Citizenship, Community Participation and Social Change: The Case of Area Coordinating Teams in Cape Town, South Africa

Social change does not roll in under the wheels of inevitability On the contrary; we have to organize for it, mobilize for it, struggle for it and indeed, plan for it. This is especially so in a country such as South Africa, where centuries of colonial-cum-apartheid thought and practices have led planning bureaucracies to create and perpetuate socioeconomic patterns of uneven development and neglect. Amidst the geographies of largely "white" affluence, fear and collective "othering", those others, i.e. predominantly "black", unemployed, homeless, destitute, angry and alienated, are increasingly demanding their basic rights, rights that are enshrined in the post-apartheid Constitution (RSA 1995). One of the many structures that have been created in order to make available constitutionally guaranteed opportunities for participation in governance has been Areas Coordinating Teams (ACTs), established in the late 1990s as a vehicle through which government agencies could engage local communities in development planning. The ACTs were established in order to encourage consensus among politicians, bureaucrats and communities with regard to specific planning issues such as housing, health care and overall infrastructure at grassroots level. This article addresses the question of whether the ACTs, as spaces for participation in development planning available to the local communities of Cape Town, do indeed contribute towards grassroots- oriented, bottom-up programmers in post-apartheid South Africa. It draws on two complementary studies. The first consists of informal interviews with councilors and officials. In these interviews, the politicians and the bureaucrats expressed their views and understanding of ACTs. The second study was based on a structured questionnaire directed at community-based organizations (CBOs) attending the ACTs initiated/coordinated meetings. My focus here is on the relationships between the official, "invited" spaces of the ACTs and other spaces within the community and on the relationships that officials and elected representatives have with these spaces, in order to assess their potential for democratizing the development planning process.International Bibliography of Social Science

Tuberculosis in persons with sudden unexpected death, in Cape Town, South Africa

Background Globally, tuberculosis (TB) remains one of the leading causes of death from a single infectious agent, but there has been little work to estimate mortality before the diagnosis of TB. We investigated the burden of diagnosed and undiagnosed TB in adult and child sudden unexpected deaths (SUDs) evaluated at Tygerberg Forensic Pathology Services, South Africa. Methods In a retrospective descriptive study spanning 2016, we identified all SUDs where active TB was detected at post-mortem and matched with routine health service data to differentiate decedents who were diagnosed or undiagnosed with TB before death. A patient pathway analysis of the health service activities preceding SUD in adults with active TB was conducted. Results Active TB was identified at post-mortem in 6.2% (48/770) of SUDs and was undiagnosed before death in 91.7% (44/48). The prevalence of active TB was 8.1% in adult SUDs (90.1% undiagnosed before SUD) and 1.8% in children (none diagnosed before SUD). Patient pathway analysis was possible for 15 adult SUDs, and this documented primary health care clinic attendances and hospital admissions in the six months preceding death and missed opportunities for TB investigations. Conclusion The prevalence of TB among SUDs in the Eastern Metro of Cape Town is high. Most active TB at post-mortem was undiagnosed before death, and multiple missed opportunities for TB investigation and diagnosis were noted. The systematic evaluation of all SUDs for TB could improve the reporting of undiagnosed TB and support risk mitigation for healthcare workers involved with the post-mortem process

Is the routine health information system ready to support the planned national health insurance scheme in South Africa?

Implementation of a National Health Insurance (NHI) in South Africa requires a reliable, standardized health information system that supports Diagnosis-Related Groupers for reimbursements and resource management. We assessed the quality of inpatient health records, the availability of standard discharge summaries and coded clinical data and the congruence between inpatient health records and discharge summaries in public-sector hospitals to support the NHI implementation in terms of reimbursement and resource management. We undertook a cross-sectional healthrecords review from 45 representative public hospitals consisting of seven tertiary, 10 regional and 28 district hospitals in 10 NHI pilot districts representing all nine provinces. Data were abstracted from a randomly selected sample of 5795 inpatient health records from the surgical, medical, obstetrics and gynaecology, paediatrics and psychiatry departments. Quality was assessed for 10 pre-defined data elements relevant to NHI reimbursements, by comparing information in source registers, patient folders and discharge summaries for patients admitted in March and July 2015

Assessment at the boundaries: service learning as case study

This is the accepted version of the following article: Shay, S. 2008. Assessment at the boundaries: service learning as case study. British Educational Research Journal. 34(4): 525-540. DOI: 10.1080/01411920701609406., which has been published in final form at http://dx.doi.org/10.1080/01411920701609406.This article explores the value systems which inform assessment practices in higher education, specifically how particular forms of knowledge valued in the curriculum shape and constrain assessment practices. The data for this article is drawn from two courses which participated in a service learning research and development project at the University of Cape Town. Drawing on Pierre Bourdieu and Basil Bernstein, the article argues that the location of these courses—within the field of higher education and a particular kind of institution, faculty and department—shapes their assessment systems, practices and outcomes in certain ways. What is valued in this field (Bourdieu) is a form of knowledge production which requires students 'to step out of the particularities'. This form of knowledge operates as a regulative discourse, constituting what counts as legitimate. Using the assessment system as a 'window', this article explores how these service learning courses constitute and are constituted by the regulative discourse of the field. While the constraints of the field are powerful, this project offers some hopeful signs of forms of curriculum, pedagogy and assessment that, at the very least, name and challenge these underlying value systems

COVID-19, disability and the context of healthcare triage in South Africa: Notes in a time of pandemic

During disasters, when resources and care are scarce, healthcare workers are required to make decisions and prioritise which patients receive life-saving resources over others. To assist healthcare workers in standardising resources and care, triage policies have been developed. However, the current COVID-19 triage policies and practices in South Africa may exclude or disadvantage many disabled people, especially people with physical and intellectual impairments, from gaining intensive care unit (ICU) access and receiving ventilators if becoming ill. The exclusion of disabled people goes against the principles established in South Africa’s Constitution, in which all people are regarded as equal, have the right to life and inherent dignity, the right to access healthcare, as well as the protection of dignity

The use of a direct manufacturing prosthetic socket system in a rural community in South Africa: a pilot study and lessons for future research

BACKGROUND: Challenges exist with the provision of appropriate mobility assistive devices in rural areas. The use of the direct manufacturing prosthetic socket system is a possible solution to these challenges. OBJECTIVES: The objective of this study was to test and explore the clients’ perspectives with the application of this device. Study design: Within a mixed-methods approach, a longitudinal sequential explanatory design was applied. METHODS: The Orthotic and Prosthetic User’s Survey was administered to explore the use of the direct manufacturing prosthetic socket system in terms of function, health-related quality of life and client satisfaction. A conveniently selected sample of 21 individuals who suffered a unilateral trans-tibial amputation was included. Data were collected at 1, 3 and 6 months post fitting, and two focus group discussions were also administered. RESULTS: Of the 21 participants recruited, 11 returned for follow up. Although participants reported favourably about the prosthesis, their scores were generally worse than the norms with regard to function and quality of life. Participants highlighted the need for improvement in the cosmetic appearance of the prosthesis. CONCLUSION: The direct manufacturing prosthetic socket system could be considered as an alternative technique of socket manufacturing for individuals living in rural areas due to the shorter manufacture time and promising initial results, but further research on this topic with a bigger sample is recommended.ISI & Scopu