Period In South Africa Research Articles

Healthcare systems: typologies, framework models, and South Africa’s health sector

PurposeA healthcare system in any country is rarely the product of one logical policy-making experience, but rather a manifestation of many years of historical development. The purpose of this paper is to examine the characteristics, components, and variables of South Africa’s healthcare system in the context of global patterns. It leverages a dynamic period in South Africa since 1994, and applies a comparative health systems analysis to explain where the country’s healthcare system is, and where it is potentially going.Design/methodology/approachThis paper reviews literature related to South Africa’s healthcare system, outlines its historical development, and discusses three fundamental challenges experienced in the country. This paper also reviews the literature on healthcare system typologies and identifies three framework models that have been used to categorise national healthcare systems since the 1970s. This paper then discusses the categorisation of South Africa’s healthcare system in these models, in comparison to Canada and the USA.FindingsThis paper finds that the framework models are useful tools for comparative analysis of healthcare systems. However, any use of such typologies should be done with the awareness that national healthcare systems are not isolated entities because they function within a larger context. They are not static, since they are constantly evolving with many nuances, even with very similar healthcare system categorisations.Originality/valueThis paper charts the trajectory of change in the South African healthcare system, and demonstrates that the change process must keep internal conditions in mind if the outcome is to be successful. Imitating policies of countries with well-functioning systems, without regard to local realities, may not work, as the government attempts to usher in changes within a short span of time.

Rereading Texts of “Targeted Killings” in the Hebrew Bible: An Indigenous Knowledge Systems Perspective

The biblical text is replete with narratives of targeted killings (TKs), although it is not stated as such. For example, David is depicted as “a man after God’s own heart” (1 Sm 13:14). However, when David was on his deathbed, he summoned his son Solomon to kill his enemies, namely Joab son of Zeruiah (1 Ki 2:5) and Shimei son of Gera (1 Ki 2:8). From an indigenous knowledge systems (IKS) perspective, this essay analyses David’s killings in view of TKs in the following eras: the apartheid era in South Africa; the post-apartheid period in South Africa; colonial Rhodesia; during the liberation struggle for Zimbabwe’s independence; and in the post-independence Zimbabwean era. It is explored that for the majority of African cultures, the spirit of a killed person will always return as ngozi (“avenging spirit”) to afflict the killer or a blood relative of the guilty person with various curses, illnesses or deaths.

The Analysis of the 2008 US Financial Crisis: An Intervention Approach

The current study investigates the impact of the 2008 US financial crises on the real exchange rate in South Africa. The data used in this empirical analysis is for the period from January 2000 to June 2017. The Seasonal autoregressive integrated moving average (SARIMA) intervention charter was used to carry out the analysis. Results revealed that the financial crises period in South Africa occurred in March 2008 and significantly affected the exchange rate. Hence, the impact pattern was abrupt. Using the SARIMA model as a benchmark, four error metrics; to be precise mean absolute error (MAE), mean absolute percentage error (MAPE), mean error (ME) and Mean percentage error (MPE) was used to assess the performance of the intervention model and SARIMA model. The results of the SARIMA intervention model produced better forecasts as compared to that one of SARIMA model.

The Analysis of the 2008 US Financial Crisis: An Intervention Approach

The current study investigates the impact of the 2008 US financial crises on the real exchange rate in South Africa. The data used in this empirical analysis is for the period from January 2000 to June 2017. The Seasonal autoregressive integrated moving average (SARIMA) intervention charter was used to carry out the analysis. Results revealed that the financial crises period in South Africa occurred in March 2008 and significantly affected the exchange rate. Hence, the impact pattern was abrupt. Using the SARIMA model as a benchmark, four error metrics; to be precise mean absolute error (MAE), mean absolute percentage error (MAPE), mean error (ME) and Mean percentage error (MPE) was used to assess the performance of the intervention model and SARIMA model. The results of the SARIMA intervention model produced better forecasts as compared to that one of SARIMA model.

Influence of External Sources of Funding on Corporate Financial Policies in a Pre-Financial Crisis Period in South Africa—A Case Study of Mauritian Enterprises

<p><em>A number of scholars have been motivated to study the manner to which firms adjust their corporate finance strategies in light of the availability and easiness of accessing external sources of funding. Till recently, researchers have also been interested to analyse the external factors that allow firms to relax their fixed budget and the consequent impact on corporate strategies. These mainly include alterations in the composition of their funding and the second round effects on other corporate decisions such as on investment projects and their dividend policies. External financing can be assessed both from a policy perspective, i.e., via financial liberalisation policies, as well as other development in the financial sector such as availability of alternative bases of finance, both from banks and non-banks. It will thus be pertinent to examine the impact of FL policies as well as availability of financial resources on the capital structure of Mauritian firms and their investment decisions in a post financial liberalization period. A judicious investigation is undertaken and the empirical soundness of our different formulations tested with the techniques of panel data and GMM estimates. We compare and contrast the results in the 7 different sectors notably banking, insurance, leasing, hotel, oil, retail/distributive trade and the construction industry. For a better analysis, the full sample of firms is divided into several subsamples as follows: top 100 companies, firms in group-structure, those which are not in group structures, local firms, international firms, firms with good banking ties, those with good and poor corporate governance, listed and unlisted firms. By employing different econometric investment models, we found that all indices of FL, including the index of money market liberalisation, index of capital account liberalisation and overall financial liberalisation index have do not have any influence on private investment behaviour. In contract, higher amount of money in circulation, bank credit, leasing activities and subsidised financing from the Development bank have a positive impact on private investment expenditures. Development in the financial sector in terms of credit facilities offered by insurance companies, venture capitals and the stock market activities have not been effective in inducing firms to increase their investment portfolios.</em></p>

The first hominin from the early Pleistocene paleocave of Haasgat, South Africa.

Haasgat is a primate-rich fossil locality in the northeastern part of the Fossil Hominid Sites of South Africa UNESCO World Heritage Site. Here we report the first hominin identified from Haasgat, a partial maxillary molar (HGT 500), that was recovered from an ex situ calcified sediment block sampled from the locality. The in situ fossil bearing deposits of the Haasgat paleokarstic deposits are estimated to date to slightly older than 1.95 Ma based on magnetobiostratigraphy. This places the hominin specimen at a critical time period in South Africa that marks the last occurrence of Australopithecus around 1.98 Ma and the first evidence of Paranthropus and Homo in the region between ∼2.0 and 1.8 Ma. A comprehensive morphological evaluation of the Haasgat hominin molar was conducted against the current South African catalogue of hominin dental remains and imaging analyses using micro-CT, electron and confocal microscopy. The preserved occlusal morphology is most similar to Australopithecus africanus or early Homo specimens but different from Paranthropus. Occlusal linear enamel thickness measured from micro-CT scans provides an average of ∼2.0 mm consistent with Australopithecus and early Homo. Analysis of the enamel microstructure suggests an estimated periodicity of 7–9 days. Hunter–Schreger bands appear long and straight as in some Paranthropus, but contrast with this genus in the short shape of the striae of Retzius. Taken together, these data suggests that the maxillary fragment recovered from Haasgat best fits within the Australopithecus—early Homo hypodigms to the exclusion of the genus Paranthropus. At ∼1.95 Ma this specimen would either represent another example of late occurring Australopithecus or one of the earliest examples of Homo in the region. While the identification of this first hominin specimen from Haasgat is not unexpected given the composition of other South African penecontemporaneous site deposits, it represents one of the few hominin localities in the topographically-distinct northern World Heritage Site. When coupled with the substantial differences in the mammalian faunal communities between the northern localities (e.g., Haasgat, Gondolin) and well-sampled Bloubank Valley sites (e.g., Sterkfontein, Swartkrans, Kromdraai), the recovery of the HGT 500 specimen highlights the potential for further research at the Haasgat locality for understanding the distribution and interactions of hominin populations across the landscape, ecosystems and fossil mammalian communities of early Pleistocene South Africa. Such contextual data from sites like Haasgat is critical for understanding the transition in hominin representation at ∼2 Ma sites in the region from Australopithecus to Paranthropus and early Homo.

Spatial patterns of African ungulate aggregation reveal complex but limited risk effects from reintroduced carnivores.

The "landscape of fear" model, recently advanced in research on the non-lethal effects of carnivores on ungulates, predicts that prey will exhibit detectable antipredator behavior not only during risky times (i.e., predators in close proximity) but also in risky places (i.e., habitat where predators kill prey or tend to occur). Aggregation is an important antipredator response in numerous ungulate species, making it a useful metric to evaluate the strength and scope of the landscape of fear in a multi-carnivore, multi-ungulate system. We conducted ungulate surveys over a 2-year period in South Africa to test the influence of three broad-scale sources of variation in the landscape on spatial patterns in aggregation: (1) habitat structure, (2) where carnivores tended to occur (i.e., population-level utilization distributions), and (3) where carnivores tended to kill ungulate prey (i.e., probabilistic kill site maps). We analyzed spatial variation in aggregation for six ungulate species exposed to predation from recently reintroduced lion (Panthera leo) and spotted hyena (Crocuta crocuta). Although we did detect larger aggregations of ungulates in "risky places," these effects existed primarily for smaller-bodied (<150 kg) ungulates and were relatively moderate (change of 4 individuals across all habitats). In comparison, ungulate aggregations tended to increase at a slightly lower rate in habitat that was more open. The lion, an ambush (stalking) carnivore, had stronger influence on ungulate aggregation than the hyena, an active (coursing) carnivore. In addition, places where lions tended to kill prey had a greater effect on ungulate aggregation than places where lions tended to occur, but an opposing pattern existed for hyena. Our study reveals heterogeneity in the landscape of fear and suggests broad-scale risk effects following carnivore reintroduction only moderately influence ungulate aggregation size and vary considerably by predator hunting mode, type of predation risk, and prey species.

Woody cover in wet and dry African savannas after six decades of experimental fires

Summary Fire is an integral process in savannas because it plays a crucial role in altering woody cover of this globally important biome. In this study, we examine the long‐term effects of varying fire frequencies over a 60‐year time period in South Africa. We analyse the effects of fire exclusion and of experimental burns every 1, 2 and 3 years on woody cover, tree abundance and stem structure on a wet and dry savanna. Increased fire frequency did not display a consistent effect on woody cover. The presence of fire, irrespective of frequency, was much more influential in lowering tree abundance in the wet savanna than the dry savanna. In the dry savanna, fire was more effective in greatly increasing coppicing in trees, when compared to the wet savannas. Synthesis. The effects of fire on three measures of savanna woody vegetation differed between wet and dry experimental sites. We suggest that vegetation responses to fire are dependent on local conditions, which are likely influenced by rainfall. Therefore, we suggest that management strategies should take account of whether a savanna is a wet or dry system when implementing fire management regimes.

HIV-Associated Disseminated Emmonsiosis, Johannesburg, South Africa

HIV-Associated Disseminated Emmonsiosis, Johannesburg, South Africa

Prevalence, rates and correlates of intimate partner violence among South African women during pregnancy and the postpartum period.

Intimate partner violence (IPV) is a significant public health problem in South Africa. However, limited research exists on IPV during pregnancy and the postpartum period in South Africa. The purpose of this study is to describe the prevalence, rates and correlates of IPV among South African women during pregnancy and the first 9 months postpartum. Data are from a longitudinal study with women recruited during pregnancy between 2008 and 2010 at a public clinic in Durban. We used a modified version of the World Health Organization's IPV scale to estimate prevalence and rates of IPV during pregnancy, at 4 months postpartum and 9 months postpartum and we used logistic regression to assess the correlates of IPV during this time. More than 20 % of all women experienced at least one act of physical, psychological or sexual IPV during pregnancy. Nearly one-quarter of all women experienced at least one act of physical, psychological or sexual IPV during the first 9 months postpartum. Psychological IPV was the most prevalent type of IPV during pregnancy and the first 4 months postpartum. Age and previous violence within the relationship were associated with IPV during pregnancy and IPV during the postpartum period. The high levels of IPV during pregnancy and the postpartum period highlight the need to develop screening and intervention strategies specifically for this time. Further, women should be screened not only for physical violence but also psychological violence given that psychological violence may result in distinct negative consequences.

�Public theology� from within the church? A reflection on aspects of the theology of W.D. Jonker (1929�2006)

In this essay, aspects of the work of theologian W.D. (Willie) Jonker are reframed to complement current debates about �public theology� in South Africa. The introduction points out that Jonker worked during a crucial period in South Africa�s history and that his theology is intrinsically linked to the church struggle between 1955 and 1994. The second part reframes Jonker�s theology as a public theology from within the church by referring to his understanding of preaching, confessions and public witness. The last part attempts to move beyond Jonker in appropriating some of his ideas for a public theology in South Africa today.

Replacement and Positive Evolution of Subtype A and B Respiratory Syncytial Virus G-Protein Genotypes From 1997–2012 in South Africa

Of the respiratory syncytial virus (RSV) genotypes previously described in South Africa during 1997-2002, only GA2 and GA5 persisted until 2006, with BA having replaced all previous RSV-B genotypes. This poses the question whether RSV-A is more stable than RSV-B and whether positive selection drives evolution of genotypes. RSV-positive specimens were randomly selected during 2009-2012, subtyped, sequenced, and compared to RSV recovered from specimens obtained during 1997-2001 and 2006-2009. Bayesian phylogenetic analysis was performed on the G-protein. Phylogenetic analysis indicated that RSV-A genotype GA2 dissolved to form SAA2 (unique to South Africa), NA1 and NA2 (identified in Japan), and ON1 (identified in Canada and having a 72-bp insertion) and that GA5 drifted from 1999-2012 to form 3 subgenotypes (GA5 I-III). RSV-B genotypes all had the 60-bp insertion typical of BA genotypes but clustered into subgenotypes BA8-10. Positive selection was identified in the G-protein of both subtypes, but RSV-A's rate of evolution was slower than that of RSV-B, with the most recent common ancestors dating from 1945 and 1951, respectively. Seven new positively selected sites were identified in South African strains, 2 for RSV-A and 5 for RSV-B. Positive selection drove both RSV-A and -B genotypes to evolve, resulting in replacement of all genotypes over the 15-year study period in South Africa.

Shifts and continuities in Zulu personal naming practices

It is widely accepted that, in all societies, personal naming practices and culture are intertwined. Given that culture is not static, but dynamic and ever changing, personal names have undergone a major transformation due to socio-cultural and political factors. This article reflects on shifts and continuities in the practice of personal naming amongst the Zulu people. Emerging data demonstrate the evolution from pre-colonial Africa to the post-1994 period in South Africa. It is further illustrated that the reclaiming of indigenous names in the new democratic dispensation is perceived as a way for Africans to re-define and re-affirm their identities, thus de-stigmatising their culture. Ultimately, this article makes a strong argument that personal naming, in any society, is not detached from the socio-cultural environment. Rather, personal naming and culture are inextricably linked to socio-political conditions at any historical moment. This is demonstrated in the shift from personal naming practices greatly inspired by communal values to those steeped in contradictions within the epoch of neo-liberal capitalism. It is, therefore, concluded that shifts in people’s consciousness lead to fundamental shifts in personal naming practices.

Amy Biehl and the ANC: A Scholar-Activist in South Africa, 1992—93

ABSTRACT In the twenty years since her death in South Africa in 1993, American Fulbright scholar Amy Biehl has been memorialised in numerous ways – by a historical marker in Gugulethu, a novel and play by Sindiwe Magona (Mother to Mother, 1998 and 2009), a documentary film on the Truth and Reconciliation Commission (Long Night's Journey Into Day 2000), and the continuing work of the Amy Biehl Foundation. Biehl's death was among the most highly publicized killings in the turbulent period before South Africa's first democratic election in 1994. Although the circumstances of her death were widely reported – she was attacked by a group of militant black students chanting anti-white slogans as she was giving several black friends a ride home – relatively little was revealed about her activities in South Africa before her death. This article outlines Biehl's work in South Africa in 1992–1993 and shows that she forged close ties with leading members of the African National Congress (ANC) and did substantive research on the role of black women in South Africa's transition to democracy. In documenting her work, the article also reveals how Biehl tried to balance the roles of scholar, activist and outsider during a crucial period in South Africa's recent history.

Pediatric burn injuries in South Africa: A 15-year analysis of hospital data

IntroductionBurns are a significant burden of pediatric injuries, particularly in low and middle-income countries, were more than 90% of burn-related pediatric deaths occur. This study explores pediatric burn-related injuries over a fifteen year time period in South Africa through an analysis of a pediatric trauma surveillance system. MethodsThis retrospective observational study used data collected by Childsafe South Africa from the Red Cross War Memorial Children's Hospital (RCH) trauma registry in Cape Town, South Africa between 1995 and 2009 for children less than 13 years of age who presented with burn injuries to the hospital's casualty department. Demographic data and Abbreviated Injury Scores (AISs) were first assessed, followed by an analysis of time trends using Poisson regression. Logistic regression models were used to analyse factors related to hospital admissions. ResultsBetween 1995 and 2009, 9438 children with burn-related injuries presented to RCH, of which nearly three-quarters resulted from scalds (73%; n=7024). The mean age of the injured children was 3.1±2.9 years 58% were male. 11 deaths occurred in the hospital's casualty department. 39% of injuries were minor, 56% were moderate, and 5% were severe. During the 15-year study period, moderate burn injuries increased by 3%, while minor injuries decreased by 10% (p<0.05). 49% of all children were admitted to the hospital. Hospital admissions increased by 3% (p<0.05) during the study period. ConclusionsPediatric burn injuries are a significant contributor to the burden of child diseases in developing county hospitals. Pediatric surveillance systems, such as Childsafe South Africa's, are important to study epidemiologic changes in burn injuries. Findings suggest the need for targeted interventions to address the prevention of specific burn-related injuries.

‘I Read What I Like’: politics of reading and reading politics in apartheid South Africa

This article discusses the alternative reading practices that occurred in the shadow of censorship during the apartheid period in South Africa. Following a brief overview of the censorship apparatus’ institutionalisation process, the focus of this article turns to readers and the alternative reading networks and sites of book distribution of banned or likely to be banned publications that emerged despite censorship. By linking these reading practices to the broader political landscape, this article will examine the role played by readers as agents of social change, drawing parallels between their reading protocols and political activism. Building on the field of book history, albeit modestly, this research reflects on the value of literature as a medium for social change, or in the words of Robert Darnton, investigate ‘the world behind books’ (1982: ix).

REFLECTIONS ON THE MAIN SYNTACTIC PROCESSES OF THEMATIZATION IN ENGLISH IN ALAN PATON’S PLAY SPONONO

This paper will analyse the main marked syntactic structures of thematization in English in the play Sponono, written by Alan Paton in 1965. The analysis will point out that due to the use of these thematization processes in the play, i.e. cleft sentence, pseudo-cleft sentence, topicalization and passive, the author emphasizes the feelings and thoughts of the main characters in the play. The analysis will also make clear that the examples of the structures under analysis are used in situations of climax and the main reason for the author to use them is to highlight the social situation that surrounds the play: the apartheid period in South Africa. The paper will discuss how Alan Paton creates a social reality throughout the recurrent use of these processes. In the same way, these syntactic processes contribute to the vividness of the play. The social situation of this period in South Africa has very particular characteristics that the author tries to point out and reproduce with the processes of thematization he uses recurrently during the whole play. The analysis of the corpus following the theory of Systemic Functional Grammar will be helpful to understand the relationships between language and culture and language and situation.

Carnivoran Remains from the Malapa Hominin Site, South Africa

Recent discoveries at the new hominin-bearing deposits of Malapa, South Africa, have yielded a rich faunal assemblage associated with the newly described hominin taxon Australopithecus sediba. Dating of this deposit using U-Pb and palaeomagnetic methods has provided an age of 1.977 Ma, being one of the most accurately dated, time constrained deposits in the Plio-Pleistocene of southern Africa. To date, 81 carnivoran specimens have been identified at this site including members of the families Canidae, Viverridae, Herpestidae, Hyaenidae and Felidae. Of note is the presence of the extinct taxon Dinofelis cf. D. barlowi that may represent the last appearance date for this species. Extant large carnivores are represented by specimens of leopard (Panthera pardus) and brown hyaena (Parahyaena brunnea). Smaller carnivores are also represented, and include the genera Atilax and Genetta, as well as Vulpes cf. V. chama. Malapa may also represent the first appearance date for Felis nigripes (Black-footed cat). The geochronological age of Malapa and the associated hominin taxa and carnivoran remains provide a window of research into mammalian evolution during a relatively unknown period in South Africa and elsewhere. In particular, the fauna represented at Malapa has the potential to elucidate aspects of the evolution of Dinofelis and may help resolve competing hypotheses about faunal exchange between East and Southern Africa during the late Pliocene or early Pleistocene.

Living kidney donor transplants over a 16-year period in South Africa: A single center experience

Kidney transplantation is the treatment of choice for end-stage renal disease (ESRD). The number of patients on the waiting list is increasing due to an imbalance between organ supply and demand. This has led to an increase in the number of living donor transplants in most parts of the world. The benefits to the recipients must, however, be weighed against the risks to the donors. Long-term follow-up of the donors is therefore imperative to ascertain the risks of living kidney donation. We reviewed the records of 571 potential living kidney donors (PLDs) in Johannesburg hospital over a 16-year period between 1990 and 2005. There were 1030 kidney transplants during this period, with 800 cadaveric and 230 actual living donor (ALD) transplants. There were 571 PLDs; however, 341 (59.7%) withdrew or were withdrawn because of medical and non-medical reasons. Among the 230 ALDs, the mean age of the donors was 35.2 ± 8.3 years; 55% were females; 24% were Blacks. Eighty-five percent were related to the recipients while 15% were unrelated. Mean duration of follow-up was 8.6 ± 6.4 years. The pattern of post-donation follow-up was excellent in 29.7%, adequate in 34% and unacceptable/poor in 36.3%, based on the number of clinic visits post-donation. Hypertension was noted in 24% of the donors during long-term follow-up. Three of the donors also developed significant microalbuminuria. There is a need to encourage living kidney donation, especially amongst the Black populations, and to emphasize the value and significance of post-donation follow-up visits to all potential donors.

Analyses of Pediatric Isolates of Cryptococcus neoformans from South Africa

Compared to the incidence in adults, cryptococcosis is inexplicably rare among children, even in sub-Saharan Africa, which has the highest prevalence of coinfection with HIV and Cryptococcus neoformans. To explore any mycological basis for this age-related difference in the incidence of cryptococcosis, we investigated isolates of C. neoformans recovered from pediatric and adult patients during a 2-year period in South Africa. From reports to the Group for Enteric, Respiratory, and Meningeal Disease Surveillance in South Africa (GERMS-SA), we reviewed all cases of cryptococcosis in 2005 and 2006. We analyzed one isolate of C. neoformans from each of 82 pediatric patients (<15 years of age) and determined the multilocus sequence type (ST), mating type, ploidy, and allelic profile. This sample included isolates of all three molecular types of serotype A or C. neoformans var. grubii (molecular types VNI, VNII, and VNB) and one AD hybrid. Seventy-seven (94%) of the strains possessed the MATα mating type allele, and five were MATa. Seventy-five (91%) were haploid, and seven were diploid. A total of 24 different STs were identified. The ratios of each mating type and the proportion of haploids were comparable to those for the isolates that were obtained from 86 adult patients during the same period. Notably, the most prevalent pediatric ST was significantly associated with male patients. Overall, these pediatric isolates exhibited high genotypic diversity. They included a relatively large percentage of diploids and the rarely reported MATa mating type.