Africa's Eastern Cape Province Research Articles

Are social protection and food security accelerators for adolescents to achieve the Global AIDS targets?

Without effective, scalable interventions, we will fail to achieve the Global AIDS Targets of zero AIDS-related deaths, zero HIV transmission and zero discrimination. This study examines associations of social protection and food security among adolescents living with HIV (ALHIV), with three Global AIDS Targets aligned outcomes: antiretroviral treatment (ART) adherence and viral suppression, HIV transmission risk behaviour and enacted stigma. We conducted three study visits over 2014-2018 with 1046 ALHIV in South Africa's Eastern Cape province. Standardized surveys provided information on receipt of government-provided cash transfers and past-week food security, alongside self-reported ART adherence, sexual debut and condom use, and enacted HIV-related stigma. Viral load (VL) data was obtained through data extraction from patient files and linkage with National Health Laboratory Service test results (2014-2020). We used a multivariable random-effects regression model to estimate associations between receiving government cash transfers and food security and three outcomes: ART adherence and viral suppression, delayed sexual debut or consistent condom use and no enacted stigma. We tested moderation by sex and age and fitted disaggregated models for each outcome. Among the 933 ALHIV completing all three study visits, 55% were female, and the mean age was 13.6 years at baseline. Household receipt of a government cash transfer was associated with improvements on all outcomes: ART adherence and viral suppression (aOR 2.03, 95% CI 1.29-3.19), delayed sexual debut or consistent condom use (aOR 1.62, 95% CI 1.16-2.27) and no enacted stigma(aOR 2.33, 95% CI 1.39-3.89). Food security was associated with improvements on all outcomes: ART adherence and viral suppression (aOR 1.73, 95% CI 1.30-2.30), delayed sexual debut or consistent condom use (aOR 1.30, 95% CI 1.03-1.64) and no enacted stigma (aOR 1.91, 95% CI 1.32-2.76). Receiving both cash transfers and food security increased the probability of ART adherence and VL suppression from 36% to 60%; delayed sexual debut or consistent condom use from 67% to 81%; and no enacted stigma from 84% to 96%. Government-provided cash transfers and food security, individually and in combination, are associated with improved outcomes for ALHIV aligned with Global AIDS Targets. They may be important, and underutilized, accelerators for achieving these targets.

Addressing colonial-apartheid legacy and infrastructural barriers in access to substance use disorder treatment in South Africa's Eastern Cape Province

Addressing colonial-apartheid legacy and infrastructural barriers in access to substance use disorder treatment in South Africa's Eastern Cape Province

The Impact of ICT Adoption in Enhancing Teaching and Learning in Primary Schools of Amathole East District, Eastern Cape

This study examines how information and communication technology (ICT) impacts the schooling environment within the primary sector in South Africa's Eastern Cape Province's Amathole East District. ICT adoption in education can fully modify the ways that instruction and learning are given to students, but it also comes with obstacles, especially in the rural primary schools in the Amathole East District. This research intends to shed light on the current ICT status adoption of Amathole East District's primary schools. Three primary schools were chosen, and three research participants from each school were chosen using the purposive sample technique. Data were gathered through focus groups and in-person interviews. The acquired data were analyzed and presented using a thematic approach. It was revealed as the findings that while teachers were willing to embrace ICTs into teaching and learning and had a good attitude toward technology adoption, they needed the necessary ICT competencies. Furthermore, several challenges and barriers were identified, and these included inadequate ICT infrastructure, a shortage of teacher training in technology integration and a lack of access to ICT tools. The study concludes that teacher training programs be expanded, invest in infrastructure development, and develop a comprehensive ICT policy framework. Taking the research's findings into account, the research offers practical recommendations in enhancing ICT adoption, investing in infrastructure development, expanding teacher development opportunities, to formulating a comprehensive ICT strategy framework so that schools are ready to run virtually in the event of another pandemic related to COVID-19.

Social drivers and differentiated effects of deagrarianisation: A longitudinal study of smallholder farming in South Africa's Eastern Cape province

South Africa's smallholders have progressively become disengaged from farming despite their lack of alternative livelihood options, resulting in the deepening of rural poverty. Farming's reduced role in rural livelihoods represents a wider trend of deagrarianisation seen across contexts and geographies. While most literature on deagrarianisation focuses on its economic dimensions, this paper places the social and cultural dimensions of farming at the centre of its analysis to understand why smallholders are becoming less engaged in agriculture. Drawing on Habermas's concept of the colonisation of the lifeworld and on ethnographic fieldwork in four villages in South Africa's Eastern Cape Province, we show how local social cohesion in farming has been undermined by a series of oppressive state policies. Recent agricultural development interventions have not managed to break with this trend, but instead continue to undermine social cohesion and reciprocity. The impacts of this loss of social cohesion in farming have been most severe for the poorest households who seldom plant their fields today. Based on our findings, we suggest that agricultural development programmes should aim to build on smallholders' appreciation of agriculture, their remaining connections to the land and their sense of solidarity, rather than focusing exclusively on stimulating the development of individual entrepreneurs.

Impacts of intimate partner violence and sexual abuse on antiretroviral adherence among adolescents living with HIV in South Africa.

We are failing to reach 95-95-95 for adolescents living with HIV (ALHIV). Sexual abuse and intimate partner violence (IPV) may impact antiretroviral therapy (ART) adherence, with high rates of 17.4 and 29.7%, respectively, across the southern sub-Saharan African region. However, evidence on their associations with adolescent ART adherence remains limited, with only three cross-sectional studies globally. A prospective cohort of ALHIV (sample N = 980, 55% female individuals, baseline mean age 13.6 years) were recruited from 53 health facilities in South Africa's Eastern Cape Province and responded to a structured questionnaire at 18-month and 36-month follow-up (2015-2016, 2017-2018). A repeated-measures random effects model assessed multivariable associations of self-reported sexual abuse and IPV with past-week ART adherence, controlling for individual, socioeconomic, and HIV-related factors. Past-week adherence was defined based on currently taking ART and not having missed any doses in the past 7 days (including weekends). We further fitted a moderation model by sex. Fifty-one percent of adolescents reported consistent ART adherence at both time points. Exposure to IPV was associated with lower odds of self-reported ART adherence (aOR 0.39, 95% CI 0.21-0.72, P = 0.003), as was sexual abuse (aOR 0.54, 95% CI 0.29-0.99, P = 0.048). The marginal predicted probability of ART adherence for adolescents with no exposure to either IPV or sexual abuse was 72% (95% CI 70-74%) compared with 38% (95% CI 20-56%) for adolescents with exposure to both IPV and sexual abuse. Moderation results showed similar associations between sexual violence and ART adherence by sex. Sexual violence prevention and postviolence care may be essential components of supporting adolescent ART adherence. Integration of HIV and violence prevention services will require accessible services and simple referral systems.

Food security reduces multiple HIV infection risks for high-vulnerability adolescent mothers and non-mothers in South Africa: a cross-sectional study.

IntroductionAdolescent girls and young women, including adolescent mothers, in Southern Africa have high HIV seroconversion and transmission. We need to know which risks drive HIV infections, and what can reduce these risks.MethodsWe interviewed 1712 adolescent girls and young women (11–23 years), including 1024 adolescent mothers who had conceived before age 20 and had a living child, from two health municipalities of South Africa's Eastern Cape Province between March 2018 and July 2019. Recruitment was through multiple community, school and health facility channels. Associations between adolescent motherhood and seven HIV risk behaviours (multiple sexual partners, transactional sex, age‐disparate sex, condomless sex, sex on substances, alcohol use and not in education or employment) were investigated using the generalized estimating equations method for multiple outcomes specified with a logit link and adjusting for nine covariates. Using the same model, we investigated associations between having enough food at home every day in the past week (food security) and the same seven HIV risk behaviours. When we found evidence of moderation by HIV status, we report stratum‐specific odds ratios.ResultsMean age was 17.51 years (SD: 2.54), 46% participants were living with HIV. Compared to non‐mothers, adolescent mothers had lower odds of alcohol use (AOR = 0.47, 95% CI = 0.29–0.75), but higher odds of multiple sexual partners (AOR = 1.93, 95% CI = 1.35–2.74), age‐disparate sex (HIV‐uninfected AOR = 1.73, 95% CI = 1.03–2.91; living with HIV AOR = 5.10, 95% CI = 2.98–8.73), condomless sex (AOR = 8.20, 95% CI = 6.03–11.13), sex on substances (AOR = 1.88, 95% CI = 1.10–3.21) and not in education/employment (HIV‐uninfected AOR = 1.83, 95% CI = 1.19–2.83; living with HIV AOR = 6.30, 95% CI = 4.09–9.69). Among non‐mothers, food security was associated with lower odds of multiple sexual partners (AOR = 0.45, 95% CI = 0.26–0.78), transactional sex (AOR = 0.32, 95% CI = 0.13–0.82) and not in education/employment (AOR = 0.48, 95% CI = 0.29–0.77). Among adolescent mothers, food security was associated with lower odds of transactional sex (AOR = 0.17, 95% CI = 0.10–0.28), age‐disparate sex (AOR = 0.66, 95% CI = 0.47–0.92), sex on substances (AOR = 0.51, 95% CI = 0.32–0.82), alcohol use (AOR = 0.45, 95% CI = 0.25–0.79) and not in education/employment (AOR = 0.56, 95% CI = 0.40–0.78).ConclusionsAdolescent motherhood is associated with multiple vulnerabilities to HIV infection and transmission. Social protection measures that increase food security are likely to reduce HIV risk pathways for adolescent girls and young women, especially adolescent mothers.

Pathways to parenting stress reduction among parents in South Africa

AbstractParenting stress has a range of effects on parents and their children. Despite existing evidence on the effectiveness of family‐based interventions on reducing parenting stress, little is known about the mechanism of change that contributes to its reduction. This study investigates the mechanism of change in a parenting programme (Parenting for Lifelong Health [PLH]) on reducing parenting stress among parents of adolescents in South Africa. A pragmatic cluster randomized controlled trial was conducted among a total sample of 552 parents and primary caregivers (aged, M = 49.37; SD = 14.69) who were recruited from 40 communities in South Africa's Eastern Cape Province. A mediation analysis was performed to investigate direct and indirect effects using PROCESS macrostatistical software. The findings of the study indicate that parenting stress reduction operates via three significant mediators: improved parent–child relationship (β = 0.058, P < 0.000), reduced parental depression (β = −0.103, P < 0.000) and reduced family financial strain (β = −0.049, P < 0.000). The findings of the study highlight the importance of considering child, parental and contextual factors in the design and development of interventions aimed at reducing parenting stress in families in low‐ and middle‐income settings.

Diversity and determinants of traditional water conservation technologies in the Eastern Cape Province, South Africa

Water scarcity remains a major threat to most rural areas in Africa due to heavy reliance on rainfed agriculture. This prompts the need to document and understand the determinants of traditional knowledge of water conservation practices. Our aim here is to document and identify the determinants of people’s knowledge of traditional knowledge of water conservation in the South Africa’s Eastern Cape province. A mixed research method was used. Purposive approach was used to collect data, i.e., elderly people were targeted during the face-to-face pre-COVID-19 pandemic interviews on the basis that traditional knowledge increases with age. However, people of different age groups were also included in the study especially when we employed only online questionnaire during the pandemic. We used questionnaire to collect all the data, and 93 people responded in total to our questions. We documented 10 traditional water conservation technologies. We identified rainfall variation, water quality issues, and increased water demand as the major challenges linked to these technologies, while easy access and the amount of water harvested are reported as benefits of these technologies. We found that traditional knowledge is not influenced by age (β = −0.006 ± 0.01, P = 0.64) or gender (β = −0.16 ± 0.25, P = 0.64) but rather correlates positively with geographic location, irrespective of the starting point of the distance measurement (distance from Port Elizabeth city: β = 0.002 ± 0.0008, P = 0.004; distance from Ngqushwa village: β = 0.0024 ± 0.0009, P = 0.008). Counterintuitively, formally educated people tend to have more traditional knowledge, but this is likely linked to the modern technologies (online survey and social media platforms) used to collect data during the COVID-19 pandemic. We suggest that traditional knowledge that has sustained life for centuries in rural communities must be integrated into water resource management to address water scarcity issues in rural Africa.Supplementary informationThe online version contains supplementary material available at 10.1007/s10661-022-09848-2.

Using Municipal Tourism Assets for Leveraging Local Economic Development in South Africa

Abstract Tourism development can be a vital component of place-based development initiatives in the global South. The nexus of tourism and place-based development thinking in the global South and of the role of local governments is only beginning to be investigated by tourism scholars. This article explores the record of using tourism assets in one South African local municipality for leveraging local economic development. Evidence is drawn from the experience of the King Sabata Dalindyebo Local Municipality in South Africa's Eastern Cape province. The research results point to an unimpressive record on the part of local government in directing the use of local assets for assisting tourism development. Several challenges are revealed to explain the underperformance of potentially valuable local assets in this municipality. Institutional and governance shortcomings, including widespread corruption, underpin the observed weaknesses both in the everyday workings of local government in relation to service delivery and infrastructure support as well as its inability to implement plans for local economic development. Well-meaning policies proposed for tourism development are not implemented variously for reasons of funding, lack of local support, lack of entrepreneurialism by the municipality and lack of ability to implement because of capacity issues. Potential state assets which could bolster tourism and local development outcomes are not being realized and in many cases the assets themselves are in a state of deterioration because of neglect.

Theorising the Image as Act: Reading the Social and Political in Images of the Rural Eastern Cape

Certain anthropological narratives of South Africa's Eastern Cape province, such as Monica Hunter's 1936 Reaction to Conquest and Philip Mayer's 1963 Townsmen or Tribesmen, persist as potent referential 'bodies of knowledge'. By laying down the coordinates of Black rural and urban experience, such studies continue to animate concepts of tradition and modernity, effectively conjuring up notions of 'the border', both literally and metaphorically. Encountering Pauline Ingle's photographic collection amidst these circuits of knowledge and ways of seeing is to recognise that it is both unusual and exceptional. It is a collection of over 4000 images that are not only located in a rural area but also covers a sustained time period, corresponding to the period of formal apartheid. The concept of the rural is amplified in the collection, positioning it as a site of development, as the 'not yet modern', in which subjects are figured both in class hierarchies and in relation to Daniel Morolong's urban photographs in and around East London in the 1950s. Employing the theory of social acts enables a re-contemplation of the subject, and a reading of the social that suggests a set of possibilities and futures beyond what currently constitutes the rural and the urban; and upturns the disciplinary optics that condition the predominating ethnographies and historiographies of the Eastern Cape.

High-resolution record of Holocene climate change dynamics from southern Africa's temperate-tropical boundary, Baviaanskloof, South Africa

South Africa's southern Cape is a highly dynamic climatic region that is influenced by changes in both temperate and tropical atmospheric and oceanic circulation dynamics. Recent research initiatives suggest that the major elements of the regional climate system have acted both independently and in combination to establish a mosaic of distinct climate regions and potentially steep climate response gradients across the southern Cape. To consider this further, we present new high resolution δ13C and δ15N data from a rock hyrax (Procavia capensis) midden from Baviaanskloof, in the Cape Fold Mountains of South Africa's Eastern Cape Province. Spanning the last 7200 years, these data provide detailed information regarding environmental changes in the mid- and late Holocene, allowing us to assess the spatio-temporal nature of climate change anomalies across the wider region. Throughout the full duration of the record, a negative correlation between humidity and palaeotemperature reconstructions from nearby Cango Cave is observed. In conjunction with correlations with Southern Ocean sea-surface temperatures and sea-ice presence, we infer a dominant influence of the southern westerlies in determining multi-millennial scale hydroclimate variability. At shorter, multi-centennial to millennial timescales, the Baviaanskloof data indicate a clearer expression of tropical influences, highlighting a delicate balance between the mechanisms driving regional climate dynamics across timescales, and the sensitivity of the region to changes in global boundary conditions.

Performing the common good: volunteering and ethics in non-state crime prevention in South Africa

AbstractUsing fieldwork data from South Africa's Eastern Cape Province, this article highlights ambiguities of volunteering as idea and practice by exploring discursive strategies used by volunteers in the field of civic crime prevention when the ethical honesty and selflessness of their commitment to volunteering is questioned by others. These ambiguities relate to asymmetries in the relationship between donors and recipients of volunteering, as well as, most importantly, the challenge to determine what constitutes the ‘common good’. This article demonstrates that these strategies entail the accommodation of contentions about: (1) the social identity of the volunteer by stressing the volunteer's commitment to abstract causes and objectives; (2) powerful asymmetries between donors and recipients of volunteering by invoking an encompassing sociality; and/or (3) the (alleged) self-interest of volunteers by defining the personal benefits achieved by volunteering not as an end in themselves but as ‘private means’ to ‘public ends’. All three strategies have in common that volunteers as ‘ethical subjects’ can here be shown to be co-produced with South African ‘communities of ethics’ on different social scales.

School Governance in a Fragmented Political and Bureaucratic Environment: Case Studies from South Africa's Eastern Cape Province

This paper explores governance dynamics in four case study schools in low-income communities in South Africa’s Eastern Cape province. A main aim is to identify empirically the causal mechanisms through which horizontal, school-level governance might function as an ‘institutional substitute’ for weaknesses in the province’s education bureaucracy. The case studies uncovered both vicious circles of capture, and virtuous spirals – with the latter characterised by shared developmental commitment among school leaders, teachers, parents and the community, strong enough to counter efforts at predation. The findings offer encouragement that non-hierarchical entry points for improving educational outcomes indeed have some potential to achieve gains.

Environmental apartheid: Eco-health and rural marginalization in South Africa

South Africa's infamous apartheid policies were not based on social, political, and economic injustice alone. They were also instituted environmentally with consequences that continue to scar the land and its people today. We offer the term environmental apartheid to refer to the use of the rural environment to deliberately marginalize racially defined groups, as well as the subsequent consequences of that marginalization. In the case of South Africa, the paradigmatic example of apartheid, environmental apartheid was largely instituted through rural marginalization, the use of rural space as an environmental means of marginalization. Although legal apartheid is over, environmental apartheid and its consequences continue to oppress Black South Africans, with devastating implications for their health, livelihoods, and ecological integrity. We illustrate these rural injustices through a case study of KuManzimdaka, a community of smallholder farmers on communal land in South Africa's Eastern Cape Province.

Surviving change by changing violently: ukuthwala in South Africa's Eastern Cape province

During the last decade a comeback of the apparently extinct marriage practice called ukuthwala has been noted and has found much attention in the South African media. It has been raised as a particular concern that, apparently, ukuthwala increasingly entails the abduction and rape of underage girls as a precursor to marriage. This article aims to illustrate why this alleged “cultural throwback” occurs as the result of national socio-cultural, legal and economic processes in South Africa. Operationalising the concepts of policulturalism and Afromodernity as suggested by Comaroff and Comaroff (2012), ethnographic fieldwork revealed that local communities are establishing new autonomous identities, set against the Constitution's ideal of human rights, through the revival and change of customary practices. These revived customs are then employed as survival strategies to combat new economic challenges and the HIV/ AIDS pandemic. Concurrently, these survival strategies influence the way in which ukuthwala is practiced, re-articulating an old tradition within modernity.

Creating and developing a non-profit community-outreach healthcare clinic in the developing world: lessons learnt in South Africa

Chesed Children's Clinic is a non-profit, non-governmental, volunteer-run primary care paediatric-outreach clinic servicing the severely under-resourced informal settlement of Mzamomhle within South Africa's impoverished Eastern Cape Province. Founded in May 2011 by a group of junior medical professionals and volunteers, the clinic has been successfully operating a weekend clinic on alternate Sundays since September 2011. This paper discusses 10 points of essential consideration for individuals and organisations intent on pursuing similar projects.

Small Towns and Small Enterprises: A Study of Workplace Relations in a Rural Town in South Africa

KEYWORDS Workers. Employers. Vulnerability. Exploitation. SMMEs. Rights ABSTRACT Scholarly literature on Small, Micro and Medium Enterprises (SMMEs) view small scale businesses as employment generators, skills developers, and therefore, contributors to economic growth and poverty reduction. While this notion dominates scholarship and policy circles, it ignores other issues that are inherent in management- labour relations in SMMEs. This study explores the vulnerability of workers in small businesses. It examines the factors contributing to workers exploitation, the extent of workers vulnerability to exploitation an d workers awareness of their rights in their workplaces. It focuses on employees of small businesses in Stutterheim, a small town in Amatole District in South Africa's Eastern Cape Province. The study uses both qualitative and quantitative methods to collect empirical data. Research findings reveal that workers in the study area are vulnerable to exploitation occasioned by high rate of poverty, scarcity of jobs, low levels of worker education, workers' unawareness of their rights, and official indifference to labour practices.

A further species of Agave L., A. salmiana Otto ex Salm-Dyck (subsp. salmiana) var. salmiana (Agavaceae), naturalised in the Eastern Cape Province of South Africa

Agave salmiana Otto ex Salm-Dyck subsp. salmiana var. salmiana, the typical variety of this large-growing Mexican species, is here recorded as having become established in South Africa's Eastern Cape Province. A description and key that can be used to distinguish it from A. americana L. subsp. americana var. americana and A. americana subsp. americana var. expansa (Jacobi) Gentry, both of which are large-growing and more widely naturalised in southern Africa, are provided. A comprehensive chronological synonymy summarises the complex nomenclatural and taxonomic histories of the species.

Land and Agrarian Reform in South Africa's Eastern Cape Province: Caught by Continuities

Investigating continuities and discontinuities is useful for an analysis of changes over time. Continuity is not just a simple, unbroken line of events, but involves a set of institutional and discursive linkages. The paper explores continuities in that relate to the agricultural expert system that has gradually taken shape in South Africa and that plays a prominent role in the design of land reform. The persistence of continuities indicates the extent to which dramatic transformations of the institutional infrastructure in agriculture have occurred, but with fewer changes in its content. Historical and contemporary analysis allows us to underline the continuity of prescriptions and modes of ordering in the past and present, evident in three land and agrarian reform projects in the Eastern Cape.

Practical Considerations for the Reintroduction of Large, Terrestrial,Mammalian Predators Based on Reintroductions to South Africa's Eastern Cape Province

The expansion of conservation estate in South Africa has seen large predators increasingly reintroduced in or- der to restore ecological integrity, conserve threatened species and maximise tourism. Reintroductions occurred at fenced, ecotourism sites in South Africa's Eastern Cape Province. Lion Panthera leo reintroduction began in 2000 and has been highly successful with a population of 56 currently extant in the region arising from 35 reintroduced individuals. The Af- rican wild dog Lycaon pictus population has increased to 24 from a founder population of 11. Reintroduction of spotted hyaenas Crocuta crocuta also appears successful, although reintroductions of leopards Panthera pardus and cheetahs Aci- nonyx jubatus have been less successful. Here we review the successes and failures of the reintroductions that have oc- curred in the region and describe recommendations to assist future translocations. Ecological attributes of each species af- fected the success with which they were reintroduced. Soft-release techniques, adequate fencing, appropriate socio- economic environment, the order of predator reintroduction with subordinate species released prior to dominant ones, adequate prey base and adequate monitoring all improved the success of reintroductions. Carrying capacity for large predators is unknown and continued monitoring and, we fear, intensive management will be necessary in virtually all modern day conservation areas.