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In the past few years, Africa has joined the rest of the world as an active participant in the Open Educational Resource (OER) movement with a number of home-grown and externally driven initiatives. These have the potential to make an immense contribution to teaching and learning in Sub-Saharan Africa (SSA). However, certain barriers prevent full participation. This paper reports on qualitative research that sought to investigate SSA's readiness to adopt OERs. This study involves three case studies based in higher education institutions involved in OER projects and located in Kenya, Uganda and South Africa. Contrary to the popular belief, findings indicate that low technological levels in Africa do not necessarily impede the adoption of such educational technologies; the real challenges facing the readiness to adopt OERs appear to be related to socio-economic, cultural, institutional and national issues. This paper argues for a complete mind shift in how people perceive OERs. It also proposes raising awareness of OERs at all levels, involving institutions and government, versioning OERs for the African context and conducting more research on OER adoption. (Contains 2 tables and 6 notes.)

Purpose: The purpose of this paper is to build a detailed description of the Global Seminar (GS) curricula model by exploring its on-the-ground participatory practices in America, Europe, Africa, Asia, and Australia. Design/methodology/approach: Within a qualitative research design framework, the authors interviewed 20 faculty members from the USA, Mexico, Costa Rica, Italy, Australia, Sweden, Honduras, South Africa, Germany, Austria, and Denmark. They observed 11 class sessions; and analyzed available course documents. Findings: The GS model provides a broader notion of teaching and learning for sustainability that incorporates greening and education for sustainability into curricula. This participatory model proves the emerging shift towards a new paradigm of teaching and learning for sustainability in academia. Originality/value: This paper shows how academia can address sustainability through curricula models that promote a fundamental change to the dominant academic paradigm and challenge the existing understanding of sustainability in higher education. (Contains 1 table and 5 figures.)

The interface between African tradition and modernity is one of the concerns of spirited debates in the post-colonial period. Although most African writers deal with it, relatively few have attempted to depict how tradition and modernity may both benefit African societies. Modernity has reached Africa and, thus, the African tradition cannot remain intact. The utmost global portent that distresses human social life is the impact of modernity. Therefore, the paper's key objective is to delineate the degree of social impairment in the present-day Africa engendered by the interface between tradition and modernity. In Africa, modernity has not only influenced personal characteristics but also social, cultural, religious and the operation of establishments. Most believers of African tradition are very conventional, counterattacking the effects of modernity signalled by the colonial period, including the arrival of Christianity and Western teachings. This noted, the paper has utilised a qualitative research method and a textual analysis to critically scrutinise the impacts of the clash between tradition and modernity through the lens of the literary text, Heart of Redness (2000) by Zakes Mda. The findings from the study divulge the clash between African tradition and modernity has resulted in the erosion of many African traditional systems notwithstanding the dethronement of the colonial administration that empowered modernity at the expense of African traditional systems. The paper concludes that to reesseentialise African traditions, the remnants of colonialism should be successfully uprooted. This noted, this study will make a significant contribution to the rehabilitation of African traditions as it unravels the foundations and gatekeepers of modernity at the expense of African tradition. [ABSTRACT FROM AUTHOR]

Access to mental healthcare in low- and middle-income countries (LMICs) is one of the greatest challenges in public health today. One suggestion for improving accessibility is through collaboration between biomedical practitioners and traditional healers. This paper reviews studies of traditional healers' and biomedical practitioners' perceptions of collaboration. We conducted a systematic review of online databases, selected journals, and reference lists for relevant studies. Eligible papers were assessed using a tool designed for this review for quality and study characteristics, and qualitative data demonstrating participants' views were extracted. A total of 14 papers from seven countries were included. The published literature on this topic is relatively homogenous and studies are of variable quality. The findings suggest that, despite differing conceptualisations of mental illness causation, both traditional healers and biomedical practitioners recognise that patients can benefit from a combination of both practices and demonstrate a clear willingness to work together. There are concerns about patients' safety and human rights regarding traditional methods and some healers are sceptical about the effectiveness of Western psychiatric medication. Despite keeping the inclusion criteria open to all LMICs, 13 of the studies were conducted in Africa, seven of which were in South Africa. This limits the applicability of the findings of this review to the wider LMIC context. The paper concludes with recommendations for research and practice. [ABSTRACT FROM AUTHOR]

The Open Science (OS) movement promises nothing less than a revolution in the availability of scientific knowledge around the globe. By removing barriers to online data and encouraging publication in Open Access formats and Open Data archives, OS seeks to expand the role, reach and value of research. The promises of OS imply a set of expectations about what different publics hope to gain from research, how accountability and participation can be enhanced, and what makes science public in the first place. This paper presents empirical material from fieldwork undertaken in (bio)chemistry laboratories in Kenya and South Africa to examine the extent to which these ideals can be realized in a sub-Saharan context. To analyse the challenges African researchers face in making use of freely available data, we draw from Amartya Sen’s Capabilities Approach. His theorisations of ‘conversion factors’ helps to understand how seemingly minor economic and social contingencies can hamper the production and (re-)use of online data. In contrast to initiatives that seek to make more data available, we suggest the need to facilitate a more egalitarian engagement with online data resources. [ABSTRACT FROM PUBLISHER]

Vaccine hesitancy has gained renewed attention as an important public health concern worldwide. Against this backdrop, over the last decade, we have conducted various qualitative, social science studies with the broad shared aim of better understanding this complex phenomenon. This has included various Cochrane systematic reviews of qualitative research globally, systematic reviews of qualitative research in Africa, and primary research studies in South Africa. These studies have also explored vaccine hesitancy for various vaccines, including routine childhood vaccination, HPV vaccination and other routine vaccinations for adolescents, and, most recently, COVID-19 vaccination. In this reflective and critical commentary piece we reflect on seven key overarching insights we feel we have gained about this complex phenomenon from the varying studies we have conducted over the past decade. These insights comprise the following: (1) the relationship between vaccine knowledge and hesitancy is complex and may operate in multiple directions; (2) vaccine hesitancy is driven by multiple socio-political forces; (3) vaccine hesitancy may be many things, rather than a single phenomenon; (4) vaccine hesitancy may be an ongoing 'process', rather than a fixed 'stance'; (5) vaccine hesitancy may sometimes be about a 'striving', rather than a 'resisting'; (6) 'distrust' as a driver of vaccine hesitancy needs to be better contextualized and disaggregated; and (7) the 'demand-side' versus 'supply/access-side' distinction of the drivers of suboptimal vaccination may be misleading and unhelpful. In unpacking these insights, we problematize some of the common assumptions within the vaccine hesitancy literature and flag topics that we think could benefit from further scrutiny and debate. Our hope is that this can provide a platform for further engagement on these issues and ultimately contribute towards fostering a more critical public health understanding of vaccine hesitancy. [ABSTRACT FROM AUTHOR]

Malawi and specifically the Northern Region remains a mostly agricultural and very rural country. Hence, many households rely on agricultural activities, either as smallholder farmers or employees on bigger farms. Furthermore, the Malawian population growth of three per cent per annum is very high, which is why the demand for food and other resources like water or energy increases drastically. As ‘Agriculture’ is a subject within the Malawian curriculum this article focuses on its role and content. The research focuses on the teaching methods and content of the subject. A main focus was put on the way the concept of sustainability is being taught and the areas of sustainability that are being covered. A qualitative methodological approach, combining document analysis, ethnographical research and fourteen semi-structured interviews with teachers at public secondary schools in the Northern Region provided an in-depth insight into how the concept of sustainability is being grasped and taught. The importance and chances of teaching ‘Agriculture’ as a subject became visible, while at the same time many general and subject-specific obstacles remain and partly diminish the positive effects of the subject. Teachers are aware of the concept of sustainability, without necessarily being familiar with the terminology ‘sustainability’. [ABSTRACT FROM PUBLISHER]

Written voluntary informed consent (VIC) procedures are the standard approach for operationalising the ethical principle of respect for persons' autonomy in qualitative research. However, achieving fully informed and truly voluntary consent is challenging, particularly in qualitative research and/or postcolonial contexts. Evidence about (mis)understandings (i.e., unintended meanings) surrounding VIC comes primarily from participants in quantitative, biomedical research. I aim to advance knowledge about qualitative research participants' (mis)understandings of VIC. I used ethnographic methods to document the evolving (mis)understandings participants attached to written VIC procedures in two postcolonial settings, Eswatini and South Africa. All participants provided me consent to document their interactions as co-researchers in participatory research, in which they learned about, designed and implemented VIC procedures. I analysed the data interpretively and abductively, informed by Bourdieu's theory of practice. Participants valued the opportunity to decide and sign consent to participate but held (mis)understandings of study information and signing, which evolved as they participated. Many (mis)understandings were shaped by what the unfamiliar act of signing symbolised to them (i.e., binding, contractual agreements that protected the researcher/university and through which they relinquished their rights), from their positions of marginalisation amidst economic/material, cultural and social power inequalities. In postcolonial settings, requiring qualitative research participants to sign consent forms likely undermines the ethical principle of respect that VIC is intended to operationalise. Based on these findings I recommend alternative non-written procedures are used to operationalise the principle of respect in postcolonial qualitative research settings. [ABSTRACT FROM AUTHOR]

Background: The global focus on promoting Universal Health Coverage has drawn attention to the need to increase public domestic funding for health care in low- and middle-income countries. Objectives: This article examines whether increased tax revenue in the three territories of Kenya, Lagos State (Nigeria) and South Africa was accompanied by improved resource allocation to their public health sectors, and explores the reasons underlying the observed trends. Methods: Three case studies were conducted by different research teams using a common mixed methods approach. Quantitative data were extracted from official government financial reports and used to describe trends in general tax revenue, total government expenditure and government spending on the health sector and other sectors in the first decade of this century. Twenty-seven key informant interviews with officials in Ministries of Health and Finance were used to explore the contextual factors, actors and processes accounting for the observed trends. A thematic content analysis allowed this qualitative information to be compared and contrasted between territories. Findings: Increased tax revenue led to absolute increases in public health spending in all three territories, but not necessarily in real per capita terms. However, in each of the territories, the percentage of the government budget allocated to health declined for much of the period under review. Factors contributing to this trend include: inter-sectoral competition in priority setting; the extent of fiscal federalism; the Ministry of Finance's perception of the health sector's absorptive capacity; weak investment cases made by the Ministry of Health; and weak parliamentary and civil society involvement. Conclusion: Despite dramatic improvements in tax revenue collection, fiscal space for health in the three territories did not improve. Ministries of Health must strengthen their ability to motivate for larger allocations from government revenue through demonstrating improved performance and the relative benefits of health investments. [ABSTRACT FROM AUTHOR]

Background: South Africa has a serious burden of avoidable blindness and visual impairment, which may be due to poor ocular health promotional policies and programs or implementation. Therefore, this paper sought to critically analyse the South African primary health-care policies and programs, to identify the components of ocular health promotional policies and programs as well as how they are currently being implemented and to suggest areas that can be improved in order to minimise the burden of blindness and visual impairment.Methods: Triangulated quantitative and qualitative research methods were used in the study. Questionnaire and interviews were used to solicit data from national and provincial managers of different health directorates. Eye-care managers from each province also completed the questionnaire. Furthermore, relevant health policy and program documents from national and provincial departments of health were studied to identify areas relating to ocular health promotion.Results: The study found varying degrees of implementation of various ocular health promotional activities in the provinces with the majority of respondents (62 per cent) indicating that ocular health promotion was not part of their responsibility and another 81 per cent revealing that vision screening does not form part of their health promotional programs. It further revealed a lack of a dedicated directorate for ocular health-care issues and the absence of an integrated ocular health promotional policy.Conclusion: Ocular health promotional activities were absent in other provinces. This may be a major contributing factor to poor ocular health promotion in South Africa and hence, the high prevalence of blindness and visual impairment. Therefore, it is recommended that an integrated ocular health promotional model (directorate and policies) be developed and be part of the South African primary health-care system. [ABSTRACT FROM AUTHOR]

There is a wealth of research on parent–child communication about sexual and reproductive health and rights (SRHR) and its influence on young people’s sexual behaviours. However, most of it is from the global North. The aim of this study was to explore parent–child communication in three South African provinces: Eastern Cape, KwaZulu-Natal (KZN) and Mpumalanga. Nine, peer, focus group discussions (FGDs) were conducted with young and adult black African men and women in their spoken languages. Data were analysed thematically. Findings revealed that cultural and religious constructions of taboo silenced direct communication and restricted the discussed topics. Parents’ older age, low educational level, lack of knowledge, and discomfort in talking about sexuality matters were reported to restrict conversations with children about sex and sexuality. The influence of these factors differed for parents residing in an urban setting who were more liberal than their counterparts residing in more rural areas. The child’s age and gender were also reported to be a consideration in approaching these conversations. There is a need for interventions to assist parents on how to communicate with their children about SRHR topics beyond pregnancy and HIV/AIDS. These interventions should take into account and address factors that seem to influence parent–child communication. [ABSTRACT FROM AUTHOR]

Consistent over-reporting of product use limits researchers' ability to accurately measure adherence and estimate product efficacy in HIV prevention trials. While lying is a universal characteristic of the human condition, growing evidence of a stark discrepancy between self-reported product use and biologic or pharmacokinetic evidence demands examination of the reasons research participants frequently misrepresent product use in order to mitigate this challenge in future research. This study (VOICE-D) was an ancillary post-trial study of the vaginal and oral interventions to control the epidemic (VOICE) phase IIb trial (MTN 003). It was conducted in three African countries to elicit candid accounts from former VOICE trial participants about why actual product use was lower than reported. In total 171 participants were enrolled between December 2012 and March 2014 in South Africa (n = 47), Uganda (n = 59) and Zimbabwe (n = 65). Data suggested that participants understood the importance of daily product use and honest reporting, yet acknowledged that research participants typically lie. Participants cited multiple reasons for misreporting adherence, including human nature, self-presentation with study staff, fear of repercussions (study termination resulting in loss of benefits and experience of HIV-related stigma), a permissive environment in which it was easy to get away with misreporting, and avoiding inconvenient additional counseling. Some participants also reported mistrust of the staff and reciprocal dishonesty about the study products. Many suggested real-time blood-monitoring during trials would encourage greater fidelity to product use and honesty in reporting. Participants at all sites understood the importance of daily product use and honesty, while also acknowledging widespread misreporting of product use. Narratives of dishonesty may suggest a wider social context of hiding products from partners and distrust about research, influenced by rumors circulating in clinic waiting-rooms and surrounding communities. Prevailing power hierarchies between staff and participants may exacerbate misreporting. Participants recognized and suggested that objective, real-time feedback is needed to encourage honest reporting. [ABSTRACT FROM AUTHOR]

Migration of African-trained health workers to countries with higher health care worker densities adds to the severe shortage of health personnel in many African countries. Policy initiatives to reduce migration levels are informed by many studies exploring the reasons for the original decision to migrate. In contrast, there is little evidence to inform policies designed to facilitate health workers returning home or providing other forms of support to the health system of their home country. This study explores the links that South African-trained health workers who now live and work in the United Kingdom maintain with their country of training and what their future migration plans may be. Semi-structured interviews were conducted with South African trained health workers who are now living in the United Kingdom. Data extracts from the interviews relating to current links with South Africa and future migration plans were studied. All 16 participants reported strong ongoing ties with South Africa, particularly through active communication with family and friends, both face-to-face and remotely. Being South African was a significant part of their personal identity, and many made frequent visits to South Africa. These visits sometimes incorporated professional activities such as medical work, teaching, and charitable or business ventures in South Africa. The presence and location of family and spouse were of principal importance in helping South African-trained health care workers decide whether to return permanently to work in South Africa. Professional aspirations and sense of duty were also important motivators to both returning and to being involved in initiatives remotely from the United Kingdom. The main barrier to returning home was usually the development of stronger family ties in the United Kingdom than in South Africa. The issues that prompted the original migration decision, such as security and education, also remained important reasons to remain in the United Kingdom as long as they were perceived as unresolved at home. However, the strong residual feeling of identity and regular ongoing communication meant that most participants expressed a sense of duty to their home country, even if they were unlikely to return to live there full-time. This is a resource for training and short-term support that could be utilised to the benefit of African health care systems. [ABSTRACT FROM AUTHOR]