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Highlights• South Africa has an enabling, comprehensive and progressive legislative and policy framework for the provision of adolescent and youth friendly services in South Africa is laudable.• However various provider, health facility, and programme design characteristics continue to hamper effective provision and delivery of adolescent and youth friendly health services.• The need to consider the amendment of some health facility regulations such as operating hours and/or days to ensure that service provision is convenient for young people.• The provision of all cadres of primary health service providers with on-going professional development and attitudinal training is imperative to break down prejudices that may limit the success of the adolescent and youth friendly programming in the country.• There is need for more youth involvement in programme design and service provision. AbstractAgainst the background of increasing international calls for the development and implementation of age-appropriate programmes that address both quality and access issues to improve adolescent and youth health, this paper explores the extent to which public health facilities are available and accessible to adolescents and youth in South Africa. The impetus for the study was the current evidence that there was generally poor utilisation of services offered at public health facilities by young people in the country. The overall findings are that despite the country"s comprehensive legal and policy framework and commitment to improve the health of young people, there continues to be some structural and systemic factors that hamper effective provision and programming of adolescent and youth friendly services. The paper concludes with recommendations for policy and practice.

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The use of a single geographical unit to both collect and disseminate census data is common in many countries across the world, especially in developing countries. In South Africa this approach poses some challenges, as the design of small geographical units called enumeration areas to facilitate data collection differs considerably from the design of units that aid data analysis and interpretation. We aimed to create optimised census output areas using the Automated Zone-design Tool (AZTool) program, using the 2001 census enumeration areas as building blocks at various spatial levels, for both rural and urban settings in two South African provinces. The results were consistent and stable. The primary criterion of the confidentiality limit of 500 people was respected at all geographical levels or regions, in both urban and rural settings, for newly created optimised output areas. For the second criterion, lower intra-area correlation values at lower geographical levels for both rural and urban areas showed that higher geographical levels produced more homogeneous output areas than did lower geographical levels or regions. Our obtained intra-area correlation of 0.62 for the two provinces combined indicated that the selected homogeneity variables were good indicators of social homogeneity for creating optimised output areas in South Africa. We conclude that the AZTool software can be used to effectively and objectively create optimised output areas for South African data. Further research on the comparison of the newly created output areas with existing output areas in South Africa should be explored.

Background: Background: SARS-CoV-2 has resulted in the COVID-19 pandemic. Based on a nationally representative online survey conducted several weeks on the pandemic, this paper explores how South Africans responded to the compliance regulations laid down by the national government and factors associated with individuals’ confidence in their community adhering to lockdown regulations. Methods: The study was conducted using a closed-ended questionnaire on a data-free online platform. Additionally, a telephonic survey was included to accommodate individuals who do not have access to smart-phones. The study population consisted of respondents who were 18 years and older and living in South Africa (n=19 933). Data were benchmarked to the 2019 midyear population estimates. Descriptive statistics and bivariate logistic regression are presented. Results: Over a quarter (26.1%) of respondents reported that they had not left home, indicating compliance with the COVID-19 control regulations, and 55.3% who did leave their homes did so to purchase essential items. A small proportion (1.2%) reported that they had visited friends. People, classified as coloured, those who were more literate (those with secondary, matric and tertiary education status), those residing in disadvantaged areas (informal settlements, townships, rural areas and farms), and those who perceived their risk of contracting COVID-19 as moderate and high, reported not being confident of their community adhering to lockdown. Conclusion: Communication strategies must be employed to ensure that important information regarding the pandemic be conveyed in the most important languages and be dispatched via various communication channels to reach as many people as possible.

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Background: Adequate information and knowledge about COVID-19 has been shown to induce the confidence and positive performance among healthcare workers (HCWs). Therefore, assessing the relationship between confidence in knowledge and associated factors among HCWs is vital in the fight against COVID-19. This paper investigates factors associated with HCWs' confidence in their overall knowledge about COVID-19 in South Africa in the early stages of the epidemic.Methods: Data utilized in this paper were from an online survey conducted among HCWs using a structured questionnaire on a data free online platform. The study population were all the medical fraternity in South Africa including medical and nurse practitioners as well as other healthcare professionals. Bivariate and multivariate logistic regression models were performed to examine the factors associated with confidence in HCWs' overall knowledge about COVID-19.Results: Overall, just below half (47.4%) of respondents indicated that they had confidence in their overall knowledge about COVID-19. Increased odds of having confidence in the knowledge about COVID-19 were significantly associated with being male [aOR = 1.31 95% CI (1.03–1.65), p < 0.05], having a doctorate degree [aOR = 2.01 (1.23–3.28), p < 0.05], being satisfied with the information about COVID-19 guidelines [aOR = 6.01 (4.89–7.39), p < 0.001], having received training in 6–8 areas [aOR = 2.54 (1.89–3.43), p < 0.001] and having received training in 9–11 areas [aOR = 5.33 (3.81–7.47), p < 0.001], and having already treated COVID-19 patients [aOR = 1.43 (1.08–1.90), p < 0.001]. Those who were highly concerned with the levels of training of HCWs [aOR = 0.47 (0.24–0.92), p < 0.05] had decreased odds of having confidence in their overall knowledge about COVID-19.Conclusion: This study sheds light on the importance of capacitating HCWs with knowledge and adequate relevant training as part of infection prevention control measures during pandemics. Future training and information sharing should be sensitive to knowledge gaps by age, gender, qualifications, professional categories, and experience.

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