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Item Different adiposity indices and their association with blood pressure and hypertension in middle-aged urban black South African men and women: findings from the AWI-GEN South African Soweto Site(BioMed Central, 2018-04) Pisa, Pedro T.; Micklesfield, Lisa K.; Kagura, Juliana; Ramsay, Michele; Crowther, Nigel J.Background: To report associations between different adiposity indices [anthropometric and dual-energy X-ray absorptiometry (DXA) measures] and blood pressure (BP) and hypertension in urban black South African adults. Methods: Anthropometric and DXA whole body measures were performed on 1026 men and 982 women. Participants were classified as being hypertensive if they had a systolic BP (SBP) ≥ 140 mmHg and/or diastolic (DBP) ≥ 90 mmHg. Within each gender the relationship of adiposity with BP and hypertension risk was assessed using linear and logistic regression models respectively. Bivariate models were computed for each body composition variable. Furthermore, we computed a multiple regression model to illustrates how body composition parameters are associated with the outcome variables independent of each other. Results: The males were significantly taller and had a higher fat free soft tissue mass (FFSTM), DBP and socio-economic status, and were more likely to use tobacco and be hypertensive (48.0% vs. 38.8%). The females had higher body mass index (BMI), waist circumference (WC), fat mass (FM), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), FM/ FFSTM ratio and body fat % than males. All body composition parameters were positively associated with hypertension. In both males and females, the FM/FFSTM ratio associated the strongest with hypertension illustrating the following odds ratios [males: 70.37 (18.47, 268.16) p ≤ 0.001; females 2.48 (0.86,7.21) p = 0.09]. The multiple regression model, indicated that the VAT and WC significantly associated with both SBP and DBP in the men and women respectively, whilst WC was the only significant predictor for hypertension. Conclusions: All body composition parameters were associated with hypertension and FM/FFSTM ratio showed the strongest relationship. It was reassuring that WC remains a useful measure of central adiposity that can be used as a risk indicator for hypertension if more sophisticated measures are not available. Furthermore, our data in part, implies that reducing abdominal adiposity in aging adults could contribute to reducing the risk of elevated blood pressure and hypertension.Item “People look and ask lots of questions”: caregivers’ perceptions of healthcare provision and support for children born with cleft lip and palate(BioMed Central, 2018-04) Hlongwa, Phumzile; Rispel, Laetitia C.Background: Clefting of the lip and/or palate (CL/P) is amongst the five most common birth defects reported in South Africa. The emotional impact on parents at the birth of their new-born with CL/P could affect parent-child relationships. In light of insufficient scholarly attention parental experiences and perceptions, this study reports on caregivers’ perceptions of health service provision and support for children born with cleft lip and palate in South Africa. Methods: The study setting consisted of 11 academic hospital centres situated in six of South Africa’s nine provinces. At each of the academic centres cleft clinic, five to ten parents or caregivers were selected purposively. Participants were interviewed, using a semi-structured interview schedule that elicited socio-demographic information, explored the family experiences of having a child with CL/P, and their perceptions of care provision and support services available. The interviews were analysed using thematic content analysis. Results: Seventy-nine participants were interviewed. Their mean age was 33.3 years (range 17–68 years). The majority of the parents were black African (72%), unemployed (72%), single (67%) and with only primary school education (58%). The majority of the children were male, with a mean age of 3.8 (SD = ±4.3) years. Five broad themes emerged from the interviews: emotional experiences following the birth of a child with cleft lip and palate; reactions from family, friends or the public; the burden of care provision; health system responsiveness; and social support services. Caregivers reported feelings of shock, anxiety, and sadness, exacerbated by the burden of care provision, health system deficiencies, lack of public awareness and insufficient social support services. Conclusions: The findings have implications for the integrated management of children with cleft lip and/or palate, including information to parents, the education and training of healthcare providers, raising public awareness of birth defects, and social support.Item The policy we want: An economic policy for informal traders in South Africa(University of the Witwatersrand (Southern Centre for Inequality Studies), 2025-04-04) Siphelele Ngidi; David FrancisIn 2024, SCIS, in partnership with WIEGO (Women in Informal Employment: Globalising and Organising), embarked on a research and policy project to develop an economic policy for informal traders in South Africa. The project gathered insights from individuals actively working in the sector, offering valuable perspectives for policymakers and stakeholders seeking to improve the conditions of informal traders and strengthen the informal trading economy. Based on these findings, we identified actionable policy recommendations to help create a more conducive environment for informal trading. The results are presented in a policy brief structured around eight key pillars, titled “The Economic Policy We Want.”Item Alcohol industry involvement in the delayed South Africa Draft Liquor Amendment Bill 2016: a case study based on freedom of information requests(BioMed Central, 2025-03) Goldstein, Susan; Mitchell, Gemma; Siwela, Pfumelani; Diedericks, Aadielah MakerBackground South Africa is reported to have one of the highest per capita rates of alcohol consumption among drinkers globally, with alcohol harms exacerbating socio-economic inequalities in the country. The Draft Liquor Amendment Bill 2016 proposed new restrictions on alcohol advertising, availability, and liability of retailers and manufacturers for harm related to any contravention of the regulations. To date, the Bill has not progressed through the legislative process. The alcohol industry is known to use a diverse set of strategies to delay evidence-based policies globally. Methods We aimed to explore Bill-related activity by industry within the National Economic and Development Labour Council, a multi-stakeholder forum that assesses socio-economic policies before they reach parliament. On 06 July 2023 we made a Request for Access to Record, using form two of the Promotion of Access to Information Act (PAIA), no. 2 of 2000 to the National Economic and Development Labour Council for access to minutes of all meetings, reports, and any other publications related to the Bill between January 2016 and December 2022. Informed by Ulucanlar et al’s (2023) model and taxonomies of corporate political activity, we extracted data on industry Bill-related activity and thematically analysed key events, presented here as a narrative synthesis. Results We identified activity by 14 alcohol industry organisations related to the Bill between 2016 and 2022. Industry representation on five National Economic and Development Labour Council-related committees identified between 2017 and 2021 facilitated their involvement in Bill-related discussions and supported access to other government departments. Community representation was low in all committees compared to industry, labour, and government. Industry funded two socio-economic assessments of the Bill in 2017 and 2022, despite an independent socio-economic impact assessment having already been completed. The 2017 report delayed progress of the Bill, and the 2022 ‘re-evaluation’ was more critical of the proposed measures, with the differing conclusions attributed to different methodologies. During the covid-19 pandemic, industry used a ‘carrot and stick’ approach of legal threats and donations to attempt to move towards self-regulation via a social compact. The National Economic and Development Labour Council confirmed in 2023 that the social compact was unsuccessful. Conclusions Early ‘regulatory capture’ gave the alcohol industry the opportunity to shape assessment of the Bill within the National Economic and Development Labour Council. Our findings are in line with previous studies on corporate influence on policy globally, and support calls for a reassessment of the role and proportion of industry representation within the National Economic and Development Labour Council locally.Item Trends in national and ethnic burden of ovarian cancer mortality in South Africa (1999–2018): a population based, age-period-cohort and join point regression analyses(BioMed Central, 2025-03) Olorunfemi, Gbenga; Libhaber, Elena; Musenge, Eustasius; Ezechi, Oliver C.Ovarian cancer is the most lethal and third leading cause of gynaecological cancers globally and in South Africa (SA). However, its current mortality trends have not been evaluated in most sub-Saharan African Countries including South Africa that is currently undergoing epidemiological and health transitions. We evaluate the trends in the ovarian cancer mortality rates in SA over 20 years (1999–2018). Methods: Crude (CMR) and age standardised mortality rates (ASMR) of ovarian cancer was calculated based on national mortality data of South Africa. The overall and ethnic trends of ovarian cancer mortality among women aged 15 years and older from 1999 to 2018 was assessed using the Join point regression model, while Age-period-cohort regression analysis was conducted to evaluate the underlying impact of age, period and cohort on ovarian cancer mortality. Results: In all, 12,721 ovarian cancer deaths were reported in South Africa from 1999 to 2018 and the mortality rates increased from 2.34 to 3.21 per 100,00 women at 1.8% per annum. In 2018, the overall mean age at ovarian cancer death in South Africa was 62.30±14.96 years while the mean age at death among Black women (58.07±15.56 years), was about 11 years earlier than among White women (69.48±11.71 years). In 2018, the White ethnic group (4.93 deaths per 100,000 women) had about doubled the ovarian cancer ASMR for the non-Whites (Indian/Asians, 2.92/100,000 women, mixed race, 2.49/100,000 women and Black women (2.36/ 100,000 women). All the ethnic groups had increased ASMR with Black women (Average annual percent change, [AAPC]: 4.7%, P-value<0.001) and Indian/Asian women (AAPC: 2.5%, P-value<0.001) having the highest rise. Cohort mortality risk ratio of ovarian cancer increased with successive birth cohort from 0.35 among 1924–1928 birth cohorts to 3.04 among 1999–2003 cohort and the period mortality risk increased by about 13% and 7.5% from 1999 to 2003 to 2004–2008 (RR: 0.87, 95% CI: 0.80–0.94), and from 2004 to 2008 to 2009–2013 (RR: 1.075, 95% CI:1.004–1.152) respectively. The longitudinal age analysis revealed that ovarian cancer increased with age, but there was an exponential increase from 55 years. Conclusions: Our study showed that there was increasing trends in ovarian cancer mortality among all the South African ethnic groups, driven partly by increasing cohort and period mortality risks. We therefore highlight the huge burden of ovarian cancer in SA and the need for targeted intervention. Public health interventions geared towards reducing ovarian cancer mortality should be instituted and ethnic disparity should be incorporated in the cancer control policyItem Budget 2025 Preview: Pressures and tensions along the austerity road to fiscal sustainability(Southern Centre for Inequality Studies, 2025-02) Sachs, Michael; Amra, Rashaad; Madonko, Thokozile; Willcox, OwenThis policy brief, ahead of the tabling of the 2025 Budget Review, considers the policy context and the fiscal and economic environment in which the Budget will be tabled. It considers the merits, limitations, and likely consequences of the government’s approach to budget policy over the medium term, as contained in the 2024 Medium-Term Budget Policy Statement (MTBPS), which redoubled efforts to consolidate public finances while attempting to promote capital spending. Since the MTBPS, several material expenditure pressures have emerged, some of which were flagged in the Public Economy Project’s (PEP) 2024 MTBPS analysis, and the economic outlook has been revised. Based on this, the Public Economy Project’s revised outlook for public finance finds that the government’s ambitious plan to stabilise debt over the medium term is unlikely to be realised.Item A panoptic view of the South African wealth tax(AOSIS, 2025-01) Ram, Asheer JaywantBackground: Wealth taxes are a topic of intense debate, with most countries having either abolished them or considered, but not implemented such measures. The South African government is contemplating the introduction of a wealth tax, purportedly to enhance revenue collection. Aim: This article examines whether the proposed South African wealth tax functions as a government panopticon, offering an alternative explanation for its introduction. It also considers the government’s transparency regarding the potential wealth tax. Setting: This article examined the opinions of tax experts in South Africa. Method: An interpretive approach is adopted. The traits of the wealth tax and the themes of the panopticon are identified and used as the row and column headings in a correspondence table, which serves as the research instrument distributed to tax experts. The tax experts indicate any associations between the themes of the panopticon and the traits of the wealth tax. Forty aggregated responses are subjected to correspondence analysis. Results: The potential wealth tax functions as a panopticon. It identifies and reveals relevant tax information about high-wealth individuals, appearing to coerce their compliance. Conclusion: There is credence to the alternate rationale for introducing a wealth tax in South Africa. Contribution: This is one of the first articles to apply the panopticon, a novel theoretical framework, in a tax context in South Africa. The findings are relevant to the exploration of similar taxes in other jurisdictions and provide a means for the critical evaluation of the motives behind tax policy decisions made by governments.Item Feeding children with autism in South Africa: the teachers’ perspectives(AOSIS Publishing, 2024-02) Adams, Skye N.; Matsimela, NthabisengBackground: Over 80% of children diagnosed with autism spectrum disorders (autism) exhibit disruptive behaviours during mealtimes, highlighting the need for personalised care. In South Africa, teachers often take on the responsibility of feeding due to resource constraints and the time children spend at school. Moreover, children with autism have unique and individualised feeding requirements, which many teachers may not have the necessary training or skills to address adequately. Objectives: To explore the ways in which teachers of autistic children manage feeding difficulties in the classroom. Method: A qualitative research design was employed using semi-structured interviews. Eight teachers were interviewed on feeding autistic children between the ages of 3 years - 9 years in Johannesburg, South Africa. Data were transcribed and analysed using thematic analysis. Results: The findings revealed that teachers encountered distinct challenges when it came to feeding autistic children in the classroom, particularly concerning the management of associated feeding difficulties. Teachers employed several strategies to encourage eating in the classroom setting including: (1) bolus modification, (2) behaviour modelling, (3) positive reinforcement and (4) offering choices and alternatives. Conclusion: The study concludes the need for specialised support and training for teachers to address the individualised feeding needs of children with autism. Implementing targeted interventions and providing resources for teachers could enhance their abilities to effectively support children with autism during mealtimes and promote a more inclusive classroom environment. Contribution: This study highlighted the importance of including the teacher in the multidisciplinary team when managing the feeding challenges in children with autism.Item Digestible memories in South Africa’s recent past: processing the Slave Lodge Museum and the memorial to the enslaved(Taylor and Francis Group, 2021-07) Cloete, NicolaGiven the recent oppressive histories of apartheid and colonialism, the legacies of slavery in South Africa are often overlooked in thinking about aspects of post-apartheid democracy’s discursive formulation of race, nation, and reconciliation. This paper analyses how two examples in Cape Town – the permanent exhibition Representing Slavery at the Slave Lodge Museum and the Memorial to the Enslaved in Church Square – represent the historic event of slavery in South Africa. The paper argues that the museum exhibition and the memorial site are instances of memorialisation and simultaneously function as political processes that offer insight into discourses of race and reconciliation in South Africa during the early stages of democracy.Item Comparing occupant satisfaction in Green versus Conventional Residential Real Estate in South Africa(Proceedings of the AfRES 2024 Conference, 2024-09) Masotya, Adam; Simbanegavi, Prisca; Weaich, Malcolm; Adewunmi, Yewande; Ndlovu, Pride; Gethe, FarananiThis study compares occupant satisfaction in green versus conventional residential real estate in South Africa. It investigates the benefits and satisfaction levels related to green developments, particularly in terms of energy savings and socio-economic Impacts. The research aimed to determine if there is a significant difference in occupant satisfaction between green and conventional residential developments. A quantitative approach was employed, utilizing stratified random sampling to survey 160 occupants from two developments: Crossberry Central (green) and Little Manhattan (conventional). Data was analysed using the Mann-Whitney U and Wilcoxon W tests due to non- normal data distribution. The findings indicate that occupants of green developments report significantly higher satisfaction levels. Key areas of satisfaction include air quality, utility savings, and environmental benefits. Green developments demonstrate higher levels of satisfaction regarding reduced utility bills, improved indoor air quality, and contributions to environmental conservation. The study concludes that green residential developments significantly enhance occupant satisfaction compared to conventional housing. This suggests a socio-cultural shift towards valuing sustainable living environments, emphasising the importance of promoting green building practices to improve both environmental and occupant well-being.