Gauteng Province Research Articles

Violence Victimization and Depressive Symptoms Among a Sub-Sample of Sexual and Gender Minority Adults in a Population-Based South African Study.

Sexual and gender minority (SGM) adults in South Africa face high levels of violence and poor mental health outcomes. Interventions to prevent these negative health implications are hampered by a lack of representative data among this population. This study aims to quantify the associations between three forms of violent victimization and depressive symptoms in a sub-sample of SGM drawn from a population-based cross-sectional study in Gauteng, South Africa. Data come from the sixth Quality of Life survey conducted in South Africa's Gauteng province. Brief screeners assessed childhood sexual abuse (CSA), past-year intimate partner violence (IPV), non-partner violence, and depressive symptoms. Three survey-weighted logistic regression analyses were fit to model associations between elevated depressive symptoms and CSA, past-year IPV, and past-year non-partner violence, controlling for socio-demographics (age, race, sex, area of residence, education, socioeconomic status, and recent employment). N = 1,328 SGM respondents were included. Over 40% (n = 537) reported depressive symptoms, while 17% (n = 222) reported CSA, 5% (n = 67) reported IPV, and 16% (n = 208) reported non-partner violence. CSA and non-partner violence were associated with significantly higher odds of reporting depressive symptoms (aOR: 1.51, 95% CI [1.03, 2.23]; aOR: 1.84, [1.24, 2.73], respectively). IPV was not associated with elevated depressive symptoms (aOR: 1.17, [0.64, 2.16]). In all models, employment in the past 7 days was associated with significantly lower odds of reporting depressive symptoms. Recent and childhood violence is a major burden that is associated with elevated symptoms of depression among SGM in urban South Africa. Community-tailored interventions and policy-related advocacy related to employment and violence prevention may alleviate depressive symptoms in SGM adults in Gauteng.

Experiences of pregnant and parenting students at a university in Gauteng province.

Pregnancy and parenting in tertiary institutions is a worldwide concern. The number of pregnancies among tertiary students is increasing globally. About 16 million young women between the ages of 15 years and 19 years around the world became mothers and two million girls under the age of 15 years are reported to be pregnant every year. South African universities continue to report high rates of student pregnancies, and are looking for solutions to the crisis that female students are facing. The purpose of the study was to explore the experiences of pregnant and parenting students. At a university in Gauteng province, South Africa. A qualitative, exploratory and descriptive design was used in a study that was conducted at a university in Gauteng province, South Africa. Undergraduate pregnant and parenting students were sampled purposively, and the sample size was 15 participants. Semi-structured interviews were used to collect data and data were analysed using thematic analysis. The findings of the study produced four themes, namely emotional experience during pregnancy, academic challenges during parenting, experiences during antenatal care, and students' resilience during pregnancy and parenting. Pregnant and parenting students require emotional, academic and social support from the university and other stakeholders. The university should offer on-campus medical services such as antenatal care and provide academic support for pregnant and parenting students to help them achieve their academic objectives. This study highlights the importance of developing support programmes that focus on pregnant and parenting students in universities.

When we came back the ball was just not rolling: Special needs educators' perspectives of improvisation through the COVID‐19 pandemic

AbstractWhile the COVID‐19 pandemic disrupted education across the globe, special needs schools in middle‐ and low‐income countries were particularly affected. Learners in these contexts often did not have access to assistive technologies and individualised adaptations of materials in their home environment. This study aimed to explore the experiences of special needs educators regarding how lockdown restrictions had impacted their educational practices. In‐depth, semistructured interviews were conducted with 12 special needs educators across the Gauteng and Western Cape provinces of South Africa and were analysed through the lens of interpretive phenomenological analysis. Three themes emerged from the interviews. First, the teachers discussed the ways in which they ensured that the curriculum continued during the period of hard lockdown. Second, they discussed the challenges of remote teaching, and lastly, they addressed the challenges when the learners returned to face‐to‐face learning. These themes shed light on the teachers' flexibility, creativity and ability to improvise within uncertain, unpredictable and unfamiliar educational terrains. We draw the conclusion that it was largely due to positive teacher–learner relationships and the commitment by teachers that improvisation and creativity were possible and effective.

Motives of water and sanitation entrepreneurs in South Africa

The study aims to understand what motivates water and sanitation social entrepreneurs(SEs) in South Africa as they navigate the complex business environment of collaborating with municipalities in undertaking public service delivery. In an attempt to achieve higher sustainability in their SE business models, SE processes become risky and inevitably involve higher complexity as SE business model designers seek to also understand their business impact on the whole ecosystem. Any impact on any of the water and sanitation subsystems can stress or compromise the stability of the whole system.As such, in-depth face-to-face semi-structured interview was conducted with purposively selected social entrepreneurs in South Africa‘s Gauteng and Western Cape provinces. The study finds that SEs are motivated by compassion, religious, problem solving motives as well as the desire for self-sufficiency for sustainable business operation so as to make impact at scale. The overall mission is to change human living environments and provide sustainable alternative public services

Exploring patient referral practices of traditional healthcare practitioners in Soshanguve, Gauteng Province, South Africa.

It may be necessary for healthcare professionals to refer patients to other professionals and institutions that are able to provide the care needed by patients, depending on the severity each case presents, healthcare requirements, and resources available to offer care. In healthcare generally, patient referral is standard procedure; however, in South Africa, referral patterns between allopathic and traditional healthcare practitioners are unknown, and this is a problem yet to be addressed. The study objective was to explore patient referral practices from the perspectives of traditional healthcare practitioners of South Africa. A qualitative, exploratory and descriptive design was employed to collect data from 11 traditional healthcare practitioners who were sampled using snowball sampling. An individual semi structured interview schedule was used to collect data. Content analysis was used to analyze the data. Patient referral was common practice in traditional health practices, however not reciprocal between the traditional and allopathic healthcare. Several indications for patient referral to allopathic healthcare practitioners included management of chronic conditions amongst others. Patient referral being an important part of healthcare practices should be promoted and regulation and traditional health practices improved to promote safe referral practices and curb unsafe self-referrals by patients.

Detection and characterisation of microplastics in tap water from Gauteng, South Africa

This study reports the presence, concentration, and characteristics of microplastics (MPs) in tap water in three suburbs in Gauteng Province in South Africa. Physical characterisation was conducted using stereomicroscopy and scanning electron microscopy following staining of MPs with the Rose Bengal dye. The concentrations of MPs in all samples ranged from 4.7 to 31 particles/L, with a mean of 14 ± 5.6 particles/L. Small-sized (<1 mm) and fibrous-shaped MPs were most abundant in all samples. Fibers accounted for 83.1% of MPs in samples from all the three areas, followed by fragments (12.4%), pellets/beads (3.1%), and films (1.5%), with a minor variation in the distribution of shapes and sizes in samples from each area. Raman microspectroscopy was used for chemical analysis, and five polymers were identified, namely: high-density polyethylene, polyurethane, polyethylene terephthalate, poly(hexamethylene terephtalamide), and poly(acrylamide-co-acrylic acid). C.I Pigment Red 1, C.I. Solvent Yellow 4, Potassium indigotetrasulphonate, and C.I Pigment Black 7 were the colourants detected. These colourants are carcinogenic and mutagenic and are potentially toxic to humans. The prevalence of MPs in tap water implies their inadequate removal during water treatment. For instance, the presence of poly(AM-co-AA) suggests that drinking water treatment plants may be a potential source of MPs in tap water. Other polymers, e.g., high-density polyethylene may be released from pipes during the transportation of drinking water. The estimated daily consumption of MPs from tap water was 1.2, 0.71, and 0.50 particles/kg.day for children, men, and women, respectively. The findings of this study provide evidence of the presence of MPs in drinking water in South Africa, thus giving some insights into the performance of treatment plants in removing these contaminants and a benchmark for the formulation of standard limits for the amount of MPs in drinking water.

Exploring the impact of 12-hour shifts on police officers' personal lives: a case study in the City of Tshwane, South Africa

Shift work has become a necessity in various professions, including law enforcement, to ensure the continuous operation of essential services. The implementation of 12-hour shifts has become common practice in police departments, aiming to meet the demands of public safety. However, the implications of such extended work periods on the personal lives of police officers are significant and warrant exploration. This study focuses on examining the effects of a 12-hour shift schedule on police officers within the South African Police Service (SAPS) stationed in the City of Tshwane, Gauteng province, South Africa. Through qualitative research methods, data was collected from eight police officers with a minimum of two years of experience through face-to-face interviews. Thematic content analysis was used to analyse the data systematically. Findings reveal that the 12-hour shift system presents challenges in maintaining a healthy work-life balance, impacting officers' social and familial responsibilities, participation in cultural and religious activities, and overall well-being. Officers expressed concerns about fatigue, limited time for family and leisure activities, and conflicts with personal commitments. Addressing these challenges is crucial for enhancing the health and effectiveness of police personnel and ensuring a positive work-life balance. This study contributes to the existing body of knowledge by shedding light on the nuanced effects of the 12-hour shift system on police officers' personal lives, particularly in the South African context. Recommendations were also made to address the effects of the shift system on officer’s personal life.

The roles of teachers in enhancing effective classroom management strategies in Gauteng high schools, South Africa

Purpose: This study explores the challenges teachers face in their classroom management roles which are essential for fostering a supportive learning environment. It investigates teachers' roles in implementing management strategies and the obstacles hindering their effectiveness in high schools.&#x0D; Design/Methodology/Approach: The present study used semi-structured interviews to collect data from twelve Grade 10 teachers in three selected secondary schools located in the Ekurhuleni North District of Gauteng Province, South Africa. The data were interpreted using a phenomenological research design and interpretive paradigm. The study was based on ecological systems theory. Thematic analysis was used to make sense of the data.&#x0D; Findings: The study revealed that key roles of teachers in effective classroom management include appropriate classroom language, acting as managers and self-criticism and evaluation of performance. However, challenges such as insufficient teaching and learning resources and the low academic ability of learners impede the fulfilment of these roles.&#x0D; Conclusion: The study finds that continuous self-criticism and evaluation are critical for improving teaching and learning processes, although teachers play a critical role in monitoring classrooms and resolving difficulties imposed by low academic competence.&#x0D; Recommendations: Recommendations include comprehensive training and support for teachers, the implementation of diverse teaching strategies and a holistic consideration of the ecological system encompassing both learners and teachers.

Prevalence of needle stick and sharps injuries and associated factors among nursing students in Gauteng province, South Africa

Prevalence of needle stick and sharps injuries and associated factors among nursing students in Gauteng province, South Africa

45 Evaluation of Drug-Resistant Tuberculosis Guidelines and Outcomes by Treatment Site in South Africa

OBJECTIVES/GOALS: DR-TB care in South Africa includes decentralized treatment with shorter, all-oral regimens. Treatment guidelines direct regular clinical and laboratory evaluation to assess patient improvement. We therefore measured sputum collection frequency and follow-up time to assess fidelity to these guidelines in Gauteng Province, South Africa. METHODS/STUDY POPULATION: We included Rifampicin-resistant (RR) sputum specimens from the South African National Health Laboratory Service, which provides pathology services to 80% of the population, submitted between August 2022-September 2023. Patient data were obtained from a DR-TB registry and additional sputum specimen data were collected from follow-up laboratory worksheets. Follow-up spanned from first sputum collection date (baseline) to patient outcome date (e.g., completion, lost) or study closure date (if still on treatment). Monthly sputum submission rate was measured for those with ≥1 additional sputum submitted. We compared patient data by treatment site: at the specialized hospital vs. any other site, using Wilcoxon ranksum and χ2 tests. RESULTS/ANTICIPATED RESULTS: Baseline RR-TB specimens were available for 142 patients, of whom 28 (20%) had specimens submitted from the specialized hospital. Patients at the specialized hospital were older (median age 41 vs. 35.5 years, p=0.03), had higher baseline fluoroquinolone resistance (10% vs. 1%, p=0.01), and longer follow-up (median 5.2 vs. 3.5 months, p=0.01) compared to patients elsewhere. Further, 43 (30%) patients had ≥1 additional sputum submitted during follow-up. Among these, monthly sputum collection rates did not differ by site (0.3 vs. 0.3 sputum per month, p=0.89). We anticipate that increased sputum frequency will be associated with successful TB treatment outcomes based on preliminary findings. DISCUSSION/SIGNIFICANCE: These findings highlight ongoing challenges with routine laboratory follow-up according to DR-TB guidelines across treatment sites in South Africa. Future research is needed to determine reasons for low sputum collection rates, such as low patient adherence, variation in practice of healthcare workers, loss to follow-up, and clinical challenges.

Collaborative design of a health research training programme for nurses and midwives in Tshwane district, South Africa: a study protocol

IntroductionNurses are essential for implementing evidence-based practices to improve patient outcomes. Unfortunately, nurses lack knowledge about research and do not always understand research terminology. This study aims to develop an...

Mental health services in Gauteng, South Africa: A proxy evaluation using pharmaceutical data.

South African legislation advocates for equitable access to mental healthcare services integrated into general healthcare settings. Mental, neurological, and substance use (MNS) disorders are often comorbid. Pharmacoepidemiology provides indirect evidence of service provision for conditions amenable to medicine treatment. The study aims to evaluate medicine procurement for MNS disorders at different service levels in the health system. The Public health sector, Gauteng province formed the setting for the study. A secondary analysis of the Gauteng pharmaceutical database was conducted using Anatomic Therapeutic Chemical (ATC) and defined daily dose (DDD) methodology. Anatomic Therapeutic Chemical classes of medicines for MNS disorders were included. Defined daily doses and costs were calculated per 1000 population served by each facility and service level. Statistical comparisons were made using chi-square testing. General healthcare settings accounted for 90% (R118 638 248) and specialised hospitals for 10% (R13 685 032) of expenditure on medicines for MNS disorders, procuring 94% (n = 49 442 474) and 6% (n = 3 311 528) of DDDs, respectively. Although district clinics procured 60% of DDDs, they procured the least per 1000 population served, whereas district hospitals procured the most. For almost all ATC classes, procurement differed significantly between municipalities at every service level and between specialised hospitals. In Gauteng province, most medicines for MNS disorders are procured by general healthcare services, but access to care may not be equitable. While population coverage at district clinics appears low, district hospitals may experience the greatest care burden. Research regarding quality of care at each service level is recommended. This study provides insight into service provision for MNS disorders.

Burnt out: A retrospective review of paediatric burns admissions at Chris Hani Baragwanath Academic Hospital 2015–2020

BackgroundBurn injuries in children in low- and middle-income countries are common, serious, and preventable. Despite the high burden of disease, there is a paucity of data on the profile of paediatric burns in South Africa. Such data are essential to local burn prevention strategies. MethodsA retrospective review of all recorded paediatric burns admissions to the paediatric burns unit at Chris Hani Baragwanath Academic Hospital was performed from 1 January 2015 – 31 December 2020. Ethical approval was obtained. Data extracted anonymously included patient age, sex, mechanism of injury, injury severity, date of injury and residential location. ResultsA total of 2980 admissions occurred during the study period. Infants ≤ 1 year accounted for 42.2 % (1259/2980), males 61.4 % (1689/2751), hot water burns 79.1 % (2357/2980), and major injury 40.1 % (1201/2980) of admissions. Most burn injuries occurred in winter (28.2 %, 842/2980), and most admitted patients lived in Soweto 45.5 % (1355/2980). ConclusionsMost burns admissions in the study period were characterised by male children less than one year of age, hot water burns, major burn injuries and admissions in the winter months. These results are similar to national and international data regarding age, sex, mechanism of injury and seasonality of paediatric burns. The results from the study have been utilised to inform Surgeons For Little Lives’ paediatric burns prevention campaigns in Soweto and Gauteng Province.

When bullying victims are also perpetrators: A qualitative study in high schools in Tshwane District, Gauteng Province

When bullying victims are also perpetrators: A qualitative study in high schools in Tshwane District, Gauteng Province

Experiences of families living with Nyaope users in Tshwane, Gauteng province.

Nyaope is one of the commonly used drugs in many low socio-economic communities in South Africa. Because of its highly addictive properties, the vast majority of users are not able to quit, which results in long-term difficulties for their families. The aim of this study was to explore and describe the experiences of families living with nyaope users in a township in Tshwane Metropolitan Municipality. Data were collected at the Social Development Centre, which serves a variety of social needs of families, including the various needs of families whose problems emanate from nyaope use. The family members were recruited from the registry of the centre. A qualitative design and in-depth interviews were used to collect data from a sample of family members who were purposively sampled. NVIvo 12 was used for thematic analysis of the data. Three major themes emerged from the data, these being, consequences of nyaope use on the family, family interventions, and coping strategies. Although the families have devised interventions and developed coping strategies, nyaope use remains a serious mental health challenge in affected families. The study highlighted the negative impact of nyaope on the social and mental health of the families. The assistance offered at Social Development is broad and general for substance abuse, but does little to mitigate the complex difficulties brought about by nyaope use.

Proximity to public green spaces and depressive symptoms among South African residents: a population-based study

BackgroundExposure to green spaces has been suggested to improve mental health and may reduce the risk of depression. However, there is generally limited evidence on the association between green spaces and depression originating from low-and middle-income countries and Africa in particular. Here, we investigate the association between proximity to public green spaces and depressive symptoms among residents of Gauteng Province, South Africa.MethodsWe used data from the 2017/2018 Gauteng quality of life survey. We included all individuals aged 18 years or older residing in the nine municipalities of Gauteng Province that completed the survey (n = 24,341). Depressive symptoms were assessed using the Patient Health Questionnaire-2. Proximity to public green spaces was defined as self-reported walking time (either less or greater than 15 min) from individuals’ homes to the nearest public green space. To assess the association between access to public green spaces and depressive symptoms, we used mixed-effects models, adjusted for age, sex, population group (African, Indian/Asian, Coloured (mixed race), and White), educational attainment, and municipality. We additionally performed stratified analyses by age, sex, educational attainment, and population group to evaluate whether associations differed within subgroups. Associations are expressed as prevalence ratios (PR) and their 95% confidence intervals (95% CI).ResultsWe observed a 6% (PR = 0.94, 95%CI = 0.92–0.96) prevalence reduction in depressive symptoms for individuals who reported that the nearest public green space was less than 15 min from their homes as compared to those who reported > 15 min. After stratification, this inverse association was stronger among females, individuals aged 35–59 years,those with higher levels of educational attainment, and Coloured individuals as compared to their counterparts.ConclusionOur findings suggest that public green spaces close to residential homes may be associated with a reduction in the occurrence of depressive symptoms among urban populations in resource-constrained settings like South Africa.

"All I know is that a disabled person is someone who is crippled": Using narratives of parents to unmask the misconceptions of Mild intellectual disabilities concept as a learning support hindrance.

Background: Learning-support provision by parents is key to children's scholastic success. However, when children are diagnosed with mild intellectual disabilities and in need of additional support, learning support provision is hindered. Aim: The study sought to investigate parents' experiences when providing learning support to children diagnosed with Mild intellectual disabilities. Setting: Using a phenomenological design and an interpretive paradigm, anchored in a qualitative research approach, data were gathered from parents whose children were diagnosed with Mild intellectual disabilities across three inclusive schools from disadvantaged backgrounds in the Gauteng province, in South Africa. Methods: Twenty-three (23) parents were purposefully selected to participate in the study by sharing their lived experiences. Data was collected using semi-structured interviews and thematic content data analysis methods. Bronfenbrenner's bio-ecological systems theory underpinned the study. Results: The findings revealed that the parents' misconception of the mild intellectual disability concept is one of the learning support hindrances. Conclusion: Parental empowerment through psycho-education was highlighted as a need for policy and practice adaptation.

New fossil Bovidae (Mammalia: Artiodactyla) from Kromdraai Unit P, South Africa and their implication for biochronology and hominin palaeoecology

Kromdraai is a Plio-Pleistocene site located in the Cradle of Humankind (Gauteng Province, South Africa). It has produced diverse and abundant faunal assemblages and key hominin specimens like the holotype of Paranthropus robustus and early Homo. We provide the first taxonomic study of the Bovidae Family from the hominin-bearing Unit P at Kromdraai and discuss its potential to unravel its paleoecological context. We describe the presence of an unknown medium-sized buffalo (Syncerus sp.) that could be closely related to S. acoelotus. The bovid assemblage from Kromdraai Unit P combines older Plio-Pleistocene (Gazella gracilior, Makapania broomi, Numidocapra cf. porrocornutus) and younger Pleistocene taxa (Tragelaphus strepsiceros, Oreotragus oreotragus, Raphicerus campestris, Damaliscus lunatus). Overall, these bovid species indicate a grassland-dominated environment for Unit P. Comparisons with other Plio-Pleistocene South African sites indicate that Australopithecus was associated with woodland and closed-wet environment-adapted taxa, whereas Homo was found in association with bovid species adapted to open and dry environments. In contrast, the assemblages associated with Paranthropus show an extensive range of environmental adaptation among the bovids. The biochronology indicates that Kromdraai Unit P accumulated between 2.9 and 1.8 Ma. If Kromdraai Unit P were to be confirmed to date to the older end of this scale, it would provide the earliest appearance of Paranthropus robustus, Numidocapra, and Damaliscus in southern Africa.

Traditional health practitioners' understanding of spirit possession in Gauteng province, South Africa.

Traditional health practitioners (THPs) understand spirit possession as a cultural or religious spirit occupying a person, while the mental healthcare providers understand it as a mental illness. The different understanding is based on manifestations that mimic that of mental illness, such as seeing and hearing things that others cannot see or hear. Spirit possession holds different meanings in different cultures and religions that could be either beneficial or detrimental. Furthermore, spirit possession is understood as a channel of communication between the living and the dead or God or a supernatural phenomenon in which a spirit owns a person. This study explored and interpreted THPs' understanding of spirit possession in Gauteng province, South Africa. Hermeneutic phenomenology study explored and interpreted the THPs' understanding of spirit possession in Gauteng province. In-depth individual interviews were conducted with 12 THPs who were selected through snowball sampling techniques. Data analysis followed Heidegger's and Gadamer's philosophies and Van Manen's six steps of the analytic approach. The findings revealed that THPs understood spirit possession as spiritual illness, ancestral calling and demonic spirit or witchcraft. Traditional health practitioners' understanding of spirit possession could promote mental health and prevent mental illness by providing support to a spirit-possessed person and referral to mental healthcare services. This study contributed that not all manifestations presented by persons with spirit possession are actual and clear-cut mental illness, but could be unwritten cultural and/ or religious illnesses that needs cultural and religious services also.

The Wellbeing of Healthcare Workers during COVID-19 Era in Public Primary Health Facilities in Johannesburg, South Africa.

As the world grappled with the COVID-19 pandemic, healthcare workers (HCWs) continued to provide uninterrupted health care service delivery; therefore, this disproportionately affected their wellbeing. Our study explored the wellbeing of HCWs during the COVID-19 era in public health facilities in the City of Johannesburg, Gauteng province, South Africa. A qualitative study was conducted among twenty (20) HCWs through face-to-face in-depth interviews (IDIs) in the form of semi-structured interviews, audiotapes, and transcribed verbatim, and thematically analyzed with NVivo version 10. The findings showed that over half of HCWs (aged between 27 and 60 years) tested positive for COVID-19. Also, one third of HCWs' family members tested positive while some died due to COVID-19 infection. Informed by the workers' wellbeing framework, four themes emerged with fourteen sub-themes. Firstly, unsafe work environment was characterized by human resource related challenges such as increased workload; staff shortage; insufficient resources, e.g., personal protective equipment (PPE); poor policies in terms of compensation/allowance for being infected with COVID-19; poor health services; and death of colleagues. Secondly, poor health outcomes were described as strained emotional (psychosocial distress) and physical (respiratory related conditions) wellbeing. Thirdly, home and community environments were negatively impacted by interrupted relationships with family and friends, and experiences of deaths of loved ones. Finally, HCWs engaged personal wellbeing strategies through self-motivation; staying positive; family support; and participating in resilience-promoting extra mural activities to cope during the pandemic. In conclusion, the wellbeing of HCWs was aggravated during the COVID-19 era and led to low morale and compromised healthcare quality. This study advocates for promotion of greater resilience, and psychological and physical safety of HCWs through evidence-based, multilevel-multicomponent interventions at the workplace, home, and community environments in addition to strengthening public health policies and response to future pandemics.