Journal articles: 'Rural development – KwaZulu-Natal – Umbumbulu'

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Browne, M., G. F. Ortmann, and S. Hendriks. "Expenditure elasticities for rural households in the Embo ward, Umbumbulu, KwaZulu-Natal." Agrekon 46, no. 4 (December 2007): 566–83. http://dx.doi.org/10.1080/03031853.2007.9523787.

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Govender, Laurencia, Kirthee Pillay, Muthulisi Siwela, Albert Thembinkosi Modi, and Tafadzwanashe Mabhaudhi. "Assessment of the Nutritional Status of Four Selected Rural Communities in KwaZulu-Natal, South Africa." Nutrients 13, no. 9 (August 24, 2021): 2920. http://dx.doi.org/10.3390/nu13092920.

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Under- and over-nutrition co-exist as the double burden of malnutrition that poses a public health concern in countries of the developing regions, including South Africa (SA). Vulnerable groups such as pregnant women and children under five years are the most affected by malnutrition, especially in rural areas. Major contributing factors of malnutrition include food and nutrition insecurity, poverty, and unhealthy lifestyles. The current study aimed to assess the nutritional status, using selected anthropometric indices and dietary intake methods (repeated 24 h recall and food frequency), of four rural communities in KwaZulu-Natal (SA). Purposive sampling generated a sample of 50 households each in three rural areas: Swayimane, Tugela Ferry, and Umbumbulu and 21 households at Fountain Hill Estate. The Estimated Average Requirement cut-point method was used to assess the prevalence of inadequate nutrient intake. Stunting (30.8%; n = 12) and overweight (15.4%; n = 6) were prevalent in children under five years, whilst obesity was highly prevalent among adult females (39.1%; n = 81), especially those aged 16–35 years. There was a high intake of carbohydrates and a low intake of fibre and micronutrients, including vitamin A, thus, confirming the need for a food-based approach to address malnutrition and micronutrient deficiencies, particularly vitamin A deficiency.

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Mather, Charles, Michael Lipton, Mike de Klerk, Merle Lipton, and Frank Ellis. "Populist Agrarian Visions and Rural Livelihoods in Kwazulu-Natal." Canadian Journal of African Studies 32, no. 1 (1998): 139. http://dx.doi.org/10.2307/486229.

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Ngcobo, Thandi. "Perspectives of Rural Women on Access to Land in Zululand District." African Journal of Gender, Society and Development (formerly Journal of Gender, Information and Development in Africa) 10, no. 3 (September 1, 2021): 141–62. http://dx.doi.org/10.31920/2634-3622/2021/v10n3a7.

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Most literature on land reform in South Africa negates the rural community development. Hence, this paper analyses the perceptions of rural women on land reform efforts in the Zululand District of KwaZulu-Natal. The paper aims to generate a body of knowledge on how rural women understand what is being done towards their access to land. The paper argues that patriarchy, authority figure and gatekeeping, conscious and unconscious linguistic sexism, delays and gender segregation, women`s lack of basic law and land-related law, and non-participation in local land processes impede women`s access to land in Zululand District, KwaZulu-Natal. The paper makes recommendations on the implications of individual women and women’s groups as well as policy structures at the local, provincial, and national levels. This paper uses a qualitative descriptive approach in analysing how rural women feel about the provisions of land access. Focus group discussions with thirty rural women in KwaZulu-Natal`s Zululand District were conducted. A thematic analysis was done to analyse their perceptions of provisions of land access.

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Mdluli, Fezile, Joyce Thamaga-Chitja, and Stefan Schmidt. "Appraisal of Hygiene Indicators and Farming Practices in the Production of Leafy Vegetables by Organic Small-Scale Farmers in uMbumbulu (Rural KwaZulu-Natal, South Africa)." International Journal of Environmental Research and Public Health 10, no. 9 (September 13, 2013): 4323–38. http://dx.doi.org/10.3390/ijerph10094323.

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Bob, Urmilla. "Rural women and technology in South Africa: Case studies from KwaZulu-Natal Province." GeoJournal 61, no. 3 (2004): 291–300. http://dx.doi.org/10.1007/s10708-004-3691-6.

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Pather, Joan, Stacy Maddocks, Nomzamo Chemane, and Verusia Chetty. "Physiotherapists’ Perceptions of Disability Awareness in KwaZulu-Natal." Global Journal of Health Science 10, no. 12 (November 12, 2018): 83. http://dx.doi.org/10.5539/gjhs.v10n12p83.

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BACKGROUND: Disability awareness is essential for rehabilitation professionals, such as physiotherapists, to provide an understanding of disability and to influence environmental and attitudinal societal barriers. There is a paucity of literature on the perceptions of physiotherapists about disability awareness in the South African context. OBJECTIVES: To explore the perceptions of physiotherapists on disability awareness in order to influence the rehabilitative care offered to people with disability. METHOD: This study adopted an explorative, descriptive qualitative design. Two focus group discussions were conducted with public healthcare physiotherapists employed at urban and rural facilities. Transcribed data were analysed using conventional content thematic analysis. There were five participants in each group: two males and eight females, with nine participants having worked for more than six years. RESULTS: The discussions revealed five major themes: consequences of a dearth of knowledge; personal influence; facilitators of disability awareness; barriers to disability awareness; and recommendations. CONCLUSION: Access to healthcare is hindered by a lack of understanding, and the subsequent behaviour, including the stigmatisation of people with disabilities. The study highlighted that poor knowledge of disability and lack of cultural sensitivity among physiotherapists working among communities strongly motivated by cultural beliefs, may influence the rehabilitation of people living with disability. It was concluded that self-reflection, coupled with deeper community engagement and continuing professional development, would enhance physiotherapy practice and disability awareness in the future.

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Hendriks, Sheryl L., and Michael C. Lyne. "Expenditure patterns and elasticities of rural households sampled in two communal areas of KwaZulu-Natal." Development Southern Africa 20, no. 1 (March 2003): 105–27. http://dx.doi.org/10.1080/0376835032000065516.

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Bob, Urmilla, and Mbali Majola. "Rural community perceptions of the 2010 FIFA World Cup: The Makhowe community in KwaZulu-Natal." Development Southern Africa 28, no. 3 (September 2011): 387–99. http://dx.doi.org/10.1080/0376835x.2011.595999.

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Baiyegunhi, Lloyd James S. "Social capital effects on rural household poverty in Msinga, KwaZulu-Natal, South Africa." Agrekon 53, no. 2 (April 3, 2014): 47–64. http://dx.doi.org/10.1080/03031853.2014.915478.

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Zhou, Helper, and Victor Gumbo. "Rural-Urban Comparison of Manufacturing SMMEs Performance in KwaZulu Natal Province, South Africa." African Journal of Development Studies (formerly AFFRIKA Journal of Politics, Economics and Society) 11, no. 1 (March 1, 2021): 7–31. http://dx.doi.org/10.31920/2634-3649/2021/v11n1a1.

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The paper investigated the role of location on the performance attributes of manufacturing Small, Micro and Medium Enterprises (SMMEs) in South Africa’s second-largest province of KwaZulu Natal (KZN). Panel data from 191 SMMEs covering three years between 2015 and 2017 were analysed using R software. The results utilising the Random Effects Within-Between (REWB) technique show that SMMEs in KZN have related characteristics but the extent to which they influence performance is moderated by location. The findings also indicate that the use of digital media and liability registration negatively affects the performance of urban-based, with no effect on rural-based enterprises. Based on the findings, it was recommended that SMMEs in KZN should focus on productivity, permanent employees, temporary employees and total assets to drive performance despite their locations. Based on this study, the government has an informed basis for the development of effective interventions for SMMEs in the province.

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Sheehy, T., F. Kolahdooz, T. L. Mtshali, T. Khamis, and S. Sharma. "Development of a quantitative food frequency questionnaire for use among rural South Africans in KwaZulu-Natal." Journal of Human Nutrition and Dietetics 27, no. 5 (October 7, 2013): 443–49. http://dx.doi.org/10.1111/jhn.12166.

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D'Haese, Marijke, Nick Vink, Tharcisse Nkunzimana, Ellen Van Damme, Johan van Rooyen, Anne-Marie Remaut, Lotte Staelens, and Luc D'Haese. "Improving food security in the rural areas of KwaZulu-Natal province, South Africa: Too little, too slow." Development Southern Africa 30, no. 4-05 (December 2013): 468–90. http://dx.doi.org/10.1080/0376835x.2013.836700.

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Friedman, Michelle, and Alastair McIntosh. "Challenges and perspectives of rural development‐oriented non‐government organizations in Natal/KwaZulu: Summary proceedings of a workshop∗." Development Southern Africa 6, no. 4 (November 1989): 508–14. http://dx.doi.org/10.1080/03768358908439492.

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Lekhanya, Lawrence M., and Roger B. Mason. "Selected Key External Factors Influencing the Success of Rural Small and Medium Enterprises in South Africa." Journal of Enterprising Culture 22, no. 03 (September 2014): 331–48. http://dx.doi.org/10.1142/s0218495814500149.

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Small businesses are critical to improving economic development in rural areas of South Africa. However, rural entrepreneurs are still faced with challenges and problems which make the success of small businesses, especially in rural areas, uncertain. This paper investigates business environmental, financial and infrastructural factors that influence the success or otherwise of Small and Medium Enterprises (SMEs) in rural areas. Primary data was collected in five rural areas of KwaZulu-Natal (KZN) from a sample of 374 business owners/managers, with respondents completing a questionnaire. Access to finance and skills shortages were the factors that most significantly differentiated between more successful and less successful rural businesses in KZN. The majority of respondents indicated that poor roads/transport and access to electricity were major problems.

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Chamane, Nkosinothando, Desmond Kuupiel, and Tivani Phosa Mashamba-Thompson. "Stakeholders’ Perspectives for the Development of a Point-of-Care Diagnostics Curriculum in Rural Primary Clinics in South Africa—Nominal Group Technique." Diagnostics 10, no. 4 (April 1, 2020): 195. http://dx.doi.org/10.3390/diagnostics10040195.

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Poor knowledge and adherence to point-of-care (POC) HIV testing standards have been reported in rural KwaZulu-Natal (KZN), a high HIV prevalent setting. Improving compliance to HIV testing standards is critical, particularly during the gradual phasing out of lay counsellor providers and the shifting of HIV testing and counselling duties to professional nurses. The main objective of this study was to identify priority areas for development of POC diagnostics curriculum to improve competence and adherence to POC diagnostics quality standards for primary healthcare (PHC) nurses in rural South Africa. Method: PHC clinic stakeholders were invited to participate in a co-creation workshop. Participants were purposely sampled from each of the 11 KwaZulu-Natal Districts. Through the Nominal Group Technique (NGT), participants identified training related challenges concerning delivery of quality point of care diagnostics and ranked them from highest to lowest priority. An importance ranking score (scale 1–5) was calculated for each of the identified challenges. Results: Study participants included three PHC professional nurses, one TB professional nurse, one HIV lay councilor, one TB assistant and three POC diagnostics researchers, aged 23–50. Participants identified ten POC diagnostics related challenges. Amongst the highest ranked challenges were the following:absence of POC testing Curriculum for nurses, absence of training of staff on HIV testing and counselling as lay counsellor providers are gradually being phased out,. absence of Continuous Professional Development opportunities and lack of Staff involvement in POC Management programs. Conclusion: Key stakeholders perceived training of PHC nurses as the highest priority for the delivery of quality POC diagnostic testing at PHC level. We recommend continual collaboration among all POC diagnostics stakeholders in the development of an accessible curriculum to improve providers’ competence and ensure sustainable quality delivery of POC diagnostic services in rural PHC clinics.

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Jiyane, Glenrose. "Recounting the Empowerment of Women in Rural Areas of KwaZulu-Natal from Information and Knowledge in the Fourth Industrial Revolution Era." Libri 71, no. 1 (February 12, 2021): 41–50. http://dx.doi.org/10.1515/libri-2019-0197.

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Abstract The fourth industrial revolution (4IR) marks the new, advanced era of development in humankind, and globally countries are in the process of ensuring their citizenry’s readiness. In South Africa, various governmental departments, organizations, non-governmental organizations (NGOs) and non-profit organisations (NPOs) are making efforts, through their plans, talks and actions, to attain this status for all her people, particularly women in rural areas. However, the development of women in the rural areas for empowerment remains a concern in developing countries. Consequently, there is a dire need to ensure the developmental status for women in rural areas in the advent of the 4IR, and this paper seeks to demonstrate that information and knowledge may be instrumental in empowering women in rural areas to strive in the 4IR. Accordingly, information and knowledge are a critical resource contributing to the empowerment of women in rural areas for their development. An exploratory question is raised to determine whether South Africa is ready for Fourth Industrial Revolution. The outcome of this paper will contribute to the body of knowledge advocating the importance of information and knowledge in the empowerment of women in rural areas. Significantly, it will generate insights for policymakers on the important role of information and knowledge for women’s development.

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Simonis, J. J., and A. Nweze. "A novel approach for providing potable water in rural Sodwana Bay, northern Kwazulu-Natal, South Africa." Journal of Water, Sanitation and Hygiene for Development 6, no. 3 (July 8, 2016): 425–34. http://dx.doi.org/10.2166/washdev.2016.023.

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Many people living in the Sodwana area of South Africa do not have access to potable water. Groundwater is the best source of fresh water for the rural community. Potable water in the Zululand coastal plain, Sodwana, South Africa can be enhanced by: (i) providing detailed information on the aquifer system using geophysics; (ii) providing information on groundwater quality and its efficient use; (iii) providing low-cost/low technology local drillers with light-weight, manoeuvrable rigs with trained teams for drilling of 6-inch diameter boreholes. The electrical resistivity geophysical method was used to study the aquifer system and define viable groundwater zones. The electrical resistivity survey increased the borehole success rate by providing information on the aquifer system suitable for water extraction. A hydrocensus was also conducted for identifying boreholes, quality of drilling and for collecting samples for water quality analysis. The result indicated that the groundwater in the area is of suitable quality. Poor quality drilling and inadequate drilling depth indicated a requirement for improved drilling rigs and suitable training. Providing the rural community with suitable drilling equipment, training and adequate information will help to solve the problem of water scarcity and also create jobs.

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Sharaunga, S., M. Mudhara, and E. Wale. "Values rural households in KwaZulu-Natal hold towards forests and their participation in community-based forest management." Agrekon 52, no. 4 (December 2013): 113–47. http://dx.doi.org/10.1080/03031853.2013.847039.

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Agergaard, Jytte, and Torben Birch-Thomsen. "Transitional rural landscapes: The role of small-scale commercial farming in former homelands of Post-Apartheid KwaZulu-Natal." Geografisk Tidsskrift-Danish Journal of Geography 106, no. 2 (January 2006): 87–102. http://dx.doi.org/10.1080/00167223.2006.10649559.

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Evans, Neil Davies. "TRAINING TEACHER-LIBRARIANS TO ESTABLISH AND MANAGE SCHOOL LIBRARIES IN KWAZULU-NATAL: AN EMPIRICAL STUDY." Mousaion: South African Journal of Information Studies 32, no. 2 (October 3, 2016): 106–23. http://dx.doi.org/10.25159/0027-2639/1692.

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The present study aimed to assess the establishing, managing and sustaining of public school libraries in KwaZulu-Natal (KZN) in order to recommend ways to improve the appropriateness of training and development of teacher-librarians currently offered at the University of Zululand. Both interpretive and critical research paradigms were embraced, while a case study method and inductive reasoning were followed. The findings indicate that most public school libraries surveyed are neither fully functional nor properly resourced. They lack full-time teacher-librarians who are trained to manage and integrate their collections into the curriculum. Furthermore, the quality of library services differs markedly between rural and urban schools. It is recommended that the provincial Department of Education (DoE) school library services selectively award teacher-librarian bursaries to suitable candidates and then combine these awards with the provision of core collections of books and technologies, thereby linking the establishment of their school libraries to the practical outcomes in the two-year university-based training programme.

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Matungul, P. M. "BUYING PATTERNS FOR STAPLE FOODS AMONGST RURAL HOUSEHOLDS IN KWAZULU-NATAL INFORMAL CONSTRAINTS PERSPECTIVE IN IMPENDLE AND SWAYIMANA." Agrekon 39, no. 2 (June 2000): 142–50. http://dx.doi.org/10.1080/03031853.2000.9524934.

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Fombad, Madeleine C., and Glenrose Veli Jiyane. "The role of community radios in information dissemination to rural women in South Africa." Journal of Librarianship and Information Science 51, no. 1 (September 22, 2016): 47–58. http://dx.doi.org/10.1177/0961000616668960.

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Rural women in South Africa are important role players in community development; to withhold information from them is to hold back the potential for rural development. However, obstacles such as poverty, illiteracy, fear, poor access to public agencies, and lack of knowledge about the right to information and how or where to ask for it has deprived women of access to information. Since post-apartheid South Africa, government has made progress toward empowering women. Community radio is the only accessible and readily affordable medium within the rural community and can play a significant role in rural development of women. This article adopts the case study research approach through the use of document analysis and interviews to investigate the role of two community radio stations in selected areas of the KwaZulu-Natal Province of South Africa with regard to rural development and the dissemination of information to women listeners. It also suggests ways by which these radios may be used to enhance access to information by rural women in South Africa. The findings reveal that although community radio stations are recognised as support systems for information dissemination in rural communities, their role in information dissemination and the community development of women has not been fully explored. This article suggests ways in which the services of community radios may be enhanced by the provision of information to women for rural development.

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Neely, Abigail H. "Hlonipha and health: ancestors, taboos and social medicine in South Africa." Africa 91, no. 3 (April 26, 2021): 473–92. http://dx.doi.org/10.1017/s0001972021000279.

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AbstractThis article examines the abandonment of an important food taboo – the prohibition of milk consumption by newly married women – in rural KwaZulu-Natal, South Africa in the 1940s and 1950s. Offering a detailed exploration of this hlonipha custom in three rural communities, I start from the position that food always reflects the entanglements of its material and symbolic attributes. By tracing health and illness, shifting livelihoods, diets and an important social medicine intervention, this article reveals that in the 1950s milk was a symbolically and materially different food than it had been in the 1930s. I argue that this difference determined whether or not hlonipha would be abandoned. By centring on understandings of food, health and taboos as material and symbolic, this article draws on scholarship on livestock in Southern Africa and contributes to scholarship on food taboos and hlonipha customs, pushing for the incorporation of material aspects of those customs.

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Mulopo, Chanelle, and Moses J. Chimbari. "Water, sanitation, and hygiene for schistosomiasis prevention: a qualitative analysis of experiences of stakeholders in rural KwaZulu-Natal." Journal of Water, Sanitation and Hygiene for Development 11, no. 2 (February 1, 2021): 255–70. http://dx.doi.org/10.2166/washdev.2021.182.

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Abstract uMkhanyakude District in KwaZulu-Natal province is one of the districts in the six provinces in South Africa where schistosomiasis is endemic. While it is well established that schistosomiasis is a public health problem in the district and that efforts to prevent and control the disease have been made, very little has been done to involve stakeholders in the implementation of water, sanitation, and hygiene (WASH) strategies for schistosomiasis control. Hence, this study sought to document current WASH practices and explore how engaging diverse stakeholders can contribute to the prevention and control of schistosomiasis. Qualitative data were collected through eight key informant interviews with community leaders, nurses, community caregivers, and pre-school teachers; and four focus group discussions with community members during the dry season. The study adopted a grounded theory approach. Data were analyzed using the six steps of thematic analysis. Findings show that the key players in the promotion of water, sanitation, and hygiene were not clearly defined. Although effective implementation, promotion, and adoption of WASH can be fully achieved with the involvement of various stakeholders, we found that there was a limited collaboration among WASH stakeholders.

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Nyawo, Jabulani C., and B. C. Mubangizi. "Perception of Agricultural Smallholder Farmers on Public Extension and Advisory Services in Ethekwini Municipality, Kwazulu-Natal Province." Journal of Southwest Jiaotong University 56, no. 3 (June 30, 2021): 499–518. http://dx.doi.org/10.35741/issn.0258-2724.56.3.42.

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The government’s inability in South Africa to ensure that formulated programs, structures, and policies adequately accommodate smallholder farmers hinders the sector’s ability to grow and develop. This study examines the agricultural smallholder farmers’ perception of the service delivered by the extension and advisory officers. The researchers obtained the primary data from fifteen focus group discussions with the smallholder farmers and three senior government officials under the Department of Agriculture & Rural Development who willingly responded to face-to-face semi-structured interviews. Using thematic analysis, the authors found that the public extension &advisory Officers do not provide substantial support to smallholder farmers seeking access to markets. The study results also show that the agricultural smallholder farmers are dissatisfied with the public extension and advisory officers’ services. Smallholder farmers continue to experience numerous challenges, although the extension and advisory program was implemented to help farmers deal with some challenges for growth and sustainability. New results are expected to provide empirical evidence regarding the performance of extension and advisory officers on smallholder sectors’ development. Furthermore, study results can be used as guidelines for the government when considering the best approaches and capacity building for smallholder farmers.

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Knight, Lucia, Benjamin J. Roberts, J. Lawrence Aber, and Linda Richter. "Household Shocks and Coping Strategies in Rural and Peri-Urban South Africa: Baseline Data from the Size Study in Kwazulu-Natal, South Africa." Journal of International Development 27, no. 2 (April 7, 2014): 213–33. http://dx.doi.org/10.1002/jid.2993.

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Sotshongaye, Ayanda, and Valerie Moller. "We want to live a better life like other people: Self-assessed development needs of rural women in Ndwedwe, KwaZulu-Natal." Development Southern Africa 17, no. 1 (March 2000): 117–34. http://dx.doi.org/10.1080/03768350050003451.

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Gumede, Thembinkosi, and Antonia Nzama. "Enhancing Community Participation in Ecotourism through a Local Community Participation Improvement Model." December 2020, no. 9(5) (December 31, 2020): 1252–72. http://dx.doi.org/10.46222/ajhtl.19770720-81.

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This study aimed to explore the model that can be used to improve local community participation in ecotourism development processes. The study was conducted at the communities adjoining the Oribi Gorge Nature Reserve in KwaZulu-Natal, South Africa. A mixed methods design was adopted by the study during collection and analysis of data. A total of 384 respondents were sampled through convenience sampling technique. Questionnaires were used to collect data through face-to-face surveys. The study found that local communities had not been actively participating in ecotourism development processes, especially those undertaken within the rural setting as a result of different socio-economic factors including lacking necessary skills. This study asserts that this gap could be mitigated through implementation of local community participation improvement model (LCPIM) based on its potential for influencing enactment and/or amendment of policies on ecotourism development

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LEKHANYA, Lawrence Mpele. "The Use of Modern Technology for Rural Industrialization and Its Implications on the Rural SMEs Economic Growth." Journal of Economics and Behavioral Studies 10, no. 6A (January 16, 2019): 64–71. http://dx.doi.org/10.22610/jebs.v10i6a.2662.

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Hence technology delivery is perceived to be an essential catalyst for rural development. This paper intends to present an empirical study on the use of modern technology for rural industrialization and its theoretical and practical implication on the rural SMEs economic growth. The idea of rural industrialization and how it can enhance the rural SMEs economic growth still the issue of concern of many policy-makers. The study seeks to establish understanding, knowledge and awareness about how the use of modern technology would assist in building strong rural industrialization that will have a positive change in the rural SMEs economy. In this research 127 participants consist with business managers/owners running SMEs in the province of KwaZulu-Natal were chosen for empirical data collection from both South and Northern parts of the Province. SPSS (24.0) version was used for the analysis of data. A quantitative questionnaire was used and distributed to the respondents. The findings revealed that in many cases there is no specific rural industrialization policy does not exist or somehow fall short, government attitudes towards rural industrialization as well as rural infrastructure development were also identified by respondents as areas of concern for rural industrialization. The exploratory and quantitative nature limited the survey. Hence, the application of this result should be made with utmost care. Further investigation which may include large and other parts of the country is therefore recommended.

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Mung’omba, Bernard, and Annali DH Botha. "A Continuous Professional Development Strategy for Expanded Competencies Needed by Radiographers Working in Rural Areas." Global Journal of Health Science 11, no. 13 (November 25, 2019): 121. http://dx.doi.org/10.5539/gjhs.v11n13p121.

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INTRODUCTION: The emphasis on Primary Health Care (PHC) with a focus on preventative care offers a challenge for rural radiographers to advance solutions that are change focused. Published evidence suggest that allied health professionals such as radiographers employed in rural areas of South Africa were confronted with an assortment of challenges and responsibilities that demand a wide range of skills and competencies. Additional skills could be essential and Continuous Professional Development (CPD) strategy could be used as a vehicle to equip rural radiographers. OBJECTIVE: To propose a CPD strategy that may support rural radiographers’ expanded and extended competency development needs. METHODS: This research used exploratory sequential study design involving Phase I (qualitative) and Phase II (quantitative) with seven participants and 101 respondents respectively. The CPD strategy development was based on the results from data analysis of both strands. Since strategy development is based on a process of trustworthiness, six evaluators from the clinical and academia were consulted. The evaluators were purposely selected. RESULTS: A final CPD strategy for rural radiographers was proposed. Results from a mixed method study were used in the process of developing the CPD strategy. DISCUSSION: Radiographers working in rural areas of KwaZulu Natal (KZN) a province in South Africa are faced with emerging competency need that require both extended and expanded competencies which may be beyond those required for professional registration. This unmet competency needs can be supported by a CPD strategy that is aligned to these competency needs.

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Faber, Mieke, Michael A. S. Phungula, Jane D. Kvalsvig, A. J. Spinnler Benadé, and Helen Young. "Acceptability of Community-Based Growth Monitoring in a Rural Village in South Africa." Food and Nutrition Bulletin 24, no. 4 (January 2003): 350–59. http://dx.doi.org/10.1177/156482650302400405.

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In rural areas, a lack of infrastructure often limits the promotion and implementation of community-based nutrition activities. Growth monitoring can potentially provide a platform for the promotion and implementation of community-based nutrition activities, provided that the growth-monitoring program has a high coverage. The aim of this study was to determine the acceptability of a community-based growth-monitoring project in terms of child attendance and maternal attitude. The study was done in a mountainous rural village that lacks health facilities in KwaZulu-Natal, South Africa. Attendance registers from 1996 to 2000 were used to determine the attendance ratio, coverage, adequacy of growth monitoring, and frequency distribution of the age of participating children. In 2001, focus group discussions were used for the qualitative assessment of maternal attitudes. The community-based growth-monitoring project had an estimated coverage of 90%, at least 60% of these children were covered adequately, and attendance was equally distributed over one-year-interval age categories for children aged five years and younger. Community-based growth monitoring can therefore provide a suitable platform for the promotion and implementation of community-based nutrition activities.

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Jolles, Frank, and Stephen Jolles. "Zulu Ritual Immunisation in Perspective." Africa 70, no. 2 (May 2000): 229–48. http://dx.doi.org/10.3366/afr.2000.70.2.229.

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AbstractThis article arose out of an attempt to quantify the risk of transmitting blood-borne diseases, in particular Hepatitis B and HIV, through the practice of making incisions (umgcabo) and punctures (ukutshobha) in the skin for the purpose of introducing medication (muthi) into the human body. The intention was to examine means of containing the risk. It soon became apparent that the practice of these therapies was inextricably bound up with legal and economic issues arising out of the impact of colonialism on Zulu medicine. Any endeavour to contain them would first have to address these fundamental issues. The article takes a step in that direction by (1) examining in detail some of the practices of diviners and herbalists in their historical context and (2) showing how colonial and post-colonial legislation has affected traditional healers and their clients in rural KwaZulu/Natal.

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Marcus, T., and D. Manicom. "Consciousness in Transition: A Case Study of Social Identity Formation in KwaZulu-Natal Study Description and Methodology." Sociological Research Online 4, no. 4 (February 2000): 118–26. http://dx.doi.org/10.5153/sro.344.

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The aim of this article is to describe the Class Race and Gender (CRG) Research Programme. The CRG research programme aims to explore the development of consciousness in South Africa, to understand how we come to be the black and white, rural and urban, rich and poor and men and women who make up our stratified and differentiated society and to identify and assess the impact of changes over time. This complex problem is being investigated through a study of class, race and gender identity formation in the first generation of children entering the new, compulsory education system. This article specifically tries to document the research process; its methodology and the instruments which were used and developed in order to engage with the issues under investigation. The article also tries to explain the rationale informing the choice of the sample and methods and describes how these research methods were implemented. Research with people is always interactive and reflexive, even if the researchers do not concern themselves with what the research might contribute to respondents. Yet, in questions there are ideas and information which people think about and learn from. Research is or can be a learning process for respondents. For respondents (and researchers) there is a continual tension between the limits of research (finding out) and the possibilities of intervention (acting out).

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McGregor, Richard Gavin, Andrew John Ross, and Ganzamungu Zihindula. "The socioeconomic impact of rural-origin graduates working as healthcare professionals in South Africa." South African Family Practice 61, no. 5 (October 28, 2019): 31. http://dx.doi.org/10.4102/safp.v61i5.4948.

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Background: Studies documenting the socioeconomic impact of education leading to employment of rural youth, specifically in the healthcare professions, are lacking. The Umthombo Youth Development Foundation (UYDF) is an NGO that provides financial support for rural students to train as healthcare professionals (HCPs) as a way of addressing staff shortages at rural hospitals. The aim of this study was to understand the social and economic impact on individuals and their families of qualifying as an HCP and being employed at a rural district hospitalMethodology: A mixed methodology was used to collect data from 40 graduates at eight district hospitals in rural KwaZulu-Natal province. The research tools had qualitative and quantitative questions, with additional data being extracted from the UYDF database. The qualitative data were analysed thematically, with STATA software being used for the quantitative analysis.Results: The findings indicate that graduate household assets increased significantly, as did their socioeconomic circumstances, compared with before they qualified as HCPs. Graduates attached high value to education that led to their employment, which provided them with money to afford assets. Having a permanent job and regular income also transformed their families’ lives, as they were able to care for their siblings and extended family members.Conclusions: Training rural youth for employment in scarce skills that leads to employment, such as a career in the health sciences, boosts their socioeconomic circumstances and that of their families. This contributes to the staffing of rural hospitals, job creation and the economic development of the country.

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Bailey, I. W., and L. Archer. "The impact of the introduction of treated water on aspects of community health in a rural community in Kwazulu-Natal, South Africa." Water Science and Technology 50, no. 1 (July 1, 2004): 105–10. http://dx.doi.org/10.2166/wst.2004.0031.

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A project was designed by Umgeni Water (funded by the Water Research Commission of South Africa) to monitor the implementation of water reticulation in Vulindlela and evaluate the Water Supply Scheme from a community and environmental health perspective. The findings would hopefully contribute toward the development of criteria for Health Impact Assessment on Water Reticulation Projects. One objective of this study was to evaluate the usefulness of diarrhoeal disease as opposed to other health indicators for water-associated diseases. The innovative methodology followed in the study, a “stepped wedge design”, compared four discrete areas of water reticulation implementation in Vulindlela over a 15-month period. Five surveys, including a baseline and four follow-ups at each household, were carried out. Analysis (microbiological, chemical) was carried out of samples from the household drinking water and from the source of the water. Each survey included health questionnaires, the respondent being the head of the household in each case. Overall, there was no direct correlation proved between water quality and diarrhoea per se. However, there was a marked decrease in diarrhoea with the introduction of the new water supply. There was definite correlation between hygiene behaviours and diarrhoea. Diarrhoea would seem to be the health impact associated with water, of choice.

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Okem, Andrew Emmanuel, and Alfred Oduor Odindo. "Indigenous Knowledge and Acceptability of Treated Effluent in Agriculture." Sustainability 12, no. 21 (November 9, 2020): 9304. http://dx.doi.org/10.3390/su12219304.

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The twin challenges of lack of access to improved sanitation and food insecurity remain critical, particularly in the global south. With cognizance of the nutrient potential of human excreta, there has been increasing interest in linking sanitation innovations with agriculture by using nutrients recovered from human excreta for crop production, thus, closing the nutrient loop. While studies and field trials have explored and validated the technical feasibility of reusing nutrients recovered from human excreta in agriculture, there is still limited knowledge of its social acceptability. This study examined whether indigenous knowledge can be leveraged to increase the acceptability of human-excreta-derived plant nutrient sources such as treated effluent in agriculture. A qualitative research design comprising seven focus group interviews (five in rural areas and two in peri-urban areas) was conducted in KwaZulu Natal, South Africa. Findings from the focus groups reveal a willingness to grow and consume food using treated effluent. Additionally, participants made references to indigenous practices that encourage recycling and reuse of human excreta. Given the potential to simultaneously address issues of food insecurity and sanitation that characterize many peri-urban and rural areas in South Africa, we recommend further studies in this area.

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Nkosi, Busisiwe, Janet Seeley, Natsayi Chimbindi, Thembelihle Zuma, Maureen Kelley, and Maryam Shahmanesh. "Managing ancillary care in resource-constrained settings: Dilemmas faced by frontline HIV prevention researchers in a rural area in South Africa." International Health 12, no. 6 (November 2020): 543–50. http://dx.doi.org/10.1093/inthealth/ihaa045.

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Abstract Background We describe the findings from a research ethics case study, linked with a team evaluating a package of intervention services to prevent HIV infection in adolescent girls and young women (AGYW) living in a rural and poor setting of KwaZulu-Natal, South Africa. Methods We conducted qualitative interviews (n=77) with members of the linked research team evaluating the intervention programme, programme implementing staff, AGYW enrolled in the intervention programme, caregivers, ethics committee members, Public Engagement officers, community advisory board members and community stakeholders. Data were analysed iteratively using thematic framework analysis. Themes were determined by the study aims combined with an inductive development of codes emerging from the data. Results The findings show that the burden of providing ancillary care fell primarily on the shoulders of frontline researchers and programme staff. Dilemmas around responding to gender-based violence illustrated the limits of ‘referral to services’ as a solution for meeting ancillary care obligations in contexts with barriers to basic health and social services. Conclusion Our findings show important gaps in meeting ancillary care needs. Participants’ needs required social and economic support which frontline researchers and implementing partners were not able to meet, causing moral distress.

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Kongo, V. M., J. R. Kosgei, G. P. W. Jewitt, and S. A. Lorentz. "Establishment of a catchment monitoring network through a participatory approach in a small rural catchment in South Africa." Hydrology and Earth System Sciences Discussions 4, no. 5 (October 16, 2007): 3793–837. http://dx.doi.org/10.5194/hessd-4-3793-2007.

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Abstract. The establishment of a catchment monitoring network is a process, from the inception of the idea to its implementation, the latter being the construction of relevant gauging structures and installation of the various instruments. It is useful that the local communities and other stakeholders are involved and participate in such a process as was realised during the establishment of the hydrological monitoring network in the Potshini catchment in the Bergville district in the KwaZulu-Natal Province in South Africa. The paper illustrates the participatory application of various methods and techniques for establishing a hydrological monitoring network, in a small rural inhabited catchment, to monitor hydrological processes at both field and catchment scale for research purposes in water resources management. The authors conclude that the participation of the local community and other stakeholders in catchment monitoring and instilling the sense of ownership and management of natural resources to the local communities needs to be encouraged at all times. Success stories in water resources management by local communities can be realized if such a process is integrated with other development plans in the catchment at all forums with due recognition of the social dynamics of the communities living in the catchment.

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MacKeown, Jennifer M., and Mieke Faber. "Urbanisation and cariogenic food habits among 4–24-month-old black South African children in rural and urban areas." Public Health Nutrition 5, no. 6 (December 2002): 719–26. http://dx.doi.org/10.1079/phn2002358.

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AbstractObjective:To determine if social class, education level and group environment (rural and urban) influence particular food habits commonly associated with dental caries incidence among 4–24-month-old black South African children.Design, setting and subjects:Information was collected by trained interviewers using a food-frequency questionnaire from mothers of children in two areas in South Africa: Ndunakazi, a rural area in KwaZulu/Natal (n = 105) and two urban areas in Gauteng – Soweto (low to middle socio-economic area) (n = 100) and the northern suburbs of Johannesburg and Sandton (middle to upper socio-economic area) (n = 101). Education level and occupation of the parents, which define social class, were also recorded. A linear logistic (Proc Catmod) analysis tested social class, education level and group environment as the independent variables and the food habits as the dependent variables.Results:Group environment was significantly associated with nine of the 18 food habits investigated. More urban than rural mothers added sugar to their child's comforter. More mothers in urban Soweto than in urban Johannesburg were still breast-feeding their infants at 24 months. More rural than urban mothers were giving ‘mutis’ (common and traditional medicines). Together with group environment, education level was significantly associated with giving of ‘mutis’ and the frequency of giving them. Social class was significantly associated with the frequency of breast-feeding and when the child was breast-fed. Mothers from the upper social class breast-fed less frequently than mothers from the lower class.Conclusion:The study showed a strong influence of rural/urban environment on specific cariogenic food habits among young black South African children, enabling the development and implementation of a nutrition strategy.

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Manyaapelo, Thabang, Bart Van den Borne, Robert A. C. Ruiter, Sibusiso Sifunda, and Priscilla Reddy. "Effectiveness of a Health Behavioural Intervention Aimed at Reduction of Risky Sexual Behaviours among Young Men in the KwaZulu-Natal Province, South Africa." International Journal of Environmental Research and Public Health 16, no. 11 (May 31, 2019): 1938. http://dx.doi.org/10.3390/ijerph16111938.

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Two studies evaluating the same behavioural intervention were conducted in two areas in the KwaZulu-Natal province of South Africa using a randomized pre-test post-test control group design for study 1 (peri-urban) and a pre-test post-test design without a control group for study 2 (rural). The intervention included discussions and skills training on: (1) notions of masculinity, manhood, and responsibility, (2) personal and sexual relationships, (3) general communication skills, and (4) alcohol and other substance use. The intervention was aimed at men between 18 and 35 years of age. Measures of attitude, subjective norms, perceived behavioural control and intention for condom use, human immunodeficiency virus (HIV) testing, reduction of alcohol and drug use, avoiding sex while intoxicated, and avoiding sex with intoxicated people were assessed using a facilitator-administered questionnaire. The results for study 1 showed that 4 of the 19 variables scored significantly different at baseline and that all 19 variables showed no significant changes between pre-test and post-test. For study 2, one significant difference was found for attitude towards avoiding sex when one is intoxicated. Overall, the intervention had minimal success with just one area of positive effect. Further development and testing of this programme is recommended before it can be considered for broader scale implementation.

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Jimenez, B., A. Austin, E. Cloete, and C. Phasha. "Using Ecosan sludge for crop production." Water Science and Technology 54, no. 5 (September 1, 2006): 169–77. http://dx.doi.org/10.2166/wst.2006.560.

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This paper presents the microbial risks associated with the reuse of Ecosan sludge in agriculture. Sludge from KwaZulu Natal Province in South Africa with a helminth ova content of 30 HO/g TS, faecal coliforms of 106 CFU/g TS, faecal streptococci of 106 CFU/g TS and Salmonella spp. of 105 CFU/g TS was used for this purpose. Applying different rates of sludge to spinach and carrots resulted in an increase in bacterial and helminth ova counts in crops as the quantity of sludge increased. The helminth ova content in crops was always greater in leaves than in stems, with a content varying from 2 to 15 HO/g TS for spinach with sludge application rates of 0–37.5 ton/ha and from 2–8 HO/g TS for carrot crops with sludge application rates varying from 0–35 ton/ha. Nevertheless, viability in crops was 20–25%, reducing the risk of disease. Consequently, the development of an Ecosan sludge revalorisation standard is considered important. Some recommendations are made taking into account the characteristics of the sludge as well as conditions in rural areas.

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Wilde, Benjamin C., Eva Lieberherr, Andrew E. Okem, and Johan Six. "Nitrified Human Urine as a Sustainable and Socially Acceptable Fertilizer: An Analysis of Consumer Acceptance in Msunduzi, South Africa." Sustainability 11, no. 9 (April 26, 2019): 2456. http://dx.doi.org/10.3390/su11092456.

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Sustainable smallholder farming is contingent on fertilizer access. Soils across Africa are typically nutrient deficient, a condition exacerbated by long-term nutrient mining. Nitrified urine fertilizer is a nutrient-rich and hygienically safe solution derived from human urine. It has the potential to provide a sustainable source of soil nutrients to low and middle-income countries struggling with food insecurity challenges. This study presents findings of a survey that assessed public acceptance within Msunduzi, Kwazulu-Natal, South Africa towards the use of nitrified urine fertilizer. Results indicate that in general attitudes were much more positive towards the use of nitrified urine fertilizer than raw urine as a soil amendment. Residents living within rural zones of the municipality (78.5%), as opposed to urban (65.7%) and peri-urban (65.2%), and younger individuals within the sampled population were found to be the most receptive to the use of nitrified urine fertilizer. Our findings also underscore the complex set of factors that shape attitudes towards a topic such as the use of human waste as a fertilizer, which are crucial in shaping the legitimacy of an emerging technology such as urine nitrification.

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Banhela, Nkosinathi, Myra Taylor, Siphosenkosi G. Zulu, Linnea S. Strabo, Eyrun F. Kjetland, and Svein Gunnar. "Environmental factors influencing the distribution and prevalence of Schistosoma haematobium in school attenders of ILembe and uThungulu Health Districts, KwaZulu-Natal Province, South Africa." Southern African Journal of Infectious Diseases 32, no. 4 (December 31, 2017): 132–37. http://dx.doi.org/10.4102/sajid.v32i4.38.

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Schistosoma haematobium infection is reported to facilitate the development of urogenital diseases. Its symptoms include haematuria, dysuria and tiredness, and it may cause cognitive decline in children. The prevalence of S. haematobium infection needs to be known in endemic areas and a mass treatment programme against the disease implemented. The aim of this study was to investigate the prevalence and intensity of S. haematobium infection in ILembe and uThungulu health districts, using the major symptom, haematuria, as an indicator. A total of 6 265 urine samples, from 96 rural schools, was collected for analysis using dipsticks. The prevalence of haematuria in the ILembe health district was 37% (95% CI, 35–39%) for boys and 39% (95% CI, 37–41%) for girls. The prevalence of haematuria in the uThungulu health district was 56% (95% CI, 53– 59%) and 53% (95% CI, 50–56%) for girls and boys, respectively. Light-intensity infection was the most common infection level in both health districts. A negative relationship was observed between prevalence and altitude (r = −0.262, p = 0.009); whereas, we found a slight, though significant, positive association with mid-summer temperatures (r = 0.234, p = 0.021). Associations between prevalence and distance of school to the nearest river were non-significant.

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Burgoyne, Christopher N., and Clare J. Kelso. "‘The Mkuze River it has crossed the fence’ (1) – communities on the boundary of the Mkuze protected area." Bulletin of Geography. Socio-economic Series 26, no. 26 (December 1, 2014): 51–66. http://dx.doi.org/10.2478/bog-2014-0044.

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Abstract Restricting access to wilderness and wildlife resources is a contested topic in a time when developing nations are seeking to increase quality of life for their citizens. A case in point is the Mkuze Game Reserve which encompasses rich biodiversity and is surrounded by under-resourced rural communities. A history of exclusion from land and resources has left local residents feeling negative about western conservation ideals. Perceptions of protected areas and conservation objectives are important if management authorities are to affect a meaningful buy-in to conservation and sustainable resource use among local residents. In this paper, part of a larger mixed-methods study, we set out to explore the perceptions three rural communities have of 1) local land-cover and livelihood change and 2) the socio-economic benefits expected and derived from living adjacent to Mkuze Game Reserve, a publicly administered protected area in KwaZulu-Natal, South Africa. People living around the reserve felt they receive few benefits from living near to a protected area. Management countered that they are not well funded enough to provide much development support. In addition to this, the community sees a contrast between this lack of benefit sharing and the successful benefit sharing experienced by a neighbouring community which borders a private reserve. This has added to their negative view of the way Mkuze Game Reserve management has been engaging with communities. Effective engagement with communities and understanding their expectations will be important for strengthening conservation initiatives and community engagement objectives in the area.

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Kongo, V. M., J. R. Kosgei, G. P. W. Jewitt, and S. A. Lorentz. "Establishment of a catchment monitoring network through a participatory approach in a rural community in South Africa." Hydrology and Earth System Sciences 14, no. 12 (December 13, 2010): 2507–25. http://dx.doi.org/10.5194/hess-14-2507-2010.

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Abstract. The establishment of a catchment monitoring network is a process, from the inception of the idea to its implementation, the latter being the construction of relevant gauging structures and installation of the various instruments. It is useful that the local communities and other stakeholders are involved and participate in such a process, as was highlighted during the establishment of the hydrological monitoring network in the Potshini catchment in Bergville District in the KwaZulu-Natal Province, South Africa. The paper highlights the participatory establishment of a hydrological monitoring network in a small rural inhabited catchment, in line with the overall objective of the Smallholder System Innovations (SSI) research programme, to monitor hydrological processes at both field and catchment scale for water resources management research purposes. The engagement and participation of the Potshini community precipitated a learning opportunity for both the researchers and the local community on (i) the understanding of hydrological processes inherent in the catchment (ii) appreciating the inherent dynamics in establishing a catchment monitoring network in the midst of a community (iii) paradigm shift on how to engage different stakeholders at different levels of participation. The participatory engagement in the monitoring process led to appreciation and uptake of some of the research results by the Potshini community and ensured continued support from all stakeholders. This paper is of the view that the participation of the local community and other stakeholders in catchment monitoring and instilling a sense of ownership and management of natural resources to the local communities needs to be encouraged at all times. Success stories in water resources management by local communities can be realized if such a process is integrated with other development plans in the catchment at all forums, with due recognition of the social dynamics of the communities living in the catchment.

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Clarke, Damian Luiz. "Trauma quality improvement: The Pietermaritzburg Metropolitan Trauma Service experience with the development of a comprehensive structure to facilitate quality improvement in rural trauma and acute care in KwaZulu-Natal, South Africa." South African Medical Journal 105, no. 2 (January 3, 2015): 92. http://dx.doi.org/10.7196/samj.8792.

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Olusanya, NR, U. Kolanisi, A. Van Onselen, and N. Ngobese. "Preparation, storage, and utilization of mahewu (a non-alcoholic maize meal beverage) in Ntambanana, South Africa." African Journal of Food, Agriculture, Nutrition and Development 21, no. 02 (March 24, 2021): 17492–508. http://dx.doi.org/10.18697/ajfand.97.18855.

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Maize is among the top three grain crops in the world. In Africa, especially Southern Africa,maize is the basic ingredient in fermented soft porridge known as Mahewu. Mahewu is a refreshing drink, produced at the household level using various practices and ingredients as a fermentation enhancer. The underprivileged consume Mahewuas the main meal of the day and hence, Mahewuisasource of dietary nutrients for many populations in Africa and South Africa. The ingredient and practices of making Mahewudiffer from one ethnic group to another. However, some of the indigenous practices are not well reported. These practices are fading away, hence, there is limited information on some indigenous practices. This paper reports some traditional practices of making MahewuinZulu-based households in Ntambanana, a rural municipality in KwaZulu-Natal, South Africa. An ethnographic research approach was adopted for the study to gain insight into the traditional practices of making Mahewu. Probing of key informants, interviews, and observations were complemented by four focus group discussions, within the range of 10-12 regular consumers of Mahewu. Four focus group discussions were conducted in Buchanana and LuwambainNtambanana; findings consistently reveal that Mahewuis popularly known as “umdokwe” and is consumed by all age groups beginning from four months to the aged. Irish potatoes (Solanum tuberosum), imbiliso, inserting a saucer, or a spoon deep down into the Mahewucontainer were mentioned and identified as fermentation enhancers which are lacking in other studies. Therefore, indigenous practices are diminishing while some practices are being lost between generations. Inadequatetransfer of these practices might make the drink, to soon be accessible only commercially. To prevent this dilemma, the retention of traditional techniques of making Mahewu with sweet potatoes could promote food and nutrition security while retaining the indigenous practices. This study reports the preparation, storage, and utilization of Mahewu, a non-alcoholic maize meal beverage in Ntambanana, South Africa. It is recommended that campaigns promoting indigenous food consumption should form part of health, social development, as well as welfare, hence, food and nutrition interventions should be implementedin rural communities.

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Kredo, Tamara, Sara Cooper, Amber Louise Abrams, Jocelyn Muller, Bey-Marrié Schmidt, Jimmy Volmink, and Salla Atkins. "‘Building on shaky ground’—challenges to and solutions for primary care guideline implementation in four provinces in South Africa: a qualitative study." BMJ Open 10, no. 5 (May 2020): e031468. http://dx.doi.org/10.1136/bmjopen-2019-031468.

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ObjectivesClinical guidelines support evidence-informed quality patient care. Our study explored perspectives of South African subnational health managers regarding barriers to and enablers for implementation for all available primary care guidelines.DesignWe used qualitative research methods, including semistructured, individual interviews and an interpretative perspective. Thematic content analysis was used to develop data categories and themes.SettingWe conducted research in four of nine South African provinces with diverse geographic, economic and health system arrangements (Eastern Cape, Western Cape, KwaZulu-Natal, Limpopo). South Africa is a middle-income country with high levels of inequality. The settings represented public sector rural and peri-urban health facilities.ParticipantsTwenty-two participants with provincial and district health management roles, that comprised implementation and/or training on primary care guidelines, were included.ResultsParticipants recommended urgent consideration of health system challenges, particularly financial constraints, impacting on access to the guidelines themselves and to medical equipment and supplies necessary to adhere to guidelines. They suggested that overcoming service delivery gaps requires strengthening of leadership, clarification of roles and enhanced accountability. Participants suggested that inadequate numbers of skilled clinical staff hampered guideline use and, ultimately, patient care. Quality assurance of training programmes for clinicians—particularly nurses—interdisciplinary training, and strengthening post-training mentorship were recommended. Furthermore, fit-for-purpose guideline implementation necessitates considering the unique settings of facilities, including local culture and geography. This requires guideline development to include guideline end users.ConclusionsGuidelines are one of the policy tools to achieve evidence-informed, cost-effective and universal healthcare. But, if not effectively implemented, they have no impact. Subnational health managers in poorly resourced settings suggested that shortcomings in the health system, along with poor consultation with end users, affect implementation. Short-term improvements are possible through increasing access to and training on guidelines. However, health system strengthening and recognition of socio-cultural–geographic diversity are prerequisites for context-appropriate evidence-informed practice.

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Pillay, Pavitra, Lisette van Lieshout, Myra Taylor, Motshedisi Sebitloane, Siphosenkosi Gift Zulu, Elisabeth Kleppa, Borghild Roald, and Eyrun Floerecke Kjetland. "Cervical cytology as a diagnostic tool for female genital schistosomiasis: Correlation to cervical atypia and Schistosoma polymerase chain reaction." CytoJournal 13 (April 20, 2016): 10. http://dx.doi.org/10.4103/1742-6413.180784.

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Background: Female genital schistosomiasis (FGS) is a tissue reaction to lodged ova of Schistosoma haematobium in the genital mucosa. Lesions can make the mucosa friable and prone to bleeding and discharge. Women with FGS may have an increased risk of HIV acquisition, and FGS may act as a cofactor in the development of cervical cancer. Objectives: To explore cytology as a method for diagnosing FGS and to discuss the diagnostic challenges in low-resource rural areas. The correlation between FGS and squamous cell atypia (SCA) is also explored and discussed. Cytology results are compared to Schistosoma polymerase chain reaction (PCR) in vaginal lavage and urine and in urine microscopy. Materials and Methods: In a clinical study, 394 women aged between 16 and 23 years from rural high schools in KwaZulu-Natal, South Africa, underwent structured interviews and the following laboratory tests: Cytology Papanicolaou (Pap) smears for S. haematobium ova and cervical SCA, real-time PCR for Schistosoma-specific DNA in vaginal lavage and urine samples, and urine microscopy for the presence of S. haematobium ova. Results: In Pap smears, S. haematobium ova were detected in 8/394 (2.0%). SCA was found in 107/394 (27.1%), seven of these had high-grade squamous intraepithelial lesion (HSIL). Schistosoma specific DNA was detected in 38/394 (9.6%) of vaginal lavages and in 91/394 (23.0%) of urines. Ova were found microscopically in 78/394 (19.7%) of urines. Conclusion: Schistosoma PCR on lavage was a better way to diagnose FGS compared to cytology. There was a significant association between S. haematobium ova in Pap smears and the other diagnostic methods. In low-resource Schistosoma-endemic areas, it is important that cytology screeners are aware of diagnostic challenges in the identification of schistosomiasis in addition to the cytological diagnosis of SCA. Importantly, in this study, three of eight urines were negative but showed Schistosoma ova in their Pap smear, and one of them was also negative for Schistosoma DNA in urine. In this study, SCA was not significantly associated with schistosomiasis. HSIL detected in this young population might need future consideration.

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Journal articles on the topic 'Rural development – KwaZulu-Natal – Umbumbulu'

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