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Objectives: This study evaluated the effects of reading different versions of a fotonovela about diabetes in resource-poor settings in South Africa. Design: An experimental study was conducted with 411 participants, comparing a fotonovela with a younger protagonist, a similar fotonovela version with an older protagonist and a no message control condition. Differences between the two fotonovela versions were analysed for two age groups of readers (25-49 years, and 50 years and older). Setting: Community centres in vulnerable communities in the South African provinces of the Western Cape, the Northern Cape and Gauteng. Method: In the experimental conditions, participants completed a questionnaire after reading one of the fotonovela versions. Participants in the control condition answered similar questions without having read a fotonovela. Results: Both fotonovela versions resulted in more diabetes knowledge than the control condition. Limited positive effects were found for attitudes and behavioural intentions. In the younger participant group, age similarity between the protagonist and readers resulted in knowledge gain, while in the older participant group, no such effect was found. In both age groups, no age similarity effects were found for attitudes or behavioural intentions. Conclusion: This study confirms that fotonovelas can be an effective means of health communication. Furthermore, for a narrative on a health topic for which age is relevant, it can be beneficial to choose a young protagonist. For readers from the same age group, the impact of the story on knowledge acquisition may then be greatest, while for older readers, the age of the protagonist does not seem to influence the knowledge effects of the story.

Despite the often-crucial roles played by music within theatre-based public health promotion strategies, theoretical explorations regarding music within applied theatre literatures remain largely underdeveloped. This article highlights musicking -- a reconceptualization of music from an object to a participatory act that can profoundly influence relationships and spaces -- as an approach to understanding the various roles that music can play within applied theatre programmes. The article draws from ethnographic accounts of an HIV/AIDS applied theatre group in South Africa to advocate for increased recognition of musicking as a robust theoretical and methodological component within applied theatre praxis.

Background: Most health and developmental issues affecting young people are interrelated. However, few interventions address multiple behavioral domains simultaneously or are based on theories that encompass a holistic perspective of youth development. Aim: The purpose of this scoping review was to identify and describe the range of theory-based, multibehavioral health interventions aimed at improving two or more of the following behavioral youth outcomes: (1) sexual and reproductive health; (2) education and employment; (3) violence; and (4) substance use. Methods: Interventions conducted worldwide and published in English or Spanish between January 2000 and July 2020 were identified using four databases: PubMed, PsycINFO, LILACS, and SciELO. Results: A total of 11,084 articles were identified, of which 477 were retrieved and assessed for eligibility. Twenty-three articles (evaluating 21 interventions) ultimately met the inclusion criteria. Most interventions were conducted in the United States and addressed two behavioral domains of interest, although seven interventions incorporated three domains, and one incorporated all four. Substance use was the most common domain (16 interventions) but only in the United States/Canada, followed by sexual and reproductive health (14 interventions). All produced significant improvement in at least one outcome or for at least one subgroup of youth. The most common theoretical foundations were positive youth development and social learning theory. Conclusion: Integrated interventions that are theory based and evidence informed can support positive development and empower youth to make healthy decisions. Further efforts are needed to address structural and policy issues that affect young people's developmental opportunities and health outcomes.

As a school subject, life orientation (LO) aims to improve learner well-being, but a lack of classroom resources may be a barrier. We investigated whether classroom resources were equally available for LO educators in fully funded (no-fee) and partially funded (fee-paying) high schools in Tshwane South, South Africa. In this analytical cross-sectional study, LO representatives completed questionnaires about the availability of resources in their schools. Sixty-seven LO representatives completed the questionnaire. No-fee and fee-paying schools had the same availability of government resources and textbooks, but no-fee schools had less access to audio-visual equipment and printed materials. Representatives from both categories of schools were least satisfied with the availability of resources for the topic: Health. In contrast, they thought that the resources for non-health related topics such as career and skills-development were adequate. Representatives from no-fee schools were less satisfied with physical education resources (U (56) = -2.29, p = 0.02). The government's efforts to redress inequity is evident in the availability of basic resources. However, a lack of health resources is a source of concern in a society that has a quadruple burden of disease.

Purpose: School principals are presumed to be pillars of school health promotion implementation. Their understanding of their role could enhance school health promotion. This study aims to investigate how principals understood their role in school health promotion. Design/methodology/approach: In this study, semi-structured interviews were conducted with six school principals who participated and completed the first cycle of the Continuous Professional Teacher Development programme that was offered by the South African Council of Educators. Snowball sampling was used to sample participants. Findings: The findings of this study showed that principals did not differentiate between concepts of health-promoting schools and school health promotion, the meaning was the same for them. They focused on any health improvement within the schools, regardless of its conceptual nature. The second finding pertains to the role of the principal as a manager, while the third was on expedition of collaborations and partnerships. Research limitations/implications: This research was limited to school principals who completed the Continuous Professional Teacher Development programme. It, therefore, does not include perceptions of other principals. Originality/value: The study findings suggest that despite inability of schools in poor communities to implement effective school health programmes, the principals of the sampled schools were aware of their roles. This is positive, as the efforts to enhance health promotion initiatives would focus on developing and empowering principals to improve their performance.

The "Ministerial Commitment on Comprehensive Sexuality Education and Sexual and Reproductive Health Services for Adolescents and Young People in Eastern and Southern Africa" ("ESA"), or the ESA Commitment, was affirmed December 7, 2013, by 21 countries located across this region during the 17th International Conference on AIDS and Sexually Transmitted Infections in Africa. The ESA Commitment speaks to the numerous practices and challenges of school age populations stemming from interplay among education, health, and contextual issues varying by country. Analysis of this policy is approached using methodology drawn from Bartlett and Vavrus (2014, 2017) and using a lens of policy borrowing, particularly focused on incorporating agency, process, impact, and timing (Steiner-Khamsi, 2000, 2010). This analysis seeks to understand the ESA Commitment and national curriculum subsequently implemented in Zambia by situating these actions among broader international, regional, and national discourse in the area of sexual and reproductive health and education for young people between 1994 and 2016. Through analysis considering its effectiveness in terms of implementation, scalability, and sustainability, its ability to enable progress towards improving the lives of young people, especially through increased knowledge of HIV/AIDS prevention, is examined and recommendations are presented.

Background: South Africa has a high prevalence of HIV and obesity. Interventions to date have primarily focused on adolescents and adults. Prevention of obesity, in particular, is not addressed substantively in the current pre-adolescent school curriculum. Education about factors underlying these issues early in life could reach beyond children, to their parents. Objective: We aimed to increase awareness about HIV and obesity/underweight risks and prevention through the development of a combined intervention delivered directly to pre-adolescent learners and indirectly to their parents, for immediate- and long-term benefits. Design: Scoping review and needs assessment. Setting: Five government-run primary schools in a district in Gauteng Province, South Africa. Method: Five of the six-step intervention mapping protocol guided intervention development: (1) a formative study, comprising a scoping review and needs assessment; (2) definition of programme objectives; (3) selection of theory-based intervention methods; (4) programme development and (5) adoption, implementation and sustainability planning. Results: Educators perceived that health and lifestyle issues among learners affected classroom learning and saw a need for school-based health curricula. They highlighted that HIV was an issue in their communities and that malnutrition was a concern in rural schools. The scoping review shortlisted 11 evidence-based practices which informed the design. Intervention components comprised a learning curriculum, environmental support and activity-based constituents that targeted the learner in the school environment and the parent in the home environment. The intervention was designed to increase knowledge about HIV and nutrition, enhance skills and strengthen autonomous self-efficacy in communication. Accompanying resources were designed, and implementation strategies were developed. Conclusion: The scoping review and the needs assessment informed intervention development as well as critical adaptations. In particular, stakeholder engagement guided the tailoring of the intervention to fit the target populations and context.

This paper explores students', preservice teachers' and inservice teachers' perceptions of the contributions and challenges of using participatory visual methodologies (PVM) to enhance HIV education in rural schools. Drawing on findings from three research projects conducted in KwaZulu Natal, South Africa, four positive contributions are identified: 1) novelty, fun and engagement; 2) amplifying youth voices; 3) the facilitation of teachers' reflexive learning; and 4) the production of local resources in under-resourced schools. Challenges include: 1) limited technology access; 2) teacher discomfort; and 3) resistance to PVM integration. Teachers and young people, especially in under resourced rural settings, can benefit from integrating such methodologies into their responses to HIV and AIDS. However, sustainable integration must rely on choosing the most appropriate participatory visual methodologies given the technological resources available in school. The paper concludes with recommendations to optimise participatory visual methodologies integration into rural school-based HIV responses.

Objective: In South Africa, Black African women between the ages of 15 and 24 years are especially vulnerable to HIV. The heterosexual transmission of the disease is exacerbated by social and cultural conditions that perpetuate gender relations of inequality. Problematic conceptualisations of femininity increase sexual risk. The objective of this article is to examine the ways in which undergraduate university Black African female students make meaning of gender and sexuality on campus and the social processes through which femininities are produced. Design: Qualitative research study. Setting: University of KwaZulu-Natal, South Africa. Method: In total, 10 in-depth interviews and focus group discussions with 25 Black African undergraduate female students aged between 18 and 24 years old. Results: Campus life was conceived as a place of heterosexual freedom, sexual enjoyment and engagement with dating relationships. Relationships were forged based on romantic notions of love and versions of femininity based on trust lead to sexual risk and unwanted pregnancy. In the context of material inequalities, 'sugar daddy' relationships further limited female students' ability to negotiate safe sex. The overall climate on campus was structured along gender power inequalities. Female students feared and were victims of verbal, physical assault and sexual coercion. The lack of campus security exacerbated female students' vulnerability to violence on campus. Conclusion: Addressing the specific meanings expressed by Black African female students on campus can help to improve the effectiveness of campus-based health education interventions promoting safe sex, gender equality and student safety.

This paper explores how the foundation phase subject area of "life skills" is being offered at (n= 9) higher education institutions (HEIs) in South Africa. The aim of the study, about which we report, was to identify similarities and differences in the curricula offered at these institutions and to establish the extent to which the different modules attend to the various aspects of life skills according to the most recent national curriculum. We conducted semi-structured interviews with participants who teach the subject at universities and we also analysed curriculum documents. We worked with a purposive sample of 9 respondents from the respective universities. The study found that although universities use the CAPS (national curriculum) document as guideline for structuring their curricula in teacher education programmes, some participants indicated that they follow an integrated approach, thereby implying that the different components of the school curriculum as outlined in the CAPS document are not specifically accommodated within their programmes. An additional finding was that there is a vast difference in the range of credits allocated to the various aspects of life skills that may restrict social mobility between various HEIs.

Teaching about sex and relationships is one of the greatest challenges in not only the combating of HIV and AIDS, but also in preparing the youth for responsible sexual behaviour. Although it seems as if teachers to some extent do feel comfortable with the teaching of sexuality education at school, the question however remains as to whether youth get the information they require. In this article, I present drawings produced by teacher participants in order to investigate the beliefs that teachers hold regarding young people's needs from sexuality education. As a result of the findings from this study, I will argue that teachers do have a sound knowledge of what contributes to promiscuous sexual behaviour and what is required to narrow the knowledge/practice gap, as discussed by Allen (2001), but they still want to teach what they find acceptable. I will attempt to interrogate the knowledge/practice gap from the "other side"--what do teachers base their beliefs on when deciding what content is appropriate to teach in sexuality education and their understanding with regard to what youth require from sexuality education in the classroom.

This paper reports on part of a study with the aim of exploring how Muslim learners' knowledge and attitudes of HIV/AIDS were influenced by family and school culture. Findings from data collected during individual semi-structured interviews with the principals, Life Orientation educators, and school guidance counsellors are discussed. Reviewed literature supported the assumption that there were collaborative relationships within school culture that permitted children to learn about sexuality and HIV/ AIDS. Bandura's Social Cognitive Theory and the Eight Gateways or "entry points" of school culture supported the data collection and reinforced the findings theoretically. A purposive sample was used for the qualitative case study within an interpretivist paradigm. The study indicated that the educators believed that the school should teach adolescents' about HIV/AIDS. The aim of the school was to create awareness about non-risky behaviour in terms of HIV/AIDS among the learners. Educators were aware that this education did not always lead to positive behaviour changes. The school interventions had generally engendered positive values and dependable, safe relationships that helped adolescents to make responsible decisions in the face of HIV and AIDS. Educators did concede that despite the education at school, learners had to sometimes make difficult decisions as they were tempted to behave against the principles and education within the macro-society.

A user-friendly, high quality workplace assessment field guide and an accompanying worksheet are invaluable tools for recognizing hazards in the hospital environment. These tools ensure that both front line workers as well as health and safety and infection control professionals can systematically evaluate hazards and formulate recommendations. This South African example illustrates how role play and pictorial guided orientation can empower workers to use these tools in response to complex political, cultural and environmental factors. (Contains 2 tables and 2 figures.)

This study examined the priority health behaviors of South African youth by administering a questionnaire to 635 undergraduate students enrolled in a large metropolitan university in South Africa. Results indicate that 65.5% of the participants tried cigarettes at least once during their lifetime, over 15.2% had their first cigarette and 31.2% had their first alcoholic drink before age 15, and over 95.4% consumed their first alcoholic drink by age 18. During the month preceding the survey, 37.0% consumed five or more alcoholic drinks on a single occasion and 10.3% carried a weapon at least once. Over 83.3% percent had at least three servings of fruits and vegetables the day before the survey, 44.3% engaged in vigorous physical activity on three or more of the seven days preceding the survey, 10% rarely or never wore a seatbelt when driving, 10% seriously considered attempting suicide, and 46.7% had sexual intercourse in their lifetime. Results were analyzed by demographic variables including sex, race and age. Recommendations for campus wellness programs addressing these issues are included. (Contains 12 tables.)

This study investigated facilitators and challenges to designing, implementing and evaluating school-based sexual health education in sub-Saharan Africa, using interviews with intervention designers and researchers. At the pre-planning and planning stages, participants reported that facilitating factors included addressing the reproductive health needs of participants, contextual (culture, religion, economic and social) considerations and the adoption of holistic approach to sexuality education. Lack of open communication about sexual health matters between young people and adults; concerns that sexual health education could encourage sexual activity; and inadequate funding, were key barriers. Implementation was facilitated by the involvement of relevant stakeholders, the training of facilitators and adopting strategies to overcome resistance to sexual health education. The provision of structured, detailed lessons plans and monitoring with supportive supervision optimised fidelity of delivery. Barriers to implementation included facilitators' resistance to teaching safe sex promotion and logistical challenges in school environments. Participants also reported that the validity of self-reported adolescent sexual behaviour (as part of evaluation) may be improved by complementing well-designed self-report surveys with computerised audio devices for data collection, qualitative interviews and participant observation. Study findings generate recommendations to improve future forms of school-based sexual health education in sub-Saharan Africa.

A vital facet that adds value to schools is the partnership between the departments of education and health at national level. At the heart of making this partnership effective in order to achieve its potential is the need for synchronisation of the roles of school nurses and teachers to mitigate sustainability risks. In order to investigate the harmonisation of these roles, an explorative qualitative study was conducted with school nurses and teachers in three district municipalities in two provinces of South Africa. The aim was to determine the perceptions of these two groups of their respective roles and the possibility of harmonising these roles. The administrative task, which included obtaining the consent of parents for their children's immunisation provided an opportunity for sharing responsibilities. However, the roles of school nurses--health screening and immunisation--and the roles of teachers--screening for barriers to learning--could not be harmonised due to a lack of understanding of health promotion and a tendency to work in silos because of a lack of trust and openness. This was compounded by the school managers' inability to provide guidance and leadership.

The entertainment-education (E-E) strategy in development communication has been widely described as the panacea to development challenges in Africa. However, despite its growing application on the continent, E-E is still argued to be inhibited from contributing meaningfully toward development efforts. E-E interventions are argued to be hamstrung by their failure to embrace theoretical advances in development communication and E-E scholarship and for remaining rooted in the modernization paradigm. Using the social change paradigm as its framework, this article assesses the notions of development, change, communication, audiences, and education that underpin the conceptualization and design of "Tsha Tsha," an E-E television drama that uses a novel cultural approach to address issues surrounding HIV and AIDS in South Africa. The data informing the study were gathered through a Focused Synthesis Approach and analyzed using qualitative content analysis. The study's findings show that significant efforts have been made by "Tsha Tsha's" producers to bridge E-E practice and contemporary development communication and E-E scholarship. The data analyzed in the study show that "Tsha Tsha's" notions of development, change, education, communication, and audience have been significantly remoored in line with the core tenets of the E-E for Social Change paradigm. The implications of the study are that more engagement and synergies need to be cultivated between E-E practitioners and development communication and E-E scholars if E-E's full potential, in contributing to development challenges on the continent, is to be realized.

Estimates suggest that approximately 12% of South Africans are HIV positive. As a result of the rapid increase of infections in the mid-1990s and the concomitant increase in HIV/AIDS-related deaths, it is estimated that 13% of children have lost one or both parents due to AIDS. In this study data were obtained by open-ended written accounts by teachers and in-depth interviews with teachers and school principals in a small sample of selected schools in KwaZulu-Natal. Findings indicated that in severely affected communities, teachers were often compelled to assume roles traditionally filled by parents. AIDS awareness programmes formed part of the schools' curriculum. However, many schools did not consider involving grandparents, other caregivers and community members in the physical, emotional and cognitive support needed by learners because teachers lacked training and schools lacked a policy of parent and community involvement in education of learners.

The HIV epidemic is the most serious threat to health internationally, with developing countries accounting for over 95% of new infections. Since HIV/AIDS was first identified, 20 million people have died of AIDS (Lamptey, Wigley, Carr, & Collymore, 2002). Worldwide, there will be 45 million new HIV infections by 2010 (Goliber, 2002). Social factors contribute to the spread of the epidemic; economic powerlessness and social exclusion increase vulnerability (Campbell, 2003). The predominant mode of transmission of HIV/AIDS in sub-Saharan Africa, which has the most infections, is unprotected heterosexual sex (World Health Organization, 2002). Since there is no cure for HIV/AIDS, the prevention of infection is essential. In South Africa, HIV prevention programs have been widely disseminated, but scant attention is given to the needs of people with visual impairments. As of the 2001 census, 577,096 South Africans were visually impaired (that is, were blind or had low vision) (Statistics South Africa, 2003). This article reports on work preparatory to developing and evaluating an intervention focusing on the needs of this community.

Objective: A critical evaluation of a salutogenic, wellness education programme was conducted with a group of first-year socioeconomically disadvantaged higher education students, in order to assess the value they placed on health information and wellness priorities. Methods: This study took a mixed-methods approach utilising a quantitative-qualitative design. Quantitative analysis regarding the values placed by the students on 22 aspects of health-related information and qualitative analysis of their health priorities drew on findings from a semi-structured researcher-generated questionnaire, administered pre-, post- and 15-week post-post-intervention. Setting: The setting was a higher education institution in the Eastern Cape Province of South Africa. Participants were 34 first-year consumer science students, who engaged in a year-long, salutogenic wellness programme. Results: Findings revealed an increase in the participants' value of health information for a number of wellness variables. Future planning, positive thinking and nutrition ranked high among wellness priorities, the reasons for which were disease prevention, as well as the impact of various aspects of health on participants' future success. Conclusion: A holistic, salutogenic, wellness education programme increased student values for information with regard to a number of health variables.

Globally, sexuality education is framed as a key programmatic strategy for achieving HIV prevention among youth. In particular, sexuality education is positioned as a way to address gender inequalities and promote youth empowerment in relation to gendered identities. In this paper, I argue that the focus on what content should be taught and "what" is the effectiveness of that content serves to mask how sexuality education itself is always a political project. Specifically, I problematise a neo-liberal "political rationality," following Wendy Brown, operating through sexuality education in this particular globalised moment. Drawing on data from an ethnographic study conducted in South Africa, I use the notion of encounters with gender to mobilise understanding of gender with(in) the inevitable risks of knowing and being known through educational research and practice. I argue that holding sexuality education responsible to the complexity of lived lives necessitates proposing alternative political rationalities to guide its encounters.

Noncommunicable diseases (NCDs) impose a growing burden on the health, economy, and development of South Africa. According to the World Health Organization, four risk factors, tobacco use, alcohol consumption, unhealthy diets, and physical inactivity, account for a significant proportion of major NCDs. We analyze the role of tobacco, alcohol, and food corporations in promoting NCD risk and unhealthy lifestyles in South Africa and in exacerbating inequities in NCD distribution among populations. Through their business practices such as product design, marketing, retail distribution, and pricing and their business practices such as lobbying, public relations, philanthropy, and sponsored research, national and transnational corporations in South Africa shape the social and physical environments that structure opportunities for NCD risk behavior. Since the election of a democratic government in 1994, the South African government and civil society groups have used regulation, public education, health services, and community mobilization to modify corporate practices that increase NCD risk. By expanding the practice of health education to include activities that seek to modify the practices of corporations as well as individuals, South Africa can reduce the growing burden of NCDs.

While much research has documented unsatisfactory sexual and reproductive health (SRH) awareness among young people in South Africa, understanding of gender differences in access to and evaluation of SRH information is limited. This paper concerned itself with men and women's informal sources and content of SRH, and gendered divergences around accessibility, evaluation, and impact of such information. Fifty sexual history narrative interviews and twenty-five narrative interviews with women were conducted with participants purposively sampled from a range of ages, cultural and racial backgrounds, and in urban and rural sites across five provinces in South Africa. Data were analysed using thematic analysis. While young women were more likely to learn about SRH information from family members, they also reported greater regulation concerning their sexuality. This could enhance stigma surrounding women's sexuality and hinder open communication. Men predominantly learned about sex through pornography and peers, which was reported to encourage sexual prowess to the neglect of practising safer sex. Lack of adequate SRH instruction for young people as revealed through the narratives had significant and often negative implications for men and women's early safer sex behaviours. In response to these insights, recommendations are offered to strengthen informal sources of SRH awareness.

Over the past 25 years, there has been growing investment in concepts of rights in the areas of HIV prevention, care and treatment, including HIV- and AIDS-related education delivered in schools. Despite this increasing commitment to the notion of rights, few efforts appear to have been made to understand the varying conceptions of rights that underpin different kinds of initiatives. Engaging with a multi-disciplinary body of literature on the issue of rights, and through a focus on three rights-informed HIV- and AIDS-related initiatives, this paper seeks to address this gap in the current literature. In so doing, it also examines a central tension within human rights discourse, namely between the construal of rights as shared and universally applicable to all human beings, while being created in and limited by the location in which they were elaborated, as well as by the language used to formulate them. More explicit engagement with the diversity of approaches made possible through a commitment to human rights may facilitate forms of HIV- and AIDS-related education that are more meaningful to young people.

Educational research conducted in the context of the HIV and AIDS pandemic in Southern Africa has produced diverse knowledge claims. A review of extant literature espoused elements of ambiguity and contradictions which have become challenging to explain, given the growing instrumentality of educational policy and institutional cultures. The research question addressed in this article is: What is the content and nature of the dominant literature strands informing teachers' HIV and AIDS discourses? Educational policy's preoccupation with efficacy and uniformity underplays the complexities in teachers' discourses. This article proposes Foucault's notion of "discursive practices" as a conceptual lens to analyse the diversity of teachers' HIV and sexuality discourses. Discursive practices encompass social, structural and subjective elements that constitute the wide scope of discourse formation. These elements create possibilities of uncertainty and indeterminacy in educational outcomes of HIV prevention, which often counteract intended policy's expectations of uniformity and consistency. This article presents a perspective stating that a discursive practices approach offers an innovative way in broadening an understanding of the subjective nature of teachers' HIV and sexuality, arguably a weakness in policy.

Researchers using participatory methods that are engaging, purposeful and facilitate social change may need further pragmatic strategies to encourage the required change. Using pencil-and-paper drawings to introduce HIV & AIDS integration in a discipline such as Mathematics Education is an innovative participatory strategy to initiate change. However, following up on such innovations to encourage take-up of HIV & AIDS integration would benefit the initiative. The following research question guides this study: What pragmatic strategy could I use in pre-service Mathematics Education to further take-up of HIV & AIDS education integration in school disciplines? I explore HIV & AIDS integration in a pre-service Primary Mathematics Education module that I taught at a higher education institution in KwaZulu-Natal, South Africa, by studying the drawings and experiences of eight final-year pre-service teachers. I use a metaphor-drawing activity to disrupt the "comfort zone" of teaching Mathematics, following up by providing the pre-service teachers with learner activities suitable for primary school classrooms. When asked if they were able to integrate HIV & AIDS in Mathematics classrooms, these generalist pre-service teachers appeared to rely on phase-specific teaching material in order to take up the initiative. There is a need to use innovative participatory methods to initiate change and to provide pragmatic support for this envisaged change.

Mission statements of universities in developing countries usually include serving the surrounding communities. Often this service does not reach beyond lip service. This article puts into context the experience of developing an adult education research program responding to the needs of the surrounding community in a historically disadvantaged rural area. The areas of research were adult education needs assessment and community development, young adults at risk, adult health education, and policy and implementation issues. Globalization, social exclusion, and lifelong learning were key concepts tailored to the specific context of the rural areas in South Africa. The first two authors of the article were personally involved in the program, as a visiting professor from the Netherlands and his South African successor, respectively. The third author worked in a similar program at the Eduardo Mondlane University in Maputo, Mozambique.

After the demise of apartheid in South Africa in 1994, 11 languages (English, Afrikaans and 9 indigenous African languages) were given official status. In the higher education landscape, English remains the dominant language of scholarship. At the University of KwaZulu-Natal, English is the main medium of instruction but the institution's language policy provides for the use of isiZulu (one of the indigenous African languages) as an additional medium of instruction. The paper discusses how three of the four colleges of the University are employing isiZulu in this role. This use of isiZulu is analysed through the following four theoretical perspectives: African scholarship, Africanization of higher education, the African Renaissance, and transformation. Whilst there are obviously some challenges in using isiZulu as a medium of instruction, it is very clear that the project deflates the myth that indigenous African languages can only serve in lower levels of education (such as primary schools) and not higher education. The paper is of relevance not only to South African universities, but also to other African (and even non-African) universities that plan to use indigenous languages as media of instruction.

Comprehending praxis is a critical step in developing interventions that can have a real-world impact on people's lives. In this paper, we reflect on the lessons learned in the development of a curriculum for young people living in informal settlements in eThekwini, who are exposed to numerous vulnerabilities, including HIV-related risks associated with precarious urban livelihoods. Behavioural interventions have not led to commensurate reductions in HIV incidence, and the impact of these approaches remains regulated by numerous contextual conditions affecting those participating. Our collaborative project tested the impact of implementing a combination of the well-tested gender transformation intervention, Stepping Stones, with a new livelihood transformation curriculum, Creating Futures, among young people in eThekwini's informal settlements. Creating Futures was grounded in the theory and practice of sustainable livelihoods, but equally in the experience of the multi-disciplinary project team members who have conducted both research and development work among youth in the eThekwini area. Our approach was founded on the work of Doug Kirby, and we are indebted to him for his inputs. His logical model approach ensured that the team remained orientated to specific curriculum outcomes. Analysis of the results at 12 months post-baseline indicates positive livelihood outcomes.

The idea of having a "Compare" Forum focusing on the above title was first discussed with one of the Editors of "Compare" during a PhD defence in Oslo in 2011. The PhD dissertation itself was linked to a larger project in which researchers from the North (Norway) and the South (South Africa) had been collaborating in educational research for over 10 years. Despite the fact that North-South collaboration is not a new issue on the agenda (King 1985) it is still a timely topic to explore, particularly given the recent growth and moves towards North-South-South collaboration or even "South-South Cooperation in Education and Development" (Chisholm and Steiner-Khamsi 2009). Thus, any discussion of research collaboration, whether North-South or South-South, is seen as an ideal topic for comparative education, particularly when exploring why there should be collaboration at all and if so what are some of the challenges. Ultimately, this Forum allows researchers from very different backgrounds (geographically and academically) the opportunity to explore some of the issues of collaboration between researchers/academics in the North and the South. The four contributions to this Forum have taken different perspectives towards the issue, albeit there are some commonalities. All would see North-South or South-South collaboration as something useful, but also challenging. Ultimately all of the contributors see the need for collaboration in order to promote real North-South dialogue and understanding. This "Compare" forum is comprised of the following articles: (1) Introduction (Halla B. Holmarsdottir); (2) North-South-South Collaboration: Internationalising Higher Education, Capacitating the South or Furthering Donor Agendas? (Zubeida Desai); (3) Challenging Hegemonic Knowledge Production through North-South Collaboration (Louis Royce Botha and Anders Breidlid); (4) Research Partnerships between the North and the South: Experiences from School-Based Health Promotion Projects in Sub-Saharan Africa (Sheri Bastien, Wanjiru Mukoma, Mangi J. Ezekiel, and Arnfinn Helleve); and (5) North-South-South Collaboration: Old Ideas in New Boxes? (Halla B. Holmarsdottir, Alawia I. Farag, and Vuyokazi Nomlomo). (Contains 2 notes.)

Career development for full-time Health Sciences academics through to doctoral studies is a monumental task. Many academics have difficulty completing their studies in the minimum time as well as publishing after obtaining their degree. As this problem is particularly acute in the Health Sciences, the PhD Acceleration Programme in Health Sciences was piloted in 2009 by the Faculty of Health Science Research Office at the University of the Witwatersrand to provide deliberate support to staff members registered for a PhD to attain their goals. There is little research on such interventions using coaching and coaching-learning. This article discusses the programme structure, participants' evaluation of the year-long intervention and some longitudinal data, using semi-structured interviews in a qualitative paradigm. The findings indicate that staff found the research writing course the most valuable of the skills courses and noted that the individual, goal-directed coaching helped them in many different ways in completing the thesis and managing their professional lives simultaneously. This structured support programme with coaching provides a low-cost, sustainable innovation for full-time academics during doctoral studies. (Contains 1 table and 1 figure.)

Objective: To assess the basic knowledge about HIV and AIDS among young South Africans in the Capricorn District of Limpopo Province, South Africa. Design: A questionnaire-based cohort study, involving data collection from senior high school students. Setting: Randomly selected high schools in the Capricorn District, Limpopo Province, South Africa. Method: Following university research and ethics approvals and permissions from government officials and school principals, consent forms were completed by systematically selected students and their parents or guardians. Questionnaires were distributed to the students in classrooms after school hours and were collected the same day after completion. Results: Many of the participants (64 per cent) knew what the acronym HIV stands for and 66 per cent knew what AIDS stands for. However, only 33 per cent could explain the difference between HIV negative and positive. Many knew that unprotected sex and mother-to-child transmission during pregnancy (85 and 63 per cent respectively) were modes of HIV transmission. Only two (0.1 per cent) of the participants could define the term "window period". The majority (86 per cent) agreed that it is important to know one's HIV status; however, only 6 per cent could explain why this is important. Many (66 per cent) indicated that traditional healers could not be consulted for diagnosis of HIV. Conclusion: Participants exhibited good knowledge on certain questions but performed poorly on others, suggesting the need for more awareness campaigns on the basics of HIV/AIDS among young South Africans. (Contains 2 tables.)

Like many universities worldwide, the University of Cape Town (UCT) in South Africa has joined the open educational resources (OER) movement, making a selection of teaching and learning materials available through its OER directory, UCT OpenContent. However, persuading and then supporting busy academics to share their teaching materials as OER still remains a challenge. In this article, we report on an empirical study of how UCT postgraduate students have assisted in the process of reworking the academics' teaching materials as OER. Using the concept of contradictions (Engestrom, 2001), we endeavor to surface the various disturbances or conflicts with which the postgraduate students had to engage to make OER socially inclusive, as well as Engestrom's "layers of causality" (2011, p. 609) to explain postgraduate students' growing sense of agency as they experienced the OER development process as being socially inclusive. (Contains 1 table and 4 figures.)

HIV/AIDS education should empower students to create knowledge using everyday life experiences. Such knowledge should then be used to construe experience and resolve social problems such as risk behaviour that leads to infection. In South Africa, attempts to reduce the spread of HIV include incorporating HIV/AIDS education in the biology curriculum. However, there is a dearth of knowledge regarding the effectiveness of biology-based HIV/AIDS education. The current study therefore aimed to identify strategies that can be used to enhance biology students' understanding of HIV/AIDS and promote the use of this knowledge in their daily lives. A predominantly qualitative mixed-method approach with Delphi technique was used to gather and analyse data from secondary school biology students and teachers, as well as HIV/AIDS experts specialising in medicine and research. Findings show that most students rely on knowledge learnt in biology to make decisions related to HIV/AIDS. Respondents suggested that HIV/AIDS education should be taught collaboratively by teachers, people living with HIV, and HIV/AIDS experts. Biology concepts and teaching strategies that could enhance students' understanding of HIV/AIDS, which are not part of the current biology curriculum, were identified. (Contains 3 tables.)

Stemming from a viewpoint that my applied theatre practice should include both a dialogical element and an opportunity to take creative risks, this article explores how creative risk-taking can lead to seemingly repressive outcomes for the participants. Examining two moments of practice, which occurred during sexual health communication projects in the Nyanga township, this article examines how and why these particular outcomes emerged, and explains my concerns over this outcome and its apparent inherent contradiction with the notion that applied theatre practice is based on creating a dialogue. Yet the suspicion that something else was occurring in these moments leads to the proposal of another viewpoint, where by situating the practice and the resulting outcomes within both a healthcare framework and one of tactical action, alternative explanations become apparent: that the individuals' actions were tactical acts of protection and resistance in an environment where life is not always "tolerable". (Contains 8 notes.)

This paper has the following aims: (i) to explore the extent to which students who received an intervention involving HIV/AIDS and sexuality perceived that their teacher cared for their health and well-being, (ii) to investigate the characteristics of students who reported to have caring teachers and (iii) to document the association between students' perceptions of care and reported onset of sexual activity. Data were obtained from the second follow-up survey of a prospective study carried out among high school students in South Africa (Cape Town and Mankweng). We analyzed data from 3483 students who met the inclusion criteria. Students from the intervention group perceived greater care from teachers than students in the control group. Female students and students from Cape Town perceived having received more care, and their perception of care was associated with the number of lessons received, how often students expressed their opinions in class and how often teachers talked about HIV/AIDS, condoms and abstinence. Students who perceived that their teacher cared for their health and well-being were less likely to initiate sexual intercourse. This is the first paper to demonstrate the salience of the concept of care in studies of school-based HIV/AIDS prevention programs in sub-Saharan Africa.

Despite recent progress in meeting the goals of the Education for All agenda, certain groups of young people are particularly vulnerable to exclusion and underachievement, including children with HIV/AIDS, children living in poverty, and children with disabilities. HIV/AIDS has reduced many young people's rights to access education, to live a full and healthy life, and to have a life as a child. This article focuses on attempts to continue to empower young people to protect themselves from HIV by exploring the dynamics around HIV-related education in schools, in particular by examining the role that young people's knowledge can play in improving curricula and thus reducing HIV/AIDS rates. The authors draw on qualitative research in a total of eight schools in Kenya, Tanzania, and South Africa. Preliminary findings suggest that pupil consultation and dialogue can be used to inform thinking on the curriculum for HIV education.

This study was designed to evaluate the efficacy of the HealthWise South Africa HIV and substance abuse prevention program at impacting adolescents' polydrug use and sexual risk behaviors. HealthWise is a school-based intervention designed to promote social-emotional skills, increase knowledge and refusal skills relevant to substance use and sexual behaviors, and encourage healthy free time activities. Four intervention schools in one township near Cape Town, South Africa were matched to five comparison schools (N = 4040). The sample included equal numbers of male and female participants (Mean age = 14.0). Multiple regression was used to assess the impact of HealthWise on the outcomes of interest. Findings suggest that among virgins at baseline (beginning of eighth grade) who had sex by Wave 5 (beginning of 10th grade), HealthWise youth were less likely than comparison youth to engage in two or more risk behaviors at last sex. Additionally, HealthWise was effective at slowing the onset of frequent polydrug use among non-users at baseline and slowing the increase in this outcome among all participants. Program effects were not found for lifetime sexual activity, condomless sex refusal and past-month polydrug use. These findings suggest that HealthWise is a promising approach to HIV and substance abuse prevention.

Communicating about sex is a vital component of human immunodeficiency virus (HIV) prevention and influences how HIV educators convey messages to communities and how couples negotiate safer sex practices. However, sexual communication inevitably confronts culturally based behavioral guidelines and linguistic taboos unique to diverse social contexts. The HIV interventionist needs to identify the appropriate language for sexual communication given the participants and the message. Ethnographic research can help facilitate the exploration of how sex terminology is chosen. A theoretical framework, developed to guide HIV interventionists, suggests that an individual's language choice for sexual communication is influenced by gender roles and power differentials. In-depth interviews, free listing and triadic comparisons were conducted with Xhosa men and women in Cape Town, South Africa, to determine the terms for male genitalia, female genitalia and sexual intercourse that are most appropriate for sexual communication. Results showed that sexual terms express cultural norms and role expectations where men should be powerful and resilient and women should be passive and virginal. For HIV prevention education, non-mother tongue (English and Zulu) terms were recommended as most appropriate because they are descriptive, but allow the speaker to communicate outside the restrictive limits of their mother tongue by reducing emotive cultural connotations.

Like South Africans generally, d/Deaf and hard of hearing South Africans are at risk of HIV/AIDS and mental disorders resulting from barriers to communication and care. In interviews and a focus group, members of South African organizations for d/Deaf and hard of hearing individuals all gave priority to HIV/AIDS education and prevention, citing risks resulting from language and communication barriers, inadequate schooling, and insufficient information in South African Sign Language. Participants gave varied descriptions of HIV/AIDS programs in schools for d/Deaf and hard of hearing students and described school initiatives they had directed. Some participants gave mental health problems lesser priority; others said susceptibility to mental disorders may result from communication difficulties and therefore warrants specialized services. Others, seeing a need to address mental health in HIV/AIDS prevention, had designed programs accordingly. Such prevention efforts merit support, as do activities to reduce communication barriers.