BackgroundTruck drivers have unique health needs, and by virtue of their continuous travel, experience difficulty in accessing healthcare. Currently, planning for effective care is hindered by lack of knowledge about their health needs and about the impact of on-going programmes on this population’s health outcomes. We reviewed healthcare programmes implemented for sub-Saharan African truck drivers, assessed the evaluation methods, and examined impact on health outcomes.MethodsWe searched scientific and institutional databases, and online search engines to include all publications describing a healthcare programme in sub-Saharan Africa where the main clients were truck drivers. We consulted experts and organisations working with mobile populations to identify unpublished reports. Forest plots of impact and outcome indicators with unadjusted risk ratios and 95% confidence intervals were created to map the impact of these programmes. We performed a subgroup analysis by type of indicator using a random-effects model to assess between-study heterogeneity. We conducted a sensitivity analysis to examine both the summary effect estimate chosen (risk difference vs. risk ratio) and model to summarise results (fixed vs. random effects).ResultsThirty-seven publications describing 22 healthcare programmes across 30 countries were included from 5,599 unique records. All programmes had an HIV-prevention focus with only three expanding their services to cover conditions other primary healthcare services. Twelve programmes were evaluated and most evaluations assessed changes in input, output, and outcome indicators. Absence of comparison groups, preventing attribution of the effect observed to the programme and lack of biologically confirmed outcomes were the main limitations. Four programmes estimated a quantitative change in HIV prevalence or reported STI incidence, with mixed results, and one provided anecdotal evidence of changes in AIDS-related mortality and social norms. Most programmes showed positive changes in risk behaviours, knowledge, and attitudes. Our conclusions were robust in sensitivity analyses.ConclusionDiverse healthcare programmes tailored to the needs of truck drivers implemented in 30 sub-Saharan African countries have shown potential benefits. However, information gaps about availability of services and their effects impede further planning and implementation of effective healthcare programmes for truck drivers.
RWCs were highly appreciated by the users, as they are suitable and accessible. The sex workers who used the clinics visited them irregularly, mostly for PHC services other than HIV and STIs. Services other than the one for which the sex worker came to the clinic rarely appeared to be offered. We recommend areas for service expansion.
This article considers covid-19 and precarity in South Africa’s minibus taxi industry. Covid-19 and the resulting national lockdown interrupted the operations of the industry (like other businesses) in South Africa. During the lockdown (from level 5 to level 1), some taxi operators complained that the lockdown resulted in them losing profit. Taxi drivers also complained that they are making less money through taxi fares (noting that each day they give collected fares to taxi owners and keep some of the money for petrol). The labour inspectors of the Department of Employment and Labour (DOEL) continue to find it difficult to exercise their role of inspecting working conditions in the industry. Despite the fact that the DOEL issued a Sectoral Determination for the taxi industry (Basic Condition of Employment Act 95 of 1997, Sectoral Determination 11: Taxi Sector 2005), which specifies basic employment conditions, the industry is still predominantly informal and employees have no job protection. Taxi drivers remain exempt from job-related benefits such as the Unemployment Insurance Fund (UIF), which makes it impossible for them to benefit during difficult times such as Covid-19 and unemployment. Therefore, the virus and the lockdown revealed further the precariousness of taxi drivers and the concerns around making profit by taxi owners.
Accessing the field for the purposes of conducting research often starts with negotiation and engagement with gatekeepers. This is the first requirement for the research to be conducted; however, this step has challenges. While research has been conducted on negotiating access and research ethics, very little is known about the experiences of doctoral students from the Global South on negotiating access in fieldwork, and thus giving an account of what it entails conducting qualitative research from the Global South. As such, this article engages with the challenges of negotiating access to the field for my PhD studies. Due to the nature of research for my thesis, I conducted interviews with key informants from the departments and participants from the taxi ranks. In this article, I problematize the view that gaining access to the field is a simple process, by exposing my own uncomfortable encounters during the process.
The minibus taxi industry moved from being heavily regulated before 1987 during the apartheid to the period of deregulation in 1987—which led to an increasing number of taxi operators—to the introduction of the Taxi Recapitalisation Programme (TRP) in 1999 with the purpose of transforming the industry. The TRP was—and continues to be—an attempt to respond to the problems and failures of the regulation process. Regulation of the minibus taxi industry is important to ensure that the industry operates according to the laws of South Africa. However, while this is so, there is an increasing number of illegal operators within the industry. This paper is situated in the broader context of my PhD thesis which investigated the impact of the TRP on precarious working conditions within the minibus taxi industry in Johannesburg. Using qualitative research methods, I conducted a total of fifty-eight interviews for my thesis. Results portrayed that most of the minibus taxi operators in the industry continue operating illegally, and thus making it difficult for the state to regulate. Regulation in the industry is sociologically-defined by two categories: social regulations and economic regulations. The industry remains unregulated and situated within the informal sector.
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