4. Electronic Theses and Dissertations (ETDs) - Faculties submissions
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Item COVID-19 and health care worker exposure at Chris Hani Baragwanath Academic Hospital(University of the Witwatersrand, Johannesburg, 2021-12-05) Glatt, Sara Chaya; Menezes, Colin; Winchow, Lai ling; Tsitsi, MerikaBackground: Health care workers (HCWs) are at an increased risk of acquiring coronavirus disease 2019 (COVID-19). Appropriate risk assessments and testing are essential to reduce transmission and avoid workforce depletion. Objective: Investigate the risk of COVID-19 infection among HCWs at Chris Hani Baragwanath Academic Hospital who fulfil the Person Under Investigation (PUI) case definition or had exposure to a confirmed COVID-19 contact. Methods: A retrospective review of HCW records was conducted over a two month period. Data collected included demographics, exposure type, risk level, and COVID-19 test result. Frequency distribution tables, bivariate analyses and univariate and multivariate analyses were conducted. Results: Among the 1111 HCWs reviewed, 643 were tested with 35.6% positive results. PUI’s accounted for 62.4% of positive cases. Symptomatic HCWs with no known contact were at a greater risk of infection than those with a patient exposure (p=0.000). Risk of testing positive was higher after a patient exposure (p=0.000) compared to a co-worker contact. Conclusion: There is a higher positivity rate among HCWs than the general population. The presence of symptoms warrants testing. Nosocomial transmission was derived from patient more than co-worker contacts.Item Final-year medical students' experiences and perceptions of integrated primary care learning at decentralised training sites during the COVID-19 pandemic: A mixed-methods study(University of the Witwatersrand, Johannesburg, 2023-09) Ruch, Aviva; George, Ann; Francis, JoelBackground: There is limited data on the effectiveness of online learning to augment theory and clinical knowledge and skills across decentralised training (DCT) sites. This study explored the 2021 cohort of final-year medical students’ experiences and perceptions of the integrated primary care (IPC) online teaching and learning across five DCT sites affiliated with the University of the Witwatersrand in South Africa. This information is essential to determine what online IPC teaching and learning should be retained and what adjustments are needed to enhance and standardise IPC online learning across our DCT sites. IPC is a final-year Bachelor of Medicine and Bachelor of Surgery (MBBCH) subject at Wits University. The subject focuses on primary health care, integrating Internal Medicine, Surgery, Psychiatry, Obstetrics and Gynaecology, Family Medicine, Community Paediatrics and Public Health. Training across different sites poses challenges for standardising learning content and the nature and quality of patient engagement and interaction. The Covid-19 pandemic not only exacerbated the difficulties associated with decentralised teaching and learning, but also decreased student-patient interaction. The rapid shift to emergency remote teaching left teachers with limited time to prepare for online and blended teaching and highlighted shortcomings in some health-professions educators’ ability to create meaningful, authentic learning interactions. The study design was underpinned by the Technology Acceptance Model, the Community of Inquiry Model and the Theory of Self-Regulated Learning. Methods: This explanatory sequential mixed-methods design consisted of a cross-sectional online survey conducted in November 2021, followed by two focus-group discussions in December 2021. The 316 final-year medical students who had completed their IPC block were purposively sampled to participate in this study. Medical students who had not yet completed the IPC block were excluded from the study. Twenty-one closed and four open-ended questions explored the students’ perceptions of how the online materials supported their learning and augmented their clinical skills and management of patients, their challenges with learning online, and ways to improve the online-learning experience. The closed and open-ended survey answers were analysed using descriptive and inferential statistics and content analysis, respectively. The results of the content analysis are presented graphically. The survey findings informed the questions asked in the focus-group discussions (n = 2 and n = 3). The discussions were audio-recorded and transcribed verbatim. The transcripts were analysed inductively in MAXQDA. The findings are presented as thematic maps. Results: The survey response rate was 52% (164/316). The respondents were representative of the study population. Most respondents easily accessed the online content, with more than 70% accessing the online content several times a week. More than 80% found the online content logically organised; the content analysis highlighted three categories of reasons why the online content and interactions influenced their learning. The content analysis also identified three categories of reasons why the online content influenced patient management, but more than a third of respondents remained neutral when asked if the online content introduced them to new clinical skills. Quizzes and tests were the preferred learning method. The features that best supported the respondents’ online learning were grouped into five categories: ‘Range of activities’ (n = 73), ‘Content selection’ (n = 56), ‘Flexible access to content’ (n = 8), ‘Organisation of content’ (n = 4) and ‘Other’ features (n = 7). Respondents highlighted several categories that presented challenges to online learning: ‘Pedagogical issues’ (n = 30), ‘Excessive workload’ (n = 27), ‘Operational issues’ (n = 20), ‘Learning issues’ (n = 17), ‘Technical issues’ (n = 11) and ‘Unclear course expectations’ (n = 50). Participants in the focus-group discussions (FGD) concurred with many of the perceptions and experiences of the questionnaire respondents. Three themes were identified in the thematic analysis of the FGD: ‘Features supporting learning’, ‘Challenges of learning online’, and ‘Ways to improve learning’. Conclusions: The respondents and focus-group participants displayed a positive attitude to the IPC online content and interactions offered to them during the Covid-19 pandemic. Their experiences and perceptions offered insights to better support learning through practical suggestions for students and faculty, especially around faculty competency to design meaningful learning interactions, both online and blended. While this study focused on IPC, the student recommendations may apply to other subjects nationally and internationally, suggesting the need for further research into using online teaching to support clinical teaching.Item An exploration of the Lived Mental Health Experiences of psychologists working in the public sector during the COVID-19 pandemic in South Africa(University of the Witwatersrand, Johannesburg, 2023) Harvey, Zena; Laher, SumayaThe COVID-19 pandemic severely impacted mental health in South Africa, exacerbating the existing mental healthcare treatment gap. Psychologists working at public institutions have been at the forefront of providing mental health care to the public during the crisis. However, psychologists themselves may be considered a vulnerable group at risk of developing adverse mental health outcomes, such as depression, anxiety, burnout and vicarious traumatisation due to the nature of their profession. This vulnerability may have been further amplified during the COVID-19 pandemic. The well-being of psychologists is integral to ensuring high quality patient care and to the overall management of pandemic and other disease outbreaks. There remains a significant dearth in the available literature examining the lived mental health experiences of psychologists, especially those working in the public sector. This study aims to address this pertinent gap by investigating the lived mental health experiences of ten psychologists employed in South African public institutions, amidst COVID-19 pandemic. Semi-structured interviews comprising sixteen questions were conducted with each psychologist. The following five overarching themes emerged from an Interpretive Phenomenological Analysis (IPA): ‘The personal effects of COVID-19 on psychologists’, ‘Changes to therapy During COVID-19’, ‘Experiences of COVID-19 exposure in public hospitals’, ‘Coping Mechanisms’ and ‘Survivor Guilt: Privilege during the pandemic’. A discussion of the abovementioned findings highlighted the importance of addressing, prioritising and monitoring the psychological wellbeing of these public sector-psychologists, during pandemic and other disease outbreaks to increase their support structures.Item Experiences of Youth in Agrarian Transformation in Rural South Africa: A Case of Greenplanet Primary Cooperative in Orange Farm(University of the Witwatersrand, Johannesburg, 2022-03) Chibonore, Wilma Claris; Kariuki, SamuelThis thesis advanced a qualitative approach to analyse the practices, structures and rationalities that inform youth engagement in agriculture drawing on evidence from Orange Farm in Gauteng Province of South Africa. The study takes off on the premise that there is low generational renewal in agriculture as the older and ageing generation makes the majority of active farmers yet farming holds great potential for creating youth employment whilst youth engagement in agriculture secures food of the future. The study finds that youth (dis)engagement and (dis)interest in farming is directly related to the availability and easy access to everyday support structures particularly those provided by the state and observes that many young people are in fact interested in farming but are currently operating in a structurally disabling environment amidst poor state support which does not allow for growth or access to key resources. The study finds that youth interest in farming exists although these interests are largely skewed towards technologically advanced farming systems and against backward manual farming systems therefore contradicting existing discourse as well as challenging the general narrative and consensus that youths are not interested in farming or that youth interest in farming is waning. The thesis reveals that young farmers understanding, interpretation and engagement with agricultural technology is based on their levels of exposure, location and access to resources. Poverty, structural limitations and marginalization experienced by the youth contribute significantly to their reception and perception of agriculture as a whole. The thesis argues for an agrarian developmental state approach towards the strengthening of agricultural opportunities and the relevant institutional structures and resources such as land, stipends, extension services, training, technology and market allocation to support youth farming in rural South Africa where the economies are generally stagnant and youth unemployment very high. This study observes that young people as active citizens and through utilising individual agency have the capacity to drive their own innovations within the agricultural sector when awarded the platform, opportunity and support to do so. The study reveals that the young farmers are ‘millennials’ who use their youth agency to engage in social networking facilitated by use of social media as a powerful tool for unity and resistance against unfavourable farming environments. Lastly, two contradictory perspectives on the impact of COVID-19 emerge in this study, one of COVID-19 having presented opportunities for growth and success for the young farmers and another of the pandemic having further marginalized and disrupted the already struggling young farmers with both narratives being shaped directly and indirectly by the pre-existing structural challenges. Methodologically, empirical data was mostly gathered through face to face semi-structured interviews, focus groups and conversations with the young farmers with the remainder of interviews having been conducted virtually via Skype, WhatsApp chats and WhatsApp calls upon the emergence of COVID-19 which converged with this study. Participant observation occurred through attending farmers meetings, agriculture tours, engaging in some farming activities on some sites as well as being part of the young farmers WhatsApp group. The thesis also relied on published journals, statistical reports, media reports, policy documents as well as videos from the public hearings regarding the amendment of the South African Constitution to allow for expropriation of land without compensation in order to bolster the empirical findings.Item Factors influencing fuel retail site sales in South Africa pre- and post-COVID-19(University of the Witwatersrand, Johannesburg, 2022) Kader, Junaid Abdul; Crompton, RodrickThe association between the volume of fuel sold at retail sites and predictor variables has been explored in prior research. The COVID-19 pandemic was at its height in South Africa between March 2020 and March 2022 and might have changed these associations due to restrictions on people’s movements and lifestyles during the peak of the pandemic. Understanding changes in the retail fuel industry might help Government, together with the private sector, to ensure adequate fuel supply through efficient utilisation of resources. Therefore, the association between the volume of fuel sold at retail sites and predictor variables in South Africa before and after COVID-19 was explored through this quantitative study using regression analysis and Fisher transformations. It was hypothesised that the volume of fuel sold at retail sites in South Africa was associated with the average income per adult residing within two kilometres of the fuel retail site, adult population residing within two kilometres of the fuel retail site, car ownership by people residing within two kilometres of the fuel retail site, number of competitor sites within two kilometres of the fuel retail site, saturation level, location metric, and site services. In addition, it was hypothesised that the associations did not change between 2020 and 2022. Regression analysis showed that saturation level and site services had a statistically significant association, albeit with a low R-square, with the volume of fuel sold at retail sites, while the other variables did not have a statistically significant association. In addition, Fisher transformations showed that the associations did not change between 2020 and 2022. Perhaps, there was insufficient differentiation between fuel retail competitors in South Africa to influence consumer choice. Fuel could also be regarded as a commodity by consumers and their needs were equally served at any retail site.Item Factors associated with Social Grant uptake In South Africa: A Closer Look at the Special Covid-19 Social Relief of Distress Grant among the Youth Aged 18 – 35 Years(University of the Witwatersrand, Johannesburg, 2023-08) Mabala, Moyahabo Thomas; De Wet-Billings, Nicole; Godongwana, MotlatsoBackground: Globally nearly 900 million people benefited from social assistance in 2017, most of them in the form of cash transfers, which accounts for 44% of the social assistance budget. During the same period, Sub-Saharan Africa was found to be far behind in terms of social assistance coverage, of those living in extreme poverty it is estimated that only 15% of them are receiving social assistance. In South Africa, with a population of 60 million people, it is estimated that 11.4 million of them received some sort of grant at the end of March 2021. When the Special COVID-19 Social Relief of Distress Grant (SCSRDG) was introduced, it received over 9.5 million applications of which only 6.5 million were approved with the youth aged 18 – 34 accounting for 70% of the applicants. As a result of the high number of applicants for the SCSRDG, this study wanted to gain an understanding of the profiles of the applicants. Objective: To explore the demographic, socio-economic, and household factors associated with the uptake of the Special COVID-19 Social Relief of Distress Grant (SCSRDG) among the youth aged 18 – 35 years in South Africa. Methodology: This study is a quantitative analysis of secondary data obtained from the National Income Dynamics Study – Coronavirus Rapid Mobile Survey 2020 wave 5. The survey interviewed 7074 youth aged between 18 – 35 years. The outcome variable of this study is the Special COVID-19 Social Relief of Distress Grant (SCSRDG) receipt status. To assess the uptake of the grant, descriptive statistics including tables and graphs were used. The predictor variables consist of demographic, socioeconomic and household characteristics, with age as the main predictor variable. To check for the association between the outcome and predictor variables, binary logistic regression was utilised. Where the odd ratio < 1.00, meant that the outcome was less likely in the index group when compared to the reference. Results: Using the weighted data, a total of 3 438 046 applicants who applied for the grants received it while 3 003 320 of them did not receive the grant. Among those who received the grant, the majority 1 223 192 of them are aged between 21- 25 years. Most of the applicants were male representing 63.58%. African/Black is the highest population group that applied for the grant accounting for 90.66% of the applicants while whites account for the least proportion of the applicants at 0.88%. For both that received and did not receive the grant, the African/black population group is the highest when compared to other population groups at 92.93% and 88.07% respectively, while whites are the lowest at 1.31% and 0.40% respectively. Most of the applicants 91.47% were unemployed. A total of 4 994 322 (77.54%) of the applicants reported their dwelling type as formal and 4 891 137 (75.93) reported that they had access to both water and electricity in their household. Most applicants 39.98% come from a household with between 4 – 6 family members. Out of the 14 independent variables included in this study only two variables, marital status, and multiple grants recipients, were statistically significant. Females have a lower likelihood of receiving the grant when compared to males with an odd ratio of 0.6431 and 0.55637 using the unadjusted and adjusted binary regression model, respectively. Conclusion: This study has found that marital status and multiple grants recipients are the two characteristics that are associated with the uptake of the Special COVID-19 Social Relief of Distress Grant among youth aged 18 – 35 years in South Africa. It found that males as compared to females are more likely to receive the SRD grant, this is because of the initial qualifying criteria that excluded a high number of females that were already receiving the Child Support Grant. This criterion was later changed to say that an applicant of the SCSRDG must not be entitled to a social grant for himself or herself.Item The impact of COVID-19 on the Gender Wage Gap in South Africa(University of the Witwatersrand, Johannesburg, 2023-06) Ngcobo, KhweziThe COVID-19 pandemic resulted in large distributional changes in the South African labour market. Prior to the pandemic, South African women were compensated less relative to South African men. This paper applies the Oaxaca-Blinder decomposition to investigate the impact of the COVID-19 pandemic on the gender wage gap between February 2020, April 2020, June 2020 and March 2021. Results indicate that the COVID-19 pandemic widened the existing monthly gender wage gap, while barely altering the hourly wage gap over the given period. The study finds that the main contributor to the gender wage gap is discrimination in the South African labour market. Key variables that contributed to the discrimination component across all periods are population group and having children aged below 7 years. Gender differences in the composition of the employment sector, having young children and hours of work also significantly contributed to the gender wage gap. These results suggest a need for gender- sensitive policies to improve the labour market position of disadvantaged individualsItem ‘Born free’ to unemployment? A Tax Incentive Post Implementation(University of the Witwatersrand, Johannesburg, 2023-06) Greeff, Shiaam; Padia, MishaSouth Africa, the economic engine of Africa’s youth face numerous challenges in accessing employment. Young individuals have been confronted with unemployment percentages exceeding 40 per cent after democracy and the unemployment rate has persisted closer to 50 per cent of late. To combat the youth unemployment crisis the South African government implemented the Employment Tax Incentive (ETI) in 2014. The ETI is an incentive offered with the intention of mitigating extraordinarily high youth unemployment in South Africa by encouraging qualifying firms to hire younger and less experienced individuals. This research dissertation serves to provide a critical analysis of the youth unemployment in South Africa and how the ETI has affected the youth unemployment in the nine-years post implementation. During the implementation period, South Africa endured the COVID-19 pandemic affecting life as we knew it and employment globally. The youth unemployment in the BRICS member countries has been analysed with their measures to address youth unemployment. Lastly the study analyses the experiences small business owners in South Africa have had with the ETI post implementation. This study aims to evaluate the influence of the Employment Tax Incentive on the unemployment of young South Africans. This is achieved by conducting a qualitative study using critical analysis to review the ETI post implementation, determining the impacts of the COVID-19 pandemic on unemployment, assessing the other BRICS member countries who have implemented initiatives to improve youth unemployment and conducting interviews with small business owners in South Africa to understand the ETI in the business sector. The data suggests that a subsidy is not a stand-alone answer to youth unemployment in South Africa. The subsidy, however, does create some employment according to the data analysed. The country experiences extraordinary youth unemployment rates. The employment of young South Africans generates greater value than just the employment, it allows for the youth to use their time constructively by gaining experience and skills instead of participating in socio-economic issues such as alcohol and drug abuse. It is acknowledged that the implementation of an employment incentive on its own will not be enough to resolve the South African youth unemployment crisis; the inferior education needs to be addressed. The BRIC member countries face similar challenges and their interventions have not entirelyhad the desired outcome.Item Trends in reporting on climate change, water and COVID-19 by JSE listed companies(University of the Witwatersrand, Johannesburg, 2022) Seedat, Zakiyyah; Lange, Yvette; Maroun, WarrenEnvironmental, social and governance (ESG) information is increasingly demanded by stakeholders as companies face risks and opportunities due to ESG issues, such as climate change, water and COVID-19. ESG disclosure helps reduce information asymmetry for users of company reports and helps companies maintain their social licence to operate. Disclosure is voluntary and this introduces differences in the information disclosed by companies. This study analysed the annual, integrated and ESG reports of the top 40 Johannesburg Securities Exchange (JSE) listed companies. These reports were analysed following an interpretive approach to determine the extent of disclosure on climate change, water and COVID-19 in 2018, 2019 and 2020. This study also considered the change in disclosure on climate change and water over these three years. A disclosure checklist has been developed using professional literature. Content analysis has been used to codify the disclosed information with disclosures being scored using an ordinal scale. Descriptive statistics have been used to analyse and graphically present the data. Exploratory factor analysis has been used for the identification of major disclosure themes. This study contributes to existing research by considering the current state of ESG disclosure at a time when notable developments in the reporting environment have occurred. The findings indicate that companies have focused on quantitative and strategy-related disclosure, indicating the adoption of similar reporting practices by companies. The study also found that there was no significant change in climate change and water disclosure from 2018 to 2020Item E-learning as an innovative platform for medical doctors in South Africa(2021) Pillay, TerenceE-learning could be an innovative continued medical education platform for medical doctors in South Africa, especially now with the COVID-19 pandemic and its effects on physical contact between pharmaceutical companies’ representatives and doctors. This study aimed to determine and develop a more effective way to reach and provide accurate, credible education for all doctors using an e-learning platform as an alternative to representative visits. This research involved a quantitative study, deploying a survey to a sample of 456 doctors in South Africa via an online platform. The results arising from the analyses to prove the three hypotheses were statistically significant, and all were accepted. In summary doctors in South Africa valued their relationships with medical representatives, but simultaneously questioned the credibility of the education received from the representatives. Many doctors accessed the internet for their own education as one of their channels of education. In view of the research findings, an innovative e-learning platform is proposed to deliver continued medical education to all doctors and to allow for best practices sharing across the medical fraternity in South Africa