The Mosaic of Local Governments in Post Apartheid South Africa: Municipal Asymmetries and Spatial Inequality

Vale, Helder Ferreira do; Cameron, Robert

doi:10.1057/978-1-137-57378-0_8

Cited by 5 publications

(4 citation statements)

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“…The communities comprised of three informal settlements, 21 peri-urban and five rural communities. Informal settlements are defined as communities that are occupied by migrants from rural areas or foreign nationals who are in search of employment and social services [ 33 ]. Municipal services in these areas are often free, very basic but are mostly unavailable [ 32 ].…”

Section: Methodsmentioning

confidence: 99%

“…Municipal services in these areas are often free, very basic but are mostly unavailable [ 32 ]. Peri-urban communities are neither rural nor urban; they are densely populated and underdeveloped [ 33 ]. Rural communities mainly consist of scattered elderly populations who rely on social grants.…”

Section: Methodsmentioning

confidence: 99%

“…Municipal services in these areas are also basic and free. All these communities are occupied by poor people (indigenous African people classified as blacks under the apartheid era) [ 33 ] and they all fall within the jurisdiction of eThekwini metropolitan municipality (see Table 1 for demographic information).…”

Section: Methodsmentioning

confidence: 99%

“…All FGDs were guided by a focus group schedule which contained open-ended questions. The schedule provided participants with the opportunity to provide detailed responses and for the facilitator to probe and follow-up on issues raised during the sessions [ 33 ]. The focus group schedule covered four main themes: 1) nursing care activities provided to the patients and the type of HCW that is generated in the process, 2) how HCW is handled and managed in CBC, 3) barriers and facilitators to the management of HCW and 4) strategies used to respond to challenges relating to HCWM.…”

Section: Methodsmentioning

confidence: 99%

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Health care waste management in community-based care: experiences of community health workers in low resource communities in South Africa

Hangulu

Akintola

2017

BMC Public Health

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BackgroundIn South Africa, community health workers (CHWs) working in community-based care (CBC) programmes provide care to patients most of whom are living with HIV/AIDS and tuberculosis (TB). Although studies have shown that the caregiving activities provided by the CHWs generate health care waste (HCW), there is limited information about the experiences of CHWs on health care waste management (HCWM) in CBC. This study explored HCWM in CBC in Durban, South Africa from the perspectives CHWs.MethodsWe used three ethnographic approaches to collect data: focus group discussions, participant observations and informal discussions. Data was collected from 85 CHWs working in 29 communities in the Durban metropolis, South Africa. Data collection took place from July 2013 to August 2014.ResultsCHWs provided nursing care activities to patients many of whom were incontinent or bedridden. Some the patients were living with HIV/AIDS/TB, stroke, diabetes, asthma, arthritis and high blood pressure. These caregiving activities generate sharps and infectious waste but CHWs and family members did not segregate HCW according to the risk posed as stipulated by the HCWM policy. In addition, HCW was left with domestic waste. Major barriers to proper HCWM identified by CHWs include, lack of assistance from family members in assisting patients to use the toilet or change diapers and removing HCW from homes, irregular waste collection by waste collectors, inadequate water for practicing hygiene and sanitation, long distance between the house and the toilets and poor conditions of communal toilets and pit latrines. As a result of these barriers, HCW was illegally dumped along roads or in the bush, burnt openly and buried within the yards. Liquid HCW such as vomit, urine and sputum were disposed in open spaces near the homes.ConclusionCurrent policies on primary health care (PHC) and HCWM in South Africa have not paid attention to HCWM. Findings suggest the need for primary health care reform to develop the competencies of CHWs in HCWM. In addition, PHC and HCWM policies should address the infrastructure deficit in low resource communities. In order for low-and-middle-income-countries (LMICs) to develop effective community health worker programmes, there is a need for synergies in PHC and HCWM policies.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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