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Abstract Background In low and middle income countries, public perceptions of drinking water safety are relevant to promotion of household water treatment and to household choices over drinking water sources. However, most studies of this topic have been cross-sectional and not considered temporal variation in drinking water safety perceptions. The objective of this study is to explore trends in perceived drinking water safety in South Africa and its association with disease outbreaks, water supply and household characteristics. Methods This repeated cross-sectional study draws on General Household Surveys from 2002–2009, a series of annual nationally representative surveys of South African households, which include a question about perceived drinking water safety. Trends in responses to this question were examined from 2002–2009 in relation to reported cholera cases. The relationship between perceived drinking water safety and organoleptic qualities of drinking water, supply characteristics, and socio-economic and demographic household characteristics was explored in 2002 and 2008 using hierarchical stepwise logistic regression. Results The results suggest that perceived drinking water safety has remained relatively stable over time in South Africa, once the expansion of improved supplies is controlled for. A large cholera outbreak in 2000–02 had no apparent effect on public perception of drinking water safety in 2002. Perceived drinking water safety is primarily related to water taste, odour, and clarity rather than socio-economic or demographic characteristics. Conclusion This suggests that household perceptions of drinking water safety in South Africa follow similar patterns to those observed in studies in developed countries. The stability over time in public perception of drinking water safety is particularly surprising, given the large cholera outbreak that took place at the start of this period.

Abstract Background Reliable access to basic services can improve a community's resilience to HIV/AIDS. Accordingly, work is being done to upgrade the physical infrastructure in affected areas, often employing a strategy of decentralised service provision. Spatial characteristics are one of the major determinants in implementing services, even in the smaller municipal areas, and good quality spatial information is needed to inform decision making processes. However, limited funds, technical infrastructure and human resource capacity result in little or no access to spatial information for crucial infrastructure development decisions at local level. This research investigated whether it would be possible to develop a GIS for basic infrastructure planning and management at local level. Given the resource constraints of the local government context, particularly in small municipalities, it was decided that open source software should be used for the prototype system. Results The design and development of a prototype system illustrated that it is possible to develop an open source GIS system that can be used within the context of local information management. Usability tests show a high degree of usability for the system, which is important considering the heavy workload and high staff turnover that characterises local government in South Africa. Local infrastructure management stakeholders interviewed in a case study of a South African municipality see the potential for the use of GIS as a communication tool and are generally positive about the use of GIS for these purposes. They note security issues that may arise through the sharing of information, lack of skills and resource constraints as the major barriers to adoption. Conclusion The case study shows that spatial information is an identified need at local level. Open source GIS software can be used to develop a system to provide local-level stakeholders with spatial information. However, the suitability of the technology is only a part of the system – there are wider information and management issues which need to be addressed before the implementation of a local-level GIS for infrastructure management can be successful.

Abstract Background South Africa is experiencing an HIV/AIDS pandemic of shattering dimensions. The availability and provision of antiretroviral (ARV) drugs could bring relief to the situation, but the treatment is unfortunately complex with each patient being assigned a different antiretroviral therapy varying in diet-medication regiment. The context of South Africa, its variety of urban and rural settings adds to the challenge of administering and monitoring the HIV+ person throughout the treatment, which will last for the rest of their lives. The lack of physical infrastructure, reliable statistics and adequate resources hinder the efficient management of HIV/AIDS. Results The collection of reliable data will be a first step to assess the status of HIV/AIDS in communities. A number of hospitals have started this process using the conventional approach to collect information about their patients using a paper-based system. Since time is of essence in the fight against the pandemic, data exchange between various hospitals, municipalities and decision-making bodies is becoming more and more important. The logical response to such a need is a computerised system, which will collect and administer HIV/AIDS related information within the local context and allow a monitored access to the data from a number of stakeholders. Conclusions The purpose of this study was to design and develop an HIV/AIDS database, which is embedded in a Spatial Information Management System. The pilot study area is the Gugulethu township in Cape Town where more than 27% of the 325 000 residents are HIV+. It is shown that the implementation of the HIV/AIDS database and the Spatial Information Management System can play a critical role in determining where and when to intervene, improving the quality of care for HIV+ patients, increasing accessibility of service and delivering a cost-effective mode of information.

In South Africa, the socio-economic development of rural communities lags the furthest. One of the factors contributing towards this is the incapacity of local municipalities to deliver basic services. This paper discusses how municipal capacity can be improved through an ICT system that is designed and implemented using co-design. In a case study of two South African rural municipalities, capacity was assessed before and after an ICT system was implemented. Using the co-design methodology, stakeholders became part of the design team. The study empirically showed that capacity increased in both municipalities after the ICT system was implemented. The resulting developmental change manifested itself in the sectors of governance, engagement, human resource management, institutional memory, and access to information. The findings showed that understanding the context and current capabilities of stakeholders and investing time in the design of the ICT system resulted in greater impact than literature previously suggested. [ABSTRACT FROM AUTHOR]

This exploratory investigation presents a case study of the deployment of an mHealth service in established public clinics, and assesses the findings using Activity Theory. We contribute to the limited empirical research on mHealth implementation in established public facilities, and build on work on the use of Activity Theory to frame investigations of ICT4D interventions. The study investigates the perspective of clinic staff responsible for registering women for a free maternal health messaging service. Open-ended interviews and observation sessions were used to reveal staff experiences of the implementation, and their work practices. Activity Theory analysis was adopted to help interpret the data, and identify likely dynamics leading to these specific practices. Some themes that emerged were the hierarchical nature of the medical profession and implications for task shifting, the influence of technical design choices on use patterns and issues arising from the developing-country context. [ABSTRACT FROM AUTHOR]

In South Africa, the management and monitoring of drinking water quality is governed by policies and regulations based on international standards. Water Service Authorities, which are either municipalities or district municipalities, are required to submit information regarding water quality and the management thereof regularly to the national Blue Drop System (BDS). Since 2009, a trend has emerged in which urban municipalities have been shown to consistently improve their water quality management whilst some of the rural and under-resourced municipalities are falling behind. A major concern has been that rural municipalities are failing to report the required information and are not complying with some of the regulator's requirements that speak to the overall management of water quality monitoring rather than the actual water quality itself. This paper reflects on a case study undertaken in four rural municipalities in South Africa where a cellphone-based information system was implemented to collect information relevant to the municipality. The study was conducted by the Information for Community Oriented Municipal Services (iCOMMS) research team based at the Department of Civil Engineering at the University of Cape Town. The hypothesis for the research was that improved information flow within rural municipalities - from water supplies in outlying areas to the municipal government office - can improve the efficiency of existing monitoring, if the design, development and implementation of such a system are based on collecting appropriate and locally relevant information. Water service authorities at the four field sites managed the process of monitoring in very different ways due to limited resources as well as structural challenges within each government department. The variety of stakeholders involved in water quality monitoring programmes, and the alternative methods and processes used, challenges the current understanding of information system design as well as the notion of developing a single national information system. The decentralisation of national water quality monitoring to municipal level was assessed in this research, which concluded that the BDS was of limited usefulness to water quality monitoring in the rural municipalities partaking in this research. [ABSTRACT FROM AUTHOR]

This article explores the role of ICT4D research in producing "actionable knowledge" (Hearn & Foth, 2005) for development. We consider how a frame of openness (Smith & Elder, 2010), interpreted here as an active process of engagement, knowledge sharing, and co-creation, might guide ICT4D research. Our analysis is directed at both the project and institutional levels, focusing particularly on universities in the Global South. The case of iDART, a pharmacy system for antiretroviral drug dispensing in remote and underresourced public health clinics in South Africa, is interrogated as an example of an open approach. As of early 2010, iDART managed antiretroviral drug dispensing for approximately 150,000 patients in South Africa, and the research group that initially developed it had spun out into a separate nonprofit. In iDART and related projects, we have tried to enact a shift toward openness in both the technologies we work with and the system development process. We have also engaged with the research process itself, trying to establish a developmental understanding of our work as ICT4D researchers, as well as with the university as an institutional structure. The results demonstrate barriers on both practical and institutional levels, but also encouraging successes. The success of iDART as a model for knowledge production is well framed by an open approach to ICT4D research. [ABSTRACT FROM AUTHOR]