9). The measurement results suggest that there remain substantial disparities in progress on both human security and reconstruction and development. These new composite indices are also employed to determine those development characteristics associated with progress on human security and reconstruction and development. So, for example, disparities in human security are associated with certain urban and population dynamics, as well as communications capacity and infrastructural development. Progress on reconstruction and development is associated with lower population pressure, higher matric pass rates, less poverty and inequality, and more political representativeness at the provincial level. The RDIs also underscore the extent to which progress on the RDP has not materialised in rural areas. Furthermore, current provincial disparities in progress on reconstruction and development appear still to be indicative of the racial dynamics of development so characteristic of the Apartheid era.AFRIKAANSE OPSOMMING: Dit is onmoontlik om sonder ontwikkelingsindikatore die sukses van beleid wat gemik is op ekonomiese ontwikkeling te moniteer of te evalueer. Ontwikkelingsindikatore IS ook onontbeerlik III die vergelyking van ontwikkelingsvlakke oor tyd en ruimte om sodoende 'n beter begrip van die ontwikkelingsproses te verkry. Ekonomiese ontwikkeling het egter nie dieselfde betekenis vir almal nie. Gevolglik bestaan daar 'n verskeidenheid van ontwikkelingsindikatore. Vyf hoofklasse van ontwikkelingsindikatore word onderskei op grond van verskuiwings oor tyd in die interpretasie van ekonomiese ontwikkeling (Hoofstuk 1). 'n Onderskeid word getref tussen maatstawwe van nasionale inkome en ekonomiese groei (Hoofstuk 3), indiensname, werkloosheid en onderindiensname (Hoofstuk 4), en armoede en ongelykheid (Hoofstuk 5). Sosiale indikatore (Hoofstuk 6) en saamgestelde indekse (Hoofstuk 7) van ekonomiese ontwikkeling verteenwoordig twee verdere groepe indikatore. Hierdie indikatore verskil in terme van hul inhoud, metode en tegniek, vergelykende toepassing, eenvoud, duidelikheid, fokus, beskikbaarheid en buigsaamheid. Hierdie hoofklasse van ontwikkelingsindikatore word geëvalueer met verwysing na hierdie dimensies van meting, wat in groter besonderhede in Hoofstuk 2 bespreek word. Daar is nie een indikator wat beskryfkan word as 'n ideale, allesomvattende maatstafvan ekonomiese ontwikkeling nie, ten minste nie in terme van die prestasie daarvan op hierdie dimensies van meting nie. Gevolglik is die meting van ekonomiese ontwikkeling onvolmaak, alhoewel dit 'n onskatbare bydrae lewer tot die studie van ekonomiese ontwikkeling. Om die waarheid te sê, ontwikkelingstudies salonmoontlik wees sonder toegang tot so 'n verskeidenheid van ontwikkelingsindikatore. Gegewe die belangrikheid van ontwikkelingsmaatstawwe In ontwikkelingstudies, word twee nuwe saamgestelde indekse hier aangebied om twee spesifieke gapings in navorsing oor ontwikkelingsmaatstawwe aan te spreek. Indekse van Menslike Sekuriteit (MSls) en Ondoeltreffendheidsratio's word ontwikkelom te bepaal tot watter mate lande vordering gemaak het in menslike sekuriteit, soos definieer deur die UNDP (Hoofstuk 8). Vordering word gemeet in terme van sowel pogings en uitkomste as die mate waartoe pogings werklik in uitkomste omskep word. In Hoofstuk 9 word Indekse van Heropbou en Ontwikkeling (HOIs) gebruik om te meet tot watter mate die nege provinsies in Suid-Afrika vordering gemaak het in die bereiking van die ontwikkelingsdoelwitte wat uitgespel word in die Heropbou- en Ontwikkelingsprogram (HOP). Die metingsresultate dui daarop dat daar wesenlike ongelykhede bestaan in beide menslike sekuriteit en heropbou en ontwikkeling. Hierdie nuwe saamgestelde indekse word ook gebruik om te bepaal met watter ontwikkelingskenmerke ongelykhede in menslike sekuriteit en heropbou en ontwikkeling geassosieer word. So, byvoorbeeld, toon dispariteite in menslike sekuriteit 'n verband met sowel stedelike en bevolkingsdinamika as kapasiteit in kommunikasie en infrastruktuur. Vordering in heropbou en ontwikkeling word ook geassosieer met laer bevolkingsdruk, beter matrikulasieresultate, minder armoede en inkomste-ongelykheid, en wyer politieke verteenwoordiging op provinsiale vlak. Die indekse beklemtoon ook die mate waartoe vordering met die HOP nog nie in landelike gebiede gematerialiseer het nie. Verder wil dit voorkom asof huidige provinsiale ongelykhede in vordering met heropbou en ontwikkeling steeds kenmerkend is van die rasse-dinamika agter ontwikkeling wat so kenmerkend was van die Apartheidsera

Decomposing socioeconomic inequalities in alcohol use by men living in South African urban informal settlements

Abstract Background The prevalence of alcohol consumption among males living in urban settlements in South Africa is high. This paper aims to measure socioeconomic inequalities in alcohol use among men residing in informal settlements and also to examine the factors associated with inequality in alcohol use among men living in informal settlements. Methods The study uses data from the 2016 Study of South African Informal Settlements. Multiple correspondence analysis is used to calculate a wealth index as a measure of socioeconomic status. The Erreygers concentration index is employed to quantify the degree of socioeconomic inequality in alcohol use and decomposition analysis is conducted to assess the factors associated with inequality in alcohol use by men of various age groups. Results There is a socioeconomic-related inequality in alcohol use in informal settlements that discriminates against poor men. Inequality is especially pronounced in the case of males aged 15–34 years and males aged 35–44 years. Wealth status makes the biggest contribution to socioeconomic inequality in alcohol use. The contribution of social determinants of health like marital status and employment status differ across age groups. Employment status contribute more to the alcohol use inequality among males aged 15–34 years while marital status contribute more to the alcohol use inequality among males aged 35–44 years. Being single substantially increases inequality in alcohol use. Conclusion Inequality in alcohol use exists among both younger and older males and discriminate against the poor. Public policies aimed at promoting public health and the prevention of unhealthy behaviours should target younger and middle-aged men from socioeconomically disadvantaged groups. We also suggest policies that target single males in informal settlements

Gender differences in intra-household financial decision-making: An application of coarsened exact matching

Most studies that explore collective models of intra-household decision-making use economic outcomes such as human capital, earnings, assets, and relative income shares as proxies of the relative distribution of bargaining power. These studies, however, fail to incorporate important measures of control over and management of the economic resources within households. In the current study, a direct measure of financial decision-making power within the household is used to directly assess the distribution of bargaining power. Coarsened exact matching, an identification strategy not yet applied in studies of this nature, is applied to couple-level observational data from South Africa's longitudinal National Income Dynamics Study. The influence of gender differences in intra-household decision-making on resource allocations to per capita household expenditure is assessed. In the case of greater financial decision-making power in couples being assigned to wives rather than husbands, per capita household expenditure on education increases significantly. The empowerment of women with financial decision-making power therefore holds the promise of realizing the benefits of investments in human capital