Waste management challenges to opportunities in the west rand district municipality, Gauteng, South Africa : initiatives

Abstract: The increased waste management and minimisation developments have placed enormous pressure on the West Rand District Municipality (WRDM) considering the rapidly shrinking airspace of the 5 landfill sites, rapid economic and population growth, lack of proper separation facility, which have led to waste management challenges in 4 Local Municipalities (LMs) of the WRDM i.e., Randfontein, Mogale City, Merafong City and Westonaria. Other waste management challenges faced by WRDM include recycling that is mostly done by unregistered informal recyclers/scavengers, shortage of waste transportation services, illegal dumping, in appropriate final waste disposal, generation of greenhouse gases at landfill sites such as methane gases that contributes to air pollution/global warming and water pollution through leachate migration. However, these challenges can be turned into useful resources and opportunities if properly managed and can provide employment for WRDM personnel including the conversion of waste into energy through thermal combustion and bio-gasification

Hazardous waste management in the west rand district municipality, Gauteng, South Africa : a review

Abstract: Hazardous and medical waste types are often generated in the West Rand District Municipality (WRDM). The WRDM is made up of four Local Municipalities (LMs) which are Randfontein, Mogale City, Westonaria and Merafong City. Hazardous waste can cause significant health and environmental impacts when managed inadequately. It contains organic and in-organic elements with inherent physical, chemical and biological or toxicological characteristics. All the WRDM landfill sites (Luipaarsdvlei, Rooiport, Lebanon and Uitvaalfontien) do not cater for hazardous waste as all wastes are classified and permitted as generally the same. Hazardous waste requires special handling, treatment and disposal and thus spotters and gate controllers on the landfill site screen for hazardous waste. There is no hazardous or medical waste disposal site in the WRDM therefore, hazardous waste generated by WRDM is disposed off at an incinerating plant near Roodepoort in Johannesburg

Merafong City and Randfontein municipalities community perspectives on waste management

Solid waste management (SWM) in Merafong City and Randfontein local municipalities in South Africa is a challenge that manifests itself in illegal dumpsites and unhealthy environment. In this study we set to address the Merafong City and Randfontein municipalities’ community participation and perspectives on waste management, minimization and utilization. The study objectives were achieved by using a triangulation method. This procedure included personal interviews, questionnaires and document analysis. The study also looks at households and community partnerships such as waste buy-back centers. These community partnerships promote and support the emergence of small, medium and micro recycling enterprises [1]. These partnerships also focus on sustainable waste management such as reduction of scavenging at landfill sites as well as promoting collaboration between the public and private sector. This study encourages communication among all stakeholders and integration for effective solid waste management in low- income communities

Strengthening primary care for diabetes and hypertension in Eswatini: study protocol for a nationwide cluster-randomized controlled trial

Background: Diabetes and hypertension are increasingly important population health challenges in Eswatini. Prior to this project, healthcare for these conditions was primarily provided through physician-led teams at tertiary care facilities and accessed by only a small fraction of people living with diabetes or hypertension. This trial tests and evaluates two community-based healthcare service models implemented at the national level, which involve health care personnel at primary care facilities and utilize the country’s public sector community health worker cadre (the rural health motivators [RHMs]) to help generate demand for care. Methods: This study is a cluster-randomized controlled trial with two treatment arms and one control arm. The unit of randomization is a primary healthcare facility along with all RHMs (and their corresponding service areas) assigned to the facility. A total of 84 primary healthcare facilities were randomized in a 1:1:1 ratio to the three study arms. The first treatment arm implements differentiated service delivery (DSD) models at the clinic and community levels with the objective of improving treatment uptake and adherence among clients with diabetes or hypertension. In the second treatment arm, community distribution points (CDPs), which previously targeted clients living with human immunodeficiency virus, extend their services to clients with diabetes or hypertension by allowing them to pick up medications and obtain routine nurse-led follow-up visits in their community rather than at the healthcare facility. In both treatment arms, RHMs visit households regularly, screen clients at risk, provide personalized counseling, and refer clients to either primary care clinics or the nearest CDP. In the control arm, primary care clinics provide diabetes and hypertension care services but without the involvement of RHMs and the implementation of DSD models or CDPs. The primary endpoints are mean glycated hemoglobin (HbA1c) and systolic blood pressure among adults aged 40 years and older living with diabetes or hypertension, respectively. These endpoints will be assessed through a household survey in the RHM service areas. In addition to the health impact evaluation, we will conduct studies on cost-effectiveness, syndemics, and the intervention’s implementation processes. Discussion: This study has the ambition to assist the Eswatini government in selecting the most effective delivery model for diabetes and hypertension care. The evidence generated with this national-level cluster-randomized controlled trial may also prove useful to policy makers in the wider Sub-Saharan African region. Trial registration: NCT04183413. Trial registration date: December 3, 201