Shiselweni Region Research Articles

Assessment of air pollution emitted during cooking using biomass and cleaner fuels in the Shiselweni region of Eswatini (Swaziland)

In Eswatini, 62.3% of households still rely on solid fuel for cooking, especially wood (61.8%). Smoke emissions during biomass burning remain the primary source of indoor air pollution, comprising pollutants detrimental to health. This study provides a quantitative exposure assessment of fuels used in the Shiselweni region with the objectives of monitoring the carbon monoxide (CO) and carbon dioxide (CO2) concentrations during cooking events and evaluating cancer and noncancer risks due to exposure to particulate-bound polycyclic aromatic hydrocarbons (PAHs) during cooking events among cooking personnel in households that cook indoors by burning biomass. Real-time CO, CO2, and particulate matter (PM) monitoring was performed in seventeen kitchens during cooking events across the Shiselweni region using different cooking methods: biomass in open fires and stoves, liquefied petroleum gas (LPG), and electric stoves. PM2.5, PM10, and CO exceeded indoor exposure guidelines for biomass fuel-related homesteads. Particulate PAH intake concentrations were evaluated, and biomass fuel users exhibited high cancer risks and low embryo survival chances due to particulate PAH exposure. The average total cost of reducing the incremental lifetime cancer risk (ILCR) and hazard quotient (HQ) to acceptable levels was lower when shifting from biomass to LPG stoves than when shifting to electric stoves.Graphical abstract

Sustained high fatality during TB therapy amid rapid decline in TB mortality at population level: A retrospective cohort and ecological analysis from Shiselweni, Eswatini.

Despite declining TB notifications in Southern Africa, TB-related deaths remain high. We describe patient- and population-level trends in TB-related deaths in Eswatini over a period of 11 years. Patient-level (retrospective cohort, from 2009 to 2019) and population-level (ecological analysis, 2009-2017) predictors and rates of TB-related deaths were analysed in HIV-negative and HIV-coinfected first-line TB treatment cases and the population of the Shiselweni region. Patient-level TB treatment data, and population and HIV prevalence estimates were combined to obtain stratified annual mortality rates. Multivariable Poisson regressions models were fitted to identify patient-level and population-level predictors of deaths. Of 11,883 TB treatment cases, 1302 (11.0%) patients died during treatment: 210/2798 (7.5%) HIV-negative patients, 984/8443 (11.7%) people living with HIV (PLHIV), and 108/642 (16.8%) patients with unknown HIV-status. The treatment case fatality ratio remained above 10% in most years. At patient-level, fatality risk was higher in PLHIV (aRR 1.74, 1.51-2.02), and for older age and extra-pulmonary TB irrespective of HIV-status. For PLHIV, fatality risk was higher for TB retreatment cases (aRR 1.38, 1.18-1.61) and patients without antiretroviral therapy (aRR 1.70, 1.47-1.97). It decreases with increasing higher CD4 strata and the programmatic availability of TB-LAM testing (aRR 0.65, 0.35-0.90). At population-level, mortality rates decreased 6.4-fold (-147/100,000 population) between 2009 (174/100,000) and 2017 (27/100,000), coinciding with a decline in TB treatment cases (2785 in 2009 to 497 in 2017). Although the absolute decline in mortality rates was most pronounced in PLHIV (-826/100,000 vs. HIV-negative: -23/100,000), the relative population-level mortality risk remained higher in PLHIV (aRR 4.68, 3.25-6.72) compared to the HIV-negative population. TB-related mortality rapidly decreased at population-level and most pronounced in PLHIV. However, case fatality among TB treatment cases remained high. Further strategies to reduce active TB disease and introduce improved TB therapies are warranted.

The Nexus between Ecosystem Services, Livelihood Strategies and Social Well-Being of Riparian Communities Around Sandleni Mntjuzalala Wetlands, Eswatini

An explorative descriptive study was carried out at the Sandleni Mntjuzalala wetland in the Shiselweni region of Eswatini to assess the linkages among ecosystem services, livelihood strategies, and social wellbeing of riparian people. This study followed both quantitative and qualitative research paradigms. A structured questionnaire was used to collect the quantitative data and an interview schedule was used to collect the qualitative data through interviews with key informants. A checklist was also used for observation purposes.

Knowledge, attitudes and acceptance of voluntary medical male circumcision among males attending high school in Shiselweni region, Eswatini: a cross sectional study

BackgroundIn countries such as Eswatini, where there is a high HIV prevalence and low male circumcision the World Health Organization and the Joint United Nations Programme for HIV/AIDS recommend infant and adult circumcision be implemented. The aim of this study was to assess the knowledge, attitudes and acceptability of voluntary medical male circumcision amongst males attending high school in Eswatini.MethodsAn observational cross-sectional study was conducted during February and March of 2018 amongst 407 young males (15–21 years) attending Form 4, in nine high schools in the Shiselweni region of Eswatini using a self-administered questionnaire of 42 close ended questions. Sociodemographic details, circumcision status, acceptance of voluntary medical male circumcision, knowledge and attitude scores analysed in Stata® 14 statistical software were described using frequencies, medians and ranges respectively. Bivariate and multivariate linear regression was used to assess the impact of independent variables on circumcision status and acceptance of voluntary medical male circumcision. The level of statistical significance was p < 0.05.ResultsAmongst the 407 high school-going males, 48.98% (n = 201) reported being circumcised. The majority of the adolescents (75.74%; n = 306) were knowledgeable about voluntary medical male circumcision. However, an even larger majority (84.90% (n = 343) had a negative attitude towards it. In the multivariate logistic regression analysis, having parented their own children (aOR: 3.55; 95%CI: 1.2–10.48), and having circumcised friends (aOR: 3.99; 95%CI: 1.81–8.84) were significantly associated with being circumcised. Neither knowledge nor attitude were associated with the acceptability of voluntary medical male circumcision.ConclusionIn Eswatini male high school students are knowledgeable about voluntary medical male circumcision but have a negative attitude towards it. Having parented their own children, and having circumcised friends influenced being circumcised.

Teacher Perceptions and Professional Experience of E-Learning and Practical Subjects: Views of Selected Teachers in the Shiselweni Region of Eswatini

Several institutions amplected the tremendous variants technology offers in the advent of the covid-19 outbreak, bringing a paradigm shift in various fields regardless of digital competence and availability of resources. Many sectors, education inclusive had to adjust to the “new normal” transforming education drastically with a distinctive rise of e-learning as a pandemic management tool for tumultuous circumstances. E-learning was globally promoted to replace the conventional approach whereby teaching was undertaken remotely on digital platforms (Dhawan, 2020; Li &amp; Lalani, 2020). The study evaluated primary teacher perceptions of the effectiveness of e-learning on practical subjects in 10 selected primary schools in the Shiselweni region of Eswatini. Practical subjects focus on two parts, theory and practice but practical sessions have huge significance in the learning process. Practical subject teaching posed a challenge to teachers during the covid-19 outbreak. The study was investigated by the baseline approach because it flags concerns by showing positive and negative impacts created during and after the study. Twenty-five (25) teachers were surveyed by convenience, snowballing, and random sampling procedures. Data interpretations epitomize that although the outbreak led to the sudden shutdown of schools, which was unprecedented, teachers managed to disseminate lessons by exploring different communication channels to connect learners, teachers, and parents. These were tailored toward the schedules and needs of families to ensure educational continuity. Engagement tools considered and utilized were messaging groups like WhatsApp, online conferences, e-mails, media, and other social media platforms to cater to all-inclusive instruction (UNICEF Romania, 2020). Teachers had fairly good knowledge of their subject content but no mastery over electronic tools for e-learning. E-learning demands acquired or learned skills, determination, strong self-motivation, and time management from both the teacher and learners. Amplecting newer educational technologies take time to implement effectually hence, a combined effort from the ministry of education, institutional management, teachers, and learners’ inclusiveness is of paramount importance. The study recommends that teachers must grow and learn along with their learners for added benefits as the world advances. Keywords: Covid-19 pandemic, e-learning, practical subjects, teacher perceptions. DOI: 10.7176/JEP/14-3-09 Publication date: January 31 st 2023

Analysis of Eswatini Senior Secondary School SiSwati Teachers’ Inclusive Education Practice

Purpose: Inclusive education entails children’s rights to education in spite of all; it implies that teachers align instruction alongside inclusivity. This study sought to analyze senior secondary school siSwati teachers’ inclusive education practice, a case study of schools in the Shiselweni region, Nhlangano cluster. Its objectives were; to ascertain senior secondary school siSwati teacher’s views about inclusive education practice; to determine senior secondary school siSwati teachers’ implementation of inclusive education practice and to ascertain the challenges of inclusive education practice faced by senior secondary school siSwati teachers. &#x0D; Methodology: The study employed the qualitative approach, blended semi- structured interviews, and document analysis as data collection instruments. A five (5) item semi-structured online interview guide and a document analyses guide with six (6) items designed by the researchers were used for data collection. Purposive sampling was used to select three (3) schools, six (6) teachers were used as participants. Data was analyzed using content analysis.&#x0D; Findings: Findings revealed that teachers lack knowledge on inclusive education; inclusive education strategies were used with separate lessons; shortage of inclusive education resources and the broad siSwati curriculum are major challenges.&#x0D; Unique Contribution to Theory, Policy and Practice: It was concluded that teachers hold negative views towards inclusive education; use inclusive education strategies partially; unavailability of resources and the diversity of the siSwati syllabus are major challenges. It is recommended that teachers get capacitated; siSwati language and literature be taught as separate subjects and government provides inclusive education infrastructure.

Creating a Positive Attitude toward Learners with Disabilities at a Primary School in Shiselweni Region, Eswatini

The study that directed this article focused on how a primary school in the Shiselweni Region, Eswatini, created a positive attitude toward learners with disabilities in line with the Suitability, Availability and Equitability (SAVE) Framework. Learners with disabilities in Eswatini primary schools encounter challenges such that they are either not admitted or not catered for if accepted. A qualitative approach was used, engaging a case study design of one primary school in the study. The participants of the study included the school principal, two class teachers and a parent of an out-of-school child with a disability. The findings were used to develop a framework that could assist in creating a positive environment for learners with disabilities in the school in order to comply with the SAVE Framework. The study portrayed that the school environment exhibited a negative attitude toward learners with disabilities; therefore, it was not in line with the minimum standards of the SAVE Framework. The school grounds and building structures never accommodated learners with disabilities. The way the learners were taught did not consider their disabilities. The school prospectus did not articulate how learners with disabilities were accommodated. The study recommended that the principal and teachers should be workshopped on inclusion, while learners were to be educated on behaviour that depicts the understanding of an inclusive environment. The study recommends that researchers could conduct a quantitative study focusing on how school principals should transform the traditional way of managing regular schools into an inclusive approach.

Prevalence and associated risk factors of chronic malnutrition amongst children under five in Eswatini.

BackgroundAbout 20 million children under fi-ve in Southern Africa have chronic malnutrition. This study determines the prevalence of chronic malnutrition and associated risk factors amongst children under five.AimTo determine the proportion of children with chronic malnutrition and investigate associated risk factors of chronic malnutrition.SettingThe study was conducted in communities in the four regions of Eswatini.MethodsThis study is a retrospective cross-sectional study that used data from a Multiple Indicator Cluster Survey (MICS) conducted in 2014. The study involved 3261 children who are under 5 years of age. Data on nutritional status and household characteristics were used. Logistic regression was used to identify factors associated with chronic malnutrition in the univariable and multivariable models, respectively.ResultsResults showed that 18.1% (confidence interval [CI]: 18.5–21.5) of children under five have chronic malnutrition. The highest prevalence was 20.8% (CI: 17.4–24.7) in the Shiselweni region, followed by the Manzini region with 17.6% (CI: 14.5–21.1) and the Lubombo region with 17.2% (CI: 13.9–21.2). The lowest prevalence of chronic malnutrition at 16.7% (CI: 13.6–20.3) was the Hhohho region. The results indicated that low birth weight (odds ratio [OR] = 4.63, CI: 1.12–19.2), mothers’ lack of education (OR = 1.50, CI: 1.04–2.17) and children aged 12–24 months (OR = 1.28, CI: 0.88–1.87) were significantly associated with chronic malnutrition.ConclusionThe findings showed that malnutrition is an important public health problem in children under five and needs a multisectoral response. Low birth weight, mothers’ education and the child’s age are risk factors associated with chronic malnutrition.ContributionThe results inform evidence-based programming for the prevention of chronic malnutrition in children thus assist the country to meet sustainable development goals.

Knowledge, attitudes and practices of community treatment supporters administering multidrug-resistant tuberculosis injections: A cross-sectional study in rural Eswatini.

This study assessed knowledge, attitudes and practices (KAP) of lay community treatment supporters (CTSs) delegated with directly observed treatment (DOT) supervision and administration of intramuscular multidrug-resistant tuberculosis (MDR-TB) injections in the Shiselweni region in Eswatini. A cross-sectional survey among a purposive sample of 82 CTSs providing DOT and administering injections to MDR-TB patients was conducted in May 2017. Observations in the patients' homes were undertaken to verify CTSs' self-reported community-based MDR-TB management practices. Out of 82 respondents, 78 (95.1%) were female and half (n = 41; 50.0%) had primary education or lower. Over one-tenth (n = 12; 14.6%) had not attended a MDR-TB training workshop, but were administering injections. The overall KAP scores were satisfactory. Good self-reported community-based MDR-TB practices were largely verified through observation. However, substantial proportions of respondents incorrectly defined MDR-TB, were unaware of the treatment regimen, stigmatised patients, and underreported needlestick injuries. There was no statistically significant association between duration administering intramuscular injections, MDR-TB training, knowledge and attitudes, and good community-based MDR-TB management practices. The gaps in the current KAP of CTSs in this setting raise questions about the timing, adequacy, design and content of community-based MDR-TB management training. Nonetheless, with appropriate training, lay CTSs in this region can be an option to complement an overstretched professional health workforce in providing DOT and MDR-TB injections at community level.

Professional Development of School Leaders In Supporting Effective Teaching And Learning In The Shiselweni Region, Eswatini

The study investigated how professional development of school leaders may support effective teaching and learning in the Shiselweni region of Eswatini. This was achieved through the following research objectives; to identify skills that school leaders have gained through professional development in their efforts to support teaching and learning activities; to determine how teachers perceived school leaders support as a result of their professional development for quality teaching and learning; to examine the challenges faced by school leaders as they transfer the skills gained through professional development and; to ascertain strategies for effective professional development which in turn supports teaching and learning. Using the mixed method approach, data was collected through interviews and questionnaires. Content analysis was used to analyse qualitative data and SPSS version 20 package was used to calculate frequencies and percentages which were used to analayse quantitative data. The findings of the study revealed the following; (1) School leaders acquire relevant managerial skills through professional development like instructional leadership, financial, personnel and organizational management. (2) There is a general agreement that school leaders empower teachers through in house and teacher training workshops. (3) School leaders are challenged in many ways such as financial constraints, limited resources and teachers’ resistance to change. (4) If properly trained and using a more structured approach, schools would benefit from instructional leadership, peer supervision of school leaders, performance appraisals and wellness programmes. The study recommended that (1) MoET should develop a policy on professional development of school leaders and teachers for more accountability on what has been gained. (2) There is need for a content-focused curriculum linked to effective teaching and learning. (3)Schools must develop their own capacity to learn through couching, mentoring, adopt to change and SLOs approach. (4) Shared leadership and collaboration at different levels of the school system should be encouraged as strategies for enhancing effective teaching and learning. Finally, it is recommended that INSET should conduct a needs assessment to ensure that the training is not ad-hoc and that the personnel should further their studies in institutions of higher learning.

\u201cWe have to learn to cooperate with each other\u201d: a qualitative study to explore integration of traditional healers into the provision of HIV self-testing and tuberculosis screening in Eswatini

BackgroundTraditional healing plays an important role in healthcare in Eswatini, and innovative collaborations with traditional healers may enable hard-to-reach men to access HIV and tuberculosis diagnostic services. This study explored attitudes towards integration of traditional healers into the provision of HIV self-testing kits and sputum collection containers.MethodsA qualitative study was conducted in 2019–2020 in Shiselweni region, Eswatini. Eight male traditional healers were trained on HIV and tuberculosis care including distribution of HIV self-testing kits and sputum collection containers. Attitudes towards the intervention were elicited through in-depth interviews with the eight traditional healers, ten clients, five healthcare workers and seven focus group discussions with community members. Interviews and group discussions were conducted in SiSwati, audio-recorded, translated and transcribed into English. Data were coded inductively and analysed thematically.Results81 HIV self-testing kits and 24 sputum collection containers were distributed by the healers to 99 clients, with 14% of participants reporting a reactive HIV self-test result. The distribution of sputum containers did not result in any tuberculosis diagnoses, as samples were refused at health centres.Traditional healers perceived themselves as important healthcare providers, and after training, were willing and able to distribute HIV self-test kits and sputum containers to clients. Many saw themselves as peers who could address barriers to health-seeking among Swazi men that reflected hegemonic masculinities and patriarchal attitudes. Traditional healers were considered to provide services that were private, flexible, efficient and non-judgemental, although some clients and community members expressed concerns over confidentiality breaches. Attitudes among health workers were mixed, with some calling for greater collaboration with traditional healers and others expressing doubts about their potential role in promoting HIV and tuberculosis services. Specifically, many health workers did not accept sputum samples collected outside health facilities.ConclusionsOffering HIV self-testing kits and sputum containers through traditional healers led to high HIV yields, but no TB diagnoses. The intervention was appreciated by healers’ clients, due to the cultural literacy of traditional healers and practical considerations. Scaling-up this approach could bridge testing gaps if traditional healers are supported, but procedures for receiving sputum samples at health facilities need further strengthening.

Evaluation of the GeneXpert MTB/RIF assay performance in sputum samples with various characteristics from presumed pulmonary tuberculosis patients in Shiselweni region, Eswatini

Background Tuberculosis is a global health concern and has become more complex to diagnose due to mutations in the causative agent, Mycobacterium tuberculosis. In a setting with high TB prevalence, having a rapid and accurate diagnosis may reduce the rate of infections. The study aimed to evaluate the diagnostic performance of GeneXpert MTB/RIF assay in sputum samples from suspected tuberculosis patients. Methods A total of 1 328 sputum samples were collected from patients, across 12 clinics in the Shiselweni region, Eswatini. One thousand one hundred and ten (1110; 84%) samples were simultaneously processed on GeneXpert MTB/RIF assay and MGIT culture. Results Two hundred and ninety-seven (297) samples tested GeneXpert positive and 813 GeneXpert negatives, while 310 samples tested positive and 800 tested negative on the MGIT culture method. The positive predictive value on GeneXpert MTB/RIF assay was 83% while the negative predictive value was 97.80%. At p-value = .796, sputum quality did not affect the positivity of the GeneXpert MTB/RIF results. Sputum volume had a significant impact on the performance of the GeneXpert MTB/RIF with increased sensitivity in 4 ml and 6 ml samples. Conclusions Although detection of tuberculosis using the GeneXpert MTB/RIF assay in sputum samples is not limited to one specific characteristic, sputum volume assessment should be considered as an integral part of routine laboratory diagnosis of tuberculosis especially in high tuberculosis prevalent settings. However, the ability of the GeneXpert MTB/RIF to provide rapid TB diagnosis is not dependent on sputum quality.

Abstracts from The International Society for Aerosols in Medicine 23rd ISAM Congress Boise, Idaho May 22–26, 2021

Abstracts from The International Society for Aerosols in Medicine 23rd ISAM Congress Boise, Idaho May 22–26, 2021

\u201cThey have been neglected for a long time\u201d: a qualitative study on the role and recognition of rural health motivators in the Shiselweni region, Eswatini

BackgroundCommunity health workers (CHWs) are increasingly engaged to address human resource shortages and fill primary healthcare gaps. In Eswatini, a cadre of CHWs called Rural Health Motivators (RHM) was introduced in 1976 to respond to key public health challenges. However, the emergence of health needs, particularly HIV/TB, has been met with inadequate programme amendments, and the role of RHMs has become marginalised following the addition of other CHWs supported by non-governmental organisations. This study was implemented to understand the role of RHMs in decentralised HIV/TB activities. In this paper, we explore the findings in relation to the recognition of RHMs and the programme.MethodsThis exploratory qualitative study utilised individual in-depth interviews, group and focus group discussions, participatory methods (utilising a game format) and observations. Participants were purposively selected and comprised RHM programme implementers, community stakeholders and local and non-governmental personnel. Data collection took place between August and September 2019. Interviews were conducted in English or siSwati and transcribed. SiSwati interviews were translated directly into English. All interviews were audio-recorded, manually coded and thematically analysed. Data was validated through methodical triangulation.ResultsSuboptimal organisational structure and support, primarily insufficient training and supervision for activities were factors identified through interviews and observation activities. Significant confusion of the RHM role was observed, with community expectations beyond formally endorsed tasks. Community participants expressed dissatisfaction with receiving health information only, preferring physical assistance in the form of goods. Additionally, gender emerged as a significant influencing factor on the acceptability of health messages and the engagement of RHMs with community members. Expectations and structurally limiting factors shape the extent to which RHMs are recognised as integral to the health system, at all social and organisational levels.ConclusionsFindings highlight the lack of recognition of RHMs and the programme at both community and national levels. This, along with historical neglect, has hindered the capacity of RHMs to successfully contribute to positive health outcomes for rural communities. Renewed attention and support mechanisms for this cadre are needed. Clarification of the RHM role in line with current health challenges and clearer role parameters is essential.

HIV programmatic outcomes following implementation of the 'Treat-All' policy in a public sector setting in Eswatini: a prospective cohort study.

IntroductionThe Treat‐All policy – antiretroviral therapy (ART) initiation irrespective of CD4 cell criteria – increases access to treatment. Many ART programmes, however, reported increasing attrition and viral failure during treatment expansion, questioning the programmatic feasibility of Treat‐All in resource‐limited settings. We aimed to describe and compare programmatic outcomes between Treat‐All and standard of care (SOC) in the public sectors of Eswatini.MethodsThis is a prospective cohort study of ≥16‐year‐old HIV‐positive patients initiated on first‐line ART under Treat‐All and SOC in 18 health facilities of the Shiselweni region, from October 2014 to March 2016. SOC followed the CD4 350 and 500 cells/mm3 treatment eligibility thresholds. Kaplan‐Meier estimates were used to describe crude programmatic outcomes. Multivariate flexible parametric survival models were built to assess associations of time from ART initiation with the composite unfavourable outcome of all‐cause attrition and viral failure.ResultsOf the 3170 patients, 1888 (59.6%) initiated ART under Treat‐All at a median CD4 cell count of 329 (IQR 168 to 488) cells/mm3 compared with 292 (IQR 161 to 430) (p < 0.001) under SOC. Although crude programme retention at 36 months tended to be lower under Treat‐All (71%) than SOC (75%) (p = 0.002), it was similar in covariate‐adjusted analysis (adjusted hazard ratio [aHR] 1.06, 95% CI 0.91 to 1.23). The hazard of viral suppression was higher for Treat‐All (aHR 1.12, 95% CI 1.01 to 1.23), while the hazard of viral failure was comparable (Treat‐All: aHR 0.89, 95% CI 0.53 to 1.49). Among patients with advanced HIV disease (n = 1080), those under Treat‐All (aHR 1.13, 95% CI 0.88 to 1.44) had a similar risk of an composite unfavourable outcome to SOC. Factors increasing the risk of the composite unfavourable outcome under both interventions were aged 16 to 24 years, being unmarried, anaemia, ART initiation on the same day as HIV care enrolment and CD4 ≤ 100 cells/mm3. Under Treat‐All only, the risk of the unfavourable outcome was higher for pregnant women, WHO III/IV clinical stage and elevated creatinine.ConclusionsCompared to SOC, Treat‐All resulted in comparable retention, improved viral suppression and comparable composite outcomes of retention without viral failure.

Exploring teachers’ instructional practices for literacy in English in Grade 1: A case study of two urban primary schools in the Shiselweni region of Eswatini (Swaziland)

Background: Literacy education in the foundation phase is a global concern. Studies have shown that mastering literacy in the first three years of school ensured academic success and lack of it had negative effects academically, socially and economically. This research study sought to explore teachers’ instructional practices for literacy in English in Grade 1 in the Shiselweni region of Eswatini. Objectives: The objectives of the study were to establish what instructional practices teachers used in their literacy classrooms, why they used those instructional practices, and how they experienced the teaching of literacy in English in Grade 1. Method: A qualitative case study design was followed where three teachers from two urban schools were purposively sampled and participated in semi-structured interviews and classroom observations. Focus group discussions with teachers who had experience teaching literacy in English in Grade 1 in each school were conducted, and document analysis was done. Vygotsky’s sociocultural theory was used as a lens to understand teachers’ instructional practices in literacy. Results: Data were analysed using thematic content analysis. The findings of the study showed that teachers’ instructional practices reflected their lack of pedagogical knowledge for teaching literacy in English in the foundation phase. The study also found that the teachers’ experiences were their rationale for their instructional practices. Conclusion: The study showed that teacher resilience was important for teachers to thrive under trying school conditions; developing a positive attitude towards literacy teaching enabled teachers to develop strategies to improve literacy teaching and learning.

English Language Teachers’ Experiences on School Inspection at Primary School level in the Shiselweni region of the Kingdom of Eswatini

English Language Teachers’ Experiences on School Inspection at Primary School level in the Shiselweni region of the Kingdom of Eswatini

Life Skills Education for Enhancement of Learners’ Wellness in Eswatini: A Case of High School Learners in Shiselweni Region

The researchers sought to explore how Life Skills Education enhances learners’ wellbeing. The study adopted a qualitative research approach using a multiple case study design. The study used an integrative lens and was guided by the Wellness theory by Hettler (1996) and Ubuntu theory. The target population were Life Skills Education teachers and high school learners in the Shiselweni region. A purposive sample of three high schools was selected. Data were collected using semi-structured interview guide and focus group discussion guide. Interviews were conducted with a total of nine learners whereas focus group discussions were carried out with twenty Life Skills Education teachers. Data was analysed using thematic analysis. Findings revealed several dimensions in which Life Skills Education enhances learners which include: socially, emotionally, intellectually, and occupationally. It was recommended that 1) the Ministry of Education and Training should consider training teachers who will specialise in teaching Life Skills Education, 2) Life Skills Education be considered a compulsory component in all pre-service teacher preparatory programmes, and that 3) mechanisms be put in place to ensure appropriate identification of teachers who will teach Life Skills Education. Keywords: Life skills, Life Skills Education, wellness, enhancement DOI : 10.7176/JRDM/59-06 Publication date :September 30 th 2019

Decreased risk of HIV-associated TB during antiretroviral therapy expansion in rural Eswatini from 2009 to 2016: a cohort and population-based analysis.

ObjectivesThis paper assesses patient‐ and population‐level trends in TB notifications during rapid expansion of antiretroviral therapy in Eswatini which has an extremely high incidence of both TB and HIV.MethodsPatient‐ and population‐level predictors and rates of HIV‐associated TB were examined in the Shiselweni region in Eswatini from 2009 to 2016. Annual population‐level denominators obtained from projected census data and prevalence estimates obtained from population‐based surveys were combined with individual‐level TB treatment data. Patient‐ and population‐level predictors of HIV‐associated TB were assessed with multivariate logistic and multivariate negative binomial regression models.ResultsOf 11 328 TB cases, 71.4% were HIV co‐infected and 51.8% were women. TB notifications decreased fivefold between 2009 and 2016, from 1341 to 269 cases per 100 000 person‐years. The decline was sixfold in PLHIV vs. threefold in the HIV‐negative population. Main patient‐level predictors of HIV‐associated TB were recurrent TB treatment (adjusted odds ratio [aOR] 1.40, 95% confidence interval [CI]: 1.19–1.65), negative (aOR 1.31, 1.15–1.49) and missing (aOR 1.30, 1.11–1.53) bacteriological status and diagnosis at secondary healthcare level (aOR 1.18, 1.06–1.33). Compared with 2009, the probability of TB decreased for all years from 2011 (aOR 0.69, 0.58–0.83) to 2016 (aOR 0.54, 0.43–0.69). The most pronounced population‐level predictor of TB was HIV‐positive status (adjusted incidence risk ratio 19.47, 14.89–25.46).ConclusionsThis high HIV‐TB prevalence setting experienced a rapid decline in TB notifications, most pronounced in PLHIV. Achievements in HIV‐TB programming were likely contributing factors.

Knowledge, Attitudes and Practices of Farmers Pertaining to Agro-biodiversity in the Shiselweni Region, Eswatini, Southern Africa

Knowledge, Attitudes and Practices of Farmers Pertaining to Agro-biodiversity in the Shiselweni Region, Eswatini, Southern Africa