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The value of internationalization within the limits of mobility has become more pronounced during the COVID-19 pandemic. As reflection occurs on our own history, navigating a period of reset and renewal, this paper examines how to advance our thinking, and explore and transverse essential differences within the digital space. Hence, recalibrating the global north and south agenda to create inclusionary principles through virtual exchange. First, this ethnographic paper explores the sympoeitic relationship of creating opportunities and a sense of agency toward morphogenesis. Second, it focuses on the contextual rationale for Collaborative Online International Learning (COIL) within higher education. Third, it explores equity in the digital space through multiple engagements in COIL. The paper offers associated conclusions for critical virtual exchange to advance equity, inclusion, and social justice and suggests responsible pluralistic internationalization.

Background and Objectives: Confirmed COVID-19 diagnoses underestimate the total number of infections. Blood donors can provide representative seroprevalence estimates, which can be leveraged into reasonable estimates of total infection counts and infection fatality rate (IFR)., Materials and Methods: Blood donors who donated after each of three epidemic waves (Beta, Delta and first Omicron waves) were tested for anti-SARS-CoV-2 nucleocapsid antibodies using the Roche Elecsys anti-SARS-CoV-2 total immunoglobulin assay. Roche Elecsys anti-spike antibody testing was done for the post-Omicron sampling. Prevalence of antibodies was estimated by age, sex, race and province and compared to official case reporting. Province and age group-specific IFRs were estimated using external excess mortality estimates., Results: The nationally weighted anti-nucleocapsid seroprevalence estimates after the Beta, Delta and Omicron waves were 47% (46.2%-48.6%), 71% (68.8%-73.5%) and 87% (85.5%-88.4%), respectively. There was no variation by age and sex, but there were statistically and epidemiologically significant differences by province (except at the latest time point) and race. There was a 13-fold higher seroprevalence than confirmed case counts at the first time point. Age-dependent IFR roughly doubled for every 10 years of age increase over 6 decades from 0.014% in children to 6.793% in octogenarians., Conclusion: Discrepancies were found between seroprevalence and confirmed case counts. High seroprevalence rates found among Black African donors can be ascribed to historical inequities. Our IFR estimates were useful in refining previous large disagreements about the severity of the epidemic in South Africa. Blood donor-based serosurveys provided a valuable and efficient way to provide near real-time monitoring of the ongoing SARS-CoV-2 outbreak., (© 2023 International Society of Blood Transfusion.)

Migration to South Africa is motivated by the pursuit of employment, safety, and improved living conditions. However, immigrants encounter significant challenges, such as restricted access to essential services, which were exacerbated by the COVID-19 pandemic. This paper investigates the impact of the COVID-19 pandemic on Malawian immigrants in South Africa, addressing the lack of attention given to this immigrant population by highlighting their vulnerabilities. Using a qualitative exploratory and descriptive approach, in-depth interviews were conducted with 24 Malawi immigrants who were over 18 years old and had established residency in South Africa before the onset of the COVID-19 pandemic. Five key stakeholders were also interviewed for additional perspectives and to ensure triangulation and improve data reliability. The interviews were transcribed verbatim and analyzed using thematic analysis strategies and coding with Nvivo12 software. The study highlighted the exacerbated struggles of Malawian immigrants in South Africa amid the COVID-19 pandemic, uncovering systemic discrimination in healthcare, marked by longer wait times and reluctance from health workers to treat undocumented immigrants. The study also revealed a dire security situation, with immigrants living in high-crime areas and feeling particularly targeted due to their foreign status, a situation worsened by the pandemic's economic effects. Additionally, the economic downturn induced by COVID-19 significantly impacted employment opportunities, with many immigrants facing prolonged unemployment and job losses, especially in sectors where they traditionally found work. The detailed accounts of participants highlight not only the multifaceted challenges imposed by the pandemic but also the critical need for inclusive policies and support systems that ensure healthcare access, safety, and economic resilience for immigrants, particularly during global health emergencies. Future research should focus on effective interventions for socioeconomic integration and well-being, particularly for immigrants from other African countries. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic presented challenges for qualitative researchers since many countries had to implement lockdown policies to control the spread of the virus. Within the South African context, research on sexual minority identities and experiences is automatically sensitive and risky given the extent of intolerance and high regard for heteronormative ideologies and beliefs that continually exclude sexual minorities from the "normal." The sensitivity is intensified during a national lockdown since there is an excessive reliance on digital public spaces to recruit participants and conduct interviews. Based on the experience of Ph.D. fieldwork, this paper pays attention to a sexuality researcher's experience of conducting research on gay men's experiences in the South African military and police services during a national lockdown. Particular attention is given to the dilemmas posed by the government's restriction on physical movement and reliance on digital spaces, particularly social media to identify gay men who work in the two organizations and form virtual relationships of mutual trust. Ultimately, this paper holds that reflexivity is critical to feminist research on vulnerable sexual minorities when the relationships between the researcher and the researched are established and maintained through digital platforms. While digital spaces offer opportunities to reach vulnerable populations, they present some challenges that may compromise the credibility of the study if not identified by the researcher. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) set up the messenger ribonucleic acid (mRNA) technology transfer programme in June 2021 with a development hub in South Africa and 15 partner vaccine producers in middle-income countries. The goal was to support the sustainable development of and access to life-saving vaccines for people in these countries as a means to enhance epidemic preparedness and global public health. This initiative aims to build resilience and strengthen local vaccine research, and development and manufacturing capacity in different regions of the world, especially those areas that could not access coronavirus disease 2019 (COVID-19) vaccines in a timely way. This paper outlines the current global vaccine market and summarizes the findings of a case study on the mRNA technology transfer programme conducted from November 2022 to May 2023. The study was guided by the vision of the WHO Council on the Economics of Health for All to build an economy for health using its four work streams of value, finance, innovation and capacity. Based on the findings of the study, we offer a mission-oriented policy framework to support the mRNA technology transfer programme as a pilot for transformative change towards an ecosystem for health innovation for the common good. Parts of this vision have already been incorporated into the governance of the mRNA technology transfer programme, while other aspects, especially the common good approach, still need to be applied to achieve the goals of the programme., ((c) 2024 The authors; licensee World Health Organization.)

Background: The publication of South Africa's National Mental Health Policy Framework and Strategic Plan 2023-2030 and the proposed National Health Insurance (NHI) make it timely to review that state of mental health services in the country, and to emphasize the importance of prioritising mental health as a pivotal component of holistic healthcare., Method: We searched the published literature on mental health using Google Scholar, Pubmed, and Bing Chat, focusing on these words: epidemiology of mental health disorders, depression and anxiety disorders, mental health services, mental health facilities, human resources, financing and impact of COVID-19 on mental health in South Africa and beyond. We also searched the grey literature on mental health policy that is publicly available on Google., Results: We provided information on the epidemiology and economic impact of mental health disorders, the availability of mental health services, enabling policies, human resources, financing, and the infrastructure for mental health service delivery in South Africa. We detail the high lifetime prevalence rates of common mental disorders, as well as the profound impact of socioeconomic determinants such as poverty, unemployment, and trauma on mental health disorders. We note the exacerbating effect of the COVID-19 pandemic, and emphasize the pressing need for a robust mental health care system., Conclusion: In addition to outlining the challenges, such as limited mental health service availability, a shortage of mental health professionals, and financial constraints, the review proposes potential solutions, including task-sharing, telehealth, and increasing the production of mental health professionals. The paper underscores the necessity of crafting a comprehensive NHI package of mental health services tailored to the local context. This envisioned package would focus on evidence-based interventions, early identification, and community-based care. By prioritising mental health and addressing its multifaceted challenges, South Africa can aspire to render accessible and equitable mental health services for all its citizens within the framework of the National Health Insurance., Competing Interests: Declaration of competing interest Prof.  Stein has received consultancy honoraria from Discovery Vitality, Johnson & Johnson, Kanna, L’Oreal, Lundbeck, Orion, Sanofi, Servier, Takeda and Vistagen., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: COVID-19 vaccination rates in South Africa remain low at 51% of the adult population being fully vaccinated, defined as having two shorts of the COVID-19 vaccine with or without a booster. To improve vaccine uptake, a community-based intervention was tested in a high vaccine hesitancy community in South Africa. Trained community youths used social media, face to face interactions, door to door and neighbourhood outreach activities to deliver the intervention., Methods: To assess if the intervention had an impact, data was collected before the intervention and after the intervention in two districts, Wentworth an intervention site and Newlands East a control site. Both districts are in KwaZulu Natal Province, South Africa. The following outcomes, changes on perceptions and knowledge about COVID-19, intention to get vaccinated for those who were not fully vaccinated and vaccination uptake were assessed using difference-in-difference methods applied through Augmented Inverse-Probability Weighting and contrasts of Potential Outcome Means (POM)., Results: One thousand, one hundred and fifty (1 150) participants agreed to take part in the study at baseline, and 916 (80%) were followed up after the 9-week intervention period. Intention to get vaccinated for COVID-19 was higher (difference-in-difference, DID 20%, 95% CI 6% - 35% higher), more people were fully vaccinated (DID 10%, 95% CI 0% - 20%) or partially vaccinated (DID 16%, 95% CI 6% - 26%) in Wentworth the intervention site compared to Newlands East, the control site. There were noticeable increases on the percentage of study participants indicating trust on the Government's COVID 19 programme, from 24% at baseline to 48% after the intervention in the intervention group than in the control group, 26% baseline and 29% at follow-up. There was a 10% (absolute) increase on the percentage of participants' saying they believed health care workers provided reliable information, 58% at baseline and 68% at follow-up in the intervention group, but there was little change in the control group 56% and 57% for baseline and follow-up respectively., Conclusion: The youth-led intervention implemented in Wentworth, a community with a high rate of vaccine hesitancy, was effective in increasing vaccination uptake. Given the low COVID-19 vaccine coverage in South Africa and across the African region, as well as the new emerging variant of concern (XBB 1.5), there is an urgent need to scale up such intervention at the community level to address persistent misinformation and promote vaccine equality., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: COVID-19 necessitated emergency telepractice for student-led speech-language therapy clinical practicals in training institutions, with limited preparation and evidence-based guidelines. Beyond the pandemic, practitioners and university training sites are likely to continue to offer telepractice necessitating thorough preparation for telepractice services underpinned by a comprehensive understanding of the complexities involved in online therapy., Aims: Adopting realist evaluation principles, our aim in this paper was to explore broadly what works and does not work in a set of student-led telepractice sessions in a diverse, resource-limited context. The broader goal of this project was to provide evidence-based support to enhance the efficiency and success of telepractice sessions in student clinical training contexts., Methods & Procedures: We used qualitative observational methods with reflexive thematic analysis to analyse 28 video recordings and 61 observation notes of student-led paediatric telepractice sessions from a South African university clinic as part of a pilot study., Outcomes & Results: We identified four overarching considerations for student-led telepractice: (1) additional, specific preparation is required, (2) with greater management of technology and adaptation of tasks, especially during times of poor connectivity; (3) telepractice relies heavily on caregiver input and collaboration; and (4) promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical skills that are complicated by the lack of face-to-face contact., Conclusions & Implications: Our findings indicate that telepractice pedagogy needs to be explicitly taught and students require practical assistance as they learn how to use this service delivery approach effectively. There are some aspects peculiar to telepractice that require unique consideration and planning, especially in contexts where service providers and users may be unfamiliar with this form of service provision. The findings of this pilot study can be used by clinical educators and student clinicians to enhance clinical training opportunities involving telepractice., What This Paper Adds: What is already known on this subject Many speech-language therapy (SLT) student clinicians had to transition quickly to telepractice service provision during COVID-19 with limited existing guidelines and support, especially in contexts where teletherapy is typically non-existent or difficult to access. Although there is some literature available on experiences of telepractice, there is very little evidence-based research which explores the mechanics of such sessions in real-time and which offers practical support to student clinicians and clinical educators engaging in this mode of service delivery. What this study adds This pilot study examined video-recorded, student-led, paediatric, speech-language teletherapy sessions to understand challenges and considerations involved in using telepractice as a clinical training tool. Findings show that additional preparation for telepractice sessions is required, particularly in contexts of poor digital literacy; students must learn to manage technology, especially when connectivity poses a challenge, and adapt therapy tasks for online work with clients; telepractice relies heavily on caregiver input and collaboration, more so than in in-person consultations, and this relationship requires careful management; and promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical yet challenging skills in telepractice. What are the potential or actual clinical implications of this work? Our findings highlight a need to teach telepractice pedagogy explicitly and support students practically in learning how to provide therapy effectively via this mode of service delivery. Observational methods for studying practices in recorded telepractice sessions can be used as part of a reflective approach to clinical training. Using already available data allowed us to unpack the 'messy reality' of clinical training using telepractice., (© 2023 The Authors. International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.)

The Sisonke 2 study provided a homologous boost at least 6 months after administration of the priming dose of Ad26.COV2.S for healthcare workers enrolled on the Sisonke phase 3b implementation study. Safety monitoring was via five reporting sources: (i.) self-report through a web-link; (ii.) paper-based case report forms; (iii.) a toll-free telephonic reporting line; (iv.) healthcare professionals-initiated reports; and (v.) active linkage with National Disease Databases. A total of 2350 adverse events were reported by 2117 of the 240 888 (0.88%) participants enrolled; 1625 of the 2350 reported events are reactogenicity events and 28 adverse events met seriousness criteria. No cases of thrombosis with thrombocytopaenia syndrome were reported; all adverse events including thromboembolic disorders occurred at a rate below the expected population rates apart from one case of Guillain Barre Syndrome and one case of portal vein thrombosis. The Sisonke 2 study demonstrates that two doses of Ad26.COV2.S is safe and well tolerated; and provides a feasible model for national pharmacovigilance strategies for low- and middle-income settings., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Violence against women (VAW) research is a sensitive topic, which has been conducted mainly using face-to-face methods. The COVID-19 pandemic lockdown and restrictions on movement presented an opportunity to conduct VAW research using remote methods. We discuss how we adapted methods, reflect on lessons learned, and make recommendations highlighting key considerations when conducting remote research on a sensitive topic of VAW., Methods: We designed and conducted an exploratory qualitative study using remote methods with 18 men and 19 women, aged 18 years and older, who lived with their partner or spouse during lockdown in South Africa. The aim of the study was to explore experiences of COVID-19 lockdown, and its link to women and children's experiences of violence in the homes. Data presented in this paper draws from researchers' reflections drawn from debriefing sessions during the research process, and from participants' interview transcripts., Findings: Remote recruitment of participants took longer than anticipated, and we had to re-advertise the study. We could not ensure safety and privacy during interviews. Regardless of all the safety and privacy measures we put in place during the research process, some participants had an adult person present in the room during interviews, and the researchers had no control over interruptions. Rapport was difficult to establish without an in-person connection, which limited disclosure about violence experience (amongst women) and perpetration (amongst men)., Conclusions: Given the methodological and ethical challenges which limited disclosure of VAW remotely, we conclude that telephone interviews used in our study impacted on the quality of study data. Therefore, we do not recommend VAW research to be conducted remotely, unless it is essential and participants are already known to the interviewer and trust has been established., (© 2023. The Author(s).)

The current paper explores crosslinguistic and multimodal health communication strategies employed by the South African government during the COVID-19 pandemic in 2020-2022. Some governments used multiple languages, yet in most cases, English monolingualism was a predominant form of communication. This paper utilised a multimodal critical discourse analysis to explore public health communication by government officials in South Africa and by members of the National Coronavirus Command Council mandated to combat the spread of COVID-19 in South Africa. The paper interrogates how this language and messaging limited or enabled linguistic equity and social justice. The paper concludes that in a country such as South Africa, for any government's initiative to promote linguistic and social justice, it ought to be 'languaged' and messaged through the linguistic repertoires that the majority of its citizens understand; if not, it is doomed to fail as was the case with the South African government's COVID-19 communication strategies. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic in South Africa has negatively affected the lives of many individuals and families. Undocumented migrants were not an exception to this challenge. Despite encountering a number of challenges such as unemployment and being excluded from the welfare services of the country, undocumented migrants also battled with the impact of the COVID-19 pandemic which forced them to develop survival strategies. It is from this background that this, study sought to explore survival strategies of undocumented migrants post COVID-19 lockdown in South Africa. The study used a qualitative approach wherein Musina was used as a case study. Ten migrant youth were purposively and conveniently selected to participate in this study. Data was collected through face-to-face semistructured interviews and analysed thematically through Thematic Content Analysis (TCA). Resilience theory was used to guide this study. Findings, conclusions and recommendations are provided in this paper. [ABSTRACT FROM AUTHOR]

According to the World Bank, South Africa is the most unequal society in the world. It follows that teaching philosophy takes on a unique character in this country. During the initial COVID-19 outbreak, all universities were compelled to move online, entailing that the teaching of philosophy also moved online. However, because of their socio-economic realities, students faced many barriers, and this served to further marginalise already marginalised students. The university campus provides structural support to many of these students that they do not have at home-computer labs, internet access, and residences. With campuses shutting down and learning to move online, many (if not most) of our students faced significant challenges. This paper explores the challenges encountered during this time through empirical research. Five interviews were conducted with philosophy lecturers, and the data was analysed using Atlas.ti. This article therefore provides empirical insight into the challenges faced by philosophy lecturers as they taught philosophy during a pandemic in the "most unequal society in the world". [ABSTRACT FROM AUTHOR]

Introduction: As higher education institutions (HEIs) moved from in-person to online learning during the COVID-19 pandemic, various challenges were presented. Using a large online survey conducted during the pandemic, this paper investigates the impact of COVID-19 on learning and institutional support offered to students in HEIs in South Africa. Methods: The study utilized a closed-ended questionnaire on a data-free online platform. The study sample included South African youth aged 18-35 years who were enrolled for some type of educational training or in higher education institutions (including private colleges). Data was benchmarked to the 2019 estimates of the youth population in educational institutions. Descriptive statistics are presented. Results: Among the 7011 student participants, the main challenges experienced during lockdown were loss of study time (57.9%), insufficient money for essential personal items for studying (55.8%), loss of social contact (42.2%) and insufficient money for food (40.1%). Overall, 47.0% of students reported having free access to the internet, 49.5% used personal internet or paid for internet access and 3.5% indicated having no access to internet. The majority rated their institution's eLearning portal as good or excellent, and 23.4% thought their eLearning portal was of poor quality. Significantly fewer (38.1%) technical and vocational education and training (TVET) college students indicated that their institution provided the capacity to conduct virtual learning compared to those enrolled at other types of institutions. Almost two thirds of students (66.2%) from TVET colleges experienced difficulty in communicating with their institutions. Half of the students (49.9%) reported that they had a suitable place to study during lockdown, while 78.6% had regular access to electricity during lockdown. Significantly more TVET and University of Technology students received transport to return home and fee refunds. Conclusion: While it was encouraging that most HEIs had capacity for online learning and made provision of internet access for students, it was concerning that students who are enrolled at TVET colleges faced more learning challenges during the lockdown. This highlights the inequality in learning support at different types of institutions, and that effective support from HEIs to students during the COVID-19 pandemic was not fully implemented. [ABSTRACT FROM AUTHOR]

The aftermath of COVID changed how students learn, mainly moving to a distance learning model. The research reported in this paper investigated the organizational and individual factors that influence the preference for continuing with distance / online learning post-COVID. Partial least squares structural equation modeling was applied to a model developed for this research, based on data from 452 students from residential universities in South Africa. The key results reveal an overall reluctance to continue with distance learning. This is despite the technological and faculty support offered to university students and how distance learning fits their learning styles. This is likely due to student living conditions and their perception of low institutional concern. On the other hand, faculty support has a more substantial impact on continuance, compared with a generally negative perception of support from the universities. The research underscores the importance of addressing student reluctance to continue with distance learning by improving institutional support and tailoring learning styles. The research enhances our understanding of crucial factors influencing students' preference for distance/online learning post-COVID. It also underscores the pedagogical shifts brought about by the pandemic, particularly highlighting the changing roles of faculty support and the impact on students' living conditions. [ABSTRACT FROM AUTHOR]

This paper provides an overview of learning losses and altered schooling patterns in South Africa during the COVID-19 pandemic (2020–2021). Five major trends emerge from a review of the evidence. These include significant learning losses (38–118% of a year of learning), widened learning inequality, lowered grade repetition rates, increased secondary school enrolments and an unprecedented rise in candidates writing and passing the National Senior Certificate (NSC) examination. School completion significantly increased in 2021 and 2022, spurred by COVID-19 adjusted assessment and promotion practices in Grades 10 and 11. Larger numbers of youth also achieved a NSC pass or Bachelor's pass enabling access to university. With twin pandemic shocks of learning losses and secondary school enrolment increases, remediating losses and realigning progression rules to effective assessment practices should be prioritised. [ABSTRACT FROM AUTHOR]

Due to the widespread occurrence of mental disorders among adolescents, there is globally a recognised need to assess the mental well-being of higher education students. Those in extended programmes, dealing with self-esteem and capability challenges intensified by peer and institutional attitudes, might face heightened susceptibility to mental health issues. Moreover, research suggests that the 2020 COVID-19 pandemic likely worsened students' mental health difficulties. This study aimed to assess the prevalence of mental health issues among students in a South African university's extended curriculum programme in 2022 while exploring potential gender differences. Furthermore, by comparing these findings to a 2017 study, it sought to assess the COVID-19 pandemic's potential impact on the mental health of extended programme students. Paper-based questionnaires evaluated depression, anxiety, and stress symptoms among first-year extended programme students in 2017 (pre-COVID, n = 208) and in 2022 (within the pandemic, post-lockdown, n = 202). The results showed consistently high levels of mental health issues for both cohorts, with no statistically significant difference between the cohorts. However, female students in the 2022 cohort faced notably more mental health challenges than their male peers. Universities should enhance mental health education and awareness campaigns and explore new counselling methods to assist the growing number of students in need of support. Further research ought to investigate the factors behind the heightened mental health issues, especially among female students. [ABSTRACT FROM AUTHOR]

This study explores the utility of the I-poem methodology to investigate subjective well-being in children and adolescents with ADHD in South Africa during the COVID-19 pandemic. Subjective well-being in this population has been studied extensively via quantitative methodologies. In addition, narrative studies, discourse and theme analysis, participatory and visual method studies have also contributed to deeper understandings in the field. The current study seeks to contribute to knowledge creation within this field of non-numerical studies in an attempt to decentralise the voice of researchers and highlight the voices of participants. In the I-poem methodology, self-report ratings of children and adolescents with ADHD between the ages of 10 and 18 years old (n = 376) during the COVID-19 pandemic in South Africa was captured in an open-ended question. Data was analysed through the researcher's creation of themed I-poems. The findings delineate broad categories of positive, negative and neutral feelings of subjective well-being during the pandemic. Notions of subjective well-being are related to themes of home, school, social life, self-growth and reflection, experiences of change, rules, extra-curricular activities, concerns, loss, finances, the new normal, and emotions. The study illustrates the utility of the I-poem methodology to illuminate dimensions of well-being that may otherwise remain invisible. The study also amplifies the potential of the I-poem methodology to be used in conjunction with, and complementary to, other research methodologies. [ABSTRACT FROM AUTHOR]

Background: Stillbirths are a global public health challenge, predominantly affecting low- and middle-income countries. The causes of most stillbirths are preventable. Objectives: this study reviewed perinatal clinical audit data from Kgapane Hospital over a 4-year period with a special focus on the factors associated with stillbirths. Methods: File audits were done for all stillbirths occurring at Kgapane Hospital and its catchment area from 2018 to 2021. The data from these audits were analysed to identify factors associated with stillbirths. Results: A total of 392 stillbirths occurred during the study period at Kgapane Hospital and its surrounding clinics, resulting in a stillborn rate of 19.06/1000 births. Of the 392 stillbirths recorded, audits were conducted on 354 of the maternal case records. The five most common causes of stillbirths identified were: hypertensive disorders in pregnancy (HDP) (29.7%), intrauterine growth restriction without HDP (11.6%), birth asphyxia (7.1%), premature labour (< 1000 g) (6.5%) and maternal infections (5.9%) including HIV with unsuppressed VL, intrauterine infection, coronavirus disease (COVID) and syphilis. Modifiable factors that can form the basis of improvement strategies should include training, timeous referral, plus improved resources and staffing. Conclusion: Understanding the causes of stillbirths can guide improvement strategies to reduce this heart-breaking complication of pregnancy. Contribution: Family physicians working in rural hospitals are also responsible for perinatal care. Understanding the factors associated with stillbirths will guide them to develop improvement strategies to reduce these preventable deaths. [ABSTRACT FROM AUTHOR]

It is expected that the coronavirus pandemic will exacerbate inequality in wellbeing compared to the pre-pandemic situation. However, there are theories (e.g., the Conservation of Resource (COR) theory) that acknowledge situation-specific lower wellbeing for individuals who typically have more resources. The argument is that perception of loss might occur differently across the socioeconomic spectrum such that individuals with higher socioeconomic status perceive that they experience more loss. Therefore, given the pandemic situation, it is possible that indicators of poor wellbeing (e.g., depression) becoming less concentrated among the poor, contrary to expectation. Given the above, we examine income-related inequality in self-assessed health and depressive symptoms in South Africa. This is done using both pre-pandemic data (i.e. National Income Dynamic Study) and data collected during the pandemic (National Income Dynamic Study-Coronavirus Rapid Mobile Survey). Consistent with expectation, we find that poor self-assessed health is not only disproportionately concentrated amongst the poor, but this concentration has increased compared to the pre-pandemic period. However, contrary to expectation, depressive symptoms have become less concentrated amongst the poor compared to the pre-pandemic period. We note that while there may be an alternative explanation for this change in trend, it may also be due to situation-specific lower wellbeing for individuals who typically have more resources. We argue that this has implication for tracking population health in a crisis. [ABSTRACT FROM AUTHOR]

This study applies a quantile cointegration model to investigate if COVID-19 outbreaks in the BRICS (China, India, Russia, Brazil, and South Africa) and the United States have a long-run equilibrium relationship with the dynamics of oil prices. (1) The standard cointegration models are unstable, indicating the possibility of structural breaks and nonlinearity in the relationship between the COVID-19 pandemic and oil prices; (2) The results of the quantile cointegration model suggest the COVID-19 pandemic and oil prices are nearly cointegrated over whole quantiles of the oil price distribution for the United States, Russia, South Africa, and Brazil. However, the long-run equilibrium relationship between the COVID-19 pandemic and oil prices in China is more likely to occur in the lower quantiles of the oil price distribution; (3) For India, the equilibrium link exists only across the two higher quantiles (0.7 and 0.8 quantiles) of the oil price distribution. Finally, our research has significant policy implications for the governments of the world's largest countries that are concerned about the impact of the COVID-19 pandemic outbreak on oil prices. [ABSTRACT FROM AUTHOR]

Adolescents living with HIV (ALHIVs) are considered a priority population in the fight against HIV, requiring dedicated services. The COVID-19 pandemic and subsequent disruptions deprived ALHIVs on antiretroviral therapy (ART) of the care and social support essential for treatment adherence and positive treatment outcomes. This study describes health managers' and healthcare workers' responses to the impact of COVID-19 on service delivery to ALHIVs in HIV treatment in the Cape Town Metropole. A descriptive qualitative design was employed, where semi-structured individual interviews (n = 13) were conducted with senior and programme managers as well as healthcare workers between April and October 2023. Inductive thematic analysis was performed using Atlas.ti version 23. Two main themes emerged from these interviews: "HIV service delivery to adolescents during the COVID-19 pandemic" and "Lessons learnt—the way forward". The de-escalation of health services at primary health facilities and the disruption of HIV services resulted in disengagement from care by ALHIVs, increasing mental health and treatment challenges. This warrants the restoration of psychosocial support services and the re-engagement of ALHIVs. The findings from this study can function as a guide for health systems and healthcare providers to navigate future pandemics to ensure that vulnerable populations such as ALHIVs continue to receive care and treatment. [ABSTRACT FROM AUTHOR]

Severe acute respiratory tract infections (SARIs) has been well described in South Africa with seasonal patterns described for influenza and respiratory syncytial virus (RSV), while others occur year-round (rhinovirus and adenovirus). This prospective syndromic hospital-based surveillance study describes the prevalence and impact of public interventions on the seasonality of other respiratory pathogens during the coronavirus disease-19 (COVID-19) pandemic. This occurred from August 2018 to April 2022, with 2595 patients who met the SARS case definition and 442 controls, from three sentinel urban and rural hospital sites in South Africa. Naso/oro-pharyngeal (NP/OP) swabs were tested using the FastTrack Diagnostics® Respiratory pathogens 33 (RUO) kit. Descriptive statistics, odds ratios, and univariate/multivariate analyses were used. Rhinovirus (14.80%, 228/1540) and Streptococcus pneumoniae (28.50%, 439/1540) were most frequently detected in NP/OP swabs and in children <1 years old (35%, 648/1876). Among others, pathogens associated with SARI cases causing disease were influenza A&B, HRV, RSV, hCoV 229e, Haemophilus influenzae, Staphylococcus aureus, and Streptococcus pneumoniae. Pre-COVID-19, seasonal trends of these pathogens correlated with previous years, with RSV and influenza A seasons only resuming after the national lockdown (2021). It is evident that stringent lockdown conditions have severe impacts on the prevalence of respiratory tract infections. [ABSTRACT FROM AUTHOR]

Background: Covid-19 epidemics raged around the world in years 2020–2022. The dynamics of the epidemics and their mortality varied by country depending on prevention, treatments, vaccination and health status of the population. Objective: The study compares Covid-19 morbidity and mortality in South-Africa and in France, two countries with similar population size and with reliable reporting systems, in order to better understand the dynamics and impacts of the epidemics and the effects of health policies and programs. Data and methods: Data on cases, deaths, hospitalizations, vaccinations were drawn from national statistics. Published data on cases and deaths were corrected for undercount. Results: Results show a different epidemiology in the two countries in the first three years of the epidemic (2020–2022). Incidence was higher in South Africa, and some 44% more people were infected by December 2022 than in France. Mortality and case-fatality were also higher in South Africa despite a favourable age structure. The age pattern of mortality showed higher values in South Africa among the young adults. Young women appeared somewhat disadvantaged in South Africa. Lastly, vaccination appeared to have had no effect on incidence, but a large effect on case-fatality in France. Conclusions: Despite about the same population size and the same crude death rate at baseline, South Africa exhibited more cases and more deaths from Covid-19 over the 2020–2022 period. Prevention strategies (lockdown and vaccination) appear to have had large impacts on morbidity and mortality. [ABSTRACT FROM AUTHOR]

This article examines the potential for online activism to contest hegemonic neoliberal conservation models in South Africa, using the Covid-19 crisis as a window onto discursive struggle. National lockdown measures during the pandemic sent the vital tourism sector of an already fragile economy into deep crisis. Neoliberal and militarized conservation models, with their reliance on international travel, are examined as affected by a conjunctural crisis, the meaning of which was contested by a broad range of social actors in traditional and on social media. In 30 online news videos, racial hierarchies of land ownership and conservation labour geographies are reproduced and legitimated, as is a visual vocabulary of conservation as equivalent with guns, boots, and anti-poaching patrols. Here, hope is represented as residing in the increased privatization of public goods, and the extraction of value from these goods in the form of elite, luxury consumption. In a corpus of posts on Twitter corpus, on the other hand, significant counter-hegemonic resistance to established neoliberal conservation models is in evidence. In their replies to white celebrity conservationist Kevin Pietersen, critical South African Twitter users offer a contrasting vision of hope grounded in anti-racist equality, a rejection of any special human-animal relations enjoyed by Europeans, and an articulation of a future with land justice at its centre. The analysis supports the idea that in the "interregnum" between hegemonic social orders, pathways towards transformed futures may be glimpsed as "kernels of truth" in discursive struggles on social media. [ABSTRACT FROM AUTHOR]

The teaching of English First Additional Language (EFAL) in South Africa is gradually changing from the traditional style because of the devastating effects of the COVID-19 pandemic. Efforts are being made to stimulate learners' interest in learning which include using information communication technology (ICT) in the form of e-learning to enhance understanding. The outbreak of the coronavirus disease (COVID-19) was a major challenge as it compelled teachers to engage in online teaching - even those who were never trained in the use of technology. A qualitative research method in the form of semi-structured interviews was used to collect data from 15 EFAL teachers who were purposefully selected on the basis that they used e-learning to supplement their face-to-face teaching. I found that the integration of e-learning to the traditional physical contact style was essential in improving the teaching of EFAL. The majority of participants, however, highlighted that they still encountered challenges related to heavy workload and efforts to complete items listed in the work programme. Inadequate training of teachers on e-learning, a lack of resources and poor connectivity also acted as barriers to the full implementation of blended learning, which considerably improves learners' performance. [ABSTRACT FROM AUTHOR]

This study investigates the impact of South Africa's current account balance on its economic growth from Q1 2015 to Q4 2022 using Auto Regressive Distributed Lags (ARDL) technique. This study incorporates qualitative variables like COVID-19 to understand its effect on the South African current account and economic growth rate. Generally, the results show that the South African current account deficit impacted economic growth in both the long and short run. COVID-19 also affected the current account significantly in both the long and short run, thus causing more deterioration on the South African current account and subsequently affecting the economic growth rate negatively. This study recommends more competitive export promotion and import substitution by investing in and developing domestic productivity. This study also recommends an acceleration of the tabled COVID-19 recovery initiatives through an alliance between the government and private sector. [ABSTRACT FROM AUTHOR]

The implementation of mandatory COVID-19 vaccination policies by several South African public universities highlighted the interpretive struggles of a secular polity regarding freedom of religion or conscience. Such workplace policies relied on the claim that society's collective interests took precedence over the individual's constitutional rights. In essence, the policies allowed for accommodating conscientious objectors, but in reality, the conditions for objection went beyond prioritizing collective interests and neglected the constitutional duty to protect human rights. This article examines how the restrictive vaccination policies of public universities reveal the shortcomings in secular polity's engagement with and appreciation for individual religious self-determination. [ABSTRACT FROM AUTHOR]

While the coronavirus disease of 2019 (COVID-19) pandemic exerted a devastating impact on all members of society, it highlighted the worsening inequalities experienced by marginalised groups such as people experiencing poverty and homelessness in South Africa. The pandemic also exacerbated the multiple demands and stressors of service providers working in homeless shelters. Hence, the study examined the experiences of service providers in terms of challenges and opportunities derived from working at homeless shelters in Tshwane, South Africa, during the hard lockdown from 27 March to 30 April 2020. Guided by a qualitative approach, five service providers were interviewed online. Thematic analysis revealed organizational challenges, such as a lack of knowledge and preparedness regarding disaster management, while client challenges included getting service users to adapt to living with rules. Organizational opportunities included the opportunity for the organization to conduct research, while personal opportunities included the learning experience of working with a vulnerable population during an unprecedented pandemic. Findings highlight the need for programmes to support the wellness needs of service providers and the development of a national policy on homelessness. [ABSTRACT FROM AUTHOR]