District In South Africa Research Articles

Teachers' perceptions of principals’ digital leadership practices in a school district in a developing country

The fourth industrial revolution's (4IR's) disruptive digital technologies and innovations are radically altering the educational environment. The aim and structure of schooling have become progressively digital and different from the norm. Understanding principals' digital leadership practices is particularly important in the transition to digital learning as it involves navigating the digital change process in schools. This study investigated teachers' perceptions of principals' digital leadership practices in their attempts to keep up with the digital shift. Drawing on the four core principles of transformational leadership theory, the study sought to identify leadership practices that could mobilise digital learning. A generic qualitative approach was used. The study looked at three public primary schools in the Gauteng West district in South Africa. Data were generated by means of three focus group interviews with teachers and individual interviews with three principals. The findings revealed that leadership in these schools was mainly confined to conventional leadership practices which did not promote the practice of digital leadership. The findings exposed the need for principals to improve their knowledge of digital leadership in their leadership practices. The findings further highlighted the need for system-wide change in the South African education sector to support principals in transforming schools into digital learning environments. These findings contribute to the theoretical knowledge of principals' digital leadership practices.

Impact of single-dose HPV vaccination on HPV 16 and 18 prevalence in South African adolescent girls with and without HIV.

The World Health Organization has endorsed single-dose human papillomavirus (HPV) vaccination, but data on the impact on HPV prevalence in high HIV burden settings are limited. A single-dose bivalent HPV vaccine was delivered to adolescent girls in grade 10 in a schools-based campaign in 1 district in South Africa. Impact on HPV 16 and 18 prevalence was evaluated using repeat cross-sectional surveys. A clinic-based survey in girls aged 17-18 years established HPV 16 and 18 prevalence in a prevaccine population (n = 506, including 157 living with HIV) in 2019 and was repeated in the same age group and sites in a single-dose eligible population in 2021 (n = 892, including 117 with HIV). HPV DNA was detected on self-collected vaginal swabs using the Seegene Anyplex II HPV 28. Population impact was estimated overall and by HIV status using prevalence ratios adjusted for differences in sexual behavior between surveys. Single-dose vaccination campaign coverage was 72% (4807 of 6673) of eligible girls attending high school (n = 66) in the district. HPV 16 and 18 prevalence was 35% lower in the postvaccine survey overall (adjusted prevalence ratio = 0.65, 95% confidence interval [CI] = 0.51 to 0.83; P < .001) and 37% lower in those living with HIV (adjusted prevalence ratio = 0.63, 95% CI = 0.41 to 0.95; P = .026). No protective effect was seen for nonvaccine oncogenic HPV types 33, 35, 39, 51, 52, 56, 58, 59, or 68 overall (adjusted prevalence ratio = 1.14, 95% CI = 1.03 to 1.26; P = .011) or in those living with HIV (adjusted prevalence ratio = 1.00, 95% CI = 0.83 to 1.21. P = 0.99). These data provide reassuring evidence of single-dose impact on population-level HPV 16 and 18 prevalence in a South African population, irrespective of HIV status.

Barriers to Childhood Immunisation and Local Strategies in Four Districts in South Africa: A Qualitative Study.

Introduction: In South Africa over the past 20 years, immunisation has saved countless lives as well as prevented illnesses and disabilities. Despite this, vaccine-preventable illnesses remain a danger. The demand for and uptake of immunisation services are shaped by a variety of factors that can either act as barriers or facilitators to immunisation uptake. The aim of this project was to identify the supply and demand barriers and develop local strategies to improve childhood immunisation in four zero-dose districts in South Africa. Materials and Methods: This study used a mixed-method approach. In each of these four districts, 15 in-depth key informant interviews with health workers and local health managers and four focus group discussions (10 participants per focus group discussion) with community members and caregivers were held over a three-month period. Transcribed interviews were thematically analysed using qualitative analysis software (Nvivo®) into 10 factors as identified as important in influencing immunisation demand and uptake in previous studies. A further four were identified during the data analysis process. Results: Despite the varying role of factors affecting demand and uptake of immunisation services, three consistent findings stand out as major barriers across all districts. The first is interaction with healthcare staff. This clearly highlights the crucial role that the interactions between patients and staff play in shaping perceptions and behaviours related to immunisation services. The second is the overall experience of care at healthcare facilities. This emphasises the role that patient experience of services plays in perceptions and behaviours related to immunisation services. The third is family dynamics. This highlights the important role family dynamics play in shaping individuals' decisions regarding immunisation uptake as well as the impact it has on the ability of people to access health services. Discussion: The role played by the different factors in the demand and uptake of immunisation services varied across the four districts examined in this study. Each of the districts presents a unique landscape where different factors have varying degrees of importance in affecting the utilisation of immunisation services. In some districts, certain factors are major barriers, clearly hindering the demand and uptake of immunisation services, while in others, these same factors might be a relatively minor barrier. This discrepancy highlights the unique nature of healthcare challenges across the districts and the need for tailored strategy recommendations to address them effectively.

Sexually transmitted infections and bacterial vaginosis among adolescent girls and young women in the early postpartum period: a cross-sectional study

BackgroundUniversal antiretroviral treatment (ART) for pregnant women has reduced mother-to-child transmission risk significantly. However, not all women on ART are virally suppressed during pregnancy and lactation. In addition to poor adherence to ART, co-infections particularly other sexually transmitted infections (STIs) are known to increase the risk of HIV acquisition and HIV transmission. While the prevalence of STIs during pregnancy has been well studied, the prevalence of STIs in the postpartum period and its association with HIV viral suppression are underreported.MethodsIn this cross-sectional study, we determined the prevalence of STIs among adolescent girls and young women (AGYW) living with HIV (WLHIV) and without HIV (WNLHIV) at their 6–14 week postnatal clinic visit in a high HIV prevalence district in South Africa. All women were examined for STI-related symptoms and had vaginal swabs collected and stored for later STI testing. Vaginal swabs were tested for Trichomonas vaginalis (T.vaginalis), Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae (N. gonorrhoea) and herpes simplex virus-2 (HSV-2) using PCR. All women were tested for bacterial vaginosis (BV) using the Nugent scoring criteria. WLHIV had a blood sample collected for HIV viral load, Hepatitis B and syphilis.ResultsIncluded in this analysis were 82 WLHIV and 102 WNLHIV. Between 6 and 14 weeks postpartum, 40 (21.7%) AGYW tested positive for any STI and among these 15 (37.5%) were symptomatic and received empirical treatment. C. trachomatis was most commonly detected (10.9%), followed by HSV-2 (7.7%), T. vaginalis (3.8%) and N. gonorrhoea (1.6%). WLHIV were more likely to test positive for an STI (OR 2.0; 0.96–3.96) and BV (OR 4.2; 95%CI 2.1–8.1) compared to WNLHIV. Among WLHIV on ART, 70.5% had an undetectable plasma viral load (PVL) and 20.5% had a PVL > 1000 copies/ml. Testing positive for any STI or BV at the postpartum visit was not associated with PVL > 1000 copies/ml (OR 1.33; 95%CI 0.38–4.64).ConclusionWe report a high prevalence of largely asymptomatic STIs and BV in the early postpartum period and STIs in WLHIV were not associated with unsuppressed PVL.The high STI positivity rate among WNLHIV has implications for HIV risk during the postpartum period, and subsequently breastfeeding transmission.

Trends in continuity of treatment among children and adolescents living with HIV in 14 districts in South Africa from 2018-2023: A retrospective program analysis

ObjectivesUNAIDS estimates 152,984 children under 15 years living with HIV (C/ALHIV) by 2022 in South Africa. Monitoring the continuity of antiretroviral treatment remains challenging without electronic health records. We explored treatment cohort growth and interruption trends in 14-USAID-PEPFAR-supported districts. MethodsWe reviewed data from 2018 to 2023. We triangulated this data with NAOMI HIV estimates. We used Tableau version 2023.2 for analysis to understand heterogeneity in outcomes. ResultsHIV incidence halved from 4.3 per 1000 in 2017 to 2.5 per 1000 in 2022. HIV testing doubled: 188,371 in FY19Q1 to 399,708 in FY23Q4 while testing positivity declined from 3.3% to 0.7%. Linkage to treatment increased from 67% to 102%, viral suppression increased from 79% to 84%. C/ALHIV treatment cohort started at 82,897 in FY19Q1 and increased to 105,107 in FY20Q2. Subsequently, the cohort decreased to 79,288 in FY23Q4 despite 42,498 initiations and 62,256 returns. ConclusionsThe C/ALHIV treatment and viral suppression increased substantially commensurate with expected trends. Subsequent cohort decline was aligned to vertical transmission reduction, HIV incidence decline, and expected aging. We highlight the inadequacy of the information systems to quantify losses. We underscore a need for resources to enhance program monitoring and interventions to address this gap.

Parenting program to strengthen the self-efficacy of mothers and caregivers of children with developmental disabilities in a rural district in South Africa

Parenting program to strengthen the self-efficacy of mothers and caregivers of children with developmental disabilities in a rural district in South Africa

The primary health care environment and the performance of advanced antenatal care trained nurse-midwives in South Africa.

Transfer of learning in the workplace depends on various factors, one of which is the work environment. The aim of this study was to describe the interplay between the primary healthcare work environment, the performance of advanced antenatal care trained nurse-midwives, and birth outcomes. A cross-sectional, quantitative study was conducted in two purposely selected districts in South Africa. Document analyses were also completed. Statistical Analysis Software version 9.4 was used for descriptive statistical data analysis. The participating clinics, in the TM and LJ districts, both achieved ideal clinic status. The scores for the management of low- and high-risk pregnancies ranged between 86-89% and 87%, respectively. Babies born had Apgar scores of between 7-9 and 8-10 in 1 minute and 5 minutes after birth, respectively. Nurse-midwives scored low on interpreting assessment findings. Contrary to the Transfer of Learning Theory, nurse-midwives performed better in poorer work environments. The study suggests that the performance of advanced antenatal care trained nurse-midwives may not solely depend on a well-equipped work environment. Further studies should highlight the broader determinants of advanced antenatal care nurse-midwives services output.

Exploring the Integration of Virtual Laboratories in Science Education

The advantage of VLs lies in their capacity for simulating real-world lab experiences within a fully immersive digital environment, yet the uptake in rural schools in developing countries remains low. To understand this paradox, this study explores the perceptions of seven secondary school science teachers in a rural district in South Africa. Through a qualitative case-study methodology guided by the interpretive paradigm, this research adopts a phenomenological approach to gain insights into teachers' attitudes, understandings, and the factors influencing their acceptance or rejection of this technology. The Unified Theory of Acceptance and Use of Technology is employed as a theoretical framework. The study finds that despite potential educational benefits, the actual use of VLs is largely influenced by teacher perceptions and experiences, rooted in context-specific challenges. The findings reveal that teachers perceive VL as a beneficial and practical tool providing access to high-quality lab equipment necessary for student experiments, which could otherwise be cost-prohibitive.

Community perceived barriers to uptake of health services among men at Sedibeng district in South Africa.

This qualitative study aimed to investigate the barriers that hinder men's utilisation of healthcare services in the Sedibeng district of South Africa. The study was conducted using flyers with questions posted on the Best Health Solutions' Facebook page for two weeks. A convenience sampling method was used and a total of 104 comments were collected from 64 respondents. The authors analysed the participants' self-reported data thematically on demographics, geographic area, and reasons for men not using healthcare services. The findings revealed that sociocultural norms played a significant role in men's reluctance to seek medical help, as it was perceived as a sign of weakness. The scarcity of male healthcare professionals hinders open discussions. Stigma and discrimination were identified as substantial barriers. Convenience, trust, and confidentiality concerns, along with the influence of intimate partners, also influence men's decision-making. This study highlights the complex interplay between various barriers that impact men's utilisation of healthcare services in the district. By addressing these factors, healthcare providers and policymakers can enhance healthcare access and promote better health outcomes for men in Sedibeng district. The manuscript's primary contribution lies in uncovering multifaceted barriers to men's healthcare utilisation in Sedibeng district. It explores socio-cultural norms, healthcare worker demographics, stigma, discrimination, convenience factors, trust, confidentiality concerns, and the influence of intimate partners on men's healthcare choices. These insights illuminate the complex factors affecting men's healthcare access, providing valuable knowledge for healthcare providers and policymakers.

Attrition Rates in HIV Viral Load Monitoring and Factors Associated With Overdue Testing Among Children Within South Africa's Antiretroviral Treatment Program: Retrospective Descriptive Analysis.

Numerous studies in South Africa have reported low HIV viral load (VL) suppression and high attrition rates within the pediatric HIV treatment program. Using routine laboratory data, we evaluated HIV VL monitoring, including mobility and overdue VL (OVL) testing, within 5 priority districts in South Africa. We performed a retrospective descriptive analysis of National Health Laboratory Service (NHLS) data for children and adolescents aged 1-15 years having undergone HIV VL testing between May 1, 2019, and April 30, 2020, from 152 facilities within the City of Johannesburg, City of Tshwane, eThekwini, uMgungundlovu, and Zululand. HIV VL test-level data were deduplicated to patient-level data using the NHLS CDW (Corporate Data Warehouse) probabilistic record-linking algorithm and then further manually deduplicated. An OVL was defined as no subsequent VL determined within 18 months of the last test. Variables associated with the last VL test, including age, sex, VL findings, district type, and facility type, are described. A multivariate logistic regression analysis was performed to identify variables associated with an OVL test. Among 21,338 children and adolescents aged 1-15 years who had an HIV VL test, 72.70% (n=15,512) had a follow-up VL test within 18 months. Furthermore, 13.33% (n=2194) of them were followed up at a different facility, of whom 3.79% (n=624) were in a different district and 1.71% (n=281) were in a different province. Among patients with a VL of ≥1000 RNA copies/mL of plasma, the median time to subsequent testing was 6 (IQR 4-10) months. The younger the age of the patient, the greater the proportion with an OVL, ranging from a peak of 52% among 1-year-olds to a trough of 21% among 14-year-olds. On multivariate analysis, 2 consecutive HIV VL findings of ≥1000 RNA copies/mL of plasma were associated with an increased adjusted odds ratio (AOR) of having an OVL (AOR 2.07, 95% CI 1.71-2.51). Conversely, patients examined at a hospital (AOR 0.86, 95% CI 0.77-0.96), those with ≥2 previous tests (AOR 0.78, 95% CI 0.70-0.86), those examined in a rural district (AOR 0.63, 95% CI 0.54-0.73), and older age groups of 5-9 years (AOR 0.56, 95% CI 0.47-0.65) and 10-14 years (AOR 0.51, 95% CI 0.44-0.59) compared to 1-4 years were associated with a significantly decreased odds of having an OVL test. Considerable attrition occurs within South Africa's pediatric HIV treatment program, with over one-fourth of children having an OVL test 18 months subsequent to their previous test. In particular, younger children and those with virological failure were found to be at increased risk of having an OVL test. Improved HIV VL monitoring is essential for improving outcomes within South Africa's pediatric antiretroviral treatment program.

Examining Grade 6 Teachers’ Knowledge and Understanding of Differentiated Instruction in O.R. Tambo Inland District in South Africa

It is essential to ensure differentiation in curriculum delivery to give all learners access to learning while also meeting the diversity of learner needs in the classroom in line with the Republic of South Africa’s inclusive education policy. This mixed methods study sought to examine grade 6 teachers’ knowledge and understanding of differentiated instruction to respond to the diverse needs of learners in OR Tambo Education District in the Eastern Cape. Data was collected from three randomly selected primary schools using interviews, questionnaires, and classroom observation tools. Four grade 6 teachers for mathematics and reading-to-learn were selected from each school (N 12). Key findings revealed that teachers lacked knowledge and understanding of differentiated instruction, and how it should be implemented in the classroom. This implies that all teachers should be trained or in-serviced (during and after training respectively) on how to respond to learners’ diverse needs during teaching and learning. This study contributes to knowledge in the field of inclusive education. The results of this study may influence universities to design teacher education programmes, methods, and/or interventions, which will enhance responses to learner diversity through differentiated instruction. This study could help researchers uncover the critical areas of differentiated instruction, its importance and its application in the classroom, its benefits for teachers and learners, and its impact on student learning. Keywords: Curriculum Delivery, Differentiated Instruction, Learner Diversity, Pedagogical Knowledge.

Enhancing Educational Practices during a Pandemic: Examining Teachers' Journey with Blended Learning in Rural High Schools

In response to the COVID-19 pandemic, schools and institutions all over the world utilised blended learning during the mandatory lockdowns that were imposed by their respective governments. This acted as a spur for educational reform. This study investigated teachers’ experiences with the implementation of blended learning in rural high schools during the COVID-19 era in one educational district in South Africa. The social constructivism theory served as the theoretical lens for this study. This study employed the qualitative case study design. Purposeful and convenience sampling were used to select participants for the study. The data were collected using semi-structured interviews. The interviews were recorded, transcribed, and analysed using a thematic analysis approach. This study found that teachers perceived blended learning as easy to use, simple, user-friendly, straightforward to navigate, and offering creative modes of instruction. This study further found that teachers developed a positive perception of blended learning and its potential use in teaching and learning in the post-COVID-19 era, as blended learning promoted students’ independence and engagement in the teaching-learning process. However, the participants also experienced challenges, such as a lack of pedagogical knowledge on the use of blended learning, in their respective subjects, connectivity issues, electricity cuts, and network and internet issues. This study suggests that schools implement blended learning in the post-COVID-19 era to evaluate its impact on the teaching and learning process.

Embodying Learners’ Semasiological Disparateness in an English First Additional Language Classroom

Language-in-education policy in the apartheid era in South Africa reflected a divide-and-rule strategy, which stipulated that each ethnic group was to be taught in its language. Thus, the post-1994 period in South Africa involved a dramatic re-imagination of the country from a racially divided nation to a diverse but united, non-racial nation. This is pertinent to South Africa, a linguistically diverse country whose history of language in education has been shaped by political interests, as well as pedagogical considerations. Against this background, since the impact of cultural diversity on education policy and reforms is a strategically significant issue for us all, this study sought to explore how Grade 4 English First Additional Language (EFAL) teachers incorporate Grade 4 EFAL learners’ linguistic diversity in teaching and learning. For this qualitative study, 10 Grade 4 teachers in 5 primary schools in one district in South Africa were used as respondents. The researcher used one-on-one telephonic interviews to collect data. The results revealed that teachers acknowledge the need to use some approaches to support oral language development. Besides, teachers use a range of strategies, from translanguaging, and code-switching to translation, to encourage learners to use their home languages to develop proficiency in the EFAL. Also, the study has shown that cooperative language learning, which shares some characteristics with communicative language teaching helps learners develop a great liking of EFAL.

Screening for dementia and associated factors in older adults from low socioeconomic communities in iLembe, KwaZulu-Natal.

Dementia is one of the leading non-communicable causes of disability and mortality in older adults, with recent research showing that it is increasing in low-middle-income countries compared to high-income countries. As such, multidisciplinary efforts are needed to effectively reduce the prevalence and risk of dementia through quick screening, diagnosis, and management of those with dementia and those at risk. The study's objectives were to estimate the prevalence of dementia and measure the sociodemographic and clinical risks in older adults in low socioeconomic communities. The study was conducted among older adults aged ≥ 60 years from the iLembe district in South Africa. This cross-sectional, one-phased, household study was conducted to screen for dementia over 8 months between October 2018 and October 2019. Demographic and clinical data were collected using a semi-structured questionnaire. In addition, the Mini-Mental Status Exam, Ascertain Dementia Eight-item questionnaire and Instrumental Activities of Daily Living Scale were administered to a multi-stage cluster sample of 320 participants to ascertain dementia prevalence. Frequencies and multivariate logistic regression were conducted to determine risk factors correlated with dementia. The prevalence of dementia was 13.4%. Participants aged 80 years and above were 2.73 times more likely to develop dementia than participants younger than 80 years. Those with an education level of Grade 1-7 had a 69% less chance of developing dementia than those without formal education. Single participants showed an almost seven-fold increase in dementia. Lastly, depression increased the risk of dementia by two-fold. Dementia was probable in over one-sixth of the sample. Dementia risk factors were both modifiable and non-modifiable. Dementia prevalence in South Africa is increasing and therefore it is crucial to develop a dementia plan that is specific to the South African context which will include strategies for early identification of the disease, reducing modifiable risks and strategic management of dementia associated medical conditions such as depression and vascular diseases.

Satisfaction with service delivery among HIV treatment clients enrolled in differentiated and conventional models of care in South Africa: a baseline survey.

Differentiated service delivery (DSD) models aim to increase the responsiveness of HIV treatment programmes to the individual needs of antiretroviral therapy (ART) clients to improve treatment outcomes and quality of life. Little is known about how DSD client experiences differ from conventional care. From May to November 2021, we interviewed adult (≥18) ART clients at 21 primary clinics in four districts of South Africa. Participants were enrolled consecutively at routine visits and stratified into four groups: conventional care-not eligible for DSD (conventional-not-eligible); conventional care eligible for but not enrolled in DSD (conventional-not-enrolled); facility pickup point DSD model; and external pickup point DSD model. Satisfaction was assessed using questions with 5-point Likert-scale responses. Mean scores were categorized as not satisfied (score ≤3) or satisfied (>3). We used logistic regression to assess differences and report crude and adjusted odds ratios (aORs). Qualitative themes were identified through content analysis. Eight hundred and sixty-seven participants (70% female, median age 39) were surveyed: 24% facility pick-up points; 27% external pick-up points; 25% conventional-not-eligible; and 24% conventional-not-enrolled. Seventy-four percent of all study participants expressed satisfaction with their HIV care. Those enrolled in DSD models were more likely to be satisfied, with an aOR of 6.24 (95% CI [3.18-12.24]) for external pick-up point versus conventional-not-eligible and an aOR of 3.30 (1.95-5.58) for facility pick-up point versus conventional-not-eligible. Conventional-not-enrolled clients were slightly but not significantly more satisfied than conventional-not-eligible clients (1.29, 0.85-1.96). Those seeking outside healthcare (crude OR 0.57, 0.41-0.81) or reporting more annual clinic visits (0.52, 0.29-0.93) were less likely to be satisfied. Conventional care participants reporting satisfaction with their current model of care perceived providers as helpful, respectful, and friendly and were satisfied with care despite long queues. DSD model participants emphasized ease and convenience, particularly not having to queue. Most adult ART clients in South Africa were satisfied with their care, but those enrolled in DSD models expressed slightly greater satisfaction than those remaining in conventional care. Efforts should focus on enrolling more eligible patients into DSD models, expanding eligibility criteria to cover a wider client base, and further improving the models' desirable characteristics.

The Impact of COVID-19 on Female School Leadership in the Tshwane South District in South Africa

Female school leaders in South Africa experienced challenges during the pandemic because of gender stereotypes. This study aimed to explore the impact of COVID-19 on female school leadership. Qualitative methods were used to interpret female leaders’ attitudes, experiences, and understanding of specific circumstances. Data was collected using semi-structured interviews supported by analysis of school documents. Findings revealed that female school leaders relied on their self-confidence, networking, and use of COVID-19 policy to overcome challenges. This study presented that the use of different leadership styles also made a positive impact on female school leaders. They experienced challenges such as failure to execute their leadership positions due to gender stereotypes and lack of community and district support. There is a need for the government to develop approaches that would address the impact of COVID-19 across sectors. Future studies should examine support for school leaders.

Improving HIV Case Finding Through Index Testing: Findings from Health Facilities in 12 Districts of South Africa, October 2019-September 2021.

To assess the importance of index testing in HIV case finding, we analyzed quarterly data from October 2019 to September 2021 from 371 facilities in 12 districts in South Africa. Index testing accounted for 2.6% of all HIV tests (index and non-index) (n = 163,633), but 17.8% of all HIV-positive results, with an HIV-positivity 4-times higher than non-index testing modalities (4.1%). Despite twice as many adult females ≥ 15 years accepting index testing (n = 206,715) compared to adult males ≥ 15 years (n = 102,180), females identified fewer contacts (n = 91,123) than males (n = 113,939). Slightly more than half (51.2%) of all contacts elicited were tested (n = 163,633/319,680), while 19.7% (n = 62,978) of elicited contacts were previously diagnosed as HIV-positive and not eligible for further testing. These findings indicate index testing can be effective in increasing HIV diagnoses in South Africa. Further operational research is needed to address gaps identified in the index testing cascade, including elicitation and testing of contacts.

Community perceptions of community health worker effectiveness: Contributions to health behaviour change in an urban health district in South Africa

Background. Community health worker (CHW) programmes contribute towards strengthening adherence support, improving maternal and child health outcomes and providing support for social services. They play a valuable role in health behaviour change in vulnerable communities. Large-scale, comprehensive CHW programmes at health district level are part of a South African (SA) strategy to re-engineer primary healthcare and take health directly into communities and households, contributing to universal health coverage. Objective. These CHW programmes across health districts were introduced in SA in 2010 - 11. Their overall purpose is to improve access to healthcare and encourage healthy behaviour in vulnerable communities, through community and family engagements, leading to less disease and better population health. Communities therefore need to accept and support these initiatives. There is, however, inadequate local evidence on community perceptions of the effectiveness of such programmes. Methods. A cross-sectional descriptive study to determine community perceptions of the role and contributions of the CHW programme was conducted in the Ekurhuleni health district, an urban metropolis in SA. Members from 417 households supported by CHWs were interviewed in May 2019 by retired nurses used as fieldworkers. Frequencies and descriptive analyses were used to report on the main study outcomes of community acceptance and satisfaction. Results. Nearly all the study households were poor and had at least one vulnerable member, either a child under 5, an elderly person, a pregnant woman or someone with a chronic condition. CHWs had supported these households for 2 years or longer. More than 90% of households were extremely satisfied with their CHW; they found it easy to talk to them within the privacy of their homes and to follow the health education and advice given by the CHWs. The community members highly rated care for chronic conditions (82%), indicated that children were healthier (41%) and had safer pregnancies (6%). Conclusion. As important stakeholders in CHW programmes, exploring community acceptance, appreciation and support is critical in understanding the drivers of programme performance. Community acceptance of the CHWs in the Ekurhuleni health district was high. The perspective of the community was that the CHWs were quite effective. This was demonstrated when they reported changes in household behaviour with regard to improved access to care through early screening, referrals and improved management of chronic and other conditions.

Primary School Teachers’ Perspective on Stress Triggers: A South African Case Study

This paper sought to establish teachers’ perspectives on the daily stress triggers they face in primary schools in Chris Hani East District in South Africa. Regardless of gender, wealth, or surroundings, stress is a universal phenomenon that impacts everyone. Although this occurrence has been extensively studied, teachers’ stress experiences continue to pose a serious threat, especially to the efficacy of schools. In South African classrooms, rationalization and the high teacher-to-learner ratio are just two of the problems teachers encounter. Schools must develop more effective intervention initiatives that can help instructors manage their stress. With a survey-only design, a quantitative study technique was used. One hundred schools were chosen randomly. Utilizing the Statistical Package for Social Sciences, data was examined. (SPSS). The findings of this study indicated that the demotivation of teachers which triggers stress levels in schools is due to the lack of promotion, poor rationalisation process and lack of motivation from management. It is recommended that school managers must come up with better strategies to motivate teachers and the Department of Education must intervene with programmes that can help teachers deal with stress. This article contributes to the discourse on employee welfare in the educational space. Keywords: Teacher Stress Triggers, Professional Development, Stress Management, Intervention Strategies.

Using the Strategy Instructions Approach (SIA) in Teaching Reading Comprehension: A Case Study Schools in the Amathole East District South in Africa

This study sought to explore the effectiveness of using the Strategy Instructions Approach (SIA) to teach South African children reading comprehension. The majority of language teachers, especially those who teach English as a first or second language, were found to be lacking in the skills needed to impart reading comprehension effectively to their learners. Grade 8 learners were taught reading comprehension using SIA which was basically from the curriculum and assessment policy statement (CAPS) materials. A control group of 60 learners and an experimental group of 60 learners (sampled from three schools in Amathole East District in South Africa) were used to determine the effectiveness of SIA when compared to the traditional teaching approaches used by teachers to teach reading comprehension. The outcomes demonstrated that SIA enhanced performance in reading comprehension. The study recommends that schools especially, those in rural areas should have more reading resources and activities, longer hours on the school timetable for teaching reading comprehension, and higher institutions should train teachers to use SIA. Keywords: Strategy Instructions Approach (SIA), Reading Comprehension, Curriculum and Assessment Policy Statement (CAPS), Control Group, Experimental Group