Implementation In South Africa Research Articles

Catalysing Financial Inclusion in South Africa's Rural Landscape: A Theoretical Discourse of PoS Business Model

In countries like South Africa, where cash plays a pivotal role in social and economic life, limited access to financial institutions, in rural areas has led to significant economic challenges for citizens and businesses. This limitation has further exacerbated the financial exclusion of the underserved population resonating with poor economic growth. In addressing the issue, this desktop-based theoretical discourse, draws on the Technology Acceptance Model, Schumpeterian Entrepreneurship Theory, and Circular Flow of Income Model to conceptualise cash point-of-sale business model, as an innovative mechanism with the potential to spearhead the country’s financial inclusion efforts, entrepreneurial imperatives and local economic participation. The findings provide valuable insights for policymakers and financial institutions to design and implement effective financial inclusion policies in rural areas. By addressing unique challenges faced by rural communities, such as limited infrastructure and lower levels of education, a more inclusive and resilient financial ecosystem can be achieved, contributing to broader social and economic development goals in South Africa's rural landscape. An exploratory empirical study is further recommended to pave the way for the development of a contextual framework to guide the model’s implementation in South Africa.

Xpert MTB/XDR implementation in South Africa: cost outcomes of centralised vs. decentralised approaches

Xpert MTB/XDR implementation in South Africa: cost outcomes of centralised vs. decentralised approaches

Learning through Place-Based Implementation of the UNESCO MAB Program in South Africa’s Oldest Biosphere Reserve: A Case Study of the Kogelberg Biosphere Reserve

UNESCO’s Man and the Biosphere Programme (MAB) is implemented through a world network of biosphere reserves, which offer a holistic people-centered landscape-level conservation approach. When successfully implemented the program enhances social–ecological system sustainability and resilience. However, there remains a research gap in understanding and collating lessons from individual sites for the benefit of the program globally. We assess MAB implementation in South Africa’s oldest biosphere reserve, the Kogelberg Biosphere Reserve (KBR; est. 1998). Using semi-structured in-depth interviews with directors and the coordinator, complemented by document analysis, we explore the governance and implementation learnings of the KBR as it has evolved. The KBR program implementation is guided by global necessity, but driven by the local context, which for the KBR translates to a non-profit organization cooperative governance model. The site faces a perceived lack of government financial support and awareness of the ‘biosphere reserve’ concept. Despite these challenges, successes have emerged in the formation of local partnerships to fulfil critical roles in socio-economic development and biodiversity conservation. The learnings from KBR, as it strives to become a model site for sustainability, are useful for other sites similarly operationalizing an international designation for local conditions.

Barriers to implementing patient safety incident reporting and learning guidelines in specialised care units, KwaZulu-Natal: A qualitative study.

Globally, increased occurrences of patient safety incidents have become a public concern. The implementation of Patient safety incidents reporting and learning guidelines is fundamental to reducing preventable patient harm. To improve the implementation of these guidelines in specialised care units in KwaZulu-Natal, the views of healthcare professionals were unearthed. This study explores the healthcare professionals' views toward the implementation of Patient safety incident reporting and learning guidelines in specialised care units. A descriptive, explorative qualitative approach was used to collect qualitative data from healthcare professionals working in specialised care units. The study was conducted in specialised care units of three purposely selected public hospitals in two districts of KwaZulu-Natal. Group discussions and semi-structured interviews were conducted from August to October 2021. Content data analysis was performed using Tesch's method of analysis process. The main themes that emerged during data analysis were; ineffective reporting system affecting the communication of Patient safety incident guidelines, inadequate institutional and management support for the healthcare professionals, insufficient education and training of healthcare professionals, and poor human resources affecting the implementation of Patient Safety Incident guidelines. The findings highlighted that there were more major barriers to the implementation of the Patient safety incident reporting and learning guidelines. This study confirmed that the Patient safety incident reporting and learning guidelines are still not successfully implemented in the specialised care units and the barriers to implementation were highlighted. For rigorous implementation in South Africa, the study recommends revised Patient safety incident reporting and learning guidelines, designed in consultation with the frontline healthcare professionals. These must consist of standardised, simple- user-friendly reporting process as well as a better implementation strategy to guide the healthcare professionals. Continuous professional development programmes may play an important role in the facilitation of the implementation process.

Overcoming systemic and institutional challenges in policy implementation in South Africa's water sector

The water sector in South Africa is faced with numerous challenges, among which include; increased flooding and prolonged droughts caused by increased climate variability, rapid population growth, unsustainable water demands and withdrawals by various water users, deficiencies in institutional management and infrastructural maintenance, lack of political will with accompanying high levels of corruption and steady deteriorations in all sub-sectors of the economy. Other significant challenges include provision of water in rural communities, water pollution especially from poorly operated wastewater treatments works, acid mine drainage, nutrients from agriculture, siltation of dams. A combination of these factors has led to high levels of water scarcity and an immense burden on the water supply. However, it must be noted that in 1994, South Africa (SA) embarked on developing numerous policies and strategies to address water challenges. While some levels of success have been achieved in terms of policy formulation, there is, however, a lack of comprehensive coordination and synergy that cut across the broad objectives of these policies in meeting environmental, social and economic targets and aspirations. Additionally, the implementation of the policies and programmes is stalled by structural, systemic and institutional factors, coupled with new challenges arising from climatic variabilities. Using a combination of qualitative and quantitative methods together with rapid appraisal of existing literature, we explore systemic and institutional factors impeding the implementation of policies and strategies designed to drive South Africa's water sector as envisaged within the National Development Plan of 2012. We argue that the water sector is faced with multifarious and interweaving challenges such as inadequate human capital, changes in climatic conditions, limited financial resources, infrastructural deficiencies largely linked to poor urban planning and rapid growth of informal settlements, rampant corruption and mismanagement, lack of stakeholders' involvement and compartmentalisation of institutions. This paper, therefore, recommends a community-based approach that enforces transparency and the participation of civil society, cross-sectoral cooperation and a broad range of stakeholders and decentralisation of policy implementation strategies.

Economics Teachers' Integration of ICT for Enhanced Economics Curriculum Implementation

Information and communication technology (ICT) has gained tremendous attention as a tool for instructional delivery and assessment. However, high school Economics teachers have yet to fully utilize this educational tool to implement the Economics curriculum effectively. Information and communication technology enables teachers to communicate with learners outside the physical classroom, encourages learner engagement, facilitates differentiated teaching, simplifies abstract concepts, and helps teachers design, distribute and provide immediate assessment feedback. Nevertheless, there is sparse research on Economics teachers' integration of ICT to enhance Economics curriculum implementation in South Africa. This empirical study explores Economics teachers' ICT integration to enhance Economics curriculum implementation. Mediated learning experience (MLE) was the theoretical framework which guided this study. A qualitative approach was used in this study. Three teachers from three different research sites were purposefully selected for the study. Using a case study design, data were obtained through semi-structured interviews and classroom observations. The study findings reveal that the teachers in this study were utilizing ICT to enhance their teaching. However, there is still room for improvement in teachers' ICT integration. The study recommends continuous teacher development on ICT integration to enhance economics curriculum implementation.

Perceptions of Pre-exposure Prophylaxis (PrEP) for HIV prevention among men living with HIV in the context of reproductive goals in South Africa: a qualitative study

BackgroundPre-exposure Prophylaxis (PrEP) and Treatment as Prevention (TasP) are effective strategies to prevent HIV transmission within serodifferent couples. However, limited usage of PrEP, knowledge and interest has been amongst the barriers for men, alongside testing and treatment adherence. We explored the perceptions of PreP for HIV prevention with Men living with HIV (MWH) who have reproductive goals, to understand awareness and experiences related to PrEP use in the context of HIV prevention with their partners.MethodsWe undertook a qualitative study with 25 MWH aged 18 to 65 between April and September 2021 in South Africa. Potential participants were screened for eligibility and scheduled to participate in telephonic interviews. Interviews were audio recorded, transcribed, translated and thematically analysed.ResultsThemes were organized into opportunities and barriers that men with HIV articulate as important for using PrEP to meet individual, couple, and community reproductive goals. At the individual level, some men were willing to discuss PrEP with their partners to protect their partners and babies from acquiring HIV. Lack of knowledge about PrEP among men was a potential barrier to promoting PrEP among their female partners. At the couple level, PrEP use was seen as a way to strengthen relationships between partners, signifying care, trust, and protection and was seen as a tool to help serodifferent couples meet their reproductive goals safely. At the community level, PrEP was viewed as a tool to promote HIV testing and prevention efforts, especially among men, but participants emphasized the need for more education and awareness.ConclusionDespite PrEP implementation in South Africa, awareness of PrEP among men with HIV in rural areas remains low. Engaging MWH to support their partners in accessing PrEP could be an innovative strategy to promote HIV prevention. Additionally, providing men with comprehensive reproductive health information can empower them to make more informed decisions, adopt safer sexual practices, and challenge societal norms and stigmas around HIV.

Employee Perceptions: Disjuncture between Goals of Performance Management Systems and Effective Implementation in South Africa

This study sought to investigate employee perceptions of the implementation of the Employee Performance Management Development System in a South African government department. Quantitative and qualitative data were collected from employees in the department in the form of an on-line survey. The primary findings reveal a large gap between the goal of the system and its implementation. The results of the study indicate employees perceive the EPMDS to be an ineffective and inefficient system, largely because supervisors and managers are not implementing it objectively. As a result, employees believe the system is not fairly applied in managing their performance. The study makes a significant contribution by illuminating the misalignment between the intent of the system and its actual implementation. It also points to managerial bias and the focus on punitive action rather than rewarding performance according to goal achievement and developing future performance. A major implication of the results is that the need for a monitoring function as, as required by an EPMDS directive and framework. Employees perceive its implementation to be unfair, marked by bias and punitive measures.

Enhancing Curriculum Implementation in Nkowankowa Circuit Secondary Schools: A Qualitative Analysis of Educators' Perceptions in Limpopo-South Africa

Curriculum implementation in South Africa, particularly in Limpopo Province has many challenges that ultimately affect the quality of education. This study sought to address educators’ perceptions on curriculum implementation in Nkowankowa Circuit secondary schools. Qualitative methods were employed where 16 educators from all eight public schools in Nkowankowa Circuit were purposively sampled on the basis of knowledge and experience on curriculum issues. Face-to-face interviews were conducted to collect data on educator’s perceptions on curriculum implementation. Data collected were analysed by means of thematic data analysis method. The study was conducted from an interpretivist point of view. Findings revealed that proper monitoring enforces effective curriculum implementation, which will improve academic performance. Provision of extra classes also boosts learners’ academic performance. Lack of necessary resources seem to hamper effective implementation. Managing and monitoring curriculum implementation by School Management Teams (SMTs) ensures proper implementation and compliance to policy and improves academic performance. In conclusion, the researcher advanced recommendations that could be implemented at school and circuit level to assist improve implementation of curriculum which will ultimately uplift quality of education and academic performance in schools.

A document analysis of the South African national guidelines for medical male circumcision and the implications for infant and child male circumcision decision-making

South Africa’s 2016 medical male circumcision (MMC) guidelines (“the guidelines”) provide direction for the MMC programme’s implementation in South Africa. The aim of our document analysis was to assess the guidelines, particularly in lieu of changing guidance from WHO and PEPFAR. We then assessed how the guidelines might be applied to infant and child male circumcision (ICMC). The analysis was performed by reviewing South Africa’s guidelines, along with international documents used in developing those guidelines, to identify the historical development of the guidelines, as well as the implications for MMC and ICMC decision-making within the South African context. The following principles were analysed within the context of South Africa’s guidelines: (1) quality and safety; (2) informed consent; (3) confidentiality; (4) human rights; and (5) accessibility of services. Tthe document analysis also identified ambiguities that exist in the guidelines, particularly regarding consent, recognising religious or cultural exemptions, and guaranteeing the best interests of the child. South Africa’s MMC guidelines could benefit from incorporating common definitions to assist with interpretation and understanding, thus preventing confusion and controversy among programme planners, parents and boys. The guidelines were made available in 2016 and recommendations for circumcision have evolved as new research and information has become available. South Africa’s National Department of Health should review and update these guidelines, with a focus on both MMC and ICMC issues, so that they reflect the most up-to-date, accurate information available, to avoid inconsistent practices, risks, and litigation in the management of the programme. This study was situated within a qualitative paradigm and applied a social choice theory perspective to make sense of the MMC guidelines. The study concludes that future policy revisions should develop a broader understanding of the complex medical male circumcision decision-making process, particularly faced by parents.

Innovation as a Tool to Improve Public Service Delivery: South African Government Perspective

AbstractSouth African citizens are still facing problems of poor service provision in the local, provincial, and national governments after 28 years of democracy. The standard of public service provision and implementation in South Africa is deteriorating. It is important to note that due to the country's high level of unemployment, the majority of South African citizens rely on government service provision. Because of the government's inability to reach every citizen with efficient and effective service provision, South Africa has the highest level of inequality and a huge gap between the rich and the poor, making efficient service provision a solution to bridge the gap and inequality. This article proposed that the government must develop techniques to boost innovation in the public sector to prioritize service delivery in the country, as there are many challenges surrounding the South African public sector. Qualitative approach was adopted in this research, through the review of recent secondary sources to address the objectives of this study.Keywords: Citizens, Government, Innovation, Service Provision.

Rethinking curriculum implementation in time of COVID-19 and beyond: lessons learnt from rural science teachers

The COVID-19 pandemic has influenced the way teaching and learning is carried out in South African schools. Policy decisions to curb the spread of the virus were superficially conceived as a health problem as opposed to an understanding of the interconnectedness of education in society. For teaching and learning to continue, schools were compelled to either rotate their learners or embrace remote teaching. Irrespective of the numerous curriculum reforms, curriculum implementation in South Africa has been in a moribund state with little attention given to rural science teachers. In this article, we explore how science teachers in rural areas implemented the curriculum during the COVID-19 pandemic and what lessons could be learnt from their experience to foster the curriculum implementation discussion in South Africa. We used a qualitative research approach and phenomenology as our research methodology. Nine rural science teachers were purposively selected for a semi-structured interview. An interpretative phenomenological analysis was used to analyse the data. Our findings revealed that the government’s response to the pandemic appeared to have overlooked already existing fundamental problems associated with curriculum implementation in rural areas. We learnt in this study that curriculum implementation is narrowly conceived as a classroom pedagogic exercise. As an implication, there is a need for curriculum implementation reforms in South Africa, one that would consider contextual curriculum theorising and the experiences of rural science teachers.

Adapting Attachment and Biobehavioral Catch-up for infants and young children with intellectual disabilities and developmental delays in South Africa: Reflections and recommendations from local stakeholders.

Attachment and Biobehavioral Catch-up (ABC) is an intervention targeted at enhancing the socioemotional and regulatory functioning of at-risk infants. However, to use the ABC for infants/toddlers with intellectual disabilities/developmental delays (ID/DD) and in novel cultural contexts, such as South Africa, adaptations may be required. This study aimed, therefore, to explore the opinions of clinical experts and perceptions of caregivers regarding the use of ABC for children with ID/DD in South Africa. It also sought to incorporate the experiences of families of children with ID/DD who received, and intervenors who delivered, ABC in its first implementation in South Africa. Semi-structured interviews were conducted with 18 participants. Thematic analysis explicated 12 main themes: Intervention Strengths, Points of Concern, and Recommendations (Experts); Focus on Caregiver-child Relationship, and Intervention Targets and Duration (Caregivers); Benefits of ABC, and Cultural Considerations (ABC Recipients); Focused and Targeted, Value of Feedback, Supportive Supervision, Working Alliance, and Challenges Experienced (ABC Intervenors). Practice and training recommendations include psychoeducation for parents and training for intervenors that is ID/DD-specific, expanding supervision capacity, building intervenors' cultural/linguistic sensitivity and competence, accessing referral networks, including local Community Health Workers as intervenors, and greater flexibility in how the sessions are organized.

Health facility users’ knowledge, perceptions, and practices about infant feeding in the context of option B+ in South Africa: a qualitative study

BackgroundHIV and sub-optimal infant feeding practices remain important threats to child growth, development, and survival in low- and middle-income countries. To our knowledge, few studies have explored health service users’ perspective of infant feeding in the context of WHO Option B+ policy to prevent vertical HIV transmission (PMTCT). This paper is a sub-analysis of qualitative data from a mixed-methods multi-level process evaluation of Option B+ implementation in South Africa (SA). In this study we explored health facility users’ infant feeding knowledge, perceptions, and practices one year after SA adopted the 2016 updated World Health Organization prevention of mother-to-child transmission of HIV Option B+ infant feeding guidelines.MethodsNineteen focus group discussions (FGDs) were held with six groups of men and women whose infants were aged < 6 months. Participants were attending randomly selected primary health care facilities within six purposively selected priority districts. The six groups included in the FGDs were: (i) adolescent girls and young women living with HIV (WHIV), (ii) adolescent girls and young women not living with HIV (WNHIV), (iii) older postnatal WHIV (iv) older postnatal WNHIV (v) pregnant women, and (vi) men. Data collection took place between April and December 2018. Data analysis involved coding and thematic framework analysis.ResultsWomen and men have suboptimal knowledge of the recommended breastfeeding duration and exclusive breastfeeding, especially for HIV-exposed infants. Most women received sub-optimal infant feeding counselling and mixed messages from health care workers. Fewer WHIV initiated breastfeeding at birth compared to WNHIV. Most parents believed that HIV-exposed infants should be breastfed for 6 months and many postnatal women on antiretroviral drugs and younger mothers lacked confidence to breastfeed beyond 6 months. Mixed feeding was predominant among all women due to individual, family, and socio-structural barriers. Many men were supportive on infant feeding; however, they lacked the appropriate information and skills to influence their partners’ infant feeding decisions.ConclusionsDifferences in breastfeeding practices between WHIV and WNHIV are highly influenced by the lack of knowledge of infant feeding policy recommendations. Multiple-level factors deter many mothers from adhering to recommended guidelines. Appropriate ongoing infant feeding counselling and breastfeeding support are required for women and their partners.

Context and Realities of Policy Implementation in South Africa: Quo Vadis

This paper intends to examine the context and realities of policy implementation in South Africa. This is important because South Africa has over the years crafted good policies but suffers from poor implementation. Scholars, policymakers, non-governmental organisation, and target beneficiaries have advanced various reasons contextualizing the root causes of policy failure in the South African context. Such reasons include but are not restricted to, lack of resources, lack of precision and policy design, incorrect policy instrument, lack of leadership, negligence of relevant actors, and lack of precision and clarity in the implementation stage. This paper discovered that in South Africa, there has been a particular emphasis on the delivery of services with the capacity and capabilities of national, provincial, and local government to advance service delivery, however, challenges have been encountered in the implementation processes. This article concludes that actors of public policy implementation must be seen as formal and have access to ‘implementation structures’ that they can use to advance their own “different interests; values; perceptions and policy preferences during the implementation process. This paper recommends, that the South African government should review the policy implementation strategies with clear contextual considerations to demonstrate the goals. Furthermore, the paper recommends that public policy implementation should be entrusted to suitable government departments that have the necessary administrative capacities.

Freshwater ecosystems and interactions with the SDG 2030 Agenda: implications for SDG implementation in South Africa

Freshwater ecosystems play a fundamental role in supporting the environment, the economy and people’s well-being. However, human development and mismanagement have degraded these ecosystems. Using network analysis, we examined the interlinkages (synergies and trade-offs) between indicator 6.6.1 (water-related ecosystems) and other Sustainable Development Goal (SDG) indicators related to freshwater ecosystems to support coherent policies and strategies for freshwater management. Research into scientific literature and reports on freshwater ecosystems and SDG indicator interlinkages was carried out in 2019 and 2020. Sustainable Development Goal custodians were also interviewed about indicator interlinkages and challenges, and the data analysed using thematic analysis. The results showed that water-related ecosystems had the highest positive interlinkages (synergies) with environmental goals, while more trade-offs were found between water-related ecosystems and social goals. Thematic analysis showed that Sustainable Development Goals (SDGs) should focus on partnerships, governance, and challenges regarding water-related ecosystems and SDG implementation. Our findings suggest that an integrated and sustainable freshwater management approach is necessary, one that is embedded within the nexus approach embodied by the United Nations 2030 Agenda for Sustainable Development.

Shifting Social Norms and Adolescent Girls' Access to Sexual and Reproductive Health Services and Information in a South African Township.

Despite policy on adolescent sexual and reproductive health (SRH) services and education, teen pregnancies remain common in South Africa. Social norms and cultural resistance are a well-documented challenge for SRH program implementation in South Africa, and beyond. To gain insight on the complex picture of adolescents’ access to SRH information and services in a peri-urban township, we explored this topic from a diversity of perspectives, carrying out 86 interviews to capture perceptions of adolescents, their parents, community members, and health professionals. Our research shows that despite the taboo nature of the issue of adolescent SRH, individual positions on adolescent access to SRH services and information are shifting and diverse, and are influenced by factors other than cultural norms. This research serves as a reminder to avoid simplistic reference to “culture” as a way of explaining health-related behaviors and people’s responses to health challenges.

Integrated Coastal Management (ICM) Governance and its Implementation in South Africa

Integrated Coastal Management (ICM) Governance and its Implementation in South Africa

Combining cervical cancer screening for mothers with schoolgirl vaccination during human papillomavirus (HPV) vaccine implementation in South Africa: results from the VACCS1 and VACCS2 trials

ObjectiveThe platform provided by human papillomavirus (HPV) vaccination for linked public health interventions to improve cervical cancer prevention remains incompletely explored. The Vaccine And Cervical Cancer Screen (VACCS) cross-sectional observation...

The use of tele-audiology in ototoxicity monitoring: A scoping review

Introduction Due to the growing burden of disease in South Africa, encompassing conditions such as tuberculosis, human immunodeficiency virus, and cancer, the holistic management of affected patients incorporating ototoxicity monitoring is a necessity. However, ototoxicity monitoring in developing countries may be limited due to a lack of resources and inadequate healthcare facilities. Subsequently, the use of tele-audiology may be a revolutionary technique with the potential to provide audiology services to under-served populations with limited access. Methods The study aimed to describe the use of tele-audiology services in ototoxicity monitoring through a scoping review of English peer-reviewed articles from June 2009 to June 2020. Seventeen articles were purposively selected from the following databases: PubMed, Science Direct, Taylor and Francis Online, WorldCat, and Google Scholar. Data was extracted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram and results were analyzed using deductive thematic analysis. Results and discussion While a minority of the studies indicated that the cost of implementation and network connectivity within a South African context pose as barriers, most researchers reported that tele-audiology provides a reliable, time-efficient, cost-effective, and easily accessible alternative for ototoxicity monitoring. Hardware including the WAHTS, KUDUwave, and OtoID, along with software such as the TabSINT, Otocalc, uHear, and the hearTest, have proven to be useful for ototoxicity monitoring. A need for further investigations regarding the feasibility of tele-audiology implementation in South Africa is evident. Despite this, it provides audiologists with an opportunity to offer contact-less services during COVID-19, thus, confirming its versatility as an augmentative method for ototoxicity monitoring.