Southern African Context Research Articles

Development and validation of a Knowledge, Attitudes and Practices (KAP) questionnaire for healthcare professionals on environmental sustainability in healthcare in Southern Africa

Background Global environmental degradation is increasingly driving poor health outcomes worldwide. Healthcare systems and services are often not environmentally sustainable and compound the problem, while healthcare professionals are also recognised as key leaders in advancing sustainable healthcare. To adopt this leadership position, healthcare professionals’ knowledge, attitudes, and practices regarding environmental sustainability in healthcare must be established. This article reports the development and validation of a new instrument for this purpose that corresponds to the specificities of the Southern African context. Methods Questionnaire development followed a seven-stage process. Information was obtained from a 2021 study titled ‘South African Healthcare Professionals’ Knowledge, Attitudes, and Practices Regarding Environmental Sustainability in Healthcare: A Mixed-Methods Study’ to develop the instrument. Information was also sourced from the literature regarding environmental sustainability and healthcare to generate the first questionnaire with 29 items. The following stages included two rounds of expert input, separated by a pilot study with the target population to receive feedback regarding the instrument’s structure, relevance, and length. Content validity was determined through statistical analysis. Results Feedback was received from nine experts in stage two and 13 pilot-study participants in stage four and incorporated to improve the questionnaire. In stage six, the questionnaire was rated by seven experts. The content validity index of the questionnaire was calculated at two different stages, after which the indices were compared. Following a final edit, the questionnaire has 24 questionnaire items. The closing analysis calculated the scale content validity index average (S-CVI/Ave) of 0,922; this indicates that the final questionnaire has excellent content validity. Conclusion A questionnaire that assesses the knowledge, attitudes and practices of healthcare professionals regarding environmental sustainability in Southern Africa has been developed and validated. This questionnaire can now be used for further studies in Southern Africa.

The Integration of ICT in Primary Education – Examination of the Global African Southern African Contexts

The Integration of ICT in Primary Education – Examination of the Global African Southern African Contexts

A Scoping Review of the Impact of the COVID-19 Pandemic on Family Wellbeing in Africa

Despite the immense interruptions to relationships and family life during the COVID-19 pandemic, only a few studies explicitly focused on family wellbeing. Therefore, the present study aimed to synthesize current evidence in the African context to provide a state-of-the-art representation of the pandemic's impact on family wellbeing. Using a scoping review, 22 articles on the impact of the COVID-19 pandemic on family wellbeing in Africa were analysed. The results of the study showed a diverse and immense impact of the pandemic on family wellbeing. We noted that there were few studies on this topic and that wellbeing outcomes were measured from a deficit perspective rather than as a positive state of being. The theme of stigma was more pronounced in Western Africa, whereas domestic violence was linked more to Southern African contexts. Furthermore, the economic impact of the pandemic was emphasized in Eastern and Southern African countries than in Ghana and Nigeria in Western Africa. In line with the recommendations from the articles reviewed, a multifaceted policy response is needed to protect family wellbeing. Such interventions need to focus on family functioning, happiness and social wellbeing, and not just reactive and preventative approaches, to promote wellbeing.

Implementing extended reality (XR) and artificial intelligence (AI) in health professions education in southern Africa

Background. The rapid uptake and pace at which digital transformation tools have impacted educational provision in health professions education (HPE) may reshape our teaching and learning practices in southern Africa. This article explores some ideas about the implementation using extended reality (XR) and artificial intelligence (AI) in HPE. Objectives. The objective of this article is to offer potential uses for implementing XR and AI in HPE in the southern African context. Methods. This article used a desktop approach to curate some novel ideas regarding the use of XR and AI in HPE. Results. The outcome of this article presents 10 novel ideas to implement XR and/or AI in the classroom, such as delivery of quality education, personalised learning and simulation and training. Conclusion. The use of XR and AI may improve training of students, improve patient outcomes, and ensure adequate professional development of staff in HPE.

“Living with HIV” – Changes in HIV and AIDS Metaphors in South African Educational Policy

ABSTRACT Health metaphors are commonly used in a variety of contexts. While war metaphors are common in medicine, there are also other conceptualizations and other metaphors employed in different contexts. In policies, metaphors can play an important role in framing thought and discourse, and have an important effect, and even more so in educational policy. In this article, we analyze the two South African policies regarding HIV and AIDS in the educational context – the first policy from 1999, and the one that replaced it in 2017. The focus is on identifying and categorizing the metaphors directly related to HIV and AIDS. We identified 29 such metaphors in policy 1, and 71 in policy 2, using the principles from the MIPVU, and thematic discourse analysis was used to categorize the metaphors into themes. The most prominent changes in the metaphors from policy 1 to policy 2 regard the focus of the imagery, as well as the conceptualization of HIV itself. These are then interpreted in the Southern African context.

Doing the Word: Reawakening the Church to Save Society in Southern Africa

Southern African societies are presently beleaguered by manifold socio-economic, political, and environmental challenges. Ordinary people long for answers to questions about how to mitigate these challenges. Meanwhile, the Church mostly preaches the gospel and establishes and grows denominations across the world. Proclaiming the gospel in word is good; however, without demonstrating the gospel with transformational deeds, the Church remains Salvationist and partially missionary. Bearing in mind that the integral mission of the Church is advancing the gospel holistically, fractional mindfulness of the gospel, hearing the words without performing the corresponding deeds, is defacing its identity. Today, this situation is problematic and helpless, as society is in dire need of a wholesome Church that acts in accordance with its own faith and values and attends to the soul, the body, and all other facets of life. Much has been published about the integral mission of the Church, though little has been said about its role in social action. By qualitatively reviewing the literature and observing the Southern African context and some biblical examples, this paper finds the integral mission to be the predominant and comprehensive purpose of the existence of the Church. While the Church could be aware of its mandate, it should be reawakened so that it becomes a doer of the Word and stands out as the salt and light of the world by contributing to addressing the needs of society.

Behind the waterfall - Interdisciplinary results from Holley Shelter and their implications for understanding human behavioral patterns at the end of the Middle Stone Age in southern Africa

Holley Shelter is a Middle (MSA) and Later Stone Age (LSA) site in KwaZulu-Natal, South Africa. The rock shelter is located at the intersection of three ecosystems, in a strip of the Savanna Biome between the Grassland and Indian Ocean Coastal Belt Biomes. Initial excavations in the 1950s by Gordon Cramb yielded large amounts of unifacial points and splintered pieces, as well as organic remains associated with MSA occupations. Our comparative techno-typological evaluation of this material in 2015 suggested the occupations may date to early MIS 3. We then initiated new excavations at the site using modern field methods and controlled sampling for lithic and organic material. Following the initial round of interdisciplinary analysis, we herein report the first absolute ages for Holley Shelter, a detailed technological analysis of new lithic material from the uppermost MSA layers at the site, and a preliminary study of the associated faunal remains. A set of 12 14C dates place these occupations within a constricted chronological period dated to ∼36,000–34,000 cal. BP that overlaps with the so-called ‘final MSA’. The hornfels-dominated lithic assemblages are characterized by diverse core technologies oriented toward the production of laminar products, which include bladelets and abundant splintered pieces. The zooarchaeological analysis documents an emphasis on open grasslands that provided the bulk of the animal prey exploited by the inhabitants of the shelter, with a preference for medium-sized antelopes. Three bone retouchers, a rare occurrence in southern African MSA contexts, were identified in the faunal assemblage. The archaeological deposits at Holley Shelter reflect short-term, potentially seasonal, and specialized occupations that could be influenced by its ecological position. The archaeological material exhibits marked discrepancies with other well-dated final MSA assemblages such as those from Sibhudu, Umbeli Belli, Sibebe and Border Cave. This illustrates considerable variability and a complex spatio-temporal patterning of behavioral adaptations and cultural traditions at the end of the MSA in southern Africa.

Reporting on Science in the Southern African Context: Exploring Influences on Journalistic Practice

This exploratory study investigates the journalistic influences on science reporting in Southern Africa, filling the gap that is under explored. South Africa, Mozambique, and Zimbabwe are the selected cases. Methodologically, this qualitative study relied on in-depth face-to-face interviews and purposive sampling as designs. The study employed Reese’s and Shoemaker’s hierarchy of influences model as the preferred theoretical framework because it articulates diverse factors affecting news content, categorized from a micro-individual to the macro-social system level. This study found that lack of resources, limited knowledge of science by journalists, and preference for political and economic news have largely affected the quality and frequency of science reporting in Southern Africa.

Liminal bodies left in perpetual suspension: social, cultural and political-economic responses to the Covid-19 pandemic in Southern African contexts

Liminal bodies left in perpetual suspension: social, cultural and political-economic responses to the Covid-19 pandemic in Southern African contexts

The impact of Eucalyptus plantations on herpetofaunal diversity, Maputo National Park, Mozambique

ABSTRACT Exotic afforestation has proven detrimental to biodiversity in general, however only a few studies documenting the impact of timber plantations on herpetofaunal diversity have been published within a southern African context. To determine if variations in herpetofaunal species assemblages could be detected between derelict Eucalyptus plantations, cleared plantation woodlots, and untransformed sand thicket vegetation, a pitfall and funnel trap survey was conducted in coastal southern Mozambique. Herpetofaunal species richness for derelict Eucalyptus plantations was 13 ± 2.24 species, untransformed sand thicket vegetation 17 ± 2.34 species and cleared plantation woodlots 18 ± 3.14 species. Both Shannon-Weaver and Simpson Diversity Indices estimated the highest herpetofaunal species diversity in untransformed sand thicket vegetation and the lowest diversity in derelict Eucalyptus plantations. The herpetofaunal species assemblages of derelict Eucalyptus plantations and natural sand thicket vegetation were least similar (0.507 ± 0.041), while cleared plantation woodlots and derelict Eucalyptus plantations were most similar (0.753 ± 0.032) in terms of herpetofaunal community composition. In contrast to our expectations, significantly higher capture rates were reported for a fossorial anuran in derelict Eucalyptus plantations compared to both cleared plantation woodlots and untransformed sand thicket vegetation, which requires further investigation and discussion. As with most other studies investigating the effects of exotic timber plantations on biodiversity, our results indicate that the detectable herpetofaunal diversity decreased in Eucalyptus plantations when compared to natural or cleared plantation woodlots. Subsequently it would seem as though the active clearing of dilapidated timber plantations as part of rehabilitation efforts may positively affect herpetofaunal diversity.

Decolonising the Humanities: Reimagining Black Intellectual Life and Personhood in Southern African Contexts

This review article explores possibilities for transdisciplinary entanglements between the disciplines of critical psychology and literary criticism through a reading of the volume, ʻFoundational African Writers’, edited by Bhekizizwe Peterson, Khwezi Mkhize and Makhosazana Xaba. In this article, ‘Foundational African Writers’ is approached as a distillation of Peterson’s investment in excavating the world-making activities, writing lives and activities of ordinary people as a central dimension of the project to decolonise the Humanities. As this edited volume attests, Peterson’s creative and critical oeuvre continues to provoke thinking about the ways in which the reading of the African literary archive can assist in the wider project of decolonising and re-imagining intellectual and creative history in the Global South while also providing opportunities for new modes of thinking about personhood and psychic life in contexts of precarity, intergenerational trauma and economic exclusion.

An evolving approach to unconferencing: Reflections from piloting the HELTASAFEST22 scholarly festival

This article offers insight into the planning and facilitation of a scholarly learning and teaching festival which aims to negotiate the tensions between traditional and creative scholarly engagements in the Southern African higher education context. The aim of this case study is to critically reflect on planning and facilitating a scholarly learning and teaching festival as part of an (un)conferencing approach for HELTASA. The case study adopts a critical reflective methodology, where we reflect on our experiences and perceptions of planning and facilitating/participating in the festival. The article outlines the structure and methodologies of the festival and reflects on the contextual considerations for planning the festival and the positives and challenges associated with facilitating the festival. A major tension that had to be managed as part of the festival was the questions of academic rigour and the choice of a festival by some prospective participants.

Enhancing Conservation Communication: Using Digital Literacy to Address the Misunderstanding of Southern Africa’s Sustainable Use Approach in Western Settings

Effective communication and digital literacy are crucial for addressing misunderstandings about the Southern African approach to sustainable use in Western settings. This paper highlights the need to enhance conservation communication and explores the role of digital communication in bridging the gap between the Southern African approach and Western conservation paradigms. The Southern African emphasis on community-based natural resource management (CBNRM) and sustainable wildlife use for both conservation and economic purposes often faces misinterpretation and scepticism in Western societies that prioritize preservation and non-consumptive use. By analysing literature, case studies, and communication strategies, this study identifies the challenges stemming from cultural biases, differing conservation ideologies, and limited understanding of the Southern African context. It investigates the significance of digital literacy in overcoming these challenges by promoting the development of technology skills among conservation practitioners and members of communities coexisting with wildlife, equipping them with relevant digital tools, promoting information sharing, fostering cross-cultural dialogue, and engaging diverse stakeholders through digital platforms. The paper stresses the significance of utilizing diverse communication channels (including social media, online forums, websites, campaigns, multimedia tools, and educational resources) to share accurate and culturally sensitive information about the Southern African approach. It highlights the necessity for tailored communication strategies that consider the distinct needs and values of various audiences, incorporating digital approaches involving active listening, dialogue, and the integration of local knowledge. This study promotes the development of inclusive and accessible spaces through improved digital literacy and effective communication strategies. It advocates for mutual understanding and collaboration between Western and Southern African conservation practitioners, stakeholders, and decision-makers. By leveraging digital platforms and enhancing communication competencies, the Southern African approach can be better comprehended within Western settings, fostering sustainable conservation practices and nurturing collaborative partnerships in conservation initiatives.

That all shall be saved

Central to the question of evangelism in the Southern African context is to “begin again at the beginning” of what exactly the gospel is and what it entails. This article contends that any formulation of the gospel of “the living Lord Jesus Christ …” that envisions even the possibility of the notion of hell as eternal separation from God, annihilation, or punishment for anyone is not “good” news at all, but is in fact, as one writer in the South African context puts it: “the bad news of the Gospel.” Moreover, holistic, or missional conceptions of eschatology, such as that of the influential New Testament Scholar N.T. Wright, inasmuch as they reject or do not explicitly accept universal salvation, lack theological coherence, and cannot be inculcated and shared as good news in the Southern African context. The Dutch Reformed Church and the ecumenical church urgently need to (re)discover the doctrine of ??????????????? for its rediscovery of evangelism not to be in vain.

OP120 Developing A Call To Action For Patient Involvement In Health Technology Assessment (HTA) In Southern Africa

IntroductionIn building health technology assessment (HTA) and related decision processes in Southern Africa, institutions and stakeholders face region-specific challenges such as disease prevalence and population makeup. These can be addressed by collaboratively discussing patient engagement solutions that fit the local culture and systems and serve to ensure equitable and sustainable access to patient-relevant health technologies. Our aim is to initiate a collaboration for driving patient involvement (PI) suitable for the Southern African context and Sub-Saharan patient communities. In addition, we explore current experiences in PI, including the stakeholder expectations, gaps, limitations, and new opportunities.MethodsA one-day hybrid multi-stakeholder PI in HTA workshop was held in Johannesburg, South Africa. Co-created by the participants, the outputs are a call to action and a concept draft for the vital success criteria for PI in the region. The content of the call to action is gathered from pre-workshop surveys, interviews, and outcomes from historic meetings held in conjunction with the Health Technology Assessment International (HTAi) PI workstream as well as facilitated discussion from the actual workshop.ResultsThe workshop was attended by 42 participants from nine countries, representing diverse stakeholder groups. The attendees represented multiple PI stakeholder groups. The workshop survey was completed by 44 respondents, while 12 participants completed the post-event survey. A workshop outcomes document highlighting a high level of alignment and identifying seven key success factors was developed. A workshop proceeding detailing the outcomes is now being drafted.ConclusionsOver 95 percent of respondents to pre-and post-surveys indicated an interest in contributing to a more in-depth description of PI in their country. While the majority of participants were from South Africa, participants from Tanzania, Ethiopia, Zambia, and Zimbabwe emphasized that trans-African-engagement for HTA will provide an additional opportunity for HTA in Africa and patient and community participation in HTA and healthcare decision-making. Hence, a collaborative platform could help all African countries to advance and benefit from improved healthcare decision processes.

Iingoma Zomzabalazo in Conversation: An Archival Engagement with Recordings of Liberation Songs

This text is a remix of an archival engagement with recordings/performances of 'freedom songs' or 'liberation songs' in a south or southern African context. The authors began this collaborative research project as part of a course in the Masters in History degree programme at the University of the Western Cape (UWC). The essay includes a re-edited, updated transcript of dialogue the authors shared along with two mix(tap)es they produced together. The conversation speaks of songs as archives, archives of song(s), and memory/ies pertaining to anti-Apartheid struggle and ongoing Fallism.

PRIMARY HIP AND KNEE ARTHROPLASTY AT DISTRICT LEVEL IS SAFE AND MAY REDUCE THE BURDEN ON TERTIARY CARE IN A LOW-INCOME SETTING

Arthroplasty procedures in low-income countries are mostly performed at tertiary centers, with waiting lists exceeding 12 to 24 months. Providing arthroplasty services at other levels of healthcare aims to offset this burden, however there is a marked paucity of literature regarding surgical outcomes. This study aims to provide evidence on the safety of arthroplasty at district level.Retrospective review of consecutive arthroplasty cases performed at a District Hospital (DH), and a Tertiary Hospital (TH) in Cape Town, between January 2015 and December 2018. Patient demographics, hospital length of stay, surgery related readmissions, reoperations, post-operative complications, and mortality rates were compared between cohorts.Seven hundred and ninety-five primary arthroplasty surgeries were performed at TH level and 228 at DH level. The average hospital stay was 5.2±2.0 days at DH level and 7.6±7.1 days for TH (p<0.05). Readmissions within 3 months post-surgery of 1.75% (4 patients) for district and 4.40% (35) for TH (p<0.05). Reoperation rate of 1 in every 100 patients at the DH and 8.3 in every 100 patients at the TH (p<0.05). Death rate was 0.4% vs 0.6% at district and TH respectively (p>0.05). Periprosthetic joint infection rate was 0.43% at DH and 2.26% at TH. The percentage of hip dislocation requiring revision was 0% at district and 0.37% at TH. During the study period, 228 patients received arthroplasty surgery at the DH; these patients would otherwise have remained on the TH waiting list.Hip and Knee Arthroplasty at District health care level is safe and may help ease the burden on arthroplasty services at tertiary care facilities in a Southern African context. Adequately trained surgeons should be encouraged to perform these procedures in district hospitals provided there is appropriate patient selection and adherence to strict theatre operating procedures.

The pastor as the primary teacher in the church: The meaning and expectations of pastoral ministry within the mainline denominations

A pastor is widely viewed as a shepherd and a Christian leader. Pastors have complex roles stemming from a complex calling; pastoral practice is multidimensional and not easily defined. The contemporary use of the term "pastor" denotes different kinds of religious roles in church leadership. In mainline denominations a pastor is generally viewed as an ordained minister designated for the ministry of the word and administering sacraments. The pastor has many pastoral roles including church leadership, pastoral care, the preaching of the word. It is argued in this article that the key role of the pastor is that of a teacher who empowers the lay leadership and church members in general through his/her various pastoral roles. In Southern African languages such as Shona use the term mufundisi while in Ndebele and Zulu use the umufundisi referring to a pastor. This is most appropriate because mufundisi/umufundisi means an ordained minister who is regarded as a teacher, equipper of people and leader of all sections of the church. The article begins by discussing the general processes and procedures of pastoral calling in the mainline denominations. It draws its central point of the pastor being a teacher from the very accurate way in which the pastor is viewed and defined as a mufundisi in the above-mentioned African languages, as well as from the role of Jesus as a teacher. The article then discusses the nature of the pastor as a teacher and the expectations of this role in pastoral ministry from a southern African context.

Tracking the Decolonial in African Christian Theology

AbstractDrawing on the framework and pluriversalist vision of decoloniality, this article offers a conceptual mapping of theoretical debates and trends in recent discourse on the decolonization of theology in the Southern African context with a view to outlining key missiological implications of such debates. It posits a view of African decolonial theology as the foregrounding of local, indigenous, contextual knowledge in discourse and as the praxis of faith rooted in contextual analysis of historical realities. This contribution articulates the notion of “mission from the margins,” derived from Together towards Life, as a decolonial mode of mission that gestures toward an epistemological shift in missional thinking. An initial version of this paper was presented at the seminar on decolonization organized by the World Council of Churches’ Commission on World Mission and Evangelism that was held in Lisbon, Portugal, in June 2023.

Separation During Emergencies: Is there a Stable Relationship Between Separated Children and the Rest of a Fleeing Population? Evidence from Three Situations in Africa

With the numbers of people fleeing their home countries increasing in recent decades, the need to understand refugee flow patterns, particularly of the most vulnerable groups, is more important than ever. This study is focused on the separation of children from their parents during emergencies in the east and southern African context and highlights how populations fleeing from the same country of origin into nearby countries may be characterised by quite different rates of separation. Despite the wide range of estimates of the proportion of unaccompanied and separated children among the refugee population, in all of the cases considered here, the extent of separation is fairly stable over time, revealing a fast process of adjustment towards their long-term mean values. The findings of this study contribute to improve current knowledge of the issue of separation during emergencies and provide useful support for the monitoring of refugee population movements, and in particular for predicting the number of cases of separation, especially during periods of high variability in the number of new refugee arrivals. This is expected to strongly support the programming of related humanitarian assistance and protection for separated and unaccompanied refugee children.