Knowing where the roof leaks: evidence from a quality-monitoring experiment in subsidised housing

Solid waste constitutes one of the most pressing environmental problems, requiring urgent action from urban managers to find appropriate management mechanisms. The rapid increase in municipal solid waste generation is undoubtedly due to the accelerated population growth rate triggered by massive rural-to-urban migration. This paper analyses solid waste management challenges in low-income communities in South Africa, using a case study from Alexandra, Johannesburg. Using qualitative and quantitative research approaches, findings revealed that solid waste is not reliably collected and transported in low-income communities in South Africa. The main obstacles include the scarcity of resources and equipment necessary for waste treatment. To widely involve residents of Alexandra Township in the waste management process, the municipal council should embark on a public awareness campaign. The findings further encourage effective waste sorting techniques, such as separating biodegradable from non-biodegradable waste, so that valuable goods can be taken to the local government recycling centre. The results further encourage the involvement of the homeless and unemployed in the recycling and waste management process, thereby reducing the shortage of human resources and creating jobs. These issues are analysed within the context of evolving arguments that focus on developing a pro-poor approach in solid waste management that may present an opportunity for achieving sustainable solid waste management in Johannesburg, South Africa.

Culturally relevant developmental screening is one of the best ways to appropriately identify developmental delays and disabilities in children as early as possible across diverse cultural backgrounds. This study aimed to adapt the Parents' Evaluation of Developmental Status (PEDS) tools for a low-income community in South Africa by using a detailed multiphased cultural and contextual adaption process. A three-phase mixed-method design relying on triangulation of data was used. Data were collected at an immunization clinic in a low-income community in Mamelodi, South Africa. Phase 1 was a focus group discussion with 11 community participants. The topics explored the possible changes to the PEDS tools to make them more relevant to the community. Phase 1 informed Phase 2 where 12 early childhood development experts achieved consensus through a two-round survey on a modified Delphi method. In Phase 3, a draft of the PEDS tools-SA was presented to the authors of the PEDS tools for final approval. Of 55 questions that were adapted for the PEDS tools-SA, two original questions (3.6%), 14 questions from the expert suggestions (25.4%) and 39 from the community participant's suggestions (71%) were included. A final version of the PEDS tools-SA was created. This study used a systematic method to adapt the PEDS tools to create the culturally appropriate PEDS tool-SA for a low-income community in South Africa, informed by community stakeholders' views from the first step. This resulted in a high-quality adaptation process that is more likely to result in a tool that is more acceptable to caregivers from a low-income South African community.

Knowledge of developmental milestones allows parents to support the developmental needs of their children and monitor their behaviour. Many available developmental resources, however, do not apply to culturally, economically, and linguistically diverse communities in low– and middle-income countries. There is a need to adapt established resources to improve contextual relevance. As primary stakeholders, parents should contribute to the adaptations. An existing developmental milestone resource was adapted for parents from low-income communities in South Africa using a mixed-method research design. In phases 1 and 2, a six-member expert panel reviewed and adapted the existing resource for the parents of children aged 2–47 months using a questionnaire and focus group. In phase 3, 18 parents of young children from low-income communities were interviewed to gain their perspectives on the adapted milestone. Most developmental milestones were deemed applicable, but they require adaptation to be relevant for use in low-income communities. The four themes identified were: language use, access to materials indicated in the resource, context and developmental literacy. Parents found the adapted resource relevant to promoting developmental literacy. International developmental milestone resources require contextual adaptation for diverse communities. Parents were included in developing the resource, increasing its relevance. The adapted resource should be trialled to evaluate the effectiveness of promoting parents’ developmental literacy.

BackgroundThis study describes the implementation and evaluation of a safety and peace promotion intervention for children attending Early Childhood Development (ECD) centres in a low-income community in South Africa. The...

This article aims to present a systematic review of ten studies related to asset-based community development (ABCD). The reviewer conducted a thematic synthesis, content analysis, and meta-synthesis on qualitative evidence from studies conducted between 2007 and 2015 in low-income communities in South Africa. The main research question guiding the systematic review was: What are the role-players’ views of the impact of ABCD? Role-players—including social workers, nongovernmental organisation personnel, community members, and local leaders—generally endorse ABCD as a social and community development approach. The content analysis and meta-synthesis revealed that it is essential for implementers of ABCD approaches to go beyond raising awareness of the strengths of individuals and groups and to actively integrate these strengths into the implementation of social development programmes. In addition to strengthening implementation, ABCD requires further incorporation into social development theory and practice. Given the limited research on the long-term impact of ABCD approaches, more qualitative and quantitative research studies are needed to explore topics related to their sustainability.

To investigate how acceptable and feasible a school-based contraceptive clinic (SBCC) would be in a low-income South African community. Teenage pregnancy is an important issue in South Africa, with significant health and social consequences. Issues regarding lack of confidentiality in an intimate community, unwelcoming health workers, long distances to clinics and perceptions of contraceptive side effects may all inhibit contraceptive use by adolescents. Although SBCC has been initiated and investigated in other countries, this approach is inadequately researched in South Africa. A mixed method study was conducted to assess the attitudes of one community towards establishment of an SBCC in their area. Methods of data collection included: focus group discussions (FGDs) with teenage girls from a local high school; a key informant interview with the school principal; a structured survey, including open-ended questionnaires with randomly selected parents of teenage girls from the same community; and a documentary analysis to explore relevant legal and policy considerations. Teenage girls, the school principal and parents with teenage daughters largely supported the idea of an SBCC, but with concerns about confidentiality, the possibility of increased promiscuity and contraceptive side effects. While legal statutes and policies in South Africa do not pose any barriers to the establishment of an SBCC, some logistical barriers remain.

The authors report on a 5-year project designed to improve the quality of literacy instruction and literacy learning in primary schools serving low-income communities in South Africa. The authors situate this project in the broader context of educational reforms in post-apartheid South Africa. The evaluation data suggest high levels of implementation and a positive impact for the intervention in the classrooms of participating schools and teachers. Improvement in student outcomes was evident across grade levels and across a wide range of literacy measures (e.g., decoding, reading comprehension, and writing). The authors reflect on the qualities of the intervention that contributed to its implementation and impact. They argue for the importance of these qualities in designing future efforts to reform teaching in developing countries.

A community-based Clean Development Mechanism (CDM) project – asolar water heating project in a low-income community in South Africa –is analysed to illustrate the methodological and policy challenges that faceimplementation of the Kyoto Protocol to the United Nations FrameworkConvention on Climate Change. We evaluate four baseline options, andthree potential CDM interventions. The emissions reductions range from –670 to +5 929 Mg CO2 per year, with all option but oneshowing positive emission reductions. Using metered solar water heatingwith liquefied petroleum gas back-up as the CDM intervention, and electricstorage geysers as the baseline, the annual emissions reductions are 5686 Mg CO2. The cost-effectiveness from the national perspective,which is the incremental life cycle costs divided by the lifetime emissionsreductions, is –$18 per Mg CO2 From the perspective of theCDM investor, however, the cost-effectiveness is $5.2 per mgCO2, assuming that the investor receives all of the carbon credits forproviding the incremental capital investment. From our analysis, weconclude that using the current technology (kerosene stoves) as a baselineis probably not appropriate because it does not reflect likely future trendsand also penalises the community for their poverty and current lack ofinfrastructure. We also highlight the importance of credit sharing, and howit affects the cost-effectiveness of the project from the CDM investor'sperspective. The lessons from this analysis are important for the currentinternational policy debate on how to preferentially treat small-scale CDMprojects.

Introduction Globally, more than 50 million children have hearing or vision loss. Most of these sensory losses are identified late due to a lack of systematic screening, making treatment and rehabilitation less effective. Mobile health (mHealth), which is the use of smartphones or wireless devices in health care, can improve access to screening services. mHealth technologies allow lay health workers (LHWs) to provide hearing and vision screening in communities. Purpose The aim of the study was to evaluate a hearing and vision school screening program facilitated by LHWs using smartphone applications in a low-income community in South Africa. Method Three LHWs were trained to provide dual sensory screening using smartphone-based applications. The hearScreen app with calibrated headphones was used to conduct screening audiometry, and the Peek Acuity app was used for visual acuity screening. Schools were selected from low-income communities (Gauteng, South Africa), and children aged between 4 and 9 years received hearing and vision screening. Screening outcomes, associated variables, and program costs were evaluated. Results A total of 4,888 and 4,933 participants received hearing and vision screening, respectively. Overall, 1.6% of participants failed the hearing screening, and 3.6% failed visual acuity screening. Logistic regression showed that female participants were more likely to pass hearing screening (OR = 1.61, 95% CI [1.11, 2.54]), while older children were less likely to pass visual acuity screening (OR = 0.87, 95% CI [0.79, 0.96]). A third (32.5%) of referred cases followed up for air-conduction threshold audiometry, and one in four (25.1%) followed up for diagnostic vision testing. A high proportion of these cases were confirmed to have hearing (73.1%, 19/26) or vision loss (57.8%, 26/45). Conclusions mHealth technologies can enable LHWs to identify school-age children with hearing and/or vision loss in low-income communities. This approach allows for low-cost, scalable models for early detection of sensory losses that can affect academic performance.

Background The South African food environment is characterized by pervasive marketing on television and in print media of unhealthy food and beverages. Little is known about the extent of outdoor food and beverage marketing (product, spatial advertising, branding) at transport interchange areas, community food outlets, and schools. Our study aimed to map outdoor food and beverage marketing within the vicinities of these areas in three low-income communities in Cape Town. Methods Data on food and beverage-related branding, product type, placement, pictures, and Global Positioning System coordinates were captured using a web-based questionnaire. Geographic Information System software was used to delimit the target communities and areas, geospatially map the physical food environment, and perform spatial analysis of the data. Results Overall, 986 food and beverage advertisement entries were observed. Preliminary results depicted trends of advertisements clustering around retailers. Spatial trends depicted that fast food and sugar-sweetened beverage (SSB) advertisements were likely to collocate around transport interchange areas, while SSB advertisements were more likely to collocate near schools. The spatial trend for alcohol advertisements indicated a clustering near main roads. Spatial trends for product types varied by location. Few advertisements for fruit and vegetables were captured. Further spatial analysis is underway to assess advertisement density and proximity to youth-related areas, food outlets, and transport interchange areas. Conclusions Low-income communities, commuters, and schoolchildren in South Africa are targeted by advertisements for unhealthy foods and SSBs, indicating the need for policy intervention to regulate food marketing. Key messages • Geospatial mapping of food and beverage advertisements indicated the promotion of unhealthy products in low-income communities in South Africa. • Food and beverage adverts target school children and commuters using public transport in poorer communities.

Age-appropriate early childhood development is greatly influenced by exposure to various mediating and moderating factors. Developmental outcomes cannot be viewed in isolation, but by considering the interaction of the various risks and protective factors that influence early child development. A non-experimental, cross-sectional research design was employed. Data was collected in a low-income community in Gauteng, South Africa. Caregivers with children (n = 276) between the ages of 3 years and 6 years 11months (mean 51.57months; SD ± 12.4) whose children were in a preschool were invited to participate in the research study. Participants were divided into two groups, children with developmental delays and children without a developmental delay. The study sample included high risk, vulnerable preschool children, with a developmental delay prevalence of 80.1% (221/276). Families included were exposed to an average of five (SD ± 1.86) environmental and/or biological risks. According to a logistic regression model, three factors were significantly associated with increasing resilience amongst children with no developmental delay: living with both parents (p < 0.031, OR 4.5, 95% CI 1.2-17.2), caregivers having at least completed Grade 8 to 12 (p < 0.027, OR 11.9, 95% CI 1.4-10.5) and parents being married (p < 0.023, OR 5.1, 95% CI 1.3-20.9). Important protective factors in low-income communities like caregiver education, living with both parents and parental marriage can inform public health messaging and other population-based interventions to support early childhood development.

This study aimed to establish the prevalence of underweight, overweight and obesity, the level of moderate-to-vigorous physical activity (MVPA) and the association thereof among vulnerable children from low-income communities in South Africa. Cross-sectional data were collected from 916 children (467 boys and 449 girls) aged 8–13 years ( = 10.4 ± 1.2 years) attending eight low-income schools in Gqeberha, South Africa. Measured outcomes included accelerometery-measured physical activity (PA), weight, height and body mass index (BMI). Analysis of variance was used to determine the mean difference of total MVPA stratified by sex and BMI classification. Overall, 13% of the cohort were underweight, 19% were overweight/obese and 64% engaged in 60 min of MVPA per day. Girls presented nearly twice the odds of being overweight or obese than boys (95% CI: 1.40–2.77). Underweight to normal-weight children (boys: OR = 3.89, 95% CI: 2.18–6.93; girls: OR = 1.78, 95% CI: 1.13–2.80) were more likely to engage in 60 min/day of MVPA than overweight to obese children. There is an inverse association between BMI categories and theduration of MVPA achieved per day. Special attention should be aimed at increasing awareness of healthy nutrition and promoting a variety of PA, especially among girls and children with excess weight.

Understanding how exposure to particulate matter impacts human health is complex. Personal exposure is a function of the pollution concentrations measured at any given place and time. The health impacts of this exposure are, amongst other factors, determined by how high pollutant concentrations are and what enters the body. This study considered data gathered in the winter of 2013 in a low-income community on the Mpumalanga Highveld, South Africa, which is a geographical area known for its high air pollution levels. Time-activity data collected by GPS monitors worn by individuals in the community were used to understand in which microenvironments people spend most of their time. Eight days’ worth of ambient, indoor and personal particulate matter measurements were paired with individual GPS positioning data for one study participant. We identified pollutant concentrations where the person spent time and how much particulate matter was potentially inhaled in specific micro-environments. Participants spent time in five main micro-environments: (highest rank first) inside a house, directly outside a house, on a dirt road, on a tar road, and on an open field. Exposure to particulate matter concentrations in these micro-environments exceeded the National Ambient Air Quality Standards. Highest exposure was measured inside the dwelling and directly outside the dwelling. When comparing directly- and indirectly derived time-weighted potential intake doses, directly derived intake doses were higher and more likely to represent particulate matter concentrations inhaled by the participant. This study suggests that people living in communities on the Mpumalanga Highveld are exposed to unacceptably high air pollution levels in places in which they spend most of their time. Direct exposure and intake dose assessments are an essential element of environmental health studies to supplement data collected by stationary monitors.

Significant poverty levels raise critical questions about the impact of poverty eradication programs. Literature reviews play a critical role in highlighting impactful and ineffective socio-economic approaches. This article presents a review of nine qualitative studies that were reported between 2006 and 2013 in poor urban, semi-rural, and rural communities in South Africa. The main goal of this paper is to describe how low-income communities were impacted by programs to reduce poverty. Themes on strength-based interventions, participation, and holistic-multidimensional approaches, emerge from the content analysis as the best account of the impact of community-based poverty eradication programs. Due to the qualitative nature of the small sample of studies under review, a thematic synthesis of the qualitative data provides baseline evidence for further research to assess progress in the provision of development programs, and to generate more insight to strengthen evidence-informed approaches to address persistently high rates of poverty.

Energy consumption behaviours of children in low-income communities: A case study of Khayelitsha, South Africa