COE-Human-Development Annual Report 2022

DSI-NRF Centre of Excellence in Human Development

Individual and Society

OUR IMPACT ON HUMAN DEVELOPMENT SCIENCE

socio-ecological and transformational

development the study of interactions between societies, households and their natural environment life course development the study of human development from conception to death

Director’s Report

As the global community comes to grips with the post-pandemic “new normal”, many countries will have to navigate the everchanging impacts of the COVID-19 pandemic. The shock of the pandemic has weighed heavily on social outcomes, with poverty levels estimated to have risen to levels of more than a decade ago and the United Nations Development Programme reporting a global decline over the last two years in the Human Development Index for the first time in history (UNDP Human Development Report 2021/2022). The challenges being faced by South Africans are, inter alia, compounded by several longstanding and more immediate structural, political, socio-economic and developmental hurdles. In his weekly letter to the nation on Nelson Mandela Day (18 July 2022), President Cyril Ramaphosa noted that South Africans are facing “difficult times” circumnavigating challenges such as: the energy crisis, spate of violent crimes which heighten fear and insecurity in communities, the toll poverty and unemployment are taking on the millions who are struggling, and corruption which has

intergenerational development the study of human development across generations

severely eroded the social compact between the State and its citizens. The President proclaimed that “Building a better South Africa requires each and every one of us to make a contribution in whatever way we can.”

In 2022, the CoE-HUMAN supported an ambitious programme of research and activities that added to our understanding of human development in South Africa. As a result of strategic engagements and discussions, the work of the CoE-HUMAN is now framed and guided by three core themes: life-course development, intergenerational development and the newly formulated, socio-ecological and transformational development. The latter theme seeks to investigate and uncover the interactions between societies, households and their natural environment. We are confident that the newly articulated thematic area will broaden our Human Development work and influence to span the length and breadth of our country.

As our COVID-19, Fourth Industrial Revolution, Climate Change, and Rural Development Grantee Themed Pro-

jects come to an end, we extend our appreciation to the Grantees for their meaningful contribution to science, through associated peer-reviewed publications, submission and presentation at conferences and webinars. More outputs are expected from these initiatives in 2023!

We continue to build upon our national collaborations, more specifically, collaborations with historically disadvantaged institutions (HDIs) across South Africa. Over the last year, with the University of Limpopo, we have partnered with Dr Eric Maimela and team to investigate the effects of food insecurity and malnutrition on pregnant and parenting adolescents’ mental health. We have also been to the University of Mpumalanga to partner with Professor Geoffrey Mahlomaholo and colleagues on research aimed to investigate the skills gap reported by youth and local employers in Mpumalanga. Additionally, we will soon be partnering with the Durban University of Technology on a collaborative research project.

As a research-output driven CoE of the DSI-NRF, we are happy to report that the second wave of our nationally representative study – South African Human Development Pulse Survey – is now completed. We also conducted several surveys aimed at providing rapid data to critical human development issues facing South Africans.

A highlight of 2022 was the launch of the Birth-to-Thirty (Bt30) book written by the inaugural Director of the CoE-HUMAN, Distinguished Professor Linda Richter. The Bt30 study is the largest and longest-running birth cohort study in Africa and has been colloquially nicknamed “Mandela’s Children” as the study started with children born just after Nelson Mandela was released from prison. The study culminated in a series of book launches at Wits, Johannesburg and in Jabulani, Soweto. The study intends to keep tracking these families whose lives span South Africa’s democratic transition. In addition, we congratulate Professor Monde Makiwane on the successful launch of his book, Reflections from the Margins – Complexities, Transitions and Developmental Challenges: The Case of the Eastern Cape Province, South Africa.

Finally, it has been a privilege to serve as Director of CoE-HUMAN, and as I step down, I wish the incoming Director, our partners and core team all the very best. As the CoE-HUMAN marks its 10th year in 2023, I am very proud of what it has achieved and how it has advanced the science of human development.

Prof Shane Norris Director: DSI-NRF Centre of Excellence in Human Development (CoE-HUMAN)

Executive Structure Management Committee

Prof Shane Norris (Chair) | Director

Prof Norris is Director of the DSI-NRF Centre of Excellence in Human Development and Director of the MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, at the University of the Witwatersrand. He is an epidemiologist with research interests that include child growth and development, obesity, and intergenerational risk of metabolic disease.

Associate Professor Malose Langa | Senior Lecturer, School of Human and Community Development, University of the Witwatersrand

Prof Langa is a Senior Lecturer in the School of Human and Community Development at the University of Witwatersrand and Associate Senior Researcher at the Centre for the Study of Violence and Reconciliation (CSVR) in South Africa. He has published book chapters and journal articles on violent crime, substance abuse, problems facing former combatants and masculinity. His research interests include risk-taking behaviours amongst young people and their role in politics, the trauma of collective violence and the psychology of men (masculinity) in post-apartheid South Africa.

Prof Shanaaz Mathews | Director of the Children’s Institute, University of Cape Town

Prof Mathews has extensive experience in the women’s and children’s sectors and has worked within civil society organisations, as an academic, and as an advocate for the rights of women and children. Prof Mathews is a faculty affiliate of the Care and Protection of Children (CPC) Learning Network at Columbia University and has served as an International Advisory Board member for the UNICEF Innocenti Research Office. Her research interests include violence against women and children, as well as pathways to violent masculinities using both qualitative and quantitative approaches, with a particular focus on understanding gaps in the child protection system and alternative models of treating trauma in low-resourced settings. She holds a PhD in Public Health from the University of the Witwatersrand.

Prof Zitha Mokomane | Associate Professor, Department of Sociology, University of Pretoria

Prof Mokomane holds a PhD in Demography from the Australian National University. Before joining the Department of Sociology at the University of Pretoria she was a Chief Research Specialist in the Human and Social Development Research Programme at the Human Sciences Research Council. Her research interests and expertise lie in the field of the work-family interface with a specific interest in child, adolescent, and elder care; social protection; social evaluation of policy options; and family demography.

Dr Siphelo Ngcwangu | Senior Lecturer, Department of Sociology, University of Johannesburg

Dr Ngcwangu is a senior lecturer in the Department of Sociology at the University of Johannesburg. His research interests are industrial sociology, skills development, political economics, trade unions, labour studies, work restructuring and education. He is involved in a collaborative project on Higher Education, Inequality and the Public Good in four African countries: South Africa, Ghana, Nigeria and Kenya, which is supported by the National Research Foundation, the UK Economic and Social Research Council (ESRC) and the Newton Fund. He was previously a researcher at the Centre for Researching Education and Labour (REAL) at the University of the Witwatersrand.

Prof Kopano Ratele | Professor in the MRC-UNISA Violence, Injury and Peace Research Unit

Prof Ratele is a professor at the University of South Africa and a researcher in the MRC-UNISA Violence, Injury and Peace Research Unit. He runs their Research Unit on Men and Masculinities as well as the Transdisciplinary African Psychologies Programme. His research, teaching, social-political activism, and community mobilization has focused on the subject of men and masculinity as it intersects with violence, class, traditions, sexuality, parenting and race. He is former chairperson of Sonke Gender Justice, currently a member of the Ministerial Committee on Transformation in South African Universities, and current convener of the National Research Foundation’s Specialist Committee for Psychology Rating Panel. His books include There was this goat, Liberating masculinities, and The world looks like this from here (forthcoming, Wits University Press).

Scientific Advisory Committee

Prof Aryeh D. Stein (Chair) | Professor in the Hubert Department of Global Health of the Rollins School of Public Health at Emory University

Prof Stein has a joint appointment in the Department of Epidemiology at Emory University in the USA. He is a member of the faculty of the Nutrition and Health Sciences program of the Laney Graduate School of Arts and Sciences. In his research, he identifies critical periods of susceptibility to nutritional deficits and surfeits using intervention trials and natural experiments such as war-induced famine to study the role of prenatal and childhood nutrition on the development of adult chronic disease and cognitive achievement. He obtained his B.Sc. in nutrition from the University of London, and his MPH and PhD degrees, both in epidemiology, from Columbia University in New York City.

Prof Zané Lombard | Associate Professor in Human Genetics, University of the Witwatersrand

Prof Lombard obtained her PhD in Human Genetics and Bioinformatics in 2008, under the supervision of Prof Michele Ramsay in the Division of Human Genetics (Wits University & NHLS). Her PhD research focused on a bioinformatics approach to disease-gene discovery. She is currently a Principal medical scientist and associate professor in the Division of Human Genetics, where she heads the Research

laboratory and the Research & Development team in the Department. Before this she worked as a Senior Lecturer in Bioinformatics in the School of Molecular and Cell Biology, also at Wits. She is passionate about promoting science in Africa, and therefore participates in several academic service domains at university, national and international level, like the SA Society for Human Genetics and the H3Africa Consortium. She currently is the PI of the H3Africa NIH-funded project called Deciphering Developmental Disorders in Africa, which was started in 2017. The aim of the study is to evaluate how new sequencing technologies can be used effectively in the diagnosis of rare genetic diseases to enhance the service we can offer to patients in the public healthcare sector.

Prof Kofi Marfo | Director of the Institute for Human Development at the Aga Khan University in Nairobi

Prof Marfo was previously Professor of Educational Psychology at the University of South Florida in Tampa, USA, where he founded the Center for Research on Children’s Development and Learning. He also served as Director of the Doctoral Program in Special Education. Prior to that, he taught at Kent State University (USA), Memorial University of Newfoundland (Canada), and the University of Cape Coast (Ghana). He currently serves on the Institute of Medicine’s Forum on Investing in Young Children Globally. Dr Marfo holds a BEd (Hons) from the University of Cape Coast, Ghana, and an MEd and PhD from the University of Alberta, Canada.

Prof Julian May | Director of the DSI-NRF Centre of Excellence in Food Security at the University of the Western Cape

Prof May has worked on options for poverty reduction including land reform, social grants, information technology and urban agriculture in Africa and in the Indian Ocean Islands. He has also worked on the development and use of systems for monitoring the impact of policy using official statistics, impact assessment and action research. His current research focuses on food security, childhood deprivation and malnutrition. He has been an associate researcher at Oxford University, the University of Manchester and the International Food Policy Research Institute. He currently serves on the South African Statistics Council, is a Member of the Academy of Science in South Africa, is the President of the South African Development Studies Association and is a Research Fellow in the Comparative Research Programme of Poverty at the University of Bergen in Norway. He is an associate editor of the Journal of Human Development and Capabilities and of Development Southern Africa. In 2009 the National Research Foundation awarded him a Tier One South African Research Chair in Applied Poverty Reduction Assessment.

Prof Relebohile Moletsane | Professor and the John Langalibalele Dube Chair in Rural Education in the School of Education, University of KwaZulu-Natal

Prof Moletsane’s areas of expertise include rural education and development, gender and education, and girlhood studies. She was co-editor (with Claudia Mitchell and Ann Smith) of Was it Something I Wore? Dress, Identity, and Materiality which was published in 2012. She was the 2012 winner of the DSI Distinguished Women in Science (Social Sciences and Humanities) Award. In 2014 she was Echidna Global Scholar at the Brookings Institution’s Center for Unive sal Education, and in 2015 she

was a New Voices Fellow of the Aspen Institute. She holds a PhD from Indiana University, Bloomington (USA).

Prof Clifford Odimegwu | Professor in Demography and Social Statistics, University of the Witwatersrand

Prof Odimegwu is a professor of demography and social statistics, and heads the Demography and Population Studies Programme, an interdisciplinary programme of the Schools of Public Health and Social Sciences. He is an acknowledged researcher in the field of population health and development issues in sub-Sahara Africa. He has graduated 23 PhDs, numerous Masters, and Honours students; and has over 200 publications in top Journals. He has 4 books to his credit including The Handbook of African Demography, produced by Routledge.

Steering Committee

Professor Lynn Morris | Deputy Vice-Chancellor: Research and Innovation

Prof Morris is the Deputy Vice-Chancellor of Research and Innovation at the University of the Witwatersrand in Johannesburg, South Africa. She has a DPhil from the University of Oxford and is Research Professor and Director of the Antibody Immunity Research Unit based at the National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS). Over the last 28 years she has made significant contributions to understanding the antibody response to HIV and is responsible for performing validated antibody assays for HIV clinical trials. She is an NRF A-rated scientist, has published over 270 papers holding an H-Index of 63 and has featured in the Web of Science list of highly cited researchers. She is a member of the Academy of Science of South Africa (ASSAf) and a Fellow of the African Academy of Sciences (AAS), the Royal Society of South Africa (FRSSA) and The World Academy of Sciences (TWAS).

Dr Mongezi Mdhluli | Chief Research Operation Officer in the Office of the South African Medical Research Council President

Dr Mongezi Mdhluli is the Chief Research Operation Officer (CROO) in the office of the SAMRC President. He is responsible for the research operations of the SAMRC, the Project Management Office, Research Operations (including laboratory operations), Ethics Committee and the Research Integrity Office, and overseeing the efficient operations of the Insectary and Primate Unit. Prior to the CROO position, he was employed in the SAMRC as a Scientist and then moved to head the supply Chain Management Division. Mongezi completed his PhD at the University of the Western Cape and MBA at the University of Stellenbosch Business School

Ms Mastoera Sadan | Programme Manager of PSPPD II in the Department of Planning, Monitoring and Evaluation of the national government of the Republic of South Africa

Mastoera Sadan is a social policy analyst who has twenty-seven years professional experience. She has worked at a senior management level in the national government of South Africa for the past nineteen years, first in the Presidency and then in the National Planning Commission, in the Department of Planning, Monitoring and Evaluation (DPME). Her expertise is in social policy and poverty and inequality. Currently she is the Chief Sector Expert: Social, in the National Planning Commission (NPC) Secretariat, DPME. Until 2018 she was the Programme Manager of the Programme to Support Pro-poor Policy Development (PSPPD II) in the DPME, an European Union funded programme. She successfully managed this research and capacity building Programme over an eleven-year period from 2007 – 2018, where she managed R150m in funding. During this time, she also managed the National Income Dynamics Study (NIDS), South Africa’s national panel study from 2006 – 2018 in the DPME. Prior to the PSPPD she worked in the Policy Coordination and Advisory Services (PCAS) in the Presidency. She has previously worked in the NGO and higher education sector, at the Institute for Democracy in South Africa (IDASA) and at the University of the Western Cape. Mastoera is currently a PhD candidate at the University of Johannesburg, she holds a MSc in Social Policy and Planning from the London School of Economics (LSE) and was a Visiting Scholar at the University of Oxford from 2002-2003.

Prof Leila Patel | South African Research Chair in Welfare and Social Development at the Centre for Social Development in Africa, University of Johannesburg

Prof Patel is the South African Research Chair in Welfare and Social Development at the Centre for Social Development in Africa of the University of Johannesburg. In 2014 she was awarded the Distinguished Woman Scientist Award in the Humanities and Social Sciences and in 2013 she was the Helen Harris Pearlman Visiting Professor of International Social Welfare at the University of Chicago. Previously, she was the Head of the Department of Social Work at the University of Johannesburg, the Director General of Social Welfare in South Africa, and Deputy Vice-Chancellor and Vice-Principal of Wits University. She played a leading role in the development of South Africa’s welfare policy. The second edition of her book on Social Welfare and Social Development in South Africa was published by Oxford University Press in 2015. She has a Master’s in Social Work (MSW) from West Michigan University and a PhD from the University of the Witwatersrand.

Dr Vusi Malele | Deputy Director: High-End Skills at the Department of Science and Innovation

Dr Malele is the Deputy Director: High-End Skills at the Department of Science and Innovation (DSI). He is currently a doctoral candidate in Industrial Engineering at Tshwane University of Technology, and he holds a Master’s in Engineering Sciences (Electronics and Computer Science) from the University of Stellenbosch and a certificate in Managing Public Policy from the Wits School of Governance. His working experience has included being an educator, an engineer, a lecturer, research professional and a manager. He also sits on the steering committees of other Centres of Excellence.

Dr Makobetsa Khati | Executive Director of the Research Chairs and Centres of Excellence directorate at the National Research Foundation

Dr Khati holds a BSc Honours in Public Health from the University of Cape Town. He completed his MSc at Imperial College London and his DPhil in Molecular Pathology at Oxford University where he subsequently was also a post-doctoral fellow at the Sir William Dunn School of Pathology. In addition, he was a Visiting Scientist at the Scripps Research Institute in San Diego, California. Dr Khati spent 10 years at the Council for Scientific Industrial Research (CSIR), first as Research Group Leader and later as Head of Department at the Emerging Health Technology unit. He also worked at the Institute for Infectious Diseases at UCT where he currently holds an Honorary Professorship.

Mr Nathan Sassman | Director: Centres of Excellence at the National Research Foundation

Mr Sassman is the Director: Centres of Excellence at the National Research Foundation (NRF). He holds a BSc from the University of the Western Cape, BEd and MEd degrees from the University of Cape Town, and an MBA from the Business School in Buren in the Netherlands. He also received training in financial management from Price Waterhouse Coopers, in internal financial controls from the National Treasury and in negotiation skills from the (former) South African Management Development Institute. His working experience has included being an educator, as well as working for the national Department of Education, the national Department of Provincial and Local Government, and at the Foundation for Human Rights.

Dr Robin Drennan | Director: Research Development – Research and Innovation

Robin Drennan has a PhD in Chemistry from Rhodes University, awarded for the investigation of pyrotechnic reactions. He has practiced as an applied researcher in a public company, AECI, and a science council, CSIR. He worked at a national funding agency (National Research Foundation) where he managed many different programmes. In 2011 he joined Wits University as Director for Research Development. His role entails leading, encouraging and supporting research across the University. In 2010, Dr Drennan won a Golden Quill award for research reporting and in 2017, a SARIMA award for distinguished contribution to the Research Management Profession.

Dr Garth Japhet | CEO: Heartlines

Dr Japhet is a medical doctor and the founding CEO of Heartlines. Heartlines is an NGO that initiates research-based campaigns that use story to tackle society’s big issues such as reconciliation and father absence. These campaigns utilise feature films and TV dramas, which are complemented by resources to equip workers in workplaces, schools, correctional facilities, churches and NGOs. In 1992, he co-founded the internationally acclaimed Soul City a multimedia edutainment project which addresses a variety of health issues. It has reached over 50-million people in ten southern African countries through TV and radio drama series, written resources, community mobilisation and advocacy initiatives. He was CEO for 17 years. Garth is a Schwab fellow of the World Economic Forum (WEF), a fellow of the African Leadership Initiative and Senior Ashoka Fellow. He has received the global Everett Rogers Award for contribution to Entertainment Education.

CoE-HUMAN Team

Johannesburg Office

Prof Shane Norris | Director

Prof Norris is Director of the DSI-NRF Centre of Excellence in Human Development and Director of the MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, at the University of the Witwatersrand. He is an epidemiologist with research interests that include child growth and development, obesity, and inter-generational risk of metabolic disease.

Mr Justin Du Toit | Centre & Research Manager

Mr Du Toit joined the CoE-HUMAN as Centre Manager in November 2020. Justin has more than a decade of management and research experience in the private and public sectors. His public sector career began in 2015 as Deputy Director of Research in the Private Office of then Deputy President Cyril Ramaphosa. He continued to work with Mr Ramaphosa when he became President of the Republic of South Africa. His work focused on evidence-based research to strengthen ethical and strategic policymaking and governance. Justin’s research interests include land restitution and the Fourth Industrial Revolution.

Dr

Ware | Senior Researcher

Dr Ware is a senior researcher at the CoE-HUMAN and an associate director of DPHRU at the University of the Witwatersrand. Her research interests are how health behaviours are impacted by our environment and how these relate to chronic disease risk. She has held funding from the Wellcome Trust to investigate how vascular health is transmitted across three generations in Sowetan families and is the recipient of several bilateral funding awards with UK universities to assess various ways to monitor and shift health behaviours. She is the Research Director of the Wits Health HUBB programme, a research and training initiative empowering young people as agents for change to create healthier communities. She currently holds a C-Rating from the NRF.

Ms Kopano Masemola | DOHaD Africa Project Officer

Ms Masemola is a DOHaD Africa Project Officer and a final year Bachelor of Arts (BA) Student at the University of the Witwatersrand. Her Bachelor of Arts degree majors in International Relations and Political Studies. Her academic interest lies in African agency particularly in terms of Africa’s collaboration with the world. Her career with Wits University commenced in 2018 at Wits plus; Centre for Part-Time Studies, later moved to the Student Enrolment Centre (SEnC), then to DPHRU and now CoE-HUMAN. The mission of DOHaD Africa aligns well with her objective to enhance representation, visibility and agency of Africa through collaboration and participation.

Lisa

Ms Rebecca Mudau | Research Assistant & Administrator

Ms Mudau joined the CoE-HUMAN in May 2021 as a Research Assistant and Administrator. She has a wealth of experience in business administration support. She previously worked for the South African Post Office as a Data Capturer and Call Centre agent. Before that, she fulfilled the role of Customer Service Agent for South African Airways. Her career began at Bennington Copeland Associates as a part-time administrator and receptionist.

Prof Monde Makiwane | Honorary Appointee

Prof Monde is currently a Director of MBMak (Pty) LTD which is an independent research company. He hold a C-rating from the National Research Foundation and has held positions as Extra-Ordinary Professor at the Walter Sisulu University and an Honorary Associate Professor at the CoE-HUMAN at the University of Witwatersrand. He has a BSc degree in Statistics and Computer Science from the University of the Western Cape, a Master’s Degree in Social Science in Sociology from the University of KwaZulu-Natal and a PhD in Demography from the University of the Witwatersrand. In addition, he held two fellowships: one at Harvard University and another at the University of Pennsylvania. He has previously lectured undergraduate and graduate students at Walter Sisulu University. His current areas of research interest include: ageing, family, gender, intergenerational relations, youth, teenage sexuality, fertility, social security and migration. His publication record includes a number of international and national conference presentations and journal articles. His research expertise lies in family sociology, gender, applied statistics, demography and data management. Currently, he is working with Prof Leeson, Director at the Oxford Institute of Ageing, on the broad topic of Longevity.

Dr Roisin Drysdale | Postdoctoral Fellow

Dr Drysdale is a postdoctoral fellow at the DSI-NRF CoE-HUMAN at the University of the Witwatersrand. She holds a doctoral degree (PhD) in Public Health and a Master’s degree in Development Studies (MDev) from the University of KwaZulu-Natal, as well as a Bachelors with honours (BA (Hons)) in Geography from the University of Plymouth (UK). Her research interests are focused around how household factors such as poverty and food insecurity affect individual child health, growth, nutritional status and development, and is currently investigating how the COVID-19 pandemic indirectly affected child growth and well-being.

Durban Office

Prof Linda Richter | Distinguished Professor

Prof Richter is a Distinguished Professor in the Centre, and a developmental psychologist with a PhD from the University of Natal. She is the author or co-author of more than 400 papers, books, book chapters and reports on basic and policy research in child and family development. She led the development of South Africa’s National Integrated Early Child Development Policy and Programme, adopted by Cabinet in 2015 as well as the 2017 Lancet Series Advancing Early Child Development: From Science to Scale. Linda is also the Principal Investigator of several large-scale, longterm collaborative projects, including Birth to Thirty (BT30), the birth cohort study of 3273 South African children followed up for 30 years. She has just published a book on the study describing the science emanating from the research intertwined with the stories of those involved. She also received the NRF Lifetime Achievement Award in 2021, recognizing her extraordinary contributions to science in and for South Africa and globally. Linda is also a member of the Wellcome Trust Discovery Award Interview Panel.

Tamsen Rochat | Associate Professor

Prof Rochat is a clinical psychologist who has extensively researched parenting and mental health interventions, including providing seminal research leadership to the Amagugu Intervention in KwaZulu-Natal. She is a Wellcome Trust Intermediate Fellow in Public Health and Tropical Medicine, an honorary research associate in the Department of Psychiatry, University of Oxford, and leads the adolescence research programme at the DPHRU. She also leads the Siyakhula Cohort and in 2020, established a new cohort in Soweto (the BEACON Cohort) investigating the link between executive function, mental health, and risk behaviour in early adolescence. She holds a C-Rating from the NRF.

Ms Sara Naicker | Research Project Manager

Ms Naicker is a Research Project Manager in the Centre. She has managed a number of large and small projects based in South Africa and abroad, on early childhood development, child and adolescent health and well-being, and families and children in vulnerable contexts. Sara’s current work on adversity assesses the extent to which exposure to multiple and cumulative adversities in childhood is associate with poor health and wellbeing in adulthood.

Prof

Partnerships

Facts & Figures

Grants and bursaries

The CoE-HUMAN continued to support strategic grants in 2022 around the themes of COVID-19, 4th Industrial Revolution, rural development and climate change.

4IR

SPECIAL EDITION FINALISED

Students

80 The percentage of Black South African students (including coloured, Black and Indian students)

Up 5% from 75% in 2021

60 The percentage of female students

37 The percentage of students from historicallydisadvantaged institutions

9 Master’s students Up 1 from 8 in 2021

16 Doctoral students

CONCLUDED

31

Collaborative agreements

Dissemination

24 webinar events – up 9 from 2021

6,5 Million people reached through our media output

R 1,826 Million in Advertising Value Equivalent for our media items

13 Post docs

Up 3 from 10 in 2021

Leverage

Researchers affiliated with the CoE leveraged a total of R 10,205,510 in research and innovation grant funding in 2022.

Research

61

articles published (10 with impact factors of >5), 2 books, 3 book chapters

The Lancet Series

CoE-HUMAN Director, Prof

Shane Norris, contributed to a Lancet Series on Adolescent nutrition

Adolescence is a time of rapid changes in both physical growth and development and cognitive and emotional capacities. There rightly has been much emphasis on early childhood nutrition. However, adolescence is an additional important phase of risks and opportunities for healthy nutrition with lifelong and intergenerational consequences. Yet, this age group has been neglected in national and global plans and policies. This Series highlights the effect of nutrition on adolescent growth and development, the role the food environment has on food choices, and which strategies and interventions might lead to healthy adolescent nutrition and growth.

How does the food you eat affect your growth and development?

Authors:

Associate

Abstract

Hungry? Should you eat an apple or potato chips? Does it really matter? It turns out that what you eat as a child and adolescent affects your growth and development. It can also affect your health as an adult! We wanted to understand the link between nutrition and adolescent growth. We did a review of different scientific studies to see what is currently known about this. We found that not eating enough food,

Introduction

During adolescence, you go through a transformation. From around ages ten to nineteen, all the systems in your body grow and mature. That is why what you eat is so important. Getting proper nutrition means that you eat: enough food and the right food to meet your body’s needs.

Undernutrition occurs when someone is not getting enough food. Overnutrition occurs when they eat too much. The body then stores this extra food as fat. That is why overnutrition can result in obesity. Malnutrition occurs when a person eats enough food, but not the right types.

To make sure adolescents are getting the right nutrients, we must first know what those are. That is why we did an extensive review of current scientific papers. We looked at studies that focused on different parts of the body, to see how nutrition affects each one.

eating the wrong foods, and eating too much food all affect the body’s systems. But the effects are different in each case. We also learned that the negative effects of poor nutrition aren’t permanent if they’re corrected at the right time.

The human body needs a variety of foods to meet all its needs for growth and development. Try to choose foods from several food groups, especially fruits, vegetables, protein, grains, and dairy.

Photo: Shutterstock

more free science teaching resources at: www.ScienceJournalForKids.org

1. Norris, S. A., Frongillo, E. A., Black, M. M., Dong, Y., Fall, C., Lampl, M., Liese, A. D., Naguib, M., Prentice, A., Rochat, T., Stephensen, C. B., Tinago, C. B., Ward, K. A., Wrottesley, S. V., & Patton, G. C. (2022). Nutrition in adolescent growth and development. The Lancet, 399(10320), 172–184.

https://doi.org/10.1016/S0140-6736(21)01590-7

1

2. Neufeld, L. M., Andrade, E. B., Ballonoff Suleiman, A., Barker, M., Beal, T., Blum, L. S., Demmler, K. M., Dogra, S., HardyJohnson, P., Lahiri, A., Larson, N., Roberto, C. A., Rodríguez-Ramírez, S., Sethi, V., Shamah-Levy, T., Strömmer, S., Tumilowicz, A., Weller, S., & Zou, Z. (2022). Food choice in transition: Adolescent autonomy, agency, and the food environment. The Lancet, 399(10320), 185–197.

https://doi.org/10.1016/S0140-6736(21)01687-1

3. Hargreaves, D., Mates, E., Menon, P., Alderman, H., Devakumar, D., Fawzi, W., Greenfield, G., Hammoudeh, W., He, S., Lahiri, A., Liu, Z., Nguyen, P. H., Sethi, V., Wang, H., Neufeld, L. M., & Patton, G. C. (2022). Strategies and interventions for healthy adolescent growth, nutrition, and development. The Lancet, 399(10320), 198–210.

https://doi.org/10.1016/S0140-6736(21)01593-2

Shane Norris, Edward Frongillo, George Patton and others

editors: Allison Gamzon and Marilisa Valtazanou

Early Childhood Development: Knowledge & Societal Impact 2014-2022

The CoE-HUMAN has made a significant contribution to knowledge, policy and societal impact in the field of early childhood development (ECD), locally, regionally, and globally. Much of this work has been led by Distinguished Professor Linda Richter, working with post-graduate students, fellows and colleagues in the CoE-HUMAN, other research institutions, government, civil society, and multi-national organizations. Key highlights of Prof Richter’s work, for which she received the NRF 2020/2021 prestigious Lifetime Achievement Award, and of the CoE-HUMAN are shown below.

Building on authorship in the 2007 and 2011 Lancet Series on Early Childhood Development in Developing Countries, Prof Richter led the 2017 Lancet Series Advancing Early Childhood Development: From Science to Scale, and was first author of Paper 3 Investing in the foundation of sustainable development: pathways to

the longestrunning birth cohort study on the African continent.

A second, larger, launch was held on Saturday August 20th in Soweto for the participants of the Bt30 study. This launch was an opportunity for the participants to reconnect with the amazing study, but equally as important – for the study to thank the participants for their long commitment through a celebration honouring their involvement. Participants of the Bt30 study each received a free copy of the book, funded by a grant from the Oppenheimer Memorial Trust.

Both events brought together some of the most important aspects of this remarkable project – the people and the science – and what it takes to engage in relevant research in South African society. The book is also sold online with all proceeds supporting postgraduate students working on longitudinal studies.

The stories, science and people in the largest and longest running birth cohort study in Africa, which followed more than 3,000 young people born in 1990 in Soweto-Johannesburg for the first 30 years of their lives.

Linda M Richter

HARNESSING GLOBAL DATA

The Harnessing Global Data Project brings together researchers, policymakers, and implementers from around the world with a focus on available data on young children in LMICs. The goal of the project is to improve child development, early learning, and pre-primary education through better understanding of the determinants of and risks to children’s development, the economic consequences of inaction, and policy and legal frameworks to address challenges.

Funded by the UKRI’s Global Challenges Research Fund, and led by Distinguished Professors Linda Richter (CoE-HUMAN) and Alan Stein (University of Oxford) the Project is in its 3rd year. Like many other sectors, research was impacted by the COVID-19 pan-

On average, 19.4% of young children in the 56 countries lived in households prepared for COVID-19, ranging from 0.6% in Ethiopia in 2016 to 70.9% in Tunisia in 2018.

Conclusion:

demic and shifts in political agendas directly or indirectly due to the pandemic. The Project was affected by the UK’s controversial aid cuts prompting a critique published in the Lancet from Prof. Richter outlining the direct economic and social damage the cuts might do to research institutions, scientists, civil society groups, government programmes, and the people in low-income countries who ODA research funding intends to benefit.

In response to the pandemic, the Project also published estimates of the proportion of young children in 56 LMICs who live in households that could be defined as prepared for COVID-19 given their hygiene, sanitation, media exposure, and communication capacity.

In close to 90% of countries (50), fewer than 50% of young children lived in prepared households.

The global response to the COVID-19 pandemic was driven largely by confining children and families to their homes. However, a large portion of young children under the age of five in LMICs were living in households that did not meet all preparedness guidelines for preventing COVID-19 and caring for patients at home. More needs to be done to ensure these families have the means to prevent the spread of communicable illnesses and to protect themselves and their children at home.

Young children in rural areas or in the poorest households were less likely to live in prepared households than their counterparts.

CONNECT WITH US:

The Project continues to leverage available data on young children to advance their learning and development. Connect with us on Twitter @GlobalData4Kids and visit our website globaldata4kids.com

Harnessing Global Data (GlobalData4Kids) report and publications:

Fredman S, Donati G, Richter LM, Naicker SN, Behrman JR, Lu C, Cohrssen C, Lopez Boo F, Raghavan C, Devercelli A, Heymann J. Recognizing Early Childhood Education as a Human Right in International Law. Human Rights Law Review. 2022 Dec;22(4):ngac024. https://doi.org/10.1093/hrlr/ngac024

Lu C, Luan Y, Naicker SN, Subramanian SV, Behrman JR, Heymann J, Stein A, Richter LM. Assessing the prevalence of young children living in households prepared for COVID-19 in 56 low-and middle-income countries. Global Health Research and Policy. 2022 Dec;7(1):1-2

Naicker SN, Richter LM. Parenting amid COVID-19: Challenges and supports for families with young children in South Africa. South African Journal of Child Health. 2022;16(1):1-7.

Rao N, Su Y, Gong J. Persistent Urban–Rural Disparities in Early Childhood Development in China: The Roles of Maternal Education, Home Learning Environments, and Early Childhood Education. International Journal of Early Childhood. 2022 Apr 13:1-28.

Conferences & workshops

Prof. Richter

Nurturing Care: An Opportunity for DOHaD Impact?

12th DOHaD World Congress, Vancouver, 27-31 August 2022

African Regional Convening to Support Parents and Caregivers; Supporting parents and caregivers: From science to scale, 21 to 23 June 2022

2022 Asia-Pacific Regional Virtual Conference on Early Childhood Development hosted by ARNEC; From Data to Action: Monitoring ECD in Asia and Pacific; 5 July 2022

Sara Naicker – Novel child development Research in African Settings: Exploring measurement opportunities and supporting capacity-building for African researchers; Stellenbosch University & Cambridge University; 15-17 September 2022

Webinar: Co-hosted – “Can cash payments for vulnerable families impact brain function in babies?” Joint webinar with Harnessing Global Data, ECDAN, IDB, and others, 22 February 2022

Launch of the ECD Country Profiles for 197 Countries

The early childhood development profiles were first published in 2018 for 91 countries. They now include 197 countries, including 63 high-income countries, and 42 indicators, based on the nurturing care framework, which includes the domains of good health, adequate nutrition, security & safety, early learning, and responsive caregiving. UNICEF and the Countdown Working Group on Early Childhood Development – chaired by Prof. Linda Richter of the CoE-HUMAN – are the lead contributors.

Country profiles are widely used by many audiences for various purposes. For example, civil society organizations may use them as an accountability tool; country

governments may use the data for planning and priority setting; and academic and research partners may analyse them to assess trends over time.

The profiles have been translated into 4 additional languages – Arabic, French, Russian, Spanish. A regional brochure focusing on the Asia-Pacific region has been developed due to increased interest. This was launched at the 2022 Asia-Pacific Regional Virtual Conference on Early Childhood Development hosted by ARNEC.

The profiles were launched on December 14, 2021, in collaboration with the Partnership for Maternal, Newborn and Child Health.

A video explaining the profiles and their importance has been developed: https://www.youtube.com/watch?v=RHcEL9xZ7Lk&feature=youtu.be

SA Child Gauge 2021/2022

Child and adolescent mental health

In our 2021 Annual Report we introduced the 2021/2022 SA Child Gauge which focused on child and adolescent mental health and wellbeing. This edition was supported by the CoE-HUMAN and involved pieces written by our researchers, including a Foreword from Distinguished Professor Linda Richter. The full report is now accessible online (http://www.ci.uct.ac.za/ci/cg20212022-child-and-adolescent-mental-health).

Prof Richter writes:

“In a country beset by poverty, inequality, social exclusion and violence, our most important responsibility is to our children and adolescents. We need to identify those who face difficulties early on and try to rectify or ameliorate these problems so that children can continue their life-long journey with strength and resources.”

Short summaries of key content, many produced by CoE affiliated researchers, are shown below.

A life-course perspective on the biological, psychological and social development of child mental health

Tamsen Rochat and Stephanie Redinger

This chapter explores how exposures, including positive and negative life events, can impact on normal and necessary developmental processes – which in turn impact mental health.

Mental health over the life course –findings from the Birth to Thirty Cohort Study

Sara Naicker, Shane Norris & Linda Richter

This case highlights the key findings from Bt30 on the antecedents and consequences of mental ill health, organised by life stage from the study’s inception to date. The evidence from Bt30 has collectively demonstrated that mental health problems have their origins in early life, perhaps even before conception, and that they can be passed from parents to children intergenerationally through the interplay of social and biological factors.

healthyl ifestyle choicest hatr educe risk of genetic predispositions

healthy behavioursa nd interaction modelled

Families: Foundations for child and adolescent mental health and well-being

Sara Naicker, Lizette Berry, Roisin Drysdale, Tawanda Makusha and Linda Richter

This chapter explores the central role of families in protecting and promoting child and adolescent mental health, the ways in which family form and function can contribute to mental health problems, and the ways in which families can be encouraged and supported to enhance child and adolescent mental health.

Child and adolescent mental health and the digital world: A doubleedged sword

Rachana Desai and Patrick Burton

The COVID-19 pandemic and the digital revolution has led to an exponential rise in technology and internet use. This chapter aims to bring together diverse perspectives and interrogate the impact of digital worlds on children’s mental health and to provide recommendations for policy and practice. This includes recognising the role that parents and caregivers, educators, government regulators and industry, and children themselves have to play in promoting children’s mental health and wellbeing in all aspects of children’s online engagement, from online play to learning to civic partic-

CoE-HUMAN Research 2022

South African Human Development Pulse Survey – Wave One

In October 2021, CoE-HUMAN conducted a nationally representative survey of 3,402 South Africans across the country, aged 18 and older. The survey covered many aspects of adult health and development, particularly those that had been indicated previously to have been impacted by the COVID-19 pandemic i.e., food insecurity and coping strategies, social vulnerability, alcohol consumption and tobacco smoking behaviours, and mental health. The four research objectives were:

Major finding 1: Poor socio-economic circumstances contribute to greater risk of experiencing food insecurity and social vulnerability

 Overall, one in every five South African households lacked access to sufficient food. Poor households, especially Coloured and Black African households were most affected by food insecurity.

 Living in a food insecure household in South Africa during COVID-19 was associated with a higher risk of anxiety and depression.

 All coping strategies (e.g., “sending household members to beg for food”) used by South Africans to deal with food insecurity differentially associate with the risk of anxiety and depression.

 Twenty percent of participants were classified as socially vulnerable, with higher social vulnerability prevalence when respondents were poor and unemployed, lived in Mpumalanga or in rural areas, were Black African and/or female, or did not have a high school certificate. Social vulnerability was also higher in older participants, with prevalence increasing exponentially from 45 years of age.

 The risk of food insecurity was almost 3-fold higher in the socially vulnerable group compared to their counterparts. Specifically, those with poor socioeconomic indicators (e.g., poorer households, unemployed and not completed high school) were at greater risk of experiencing food insecurity.

Major finding 2: Alcohol use and heavy smoking remains prevalent in South African adults

 Approximately, 33.2% and 19.2% of adults in South Africa consume alcohol and have smoked, respectively. Notably, 50.3% of adults who drank reported potentially harmful alcohol use and 12.2% of those smoking reported heavy smoking.

 About 24.0% and 29.1% of those who drank alcohol and smoked tobacco reported increasing or starting the use of alcohol or tobacco during the pandemic.

 Being male, employed, living in certain provinces (Free State, Limpopo, Mpumalanga), and having started or increased alcohol drinking due to COVID-19 lockdowns were found to be significantly associated with potential moderate-severe alcohol use disorder.

 Surprisingly, many respondents reported a positive change in their smoking behaviour (reduction or quit smoking) since the onset of the COVID-19 lockdowns though this was less likely in heavy smokers.

Major finding 3: South Africa’s mental health challenges continue

 Nationally, 25.7%, 17.8% and 23.6% of respondents respectively reported scores of ≥ 10 on the Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7), indicating probable depression or anxiety, and ≥ 4 Adverse Childhood Experiences (ACE), indicating a high exposure to childhood trauma.

 Respondents that were retired, older and widowed, divorced, or separated; who lived in metropolitan areas; or only had primary school education were more likely to experience probable depression and anxiety compared to their counterparts.

 Also, higher ACE exposure was associated with an increased risk of developing depression or anxiety.

Major finding 4: Social Vulnerability in South Africa

 South Africa’s socially vulnerable groups (those with fewer resources, unemployed, and without high school certificate) are at a greater risk of experiencing food insecurity.

 The South African government needs effective and innovative policies to reform the economy and invest in a decent education system so that social inequalities such as social vulnerability and food insecurity can be reduced or eliminated.

The research outputs from this national survey (in press) include:

Published:

 Mtintsilana, A., Dlamini, S. N., Mapanga, W., Craig, A., Du Toit, J., Ware, L. J., & Norris, S. A. (2022). Social vulnerability and its association with food insecurity in the South African population: Findings from a National Survey. Journal of Public Health Policy.

https://doi.org/10.1057/s41271-022-00370-w

 Craig, A., Rochat, T., Naicker, S. N., Mapanga, W., Mtintsilana, A., Dlamini, S. N., Ware, L. J., Du Toit, J., Draper, C. E., Richter, L., & Norris, S. A. (2022). The prevalence of probable depression and probable anxiety, and associations with adverse childhood experiences and socio-demographics: A national survey in South Africa. Frontiers in Public Health, 10, 986531.

Doi: https://doi.org/10.3389/fpubh.2022.986531

In-review:

 Mapanga W, Craig A, Mtintsilana A, et al. 2022. The Effects of COVID-19 Pandemic Lockdowns on Alcohol Consumption and Tobacco Smoking Behaviour in South Africa: a national survey. European Addiction Research Journal

 Dlamini SN, Craig A, Mtintsilana A, et al. 2022. Food insecurity and coping strategies, and their association with anxiety and depression: a nationally representative South African survey. Public Health Nutrition

South African Human Development Pulse Survey – Wave Two

The CoE-HUMAN ran the Second Wave of its nationally representative survey in 2022 – the results and outputs will follow in 2023.

CoE-HUMAN Projects in 2022

Youth Unemployment Survey

This 2022 Socio-Ecological and Transformational Development Project explored young South African adults’ perspectives around youth unemployment in South Africa.

The youth unemployment situation in South Africa (SA) has reached critical stages with an ominously high and increasing number of unemployed youths contributing to excessive poverty and inequality levels. According to the Quarterly Labour Force Survey (QLFS) published by Statistics South Africa (StatsSA) in the First Quarter of 2022, young people still struggle in the South African labour market. The official unemployment rate was 34,6%, with an unemployment rate of 46,3% among young people aged 15-34 years. The burden of unemployment is also concentrated amongst the youth as they account for 59,5% of the total number of unemployed persons. While the prevalence of unemployment and trends in the last few years differ by age band within the youth group category, there is no doubt that unemployment in young South Africans is a constant national burden that has proven highly intractable over the last ten years.

Given the dire youth unemployment climate in SA, the purpose of this survey was to:

 Understand the youth’s perspectives on the drivers of youth unemployment, alongside their awareness and engagement with employment initiatives (YEIs) and the gig economy in SA post-COVID-19.

 Explore how ‘in control’ young SA adults view their employment situation and what their perceptions are on the role of ‘luck’ in finding work.

 Broaden the understanding surrounding the intricate nature of youth unemployment whilst additionally providing insight to potentially enhance policy formation directed specifically towards improving the socio-economic climate for the cohort.

The results showed that:

 Young adults emphasised that there are employment, education, and individual-related obstacles that make it difficult for them to find employment.

Young people attributed having a good family life, being successful in work, and finding purpose and meaning in life, as the most important life goals.

 Participants with an undergraduate or postgraduate degree were more likely to have a job, be aware of YEIs, and have experience of digital gig economy platforms, primarily as consumers of services rather than as a source of employment. This indicates that those most vulnerable to unemployment are

also potentially those that are least aware of proemployment initiatives and opportunities.

This study specifically responds to the Future of Society priority area in the 2021-2031 DSI STI Decadal Plan as it investigates the pressing challenge of youth unemployment in South Africa, and youth at risk of being socio-economically excluded and not playing a meaningful role in national growth and development.

The Soweto Men’s Cohort Project

Previous studies have shown men who subscribe to precarious manhood beliefs may experience a higher risk of stress-related poor health following loss of masculinity status. Additionally, men who experience social pressure to conform to masculine norms exhibit lower self-esteem and masculine identities validated by social definitions of what it means to be a man may discourage help-seeking behaviour, leading to poorer health outcomes.

But there are few studies which have investigated the link between motivation of and validation for masculinity and the relationship to health in LMICs. In South Africa, with high levels of gender-based violence (GBV), men may also perceive the allocation of resources to empower women to be at their expense. While this is a necessary social transition, the impact it has on men in society is unclear with some suggestions that the

high levels of GBV result from men feeling the need to “re-establish their masculinity and dominance”. However, there is little research on the impact of social transition on the emotional state of men, and how it relates to masculine identities and health.

Dr Lukhanyo Nyati, a postdoctoral fellow at Wits, is leading this study is to assess the relationship between motivation of gender identities, perceived emotional invalidation and health. The study seeks to characterise gender stereotypes in young adult, urban black males, and females in South Africa and to understand perceived emotional invalidation, determining the relationship between gender identity and health outcomes, help-seeking behaviour, and access to health services to see if the relationship between perceived emotional invalidation and health is mediated by gender identity.

Climate Change and Youth Advocacy

DSI Global Change Research Plan

The CoE-HUMAN Climate Change and Youth Advocacy Project, led by postdoctoral fellow Dr Khuthala Mabetha, responds to the call by the Minister of the DSI in the Decadal Plan for research and innovation to support the development of solutions for climate change as a societal grand challenge (SGC). Further, the DSI Global Change Research Plan (GCRP) notes the social sciences and humanities can have a significant contribution to this SGC (Climate Change and Environmental Sustainability) as there is a need to understand the drivers of human behaviour and consumption of environmental goods and services.

Dr Mabetha’s project, entitled: “Integrating Youth Perspectives to Climate Action: Adopting a Participatory Action Research Approach to promote youth advocacy on climate change in youth-friendly health centres in Soweto, South Africa” explores how to engage younger residents to advocate for climate change action in townships.

Young people in South Africa are feeling the brunt of the climate crisis and environmental degradation, according to a 2021 UNICEF poll where 80% of South African youth reported being directly affected by a climate or environment related event1. Of those who had been impacted by this crisis, 20% indicated that their homes

UNICEF South Africa U-Report poll: 80 per cent of young people affected by a climate or environment related event. (04 November 2021). Press Release Retrieved 12 August 2022, from https://www.unicef.org/southafrica/press-releases/80-cent-young-people-affected-climate-orenvironment-related-event

“…to navigate the impact of climate change on society and steer society to environmentally-conscious citizenry, a deepened understanding of societal behaviour and change is required.”

were demolished, 16% had a disruption in their learning activities and 14% had limited access to safe water. Amid this climate crisis, now a major public health concern, young people in South Africa have joined global efforts to mitigate the climate crisis and are promoting advocacy for climate change both at the local and national level. This youth-led advocacy has taken place in schools and universities, on social media, and through community-led youth campaigns.

One example of this youth-led action is the South African Youth Climate Action Plan (SA YCAP) which seeks to mobilize youth to advocate for a just climate and to foster a sustainable environment. While the youth have made progress in expanding the network of young people to contribute to a climate resilient future, youth-focused health services remain an unex plored avenue to engage with youth. This approach also offers the potential to engage young people in health policies and increase awareness on how climate change is becoming a social determinant of health.

Dr Mabetha seeks to explore the knowledge, perceptions, experiences and needs of youth around health

and climate change and to examine how youth-focused organizations can integrate climate change discussions into their health delivery models, training and resources. Using a Participatory Action Research Approach, she will examine these issues with young men and women in Soweto including their ideas for how the findings can be disseminated to produce actionable change. In addition, in-depth interviews will be conducted with individuals working in youth-focused organisations to obtain their views on how they believe climate change discussions and education can be integrated in their training and health resources.

The study will be conducted at the Wits Health Hubb located in Jabulani, Soweto. Soweto has been identified by the City of Johannesburg (CoJ) as a “deprivation cluster”, an area that has concentrated impoverishment with poor human development index related to employment, income, education, health and the living environment2. Of note, Soweto has been reported to experience infrastructure issues such as poor storm water drain systems leading to floods, spillage of sewer, electricity issues, and a lack of recreational facilities and green spaces such as parks or community gardens3

Digital Solutions to Tackle Mental Health

Rapid technological advancement is creating a multitude of opportunities to connect with people and to supply education, goods and services, including for healthcare. However, as the DSI Decadal Plan highlights, digital healthcare solutions, especially in the mental health and wellness space, must put the person at the centre of the innovation and seek to understand through the social sciences, what it means to be human as a foundation of complex multi-disciplinary approaches to addressing healthcare challenges in South Africa.

Within this space, CoE-HUMAN have been supporting work that seeks to promote good mental health and to create awareness around mental health and social justice issues among vulnerable groups. This was achieved through an exciting collaboration with a South African

award-winning non-profit company, R-Labs and Zlto located in the disadvantaged area of Bridgetown, Cape Town. Zlto provide a platform that uses blockchain technology to increase engagement amongst youth, and to track and encourage positive social behaviours using a rewards system.

Working with the Zlto team, CoE-HUMAN supported the creation of content for micro courses to increase understanding and provide guidance around three major areas impacting young people – depression, gender-based violence, and suicide. The courses were launched online in March 2022 and so far, we have reached thousands of young people (83% age 18-24y), across the country in every province and in both rural and urban areas (depicted in the visual below).

3 McNamara, L. J. (2014). Climate Change adaptation and city governance: A case study of Johannesburg (Doctoral dissertation, University of the Witwatersrand, Faculty of Science, School of Geography, Archaeology and Environmental Studies).

Caring for the Caregiver

The Caring for the Caregiver (CFC) frontline worker package and implementation toolkit was designed for UNICEF by a clear lead by Professor Rochat and Dr Redinger in the CoE-HUMAN.

The focus of CFC is on increasing a caregiver’s confidence in caregiving, and helps caregivers manage their stress, engage in self-care, and improve their coping skills. CFC also provides activities to engage partners and family support in supporting caregiving and reducing barriers to access to resources.

THE CFC CONCEPTUAL FRAMEWORK

CFC is a global package designed to be adapted to different contexts and be integrated into or used in combination with other caregiver programmes across relevant sectors including nutrition, ECD and health. The content of the package draws attention to three UNICEF priority focal areas which are important for the developmental potential of young children and their caregivers. These focal areas are early childhood development, adolescent caregivers, and gender. CFC directly engages with discriminatory gender norms through its approach, messages, and activities. It includes essential skills training to increase the counselling capacity of frontline works and provides additional resources for managing high risk situations and developing community supports. In 2022/23 the team will also finalise a supplement for use with adolescent caregivers aged 15-19 years.

Following the prototype development and testing in Sierra Leonne and Mali, a large-scale validation project was completed in 2021/2022 with data collected in 6 countries across the globe. The map below shows the different sectors and entry points where CFC was tested, and the data collected in the validation study. CFC

has been found to be highly acceptable and feasible in all these settings and data analysis of its impact on caregivers and families is currently underway.

An online introductory course for CFC has recently been launched and is available through UNICEF’s AGORA learning platform (https://agora.unicef.org/course/info. php?id=25325)

CoE-HUMAN Inter-University Research Projects

CoE-HUMAN partnership with the UJ Community of Practice Intervention Research Project

The Community of Practice (CoP) intervention research project was a multi- and transdisciplinary initiative involving collaboration between researchers and practitioners across different sub-fields including social work, sociology, psychology, educational psychology, education, mathematics and language curriculum specialists, mental health, nutrition, primary health care, community nursing, and public health and school health care services. The CoP study targeted children in the foundation years of schooling; Grade R and Grade 1. Early interventions tailored to meet children’s needs in poor families during this development stage could have positive long-term benefits for children, their families, and communities. This collaboration between key sectors was thought to be instrumental in accelerating child wellbeing outcomes beyond only offering the Child Support Grant and aiding the search for innovative solutions suited to our local context in South Africa.

In initiating the CoP, the team were interested in understanding, firstly, what the most appropriate cross-sectoral interventions were to step up child well-being outcomes; and secondly, how these interventions could be delivered across the health, education, and social welfare sectors. Lastly, the CoP approach was evaluated as a viable way of achieving social sector systems strengthening to improve child well-being in urban communi-

ties. In line with this, several objectives were identified including:

 Development, testing and implementation of a digital Child Well-being Tracking Tool (CWTT) to assess how children are faring.

 Development of a risk assessment profile(s) for children.

 Development and implementation of co-ordinated intervention plans for at risk children.

 Delivery of integrated services co-ordinated by a social worker.

 Assessment of the outcomes of the intervention.

 Development of generic solutions and action plans and guidelines to step up child wellbeing outcomes across the social sectors.

 Documenting the lessons learnt from this collaboration to improve co-operation across the social service sectors.

The primary objective of developing a tool to assess how 162 Grade R and Grade 1 children are faring across a number of key domains forms a baseline assessment. After which, participating children will be re-assessed to determine the efficacy of the intervention (as detailed in the Figure below).

On the second day of the Symposium, CoE-HUMAN Director, Professor Shane Norris Chaired the Session: Fast-tracking child well-being outcomes in specific domains. Speakers presented data on child health, nutri-

tion, social grants, school feeding and complimentary services and the linkages between different systems of care and support.

Supporting Historically Disadvantaged Institutions

Over the years, there have been proactive efforts from the CoE-HUMAN team to engage with and support research capacity building in HDIs. During 2022, this included the work with UMP, resulting in the grant award to Prof Mahlomaholo and work with Durban University of Technology (DUT) – resulting in the grant award to Prof Gugu Mchunu, as well as a grant awarded to Prof Maimela of the University of Limpopo.

University of Mpumalanga

On Wednesday 09 March 2022, the CoE-HUMAN Centre Manager, Mr Justin Du Toit and Senior Researcher, Dr Lisa Ware met with the Collaborative Research Team at the University of Mpumalanga (“UMP”) campus. The UMP team comprised of the following Heads of Schools:

1. Prof Geoffrey Mahlomaholo: Education

2. Prof Estelle Boshoff: Development Studies

3. Prof Hilda Israel: Dean of Education

4. Prof Vusi Gumede: Dean of Economics, Development Studies, and Business Science

5. Prof Calvin Gwandure : Social Sciences

6. Prof Ntombovuyo Wayi-Mgwebi: Information Communication Technology

7. Prof Funso Kutu: Agriculture

8. Dr Thandeka Sabela: Development Studies

The UMP Collaborative Research Team and the CoE-HUMAN team worked together to brainstorm potential collaborative research topics, and CoE-HUMAN gave guidance on proposal development such as the inclusion of a detailed budget, timeline, research output and clear milestones. UMP then took the proposal forward to develop the Collaborative Research Project “Creating Sustainable Higher Education Learning Environments towards Increased Levels of Employability among Students and Youth.”

The aim of the study is to design a strategy to enable higher education institutions to create sustainable learning environments that increase the levels of employability among student and youth populations, and entrepreneurial acumen among youth in the community

in the broad learning areas of Agriculture and Natural Sciences, Early Childhood Education and Economics, Development and Business Sciences. These learning areas align directly to the employment opportunities for youth in the areas surrounding UMP.

Key outputs of the project include peer-reviewed academic publications, conference presentations, book chapters in peer-reviewed books, and two national / international webinars.

The study is inspired by challenges affecting students and youth to varying degrees depending on their respective circumstances. These include the high rate of youth unemployment, poverty, inequality, and youth’s poor levels of formal education in socio-economic contexts that demand high levels of technological functioning.

This important collaborative project speaks to the DSI Decadal Plan and aim for future-proof education through links to life-long learning, basic education links

to higher education, and the development of education ecosystems.

The project further seeks to realise the vision of the Decadal Plan in its adoption of the SDGs and pledge to increase the number of young people and adults with

Durban University of Technology (DUT)

On Friday 19 August 2022, the CoE-HUMAN Centre Manager, Mr Justin Du Toit and Senior Researcher, Dr Lisa Ware met virtually with the Collaborative Research Team from DUT, including:

1. Professor Gugu Mchunu: Executive Dean, Faculty of Health Sciences

2. Professor Julian Pillay: Research Chair, Faculty of Health Sciences

3. Dr Desmond Kuupiel: Postdoctoral Research Fellow, Faculty of Health Sciences

4. Professor Busisiwe Ncama: DVC, College of Health Sciences

5. Professor Sinegugu Duma: Dean, Teaching and Learning

6. Professor Christopher Isike: Professor, Humanities

University of Limpopo (UL)

Grantee, Prof Eric Maimela was approached by the Director: CoE-HUMAN, Prof Norris to form part of a collaborative partnership which led to the ideation and develop of the project proposal: Assessing the effects of food insecurity, malnutrition and teenage pregnancy on pregnant and parenting adolescents’ mental health needs in DIMAMO population health research centre.

Lack of access to healthy food due to limited money or other resources can lead people to poor nutrition, obesity, high levels of stress, anxiety, and depression. The effects of this may be particularly detrimental during pregnancy or for young caregivers supporting children.

This study will investigate the effects of food insecurity, malnutrition, and teenage pregnancy on pregnant and parenting adolescents’ mental health in the DIMAMO Population Health Research Centre.

skills for employment, decent jobs and entrepreneurship. Moreover, the research promotes the DSI STI priority of education for future and the future of society –strongly linked to the development of future skills.

7. Professor Cheryl Potgieter: Head, Gender Justice and Human Development

8. Professor Monique Marks: Director, Urban Future Centre

9. Dr Kira Erwin: Senior Lecturer, Urban Future Centre

After this virtual engagement, the DUT project team submitted their proposal for the project titled: “Optimising safety for women and young girls as minibus taxi commuters in Durban” – subsequently approved by the CoE-HUMAN. The team found that very little is known about how South African women and girl commuters feel about their own safety on their daily rides, or about how they believe safety could be optimised, and the impact of sexism on their well-being as users of public transport. This exploratory research project aims to provide a baseline study to contribute to the paucity of research in the area.

SPECIFIC RESEARCH OBJECTIVES:

1. To determine the prevalence and severity of food insecurity.

2. To determine proportion of malnourished pregnant and parenting adolescents.

3. To determine the level of teenage pregnancy.

4. To investigate the prevalence of depression and factors associated with depression amongst adolescent pregnant women.

5. To explore the knowledge and perceptions of adolescent pregnant women on depression associated with pregnancy.

6. To explore the barriers that often prevent adolescent mothers from seeking mental health services, and interventions for this vulnerable population that can be integrated into primary care services.

7. To investigate support structures for adolescent pregnant women.

Postdoctoral Research Initiatives

CoE-HUMAN Postdoctoral Accelerator Programme

In 2021, the CoE-HUMAN launched the pilot of a new Postdoctoral Accelerated Programme aimed at mentoring and developing post-PhD fellows to the senior researcher level within two years (inclusive of an NRF-rating). Four postdocs joined the programme in September of the same year. This programme is monitored and will be evaluated for potential scale-up.

Philosophy:

 Structured group learning model that aims to mentor and develop postdocs to be at the senior researcher level by the end of two years.

 Supervision and mentoring of postdocs by senior academics.

 The postdocs will form a peer-learning-support group.

First cohort of Postdoctoral Fellows

Strategic goal is for each postdoc to have a minimum of 20 papers either as 1st or co-author by the end of two years.

The first postdoctoral cohort of four fellows started in 2021, and the second cohort of five fellows started in November 2022.

Dr Siphiwe Dlamini

Dr Asanda Mtintsilana

Dr Witness Mapanga

Dr Ashleigh Craig

Postdoctoral Support

Dr Roisin Drysdale

Successful South African Medical Research Council Self-Initiated Research (SIR) Grant to continue her CoE-HUMAN postdoctoral research work

Project title: Child Growth and Development during a Global Pandemic: Assessing the indirect effects of SARS-CoV-2 on young children and their mothers living in Soweto, South Africa

Evidence of the impact of pandemics and national responses to them on early child development and growth is limited, particularly in the first 1,000 days of life, when the foundations for health, growth and neurodevelopment are established. The available literature, however, suggests that children conceived or in-utero during an epidemic or natural disaster are more likely to experience life-long negative consequences such as reduced education attainment and higher risk of non-communicable diseases and mental health problems. The ‘Child Growth and Development during a Global Pandemic’ study follows a cohort of infants who were conceived and born during the first year of the South African COVID-19 national lockdown to assess whether the pandemic has negatively affected their growth, development, and well-being.

The infants, who turn two years of age at the end of 2022 or beginning of 2023, spent much of their first 1,000 days living under lockdown conditions. They have been followed-up from birth at 6-month intervals, which will continue until they turn three years of age. The study will measure their growth, cognitive and socio-emotional development, and motor skills using validated tools.

In addition, the study will record their feeding practices, immunisation status, sickness and morbidity and their mother’s mental health and well-being.

Preliminary results suggest that women found being pregnant during the lockdown difficult, mainly due to stress and fear of attending the hospital or clinic. Whilst 98% of the participants advised they attended antenatal care throughout their pregnancy, 10% did not have an ultrasound indicating that they were not attending the recommended number of antenatal health visits. In addition, 10% of the infants, who were born full-term (≥ 37 weeks gestation) with no complications, were born of low birth weight (< 2.5kg). They were also between two and three times more likely to be born of low birth weight compared to those born before the pandemic.

Being born low birth weight can have a significant impact on an individual throughout their life, including but not limited to, increased risk of dying in the first year of life, higher rates of childhood illnesses, poor cognitive development, and poor growth. Through this study, Dr Drysdale hopes to better understand how the pandemic and lockdown has affected child development and growth and determine whether policies and interventions that mitigate the negative impacts of COVID-19 and promote early learning and improved growth are needed.

CoE-HUMAN Postdoctoral fellow, Dr Siphiwe Dlamini

The study, entitled Should fast food nutritional labelling be mandatory in South Africa, supported by CoE-HUMAN, was conducted at the University of the Witwatersrand.

Food labels are considered a crucial component of strategies tackling unhealthy diets and obesity. This study aimed to assess the effectiveness of food labelling for increasing the selection of healthier products and in reducing calorie intake. In addition, this study compared the relative effectiveness of traffic light schemes, Guideline Daily Amount and other food labelling schemes. A comprehensive set of databases were searched to identify randomised studies. Studies reporting homogeneous outcomes were pooled and analysed through meta-analyses and publication bias was evaluated with a funnel plot.

The results indicated that food labelling would increase the amount of people selecting a healthier food product by about 17.95% (confidence interval: +11.24% to +24.66%) and decrease calorie intake/ choice by about 3.59% (confidence interval: −8.90% to +1.72%), though results were not statistically significant. Traffic light schemes were marginally more effective in increasing the selection of healthier options than other food labels or Guideline Daily Amounts. Findings of this study suggest that nutrition labelling may be an effective approach to empowering consumers in choosing healthier products. Interpretive labels, such as traffic light labels, may be most effective. The study also recommended that consumers limit their fast-food intake and avoid eating meal combinations and that the South African Government’s consider regulations that mandate nutritional labelling of fast foods, to assist consumers in making informed dietary choices to curb the rise of non-communicable diseases.

Further publicity around the piece:

Online Media:

Women in Science

• https://www.womeninscience.africa/few-restaurants-insa-provide-nutritional-facts-on-their-products-the-studyreveals/

South African Journal of Clinical Nutrition

• https://www.tandfonline.com

• Full article: Should fast-food nutritional labelling in South Africa be mandatory? (tandfonline.com)

The Conversation

• https://www.theconversation.com/africa

• Food labelling – News, Research and Analysis – The Conversation – page 1

Wits Research News

• https://www.wits.ac.za/news/latest-news/researchnews/2022/2022-01/reading-the-nutritional-signs-in-yourburger-chips-and-soda-combo.html

• 2022-01 – Reading the nutritional signs in your burger, chips and soda combo – Wits University

Social Media:

Facebook University of the Witwatersrand, reached 18,997

Twitter University of the Witwatersrand, 795 interactions

LinkedIn Wits reached 6,541

Health Hubb 2022 Update

The Wits Health Hubb, now in its third year of operation, aims to activate health consciousness and personal wellbeing among youth, to increase community access to healthcare, and to give meaningful professional work experience, training, and qualification in the healthcare domain for formerly unemployed youth.

for them. With the 2021/22 training coming to an end, we released our recruitment advert for 25 more youth who are NEET (not in employment, education, or training) to join the programme for 2022–2023. The learnership advert was live for just four days and we received over 1200 applications. This demonstrates the how well known the programme has become and the influence on the lives of young people as well as the Soweto community.

 Our first cohort of twenty young people from Soweto, started their training to become Health Promotion Officers in October 2020. This group sat for their final exam in 2021 and obtained a 100% pass rate We held a graduation ceremony for them at Jabulani in June 2022 and over 80% of this cohort are now in employment. We are overjoyed to see how the programme has impacted our graduates long after they have completed their training, and we wish them the best of luck in all their future endeavours.

Our second cohort of 24 health advocates (2021-2022), are currently training in Soweto primary care clinics and scheduled to take the Health Promotion Officer (HPO) NQF3 exam end October. Academically, this group is thriving, and we are eager to see what the future holds

 Earlier this year, we partnered with Temple University (USA) and the Phila Sonke Wellness Initiative, an NGO that provide stroke rehabilitation and cardiovascular risk reduction services through exercise programmes at Dobsonville Stadium in Soweto. Our health

advocates went door-to-door through the Dobsonville community offering basic home health screening, including blood pressure (BP) measures. During this twoweek study, over 1000 community members had their BP measured. One third of adults had high blood pressure (hypertension) and were referred to clinics. Almost 40% of adults were found with BP in the pre-hypertensive range putting them at risk for developing hypertension. These adults were offered a free 3-month membership of the Dobsonville exercise programme (funded by the US partners).

Follow-up calls and interviews suggest that referrals to local services (gyms or clinics) are frequently refused by community members but in those that do accept the referral, people sent to the gym are far more likely to

attend, than those sent to clinics. Analysis of the interview transcripts is ongoing to understand the reasons for this.

The BP measures were also sent to the International Society of Hypertension global initiative of May Measurement Month (MMM), a campaign to explore how successful countries are at identifying, diagnosing, and effectively treating hypertension worldwide.

 Neo King Mathe (28) from Naturena, one of the current cohort members of health advocates, says he is enjoying the programme and has learned a lot – “I wasn’t familiar with health before, it’s a new thing to me and I have learned a lot”. He is also a musician and wants to fuse health messaging with his music “I haven’t heard anyone doing anything like that, they always talk about alcohol, smoking, they only promote that in their music”. He says that this programme has taught him to be more compassionate, patient, and calm, and adds that he likes making a positive impact in other people’s lives.

Since its inception in 2020, the Health Hubb has reached over 35,000 community members in Soweto with basic health screening and health promotion.

 In response to community requests, the HUBB held two successful health awareness campaigns at Jabulani on the topics of chronic illness, and substance abuse and mental health

The events brought in key local service providers including SANCA, SADAG, Amatyma, Revolife and Phila Sonke to provide information, testing, support and assistance to the community. During the second of these events, the HUBB team also organised for the Shoprite mobile soup kitchen to give out free soup and bread, feeding over 300 people on the day

Mr Lethu Kapueja, Co-Director of the Wits Health Hubb and affiliated researcher at CoE-HUMAN secures support from the Industrial Development Corporation Social Employment Fund

The project, entitled: The Local Health Investment Network Project seeks to develop 1000 job opportunities for youth and adults currently not in employment, education, or training (NEET) and funded by the Presidency’s Social Employment Fund (SEF). After an application process that started in December 2021, and culminated in March 2022, Mr Kapueja, together with The Village Well and Wits Health Consortium secured a R16.5 million grant to deliver the project, partnering with The Village Well NGO to employ up to 1000 health volunteers in the City of Johannesburg, City of Matlosana and Rustenburg Local Municipality in the North West Province for short term work in health promotion in their local communities. This model is very different from the usual Youth Employment Initiative learnership, which typically lasts 12 months and engages youth in practical experiences and a recognised qualification, typically at NQF level 3-5.

The project inception was inspired by the challenges experienced in communities, especially in community health work, when health promotion activities fall to community volunteers. With inadequate resource and support, volunteers who receive training ultimately may end up in worse situations than when they started, leaving gaps in community health support and further economic marginalisation of the intended project beneficiaries. This loss of investment negatively affects the communities they serve and the local health system; not to mention the enormous negative impact on household incomes of volunteers. Health promotion at the individual and community level frequently experiences major setbacks in these instances.

The SEF fund supports the paid employment of those local health volunteers who may have been disengaged, aiming to relaunch these community health workers within local communities to strengthen local health systems, whilst improve youth employment and health behaviour change. Through the creation of local area health investment networks (LHIN) made up of representatives from the community, public and private sectors to promote support of health workers, the project will contribute to sustainable community health work

and improved status of project beneficiaries. It is envisaged that a network of SEF-supported health promoters can improve linkage to care for community members in need of health services.

Participants will receive short-term accredited training in home-based care, research skills training, community-based planning with local health stakeholders and conduct health promotion activities in households and through community events. Alongside this, researcher Dr Ware, has submitted a Strategic Grant Application to the CoE-HUMAN to collect data to test how this experience in community health work impacts the health of the participants themselves in comparison to other Youth Employment Initiatives.

The project is focused on developing health promotion skills and activating youth as agents of change in their community’s health. Towards this end, over the 9 months the participants will:

 Be provided with a meaningful professional work experience, training and a part qualification in the health and care economy,

 Be tracked to understand their health decision making experience and changes in health awareness,

 Help in expanding community access to health information, and

 Build community solidarity in organizations that promote healthier choices.

As an implementation science initiative, the LHIN project seeks to understand the impact of research within real world conditions. Therefore, Kapueja’s research activity in this project will focus on the methods and strategies that enable the uptake of evidence-based practice into public health policy and programs that focus on youth health. However, the research will also include investigating practices that seek to make community health work more impactful and sustainable.

Quantitative Statistics Learning Resources

A collaboration between the CoE-HUMAN and the MRC/Wits Developmental Pathways for Health Research Unit (DPHRU) led by Dr Lukhanyo Nyati have been running monthly webinars on different aspects of quantitative data analysis in health and social research to support learning and encourage methodological discussions. The series (June to November 2022) covers basic to advanced topics, such as hypothesis testing, longitudinal data analysis, data reduction methods, and meta-analysis – presented by experts within respective fields. On average the sessions have attracted between 60 and 90 participants. Attendees have included students from South African Universities and other African countries, health researchers from across the world, and even some policymakers and other stakeholders from the CoE-HUMAN’s wide networks. Three learning resources are available on the CoE-HUMAN website and YouTube Channel.

Statistical Learning Fast Track Series

Webinar 1: Spurious statistical relationships … what’s in a P-value?

Have you ever been disappointed by a statistically non-significant relationship? What did you do about it? A study assessing publication bias in the social sciences showed that two-thirds of papers where the null hypothesis is true never see the light of day; they are not even written up. However, more than 90% of those with strong statistical relationships are submitted for publication. What is the value of a statistical relationship in epidemiological research? Is assessing the p-value the best method to establish a meaningful epidemiological relationship or clinical relevance? This webinar will address some of the fallacies in statistical relationships while building on the foundations for hypothesis testing.

DR LUKHANYO NYATI

Dr Lukhanyo Nyati holds a PhD from the University of the Witwatersrand, Johannesburg (Wits), which focused on longitudinal modelling of the adolescent growth spurt in Birth to Twenty Plus (Bt20+) cohort. Currently, he is a Postdoctoral Fellow at the SAMRC Developmental Pathways for Health Research Unit (DPHRU), at Wits. He’s a former Biostatisitical Consultant for the Facult of Health Sciences, Wits, as well as providing undergraduate teaching in research design and statistics. Additionally, he has worked on several global projects including as a Lead Anthropometrist (South Africa) on the Oxford Interbio 21st Study, Data Analyst on the Bt20+ Human Capital Study, the IAEA/WHO/ OXFORD Multi-centre Body Composition References Study (IAEA MBCRS), and Data Scientist on the Healthy Life Trajectories Initiative (HeLTI) South Africa. He has a keen interest on longitudinal growth modelling.

WEBINAR DETAILS:

Thursday, 30 June 2022

14.30 SAST (UTC+2)

Host: Dr Lukhanyo Nyati –lukhanyo.nyati@wits.ac.za

Register in advance for this meeting: https://bit.ly/3yeVlBT

You will receive a confirmation email containing information about joining the meeting.

GLORY CHIDUMWA

Glory Chidumwa holds a BSc

(Statistics and Mathematics, University of Zimbabwe – 2014), Masters and PhD in Biostatistics (Wits University – 2021). He is one of the first four (4) fellows to receive funding for biostatistics masters training from the Wellcome Trust (UK) under the Sub-Saharan Africa Consortium for Advanced Biostatistics training (SSACAB) at Wits University in 2016. His PhD explored interactions between nine (9) chronic NCDs using data from the WHO Study on Global Ageing and Adult Health (SAGE) Wave 1 and Wave 2 in South Africa, with some aspects of generalized structural equation modelling (GSEM) and multilevel temporal Bayesian networks. He has worked as a data scientist for MRC/Wits DPHRU, the Centre of Excellence in Human Development at Wits University, WHO and Africa Health Research. Currently, he works as a statistician at AHRI, where he provides statistical support in medicine for PIs. His interest is in statistical aspects of longitudinal and cluster randomized trials as well as SEM.

About the Statistical Learning Fast Track Series:

The modern health scientist requires a specialised set of skills to handle the rapid growth of data in the field. The application of statistics demands a deep knowledge of the field and advanced computational skills. The Centre of Excellence (CoE) in Human Development has developed a 6-part webinar series which teaches key concepts in statistical application, using a fast track method to gain statistical knowledge and application. The topics will range from basic to advanced, covering topics like hypothesis testing, longitudinal data analysis, data reduction methods, and meta-analysis. Practical examples will be run on Stata, which is the recommended package for these webinars. However, attendees can follow the examples using their preferred statistical package. The goal of these webinars is to accelerate learning in biostatistical methods to help researchers and students to speedily grasp key concepts and methods.

www.wits.ac.za/coe-human/ 011 717 2680

In

https://www.youtube.com/channel/UCe13tI5O-JWiHLnBRg1sidw/videos

https://www.wits.ac.za/coe-human/learning-resources/

The series consists of six webinars focused on the following topics:

1. Spurious statistical relationships … what’s in a P-value?

2. To transform or not to transform … challenges with linearity in regression models?

3. Introduction to variance component models

4. Questionnaire development and factor analysis

5. Introduction to metanalyses and systematic reviews

6. The scientific method and reporting of scientific research

Unit

LifeLab Soweto

The LifeLab UK team from the University of Southampton based in England have over a decade of experience in increasing health literacy in youth and adolescents. Working alongside this team, the LifeLab Soweto project was initiated. The initial step was to conduct a needs analysis with young adults living in Soweto to understand how health is perceived and what are the gaps for health literacy that are contextually relevant. This study is comprised of two phases:

 The first phase was to understand need and cocreate a health literacy intervention, and

 The second phase to test the feasibility of the developed health literacy interventions through a LifeLab exhibition with Sowetan youth.

Phase 1 – Needs analysis and Cocreation of materials

NEET youth (age 18-25 years) from the areas surrounding the Jabulani site of operation were invited to form a ‘Youth Health Council’. These youth (21 males and 19 females) were then involved in multiple focus group discussions to understand health perceptions, needs and literacy gaps and to co-create health literacy materials and tools youth could identify with.

Participatory workshops with the youth council identified the top priority for health literacy training in this group as stress and the effects of stress on mental and physical health and health behaviour. Stress emanated in young people’s lives from lack of employment and education, as well as from relationships, food security and daily experienced living conditions. As a result, prototypes, narratives, and educational material were co-developed, leveraging and adapting existing materials in the Co-creation process through the collaboration with LifeLab UK. The materials and tools were adapted for the age group and the context in Jabulani.

Phase 2 – LifeLab Feasibility Testing

The second phase aimed to use the health literacy materials and tools with 100 NEET Sowetan youth (18-25 years) who were not a part of the intervention develop-

Epigenetics

Stressmaynotjustaffectyoubutyourfuturechildren,thisiswhereepigeneticscomeintoplay. Epigeneticsisthestudyofhowyourbehavioursandenvironmentcancausechangesthataffect thewaygeneswork.EpigeneticchangesarereversibleanddonotchangeyourDNAsequence butcanchangehowyourbodyreadsaDNAsequence.

Let’stakealookatthevideoonthescreenaboutepigenetics: https://youtu.be/NvonvYx-3-0

Whatareyourthoughtsonthevideowejustwatched?WhatimpactwillSifiso’shealthand choiceshaveonhischildren?

Stressandcardiovasculardisease

ment. The aim was to evaluate their perceptions of the health literacy intervention through survey feedback and interviews. This was done by creating a LifeLab Soweto exhibition space where prototypes were displayed including charts, instructions, and a work booklet. Young people were given the booklet and encouraged to explore the exhibition with minimal assistance following a set of instructions and recording their health indicators in the workbook, to promote self-learning. Results are compared with a fictional character, Sifiso and his aunt. The workbook takes the participant through a learning journey exploring Sifiso and his families experience. An example is shown below:

Peoplethathavechronicstressaremoreatriskforheartdiseaseandstroke(cardiovascular disease).Oneofthereasonsthishappensisbecauseourbloodvessels(veinsandarteries) becomestiffandarelessflexible(orstretchy)sodon’tcopesowellwiththeeverydaydemandsof ourbodies.Theflexibilityofourbodiesandtheflexibilityofourarteriesisoftenrelated.

TheSitandreachtest:

•TheSitandreachtestisagoodflexibility testofourhamstringsandlowerback.

•Measuringtheflexibilityofourlowerback andhamstringscangiveagood indicationofhowflexibleourarteriesare.

The team have now collected data from 107 young adults, with over 30 in-depth interviews conducted and analysis of the data is ongoing!

CoE-HUMAN, Stellenbosch Institute of Advanced Study, and DOHAD Africa Partnership

In March, researchers from over 10 countries gathered under one roof at the Stellenbosch Institute for Advanced Study’s (STIAS) Summer School –under the theme “Developmental Origins of Health and Disease: Consolidating Theory into Practice”–to young scientists how to locate their research interests and outputs into the world. The convening was a partnership between STIAS, the DSI-NRF CoEHUMAN and the DOHaD Africa Chapter.

The thin line between theory and practice has been contentious across many fields. Yet, across these disci-

plines, scientists and practitioners often find themselves working toward the same goal – finding solutions to the myriad of society’s problem. From preventing diseases to correcting the history of science, the Summer School was designed to bridge this gap by capacitating young scientists. The curriculum was developed by experts from across the globe and covered a diverse range of topics including, amongst others, developmental origins of health and disease theory; DOHaD epidemiology, cardiovascular disease, and diabetes; improving maternal health during pregnancy, optimising adolescent health as well as public health policy and the SDGs.

CoE-HUMAN Think Tank on Behaviour Change during Times of Crises

The goals of policy making across national government include maximising the health and wellbeing of the population, making sure that the country’s resources are managed effectively and sustainably, and ensuring that citizens are treated equitably. During the COVID-19 pandemic the behaviour of citizens and organisations played a pivotal role in achieving these objectives. The COVID-19 pandemic presented an unprecedented challenge which required citizens to drastically change behaviour to curb the spread of the disease.

Consequently, the CoE-HUMAN convened a Think Tank of multidisciplinary experts in the field of behaviour change which commited to producing the following outputs:

Think Tank Panel Co-leads:

 A systematic review of Government behaviour change guidelines and documented the global effectiveness of the implemented preventative strategies and challenges in their implementation.

 National qualitative study investigating the perceptions and impact of the pandemic across South Africa to understand citizens compliance with policies put in place by the government.

 A national survey to determine context specific behaviour solutions during a pandemic; and

 A Guideline Document of recommendations for South Africa based on the evidence and recommendations from the Think Tank.

Professor Shane Norris is Director of the DSI-NRF Centre of Excellence in Human Development and Director of the MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics at the University of the Witwatersrand. He is a coprincipal investigator of the Birth to Twenty Plus Cohort study and principal investigator of the Soweto First 1000 Days cohort. His research interests include child growth and development, obesity, and inter-generational risk of metabolic disease.

Associate Professor Catherine Draper – SAMRC DPHRU, CoE-HUMAN is an Associate Professor in the SAMRC/Wits Developmental Pathways for Health Research Unit at the University of the Witwatersrand. She has a background in Psychology and the social sciences and obtained her PhD in Public Health in 2005 from the University of Cape Town. Dr Draper’s research interests include the development and evaluation of communitybased health promotion interventions, behaviour change, implementation science, and early childhood health and development.

Research assistant:

Dr Takana Mary Moyana – CoE-HUMAN is a postdoctoral student in the SAMRC/Wits Developmental Pathways for Health Research Unit at the University of the Witwatersrand. She has a background in nutrition and public health and obtained her PhD in Public Health Nutrition in 2022 from North-West University. Dr Moyana’s research interests include the development origins of health and disease and evaluation of community-based health promotion interventions.

Invited members:

Associate Professor Alastair van Heerden – HSRC is Research Director of the Centre for Community Based Research at the Human Sciences Research Council (HSRC) and an Honorary Associate Professor in Clinical Medicine at the University of Witwatersrand, South Africa. He has over 10 years of experience conducting clinical, behavioural and community-based research throughout East and Southern Africa, the United States, Nepal and Brazil. He has an interdisciplinary focus to his research which combines his interest in technology for development and public health with the aim of improving access to care for underserved and poorly resourced communities.

Associate Professor Lucia Knight – University of Cape Town is an Associate Professor and the Head of the Division of Social and Behavioural Sciences in the School of Public Health at the University of Cape Town, South Africa. She has training in social anthropology, family demography and population studies with a PhD from the London School of Hygiene and Tropical Medicine. Her current research focuses on the development of social and behavioural interventions to improve access to HIV treatment and care and ART adherence. She is also conducting research on the quality of maternal health care and is exploring new areas of research in sexual and reproductive health. She has extensive teaching and supervision experience and convenes the Social and Behavioural Sciences track of the master’s in public health, including the teaching of qualitative research methods

Prof Susan Goldstein – SAMRC Centre for Health Economics and Decision Science, PRICELESS SA is a public health medicine specialist and Deputy Director and COO at the SAMRC Centre for Health Economics and Decision Science-PRICELESS SA. She worked at the Soul City: Institute for Social Justice (SCI) for over 22 years, communicating about Health through drama with both adults and children.

Pathmanathan (Pat) Govender – Behavioural Science Practitioner – Pat pioneered the behaviour change approach in communications in South Africa in the year 2000 when he established Red Chili Communications – South Africa’s first marketing and advertising agency specialising in behaviour change and social marketing. He is a specialist behavioural science and behavioural change communications practitioner, with a long-spanning career in key positions in South Africa. He has served as the Communications Adviser to the late Professor Kader Asmal during his tenure as Minister of Water Affairs. He also spearheaded the Communications Division of the Constitutional Assembly (CA), which was responsible for drafting the South African Constitution. The CA was headed at the time by the now President of South Africa, Cyril Ramaphosa. Today, Pat runs The Behaviour Change Agency (BCA), South Africa’s first specialist behaviour change agency that combines behavioural and data science with creativity to solve major societal and business challenges. They have run numerous behavioural interventions in the areas of Early Childhood Development, Green Buildings, Addressing Alcohol Abuse, Financial Empowerment and Mental Health, amongst others. He holds an MSc in Behavioural Science from the London School of Economics and an MBA from the University of Birmingham (UK).

Mia Malan – Bhekisisa is the health editor and heads up the health journalism centre, Bhekisisa. The centre runs critical thinking forums on health issues and health journalism trainings. Mia started reporting on health when she landed her first job at the SABC’s Eastern Cape office in 1995.

Nicola Christofides – Wits University is an associate professor in public health with a focus on behavioral sciences. My research interests lie in designing and evaluating behavioral and structural interventions to prevent intimate partner violence (IPV) and HIV, and improve maternal health outcomes. Based in Johannesburg, South Africa, I am presently co-Principal Investigator (PI) for a cluster randomized controlled trial that is evaluating the National Department of Health flagship mobile health intervention to address maternal and infant health called MomConnect. Additionally, I am a co-investigator on the first longitudinal study in South Africa investigating the inter-generational transmission of violence. Young adults who were first interviewed in 2010 will be followed up. The study will be implemented across three generations: young adults, their children and their caregivers. I was the PI for a cluster randomized controlled trial that evaluated the effectiveness of the Sonke CHANGE community mobilization and advocacy intervention to reduce men’s perpetration of sexual and/or physical intimate partner violence (IPV) and severity of perpetration by men over twoyears of follow-up (2015-2018). The study has contributed to deepening the understanding of the field about what works to prevent IPV and whether further investment in community mobilization and education interventions is justified.

Prof Mark Tomlinson – Stellenbosch University is based in the Department of Psychology at Stellenbosch University. His scholarly work has involved a diverse range of topics that have in common an interest in factors that contribute to compromised maternal health, to understanding infant and child development in contexts of high adversity and how to develop community based intervention programmes. He has completed four large randomised controlled trials aimed at improving maternal and child health and child development. His team is currently following up the cohorts in two of these trials – children aged three years and aged 13 years. Prof Tomlinson is one of two Research Directors of PRogramme for Improving Mental health carE (PRIME). The goal of PRIME is to generate evidence on the implementation and scaling up of treatment programmes for priority mental disorders in primary and maternal health care contexts in five countries (Ethiopia, India, Nepal, South Africa and Uganda) He has received research grants from the Wellcome Trust (UK), National Institute of Alcohol Abuse and Alcoholism (NIAAA); National Institute of Drug Abuse (USA); National Institute of Child Health and Human Development; the Department for International Development (DfID -UK), and recently from Grand Challenges Canada. He has published over 100 papers in peer reviewed journals, edited two books and published numerous chapters. He is an Associate Editor of Infant Mental Health Journal, and is also on the Editorial Boards of PLoS Medicine; Psychology, Health and Medicine; International Health; and Mental Health and Prevention.

Prof Zoleka Soji – Nelson Mandela University works as a HOD and Associate Professor at Nelson Mandela University. She is an associate professor in the field of social development professions, with many years of experience in social work in disadvantaged areas of South Africa.

SOCIO-ECOLOGICAL & TRANSFORMATIONAL DEVELOPMENT

the study of interactions between societies, households and their natural environment

cognitive, and emotional development

106966. https://doi.org/10.1016/j.ypmed.2022.106966

A child’s long-term social, cognitive, and emotional development are greatly influenced by their early experiences. Due to their parents’ limited ability to invest in their development, children growing up in low- and middle-income communities or countries are at danger of not reaching their developmental potential. Low cognitive and/or socio-emotional development affects approximately 80.8 million children between the ages 3-4, with sub-Saharan Africa having the highest rate of this condition (29.4 million)

Joan Christodoulou, a postdoctoral fellow from Palo Alto University USA, looked at the township community characteristics that predicted high rates of child resilience. The data were from 1,238 South African pregnant women recruited from households in neighbourhoods identified in three of the major Cape Town townships

(Khayelitsha, Mfuleni, and Gugulethu). Mothers and their children were followed up at six visits over a fiveyear period. Children who consistently met international standards for development, cognitive ability, and behaviour were classified as resilient.

The results showed that the proportion of resilient children varied considerably by neighbourhood (from 9.5% to 27%). The neighbourhoods with a high prevalence of resilient children had more mothers who were older, and in a formal home sheltering three or more people with access to electricity and water. Resilient children in these neighbourhoods had greater food security and were less likely to have mothers who were low in mood.

The authors conclude that, even though their assessment of resilience is multi-dimensional, that resilience can fluctuate over time and how these children deal with school remains to be seen.

Surroundings play a significant role in social,

Christodoulou, J., Rotheram-Borus, M. J., Hayati Rezvan, P., Comulada, W. S., Stewart, J., Almirol, E., & Tomlinson, M. (2022). Where you live matters: Township neighborhood factors important to resilience among south African children from birth to 5 years of age. Preventive Medicine, 157,

A look into the building blocks of peace in Zimbabwe

The history of today’s Zimbabwe has been marked by recurring patterns of violence and violations of human rights, frequently on a large scale. The social, political, and economic turmoil of the country has put its condition of peace in a precarious position. In 2004, the creation of informal peace committees signalled a shift in the dynamics of local peace interventions away from external elite interventions and toward a better appreciation of the potential of localized indigenous village and community informed solution-focused perspectives and initiatives.

Any conflict-affected society’s chances for establishing peace depends on its ability to create and put in place an inclusive peace infrastructure in response to the opportunities and obstacles presented by war. Prior to colonialism, many Zimbabwean villages had local peacebuilding programs like traditional courts in place for many years, but their ideas about peacebuilding are still rarely acknowledged or valued.

Dr Norman Chivasa, a post-doctoral fellow in the Peacebuilding programme at Durban University Technology,

looked at data from the Seke district of Mashonaland East province, Zimbabwe to investigate how ward and village citizens perceive peacebuilding as they display (practice) local agency to reject top-down methods to peace and development. This study is a component of a larger attempt to understand more about how Zimbabwe’s common citizens contribute to fostering community peace through establishing ward and village peace committees.

Findings show that the failure of liberal peacebuilding in Zimbabwe demonstrates the necessity of a strong, innovative, and multifaceted solution that includes a variety of actors and institutions, both formal and informal, to address Zimbabwe’s peace difficulties. Furthermore, the NPRC, Zimbabwe’s new national peace strategy, is encouraged by citizens of the Seke district who believe that hybrid peacebuilding can address regional peace concerns.

It is evident that healing encompasses more than simply the past; it also considers how the past may impact the present and the future.

A pragmatic approach to education during the pandemic

The recent COVID-19 pandemic forced many of us to adapt and find new ways to do things. This was especially true for educational institutions when in person teaching and classes were closed to prevent new infections.

Dr Makhulu Makumane, a lecturer at the National University of Lesotho, examined how pragmatism (i.e., combining experience with actions to deploy whatever works in specific situations to achieve the desired outcome) was portrayed in publications discussing the use of digital technology use for education during the pandemic. Two questions served as the study’s compass:

1. How does pragmatism manifest itself in academic works on COVID-19?

2. Why are there specific ways that pragmatism is represented?

Findings demonstrate an onslaught of digital tools (Learning Management Systems and SMS-based technologies) employed in education during the COVID-19 era, contributing to the introduction to 5IR. The 2020 academic year was salvaged by practically all higher education institutions because of this pragmatic approach of staff and students to realise their needs, despite the difficulties that they encountered.

Makumane, M. A., Khoza, S. Bheki., & Piliso, B. B. (2022). Representation of Pragmatism in Scholarly Publications on COVID-19. International Journal of Higher Education, 11(2), 161. https://doi.org/10.5430/ijhe.v11n2p161

LIFE COURSE DEVELOPMENT

the study of human development from conception to death

In addition to the existing heavy burden of infectious disease, South Africa is also grappling with increasing levels of chronic disease. Dr Clara Calvert, from the University of Edinburgh Centre for Global Health Research, analysed data from ninety-four adult participants from Soweto who were issued with a chronic disease risk self-measurement kit. The kit was delivered to each participant at their home by a Community Health Worker (CHW) and included a tablet with a set of instructions for taking each measurement and recording the data, an automated blood pressure monitor, a tape measure, a urine dipstick, and disinfecting spray and wipes.

After the participants took their own measurements and entered their results on the tablet, the CHW immediately repeated and recorded the same measurements on participants using the same equipment. This was to determine how accurate the self-recorded data was in comparison to the measures taken by the trained CHWs for blood pressure, resting heart rate, height, waist circumference and urine glucose and protein.

The overall percentage agreement between the self-measured and the CHW-measured variables ranged from 80% for urine testing to 91% for the identification of central obesity (classified as a waist circumference greater than half of the height measurement). Concordance correlation coefficients ranged from 0.78 for waist circumference to 0.93 for height. Self- and CHW measures for the categorization of high blood pressure were consistent for over 90% of participants and had a Kappa coefficient of 0.76 indicating substantial agreement.

Although participants experienced challenges with urine testing and height self-assessment, they recognized the value of self-testing and generally regarded procedures as simple. This pilot study adds to the expanding body of research on the use of home self-testing in disease prevention and detection, particularly for blood pressure and central obesity. The approach may make it easier to identify people at risk for cardiometabolic disease in low-income settings and present a viable alternative to in person attendance at healthcare facilities.

Self-assessment and self-reporting of chronic disease risk factors from home may present a viable alternative to primary care clinic visits, especially during a pandemic!

Calvert, C., Kolkenbeck-Ruh, A., Crouch, S. H., Soepnel, L. M., & Ware, L. J. (2022). Reliability, usability and identified need for homebased cardiometabolic health self-assessment during the COVID-19 pandemic in Soweto, South Africa. Scientific Reports, 12(1), 7158. https://doi.org/10.1038/s41598-022-11072-4

Exploring the link between sleep, mental health, and physical activity in urban African young women

Dr Catherine Draper, from the University of Cape Town, investigated the relationships between sleep, physical activity, and sedentary behaviour among young South African women (18-26 years old) from over 20,000 households in historically disadvantaged urban areas.

Sedentary behaviour or physical inactivity has been associated with mental health issues like anxiety, depression, and ongoing stress. This cross-sectional analysis examined the relationship between risk factors (adverse childhood experiences, harmful alcohol use, social vulnerability), protective factors (self-efficacy and social support), and health behaviour outcomes (physical activity, sitting, screen and TV time, and sleep duration and quality).

Using multiple regression models, she showed that depression (β=0.161, p <0.001), anxiety (β=0.126, p=0.001), adverse childhood experiences (β=0.076, p=0.014), and alcohol use risk (β=0.089, p=0.002) were all linked to poor quality sleep. These findings were further supported by binomial logistic regression analysis, which

showed that anxiety and depression doubled the risk of poor sleep (OR=2.425, p <0.001, OR=2.036, p =0.003 respectively).

In relation to the examined movement behaviours, more screen time (β=0.105, p <0.001) and television time (β=0.075, p <0.016) were linked to alcohol-use risk, whereas less sitting (β=−0.187, p <0001) and screen time (β=−0.014, p <0.001) were linked to social vulnerability. Young women with higher moderate- to vigorous-intensity physical activity levels (β=0.07, p=0.036), better quality sleep (β=−0.069, p =0.020), and less television watching time (β=−0.079, p =0.012) also showed higher levels of self-efficacy. While more sitting time was correlated with having no family support (β=0.075, p=0.022).

These findings, together with previous qualitative research, highlight the need to further explore the connections between sleep, mental health and health behaviours among young women and support the need for interventions, to enhance the physical and mental health of young women from low-income environments.

Draper, C. E., Cook, C. J., Redinger, S., Rochat, T., Prioreschi, A., Rae, D. E., Ware, L. J., Lye, S. J., & Norris, S. A. (2022). Crosssectional associations between mental health indicators and social vulnerability, with physical activity, sedentary behaviour and sleep in urban African young women. International Journal of Behavioral Nutrition and Physical Activity, 19(1), 82. https://doi.org/10.1186/s12966-022-01325-w

Dietary related inflammation during pregnancy and the impact on gestational weight gain

Wrottesley, S. V., Shivappa, N., Prioreschi, A., Hébert, J. R., & Norris, S. A. (2022). Anti-inflammatory diets reduce the risk of excessive gestational weight gain in urban South Africans from the Soweto First 1000-Day Study (S1000). European Journal of Nutrition. https://doi.org/10.1007/s00394-022-02931-x

Rapid urbanization and a shift to westernized, energydense, and ultra-processed foods alongside increa singly sedentary lifestyles have contributed to a double burden of under- (poor micronutrients) and over- (macronutrient excess) nutrition in low- and middle-income nations. During pregnancy, a higher intake of more westernized, high-sugar diets and maternal obesity in early pregnancy have been linked with higher maternal weight gain and fetal growth during pregnancy, both associated with increased risk of cardiometabolic disease. However, the specific mechanisms that lead to higher risk for both mother and infant, including the role of maternal inflammatory responses, are not fully elucidated within the South African setting.

Dr Stephanie Wrottesley, a post-doctoral student from the University of Witwatersand, investigated the perinatal relationship between maternal dietary inflammatory index (DII), gestational weight gain (GWG) and delivery outcomes in urban South African women to determine the role of inflammation. The analysis was nested within the Soweto First 1000Day Study (S1000), a longitudinal pregnancy cohort study run by the South African Medical Research Council (SAMRC) and the Wits Developmental Pathways for Health Research Unit (DPHRU) at the Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto, Johannesburg.

Findings indicated that, in this fast urbanized area (Soweto, South Africa) where obesity prevalence rates are high, consumption of an anti-inflammatory diet during pregnancy decreased the risk of excessive GWG. More research is needed to fully comprehend how maternal nutrition influences maternal obesity, inflammation and fetal programming.

INTERGENERATIONAL DEVELOPMENT

the study of human development across generations

Does maternal hyperglycaemia impact early child de-

velopment in South African

children?

(2022). Cognitive and Motor Development in 3- to 6-Year-Old Children Born to Mothers with Hyperglycaemia First Detected in Pregnancy in an Urban African Population. Maternal and Child Health Journal. https://doi.org/10.1007/s10995-021-03331-z

Soepnel, L. M.,

Hyperglycaemia (high blood glucose) during pregnancy may have deleterious effects on foetal neurodevelopment with the potential to impact longerterm cognitive development through childhood. However, little research has been conducted in South African mothers and children utilizing public healthcare facilities.

Between March and November 2019, Dr Larske Soepnel, a post-doctoral fellow at the University of Witwatersrand, recruited mothers and children at the Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto. Using the Herbst Early Childhood Development Criteria test, the cognitive abilities of 95 children born to mothers with hyperglycaemia first detected in pregnancy (HFDP) were compared to 99 children who had not been exposed to maternal HFDP.

In the cognitive subsection of the test, infants who were born at term and exposed to hyperglycaemia utero scored “high” in 24.3% of cases and “low” in 25.7% of cases, compared to 37.7% and 12.9 percent in the HFDP-unexposed group, respectively. For children born atterm, ordinal regression analysis with known confounders showed that cognitive development in pre-school children was inversely correlated with exposure to HFDP.

The authors concluded that more children could achieve their developmental potential if women’s health before and during pregnancy is optimised, including glucose control during pregnancy.

Does maternal hyperglycaemia impact the blood pressure of South African children?

Journal of Hypertension, 40(5), 969–977. https://doi.org/10.1097/HJH.0000000000003102

Continuing in the same vein, Brittany Boersta, a Master’s graduate from Utrecht University, investigated the relationship between maternal HFDP and children’s blood pressure in Soweto, South Africa, among children aged 3 to 6 years. Maternal hyperglycemia during pregnancy was retrospectively determined using hospital records and blood pressure was measured in 189 children in Soweto.

While half (49.7%) of the children exhibited elevated blood pressure, this was not found to be associated with maternal hyperglycemia when adjusted offspring

age, height, and sex or after multivariable adjustment. However, the child’s BMI for age z-score was a significant predictor of systolic blood pressure in childhood.

Although childhood blood pressure does not seem related to maternal hyperglycaemia, the high incidence of raised blood pressure in this group of preschool children is alarming. Further work is needed to develop interventions for childhood obesity as a modifiable risk factor for lowering blood pressure and cardiovascular risk in an African paediatric context.

Nicolaou, V., Draper, C. E., Levitt, N. S., Klipstein-Grobusch, K., & Norris, S. A.

Boerstra, B. A., Soepnel, L. M., Nicolaou, V., Kolkenbeck-Ruh, A., Kagura, J., Ware, L. J., Norris, S. A., & Klipstein-Grobusch, K. (2022). The impact of maternal hyperglycaemia first detected in pregnancy on offspring blood pressure in Soweto, South Africa.

Early life growth is known to be a key indicator and influencer of early child development. Whether this growth mediates relationships between maternal education and socioeconomic status and child development is not clear.

Dr Wiedaad Slemming, a postdoctoral researcher at the University of Witwatersrand, analysed retrospective data from the South African Birth to Thirty cohort study to examine the maternal education and socioeconomic status (SES) of the household during pregnancy and the first two years of life, with growth data collected between birth and 4 years of age. Parents or caregivers completed a Revised Denver Pre-screening Devel-

opmental Questionnaire (R-DPDQ) when their children were age 5.

Findings showed that higher birthweight and household SES were associated with higher development scores in both boys and girls. Higher linear growth in boys, especially between 0 and 2 years, was associated with higher development scores at age 5. Growth status but not SES mediated the association between maternal education and development scores suggesting that the negative effects of lower maternal education on child development could be attenuated by better growth in the early years.

How does maternal education, socioeconomic status, and early-life growth influence child development in low resource settings?

Slemming, W., Norris, S., Kagura, J., Saloojee, H., & Richter, L. Child development at age 5 years: The effects of maternal education, socioeconomic status and early-life growth examined prospectively in a low resource setting. South African Journal of Child Health. 2022;16(2): 111.

Societal and Knowledge Impact, Importance and Continued Relevance of the CoE-HUMAN

We are guided by the NRF’s definition of impact as:

A beneficial change in society or knowledge advancement, brought about as a direct or indirect result of the NRF’s research support interventions, whether planned or unintended, immediate or longer-term.

We achieve this impact through facilitating the funding of our students, and through our work as highlighted below.

 Within South African communities – we conduct nationally representative surveys (South African Human Development Pulse Survey 2021 and 2022), and our national and international online Fast Facts Surveys 2021 and 2022

 Through our Grantees, we investigate issues of national importance and challenge including the COVID-19 pandemic, the Fourth Industrial Revolution, Climate Change and Rural Development

 We develop online quantitative and qualitative learning resources for students, the research community, clients, key stakeholders, and interested parties

 Championed by our Postdoctoral Fellows, we investigate:

– Youth Unemployment in South Africa and highlight the drivers of unemployment and perceptions of youth employment initiatives

COVID-19 and vaccine hesitancy

– Food insecurity and quality of life in South Africa

 We reach out to solidify relationships and partner with HDIs across South Africa on collaborative research projects led by PIs within these institutions.

 We promote our projects, spearheaded by our black researchers related to Food Ecology, Adolescent Mental Health, Digital Solutions to Tackle Mental Health, Climate Change and Youth Advocacy, Future Proof Youth Skills for Productivity and employment, Soweto Men’s Cohort and the Future of Society.

 We showcase relevant case studies of community impact, intergenerational research and impact, and early childhood development in South Africa.

We continue to make an impact within the research enterprise (knowledge impact), as well as within society (societal impact). Since inception and more so in 2022, we have enabled, facilitated, and performed excellent research which sought to extend knowledge frontiers, advance innovation, and address national challenges.

To further this vision and enhance our national footprint, the CoE-HUMAN continues to form part of the body of Anchor Institutions of the National Policy Data Observatory

This knowledge and societal impact research results in various outputs based on the research activities, processes, and collaborations. These include, among others, new knowledge, publications, conference papers, policy briefs and increased engagement and collaboration leading to new research networks. Moreover, we promote CoE-HUMAN science engagements through events with the community (such as the launch of the BT30 book, and community engagement events with the Wits Health Hubb in Soweto); and via media reports on science and research (our research nuggets which

gain extra exposure in the broader media, and institutional communications).

Research undertaken by the CoE-HUMAN and the generated outputs are guided by the principles of equality, diversity, and inclusion (EDI), scientific rigour and interdisciplinary research, processes, methods and collaborations.

We are confident that our newly formulated thematic area: socio-ecological and transformational develop-

An NSI that serves all

 1996 WP on S&T

 NACI established 1997

 NRF consolidation 1999

 Biotechnology Strategy 2001

 National Research Development Strategy 2002

 Separate department for S&T (DST), 2004

2006-2018

ment will enhance the reach and impact of the CoEHUMAN within societal, economic, environmental and knowledge domains as elucidated by the NRF and the field of climate change and environmental sustainability, education for the future and the future of society as detailed within the DSI Decadal Plan. Through our newly-articulated theme we will endeavour to enhance the research focus and outputs on socio-economic development, environmental sustainability, and a capable state – as espoused within the Plan.

NSI responds to post1994 demands

 SA Research Chairs Initiative 2006

 Hydrogen SA 2007

 Ten-Year Innovation Plan 2008-2018

 IP rights from R&D Act 2008

 SANSA enacted 2008

 TIA 2008

 Ministerial Review of the NSI 2012

 Bio-economy Strategy 2014

2019

NSI increases focus on STI for socioeconomic development, environmental sustainability and a capable state in a rapidly changing world

 WP on STI 2019

 DST becomes DSI 2019

 Review of NRDS & TYIP 2020

 Ministerial Review of higher education, STI institutional landscape 2021

The CoE-HUMAN also subscribes to the philosophy of the Decadal Plan to “continue building the national system of innovation (NSI) towards greater impact on addressing South Africa’s national priorities.” Furthermore, we appreciate the critical role the CoE-HUMAN is expected to play in the management of societal grand challenges (SGCs).

As contained in the Decadal Plan:

 Due to their interdisciplinary nature, addressing the SGCs requires that all NSI actors be involved. Dynamic partnerships will be critical to achieving the outcomes and impact envisaged. Knowledge produced by all the sciences – including the humanities and social sciences – must be mobilised in the development of appropriate STI interventions included under each of the SGCs.

 The humanities and social sciences, in line with their role of understanding the context-specific nature of national development challenges, are necessary participants in the conceptualisation, planning, and execution of innovation initiatives in the framing of the Decadal Plan. The humanities and social sciences are critical for the continued redefinition and remaking of South Africa over the next decade.

The Decadal Plan further highlights the importance of the humanities and social sciences (HSS) and therein, the CoE-HUMAN:

 The contribution and value of HSS to our understanding of the social and cultural aspects of the world is self-evident.

 Discipline-specific knowledge further complemented by interdisciplinary studies addressing SGCs.

 Support for research, data collection and education and training in the HSS is especially important if we are to secure the benefits of innovation and productivity growth.

 HSS are critical in highlighting the social acceptance and integration of new technologies.

 There are implications, of research on and development of new technologies, for international competitiveness and long-term employment growth. Each of these issues transgresses the individual priority areas considered in the Decadal Plan, and each involves insights from a wide variety of HSS knowledge fields.

CoE-HUMAN Performance Report: Status of Service Level Agreement and Business Plan Targets 2022/2023

When combined, the CoE-HUMAN had a total of 80 Service Level Agreement (SLA) and Business Plan (BP) target for 2022 (Appendix 2). To this end, the CoEHUMAN:

 Achieved 72 targets (or 90%)

 4 targets in process (or 5%)

 4 targets are unmet (or 5%)

The table below details targets not achieved, the reasons and the plan to address going forward to ensure the target is achieved.

Several applicants put forward were not approved. Plans will be put in place to undertake discussions with the NRF to ensure alignment of student criteria to be addressed through the screening and nomination phase(s).

While not met, there has been an improvement from 2021 by 5%.

Strategic opportunities will be put in place to meet this target.

Several applicants put forward were not approved. Plans will be put in place to undertake discussions with the NRF to ensure alignment of student criteria to be addressed through the screening and nomination phase(s).

Strategic plan will be implemented to engage DVCs within the CoE-HUMAN network to get more applications from disabled students.

Of the 80 combined SLA and BP targets for 2022:

 64 (or 80%) are official CoE-HUMAN targets (as per the SLA and reflected in the BP); with

 16 targets (or 20%) set by the CoE-HUMAN over-and-above the expected SLA targets required by the DSI and NRF.

Not only has the CoE-HUMAN met 90% of official DSI-NRF targets, we have gone above and beyond official requirements – as presented in the table below.

NRF

The CoE-HUMAN in 2023

With the CoE-HUMAN celebrating 10 years in 2023, our aim is to take stock of what we have accomplished within the national Human Development space, to celebrate our achievements, and to articulate our new strategic vision in continued pursuit of research excellence and in service of Human Development in South Africa and beyond. We look forward to welcoming our new Director.

APPENDICES COE-HUMAN ANNUAL REPORT 2022

Service Level Agreement

Preamble:

This Service Level Agreement is linked to the Memorandum of Agreement between the NRF and the University of the Witwatersrand

Activities related to the Current Stage:

• Research outputs

Research outputs of students will be increased to 70+ journal article outputs in ISI- recognised journal and reporting of research outputs will indicate the roles of authors, students and collaborators.

• Networking

– The CoE is reaching out to Historically Disadvantaged Institutions to increase its grant and student support in these institutions.

– Stronger working relationships established with key stakeholders’ communications’ people (DSI, NRF, Wits Comms, Wits Alumni)

• Knowledge transfer

– The CoE shall make available to the NRF, on a quarterly basis (March, June, September and December), current “nuggets” of information for publication on the CoE website.

– While the current high level of knowledge transfer activities will be maintained, we intend to concentrate dissemination activities to 3-4 carefully selected topics per year.

• Service delivery

– CoE researchers maintain a high level of service delivery through membership of professional and disciplinary societies, editorial boards of journals, and policy committees in South Africa and abroad.

• Capacity development – The CoE shall provide to the NRF a list of students that are being supported by the Centre by March July of each year, using the student nomination platform on the NRF online submission system. Additional students can be appended to this list as and when they arrive.

– Student capacity development will be carried out through the outlined training workshops

Attendance and feedback (rating) from each training workshop will be documented and presented

• Growing team spirit

– The CoE works to maintain its excellent relationships with stakeholders, CoE researchers, grantees and students.

– The CoE will work closer with the SAMRC Developmental Pathways for Health Research Unit

• Sustainability

– Exploring potential collaborators, partners and funders is ongoing, and the CoE will continue to apply for research and innovation grants to increase its leveraged funds and grow its research and innovation outputs. Leveraged funds will be a key indicator.

A detailed short- and longer-term sustainability plan to the Steering Committee.

Financial responsibilities:

• The CoE shall present an audited set of financial statements at the March-April 2023 Steering Committee meeting reflecting the financial situation of the CoE during the previous financial year (January to December 2021).

• The CoE shall submit quarterly cash-flow statements within 15 days of the end of each quarter, indicating expenditure and commitments.

Reports due in this Stage:

• The CoE shall submit an Annual Progress Report including Gate Review Documentation by no later than February 2023 to be reviewed by the CoE Steering Committee.

• The CoE shall comply to the NRF rule to submit the NRF online APR and shall meet the deadline set by the NRF (which currently is the end of February, unless a new date is set and provided that it is communicated two months in advance)

• The CoE shall submit a Statement of Compliance by no later than March 2023.

• The CoE will put out a call for postgraduates and postdoctoral fellows in January 2023 and ensure successful candidates from this call respond to the annual NRF call as part of its obligations in terms of nominations.

Standard Output Targets per annum in the Current Stage:

1. Research

• Number of peer-reviewed publications that acknowledge funding from the CoE ≥ 60 (must be ISI rated) which is increased from 2021

• Number of peer-reviewed publications, acknowledging the CoE (impact factor >5) ≥ 5

• Policy inputs or policy evaluations ≥ 2

• CoE researchers maintain or improve their NRF rating ≥ 6/9

2. Education and Training

• Total number of bursaries awarded ≥ 48 in total

• 1% of bursaries will be awarded to disabled students

• Women ≥ 55% of all students

• ≥ 95 % of all students supported will be South African

• Black South African students ≥ 90% of all SA students supported (Black = African, Coloured, Asian and Indian)

• Only up to 5% of bursaries will be awarded to international students (SADC; other African; non-African continent students)

• Post-doctoral Fellows < 15% of all bursaries awarded

• Education and training workshops, conferences, symposia ≥ 5

3. Dissemination

• Dissemination pieces (“nuggets”) ≥ 4

• CoE Events (Exhibitions, symposia, conferences etc) increased to 10

• Media coverage (print, radio, television, social media) ≥ 35

4. Networking

• Collaborative agreements in total ≥ 20

• Growing and Supporting Excellence Campaign – visit to 2 Historically Disadvantaged Universities with intention to sign 2 new Collaborative Agreements

• Number of workshops, symposia, seminars convened or funded ≥ 5

• Host DOHAD student training event ≥ 1

5. Service

• CoE researchers serving on journal editorial boards = 8/9

• CoE researchers serving on local science or policy committees = 8/9

• CoE researchers serving on international science or policy committees = 8/9

Special Output Targets for the Current Stage:

• Stronger working relationships established with key stakeholders’ communications’ people (DSI, NRF, Wits Comms, Wits Alumni)

• Recruit up to 600 members signed up for the DOHAD AFRICA chapter

• Host student training events

• The CoE will continue to strive to have a sound working relationship between the CoE host institution and the satellite institutions.

• Allocate 1 Opportunity Grant to researchers at the University of Limpopo

• Continuing students’ progress reports template will be provided to the students upon receipt from the NRF and evaluated by the CoE/Wits University assessment committee.

Appendix 2: SLA Targets and achievements

CoE-HUMAN 2022-2023 BUSINESS PLAN Targets and Achievements

Appendix 3: Peer-Reviewed Publications

Journal Articles

Sixty one articles published in journals (10 with impact factors of >5)

1. Alabi, A. O., & Mutula, S. M. (2022). Human development for the fourth industrial revolution: Which way for Sub-Saharan Africa? Development Southern Africa, 1–15. https:// doi.org/10.1080/0376835X.2022.2098090

2. Anakpo, G., & Oyenubi, A. (2022). Technological innovation and economic growth in Southern Africa: Application of panel dynamic OLS regression. Development Southern Africa, 1–15. https://doi.org/10.1080/0376835X.2022.2052017

3. Black, R. E., Liu, L., Hartwig, F. P., Villavicencio, F., Rodriguez-Martinez, A., Vidaletti, L. P., Perin, J., Black, M. M., Blencowe, H., You, D., Hug, L., Masquelier, B., Cousens, S., Gove, A., Vaivada, T., Yeung, D., Behrman, J., Martorell, R., Osmond, C., … Victora, C. G. (2022). Health and development from preconception to 20 years of age and human capital. The Lancet, 399(10336), 1730–1740. https://doi. org/10.1016/S0140-6736(21)02533-2

4. Boerstra, B. A., Soepnel, L. M., Nicolaou, V., Kolkenbeck-Ruh, A., Kagura, J., Ware, L. J., Norris, S. A., & Klipstein-Grobusch, K. (2022). The impact of maternal hyperglycaemia first detected in pregnancy on offspring blood pressure in Soweto, South Africa. Journal of Hypertension, 40(5), 969–977. https://doi.org/10.1097/HJH.0000000000003102

5. Calvert, C., Kolkenbeck-Ruh, A., Crouch, S. H., Soepnel, L. M., & Ware, L. J. (2022). Reliability, usability and identified need for home-based cardiometabolic health self-assessment during the COVID-19 pandemic in Soweto, South Africa. Scientific Reports, 12(1), 7158. https://doi.org/10.1038/ s41598-022-11072-4

6. Chidembo, R., Francis, J., & Kativhu, S. (2022). A Review of the Achievements, Weaknesses, and Challenges of Rural Electrification through Solar Home Systems in South Africa. African Journal of Development Studies (formerly AFFRIKA Journal of Politics, Economics and Society), 2022(si2), 191211.

7. Chidembo, R., Francis, J., & Kativhu, S. (2022). Rural Households’ Perceptions of the Adoption of Rooftop Solar Photovoltaics in Vhembe District, South Africa. Energies, 15(17), 6157. https://doi.org/10.3390/en15176157

8. Chivasa, N. (2022). Reflections on Peacebuilding Constructs in Seke District, Zimbabwe. SAGE Open, 12(1), 215824402210772. https://doi.org/10.1177/21582440221077246

9. Christodoulou, J., Rotheram-Borus, M. J., Hayati Rezvan, P., Comulada, W. S., Stewart, J., Almirol, E., & Tomlinson, M. (2022). Where you live matters: Township neighborhood factors important to resilience among south African children from birth to 5 years of age. Preventive Medicine, 157, 106966. https://doi.org/10.1016/j.ypmed.2022.106966

10. Crouch, S. H., Soepnel, L. M., Kolkenbeck-Ruh, A., Maposa, I., Naidoo, S., Davies, J., Norris, S. A., & Ware, L. J. (2022). Paediatric Hypertension in Africa: A Systematic Review and Meta-Analysis. EClinicalMedicine, 43, 101229. https://doi. org/10.1016/j.eclinm.2021.101229

11. De Wet-Billings, N., & Anyanzu, F. (2022). The Effect of Additional Childcare Roles on COVID-19 Symptom Knowledge Among Youth in South Africa. The Open Public Health Journal, 15(1), e187494452201210. https://doi. org/10.2174/18749445-v15-e2201210

12. Dlamini, S. N., Norris, S. A., Mendham, A. E., Mtintsilana, A., Ward, K. A., Olsson, T., Goedecke, J. H., & Micklesfield, L. K. (2022). Targeted proteomics of appendicular skeletal muscle mass and handgrip strength in black South Africans: A cross-sectional study. Scientific Reports, 12(1), 9512. https://doi.org/10.1038/s41598-022-13548-9

13. Draper, C. E., Cook, C. J., Redinger, S., Rochat, T., Prioreschi, A., Rae, D. E., Ware, L. J., Lye, S. J., & Norris, S. A. (2022). Cross-sectional associations between mental health indicators and social vulnerability, with physical activity, sedentary behaviour and sleep in urban African young women. International Journal of Behavioral Nutrition and Physical Activity, 19(1), 82. https://doi.org/10.1186/s12966-02201325-w

14. Draper, C. E., Mabena, G., Motlhatlhedi, M., Thwala, N., Lawrence, W., Weller, S., Klingberg, S., Ware, L. J., Lye, S. J., & Norris, S. A. (2022). Implementation of Healthy Conversation Skills to support behaviour change in the Bukhali trial in Soweto, South Africa: A process evaluation. SSM –Mental Health, 2, 100132. https://doi.org/10.1016/j.ssmmh.2022.100132

15. Drysdale, R. E., Slemming, W., Makusha, T., & Richter, L. M. (2022). Male partners’ experiences of early pregnancy ultrasound scans in Soweto, South Africa: The Healthy Pregnancy, Healthy Baby randomised trial. South African Journal of Child Health, 16(2), 72.

16. Essack, Z., Groenewald, C., Isaacs, N., Ntini, T., Maluleka, M., Bhembe, L., Nkwanyana, S., & Strode, A. (2022). Lives versus livelihoods: South African adults’ perspectives on the alcohol ban during the COVID-19 lockdown. Journal of Substance Use, 1–5. https://doi.org/10.1080/14659891.2022.2 060141

17. Farrell, A., Mapanga, W., Chitha, N., Ashton, J., & Joffe, M. (2022). Characteristics, enablers and barriers affecting entrepreneurial behaviour for academics in low- and middle-income countries: A scoping review. Development Southern Africa, 1–15. https://doi.org/10.1080/037683 5X.2022.2027230

18. Flood, D., Geldsetzer, P., Agoudavi, K., Aryal, K. K., Brant, L. C. C., Brian, G., Dorobantu, M., Farzadfar, F., Gheorghe-Fronea, O., Gurung, M. S., Guwatudde, D., Houehanou, C., Jorgensen, J. M. A., Kondal, D., Labadarios, D., Marcus, M. E., Mayige, M., Moghimi, M.,Ware,L.J., Norov, B., … Manne-Goehler, J. (2022). Rural-Urban Differences in Diabetes Care and Control in 42 Low- and Middle-Income Countries: A Cross-sectional Study of Nationally Representative Individual-Level Data. Diabetes Care, dc212342. https://doi. org/10.2337/dc21-2342

19. Groenewald, C., Isaacs, N., & Isaacs, D. (2022). Adolescent Sexual and Reproductive Health During the COVID-19 Pandemic: A Mini Review. Frontiers in Reproductive Health, 4, 794477. https://doi.org/10.3389/frph.2022.794477

20. Jewett, S., Pilime, S., & Richter, L. (2022). (Non)Marketing of Breastmilk Substitutes in South African Parenting Magazines: How Marketing Regulations May Be Working. International Journal of Environmental Research and Public Health, 19(10), 6050. https://doi.org/10.3390/ijerph19106050

21. Khambule, I., & Mdlalose, M. (2022). COVID-19 and state coordinated responses in South Africa’s emerging developmental state. Development Studies Research, 9(1), 192–205. https://doi.org/10.1080/21665095.2022.2098791

22. Khambule, I. (2022). COVID-19 and the informal economy in a small-town in South Africa: Governance implications in the post-COVID era. Cogent Social Sciences, 8(1), 2078528. https://doi.org/10.1080/23311886.2022.2078528

23. Khambule, I. (2022). Territorial Impact and Responses to COVID-19 in South Africa: Case Studies of eThekwini Metropolitan Municipality and KwaDukuza Local Municipality. World, 3(3), 513–529. https://doi.org/10.3390/ world3030028

24. Kim, A. W., Said Mohamed, R., Norris, S. A., Richter, L. M., & Kuzawa, C. W. (2022). Psychological legacies of intergenerational trauma under South African apartheid: Prenatal stress predicts greater vulnerability to the psychological impacts of future stress exposure during late adolescence and early adulthood in Soweto, South Africa. Journal of Child Psychology and Psychiatry, jcpp.13672. https://doi. org/10.1111/jcpp.13672

25. Le Roux, M., & Lesch, E. (2022). Exploring the caring of fathers in low-income, rural communities in South Africa. Journal of Family Studies, 1–24. https://doi.org/10.1080/13 229400.2022.2035246

26. Lu, C., Luan, Y., Naicker, S. N., Subramanian, S. V., Behrman, J. R., Heymann, J., Stein, A., & Richter, L. M. (2022). Assessing the prevalence of young children living in households prepared for COVID-19 in 56 low- and middle-income countries. Global Health Research and Policy, 7(1), 18. https:// doi.org/10.1186/s41256-022-00254-2

27. Mahlangu, P., Gibbs, A., Shai, N., Machisa, M., Nunze, N., & Sikweyiya, Y. (2022). Impact of COVID-19 lockdown and link to women and children’s experiences of violence in the home in South Africa. BMC Public Health, 22(1), 1029. https://doi.org/10.1186/s12889-022-13422-3

28. Makumane, M. A., Khoza, S. Bheki., & Piliso, B. B. (2021). Representation of Pragmatism in Scholarly Publications on COVID-19. International Journal of Higher Education, 11(2), 161. https://doi.org/10.5430/ijhe.v11n2p161

29. Momberg, D. J., Voth-Gaeddert, L. E., Richter, L. M., Norris, S. A., & Said-Mohamed, R. (2022). Rethinking water, sanitation, and hygiene for human growth and development. Global Public Health, 1–10. https://doi.org/10.1080/17441 692.2022.2036218

30. Mpondo, F., Kim, A. W., Tsai, A. C., & Mendenhall, E. (2022). Development and validation of the Soweto Coping Scale: A mixed-methods, population-based study of adults living in Soweto, South Africa. Journal of Affective Disorders, 303, 353–358. https://doi.org/10.1016/j.jad.2022.02.035

31. Mthethwa, S., & Wale Zegeye, E. (2022). Household vulnerability to climate change in South Africa: A multilevel regression model. Development Southern Africa, 1–16. https:// doi.org/10.1080/0376835X.2022.2085667

32. Mtintsilana, A., Dlamini, S. N., Mapanga, W., Craig, A., Du Toit, J., Ware, L. J., & Norris, S. A. (2022). Social vulnerability and its association with food insecurity in the South African population: Findings from a National Survey. Journal of Public Health Policy. https://doi.org/10.1057/s41271-02200370-w

33. Mukoma, G., Wrottesley, S. V., Kagura, J., Oni, T., Micklesfield, L., & Norris, S. A. (2022). The relationships between socioeconomic status, dietary knowledge and patterns, and physical activity with adiposity in urban South African women. South African Journal of Clinical Nutrition, 1–7. https:// doi.org/10.1080/16070658.2022.2076374

34. Naicker, S. N., & Richter, L. M. (2022). Parenting amid COVID-19: Challenges and supports for families with young children in South Africa. South African Journal of Child Health, 16(1).

35. Naicker, S. N., Ahun, M. N., Besharati, S., Norris, S. A., Orri, M., & Richter, L. M. (2022). The Long-Term Health and Human Capital Consequences of Adverse Childhood Experiences in the Birth to Thirty Cohort: Single, Cumulative, and Clustered Adversity. International Journal of Environmental Research and Public Health, 19(3), 1799. https://doi. org/10.3390/ijerph19031799

36. Nduna, M., Mayisela, S., Balton, S., Gobodo-Madikizela, P., Kheswa, J. G., Khumalo, I. P., Makhusha, T., Naidu, M., Sikweyiya, Y., Sithole, S. L., & Tabane, C. (2022). Research Site Anonymity in Context. Journal of Empirical Research on Human Research Ethics, 155626462210848. https://doi. org/10.1177/15562646221084838

37. Nicolaou, V., Levitt, N., Huddle, K., Soepnel, L., & Norris, S. A (2022). Perspectives on gestational diabetes mellitus in South Africa. South African Medical Journal, 112(3), 196–200. https://doi.org/10.7196/SAMJ.2022.v112i3.16184

38. Norris, S. A., Draper, C. E., Prioreschi, A., Smuts, C. M., Ware, L. J., Dennis, C., Awadalla, P., Bassani, D., Bhutta, Z., Briollais, L., Cameron, D. W., Chirwa, T., Fallon, B., Gray, C. M., Hamilton, J., Jamison, J., Jaspan, H., Jenkins, J., Kahn, K., … Lye, S. (2022). Building knowledge, optimising physical and mental health and setting up healthier life trajectories in South African women (Bukhali): A preconception randomised control trial part of the Healthy Life Trajectories Initiative (HeLTI). BMJ Open, 12(4), e059914. https://doi.org/10.1136/bmjopen-2021-059914

39. Nyahunda, L., & Tirivangasi, H. M. (2022). Adaptation strategies employed by rural women in the face of climate change impacts in Vhembe district, Limpopo province, South Africa. Management of Environmental Quality: An International Journal. https://doi.org/10.1108/MEQ-09-2021-0207

40. Nyahunda, L., Tirivangasi, H. M., & Mabila, T. E. (2022). Challenges faced by humanitarian organisations in rendering services in the aftermath of Cyclone Idai in Chimanimani, Zimbabwe. Cogent Social Sciences, 8(1), 2030451. https:// doi.org/10.1080/23311886.2022.2030451

41. Orri, M., Ahun, M. N., Naicker, S., Besharati, S., & Richter, L. M. (2022). Childhood factors associated with suicidal ideation among South African youth: A 28-year longitudinal study of the Birth to Twenty Plus cohort. PLOS Medicine, 19(3), e1003946. https://doi.org/10.1371/journal. pmed.1003946

42. Prioreschi, A., & Norris, S. A. (2022). Describing correlates of early childhood screen time and outdoor time in Soweto, South Africa. Infant and Child Development. https://doi. org/10.1002/icd.2313

43. Prioreschi, A., Ware, L. J., Draper, C. E., Lye, S., & Norris, S. A. (2022). Contextualising individual, household and community level factors associated with sugar-sweetened beverage intake and screen time in Soweto, South Africa. Journal of Hunger & Environmental Nutrition, 1–17. https://doi.org/1 0.1080/19320248.2022.2032901

44. Roberts, B. J., Struwig, J., Gordon, S. L., Zondi, T., Hannan, S., & Gastrow, M. (2022). Generation of change? South African attitudes towards climate change in comparative perspective. Development Southern Africa, 1–25. https://doi.org/1 0.1080/0376835X.2022.2070454

45. Rochat, T. J., Dube, S., Herbst, K., Hoegfeldt, C. A., Redinger, S., Khoza, T., Bland, R. M., Richter, L., Linsell, L., Desmond, C., Yousafzai, A. K., Craske, M., Juszczak, E., Abas, M., Edwards, T., Ekers, D., & Stein, A. (2021). An evaluation of a combined psychological and parenting intervention for HIV-positive women depressed in the perinatal period, to enhance child development and reduce maternal depression: Study protocol for the Insika Yomama cluster randomised controlled trial. Trials, 22(1), 914. https://doi.org/10.1186/s13063021-05672-0 ( (published in 2022, page numbers in 2021)

46. Sayed, N., Burger, R., Harper, A., & Swart, E. C. (2021). Lockdown-Associated Hunger May Be Affecting Breastfeeding: Findings from a Large SMS Survey in South Africa. International Journal of Environmental Research and Public Health, 19(1), 351. https://doi.org/10.3390/ijerph19010351

47. Segura-Pérez, S., Richter, L., Rhodes, E. C., Hromi-Fiedler, A., Vilar-Compte, M., Adnew, M., Nyhan, K., & Pérez-Escamilla, R. (2022). Risk factors for self-reported insufficient milk during the first 6 months of life: A systematic review. Maternal & Child Nutrition, 18(S3). https://doi.org/10.1111/ mcn.13353

48. Slemming, W., Norris, S. A., Kagura, J., Saloojee, H., & Richter, L. (2022). Child development at age 5 years: The effects of maternal education, socioeconomic status and early-life growth examined prospectively in a lowresource setting. South African Journal of Child Health, 16(2), 111.

49. Soepnel, L. M., Kolkenbeck-Ruh, A., Crouch, S. H., Draper, C. E., Ware, L. J., Lye, S. J., & Norris, S. A. (2022). Prevalence and socio-structural determinants of tobacco exposure in young women: Data from the Healthy Trajectories Initiative (HeLTI) study in urban Soweto, South Africa. Drug and Alcohol Dependence, 232, 109300. https://doi.org/10.1016/j. drugalcdep.2022.109300

50. Soepnel, L. M., Nicolaou, V., Draper, C. E., Levitt, N. S., Klipstein-Grobusch, K., & Norris, S. A. (2022). Cognitive and Motor Development in 3- to 6-Year-Old Children Born to Mothers with Hyperglycaemia First Detected in Pregnancy in an Urban African Population. Maternal and Child Health Journal. https://doi.org/10.1007/s10995-021-03331-z

51. Soepnel, L. M., McKinley, M. C., Klingberg, S., Draper, C. E., Prioreschi, A., Norris, S. A., & Ware, L. J. (2022). Evaluation of a Text Messaging Intervention to Promote Preconception Micronutrient Supplement Use: Feasibility Study Nested in the Healthy Life Trajectories Initiative Study in South Africa. JMIR Formative Research, 6(8), e37309. https://doi. org/10.2196/37309

52. Soepnel, L. M., Draper, C. E., Mabetha, K., Dennis, C.-L., Prioreschi, A., Lye, S., & Norris, S. A. (2022). A protocol for monitoring fidelity of a preconception-life course intervention in a middle-income setting: The Healthy Life Trajectories Initiative (HeLTI), South Africa. Trials, 23(1), 758. https://doi. org/10.1186/s13063-022-06696-w

53. Strauss-Kruger, M., Wentzel-Viljoen, E., Ware, L. J., Van Zyl, T., Charlton, K., Ellis, S., & Schutte, A. E. (2022). Early evidence for the effectiveness of South Africa’s legislation on salt restriction in foods: The African-PREDICT study. Journal of Human Hypertension. https://doi.org/10.1038/s41371021-00653-x

54. Temelkovska, T., Kalande, P., Udedi, E., Bruns, L., Mulungu, S., Hubbard, J., Gupta, S., Richter, L., Coates, T. J., & Dovel, K. (2022). Men care too: A qualitative study examining women’s perceptions of fathers’ engagement in early childhood development (ECD) during an ECD program for HIV-positive mothers in Malawi. BMJ Open, 12(7), e056976. https://doi. org/10.1136/bmjopen-2021-056976

55. van Honk, J., Terburg, D., Montoya, E. R., Grafman, J., Stein, D. J., & Morgan, B. (2022). Breakdown of utilitarian moral judgement after basolateral amygdala damage. Proceedings of the National Academy of Sciences, 119(31), e2119072119. https://doi.org/10.1073/pnas.2119072119

56. Vilar-Compte, M., Pérez-Escamilla, R., Orta-Aleman, D., Cruz-Villalba, V., Segura-Pérez, S., Nyhan, K., & Richter, L. M. (2022). Impact of baby behaviour on caregiver’s infant feeding decisions during the first 6 months of life: A systematic review. Maternal & Child Nutrition, 18(S3). https://doi. org/10.1111/mcn.13345

57. Victora, C. G., Hartwig, F. P., Vidaletti, L. P., Martorell, R., Osmond, C., Richter, L. M., Stein, A. D., Barros, A. J. D., Adair, L. S., Barros, F. C., Bhargava, S. K., Horta, B. L., Kroker-Lobos, M. F., Lee, N. R., Menezes, A. M. B., Murray, J., Norris, S. A., Sachdev, H. S., Stein, A., Black, R. E. (2022). Effects of early-life poverty on health and human capital in children and adolescents: Analyses of national surveys and birth cohort studies in LMICs. The Lancet, 399(10336), 1741–1752. https://doi.org/10.1016/S0140-6736(21)02716-1

58. Watermeyer, J., Scott, M., Kapueja, L., & Ware, L. J. (2022). To trust or not to trust: An exploratory qualitative study of personal and community perceptions of vaccines amongst a group of young community healthcare workers in Soweto, South Africa. Health Policy and Planning, czac060. https:// doi.org/10.1093/heapol/czac060

59. Weber, T., Protogerou, A. D., Agharazii, M., Argyris, A., Aoun Bahous, S., Banegas, J. R., Binder, R. K., Blacher, J., Araujo Brandao, A., Cruz, J. J., Danninger, K., Giannatasio, C., Graciani, A., Hametner, B., Jankowski, P., Li, Y., Maloberti, A., Mayer, C. C., Ware, L. J., McDonnell, B. J., International Academic 24-Hour Ambulatory Aortic Blood Pressure Consortium (i24abc.org). (2022). Twenty-Four–Hour Central (Aortic) Systolic Blood Pressure: Reference Values and Dipping Patterns in Untreated Individuals. Hypertension, 79(1), 251–260. https://doi.org/10.1161/HYPERTENSIONAHA.121.17765

60. Wrottesley, S. V., Shivappa, N., Prioreschi, A., Hébert, J. R., & Norris, S. A. (2022). Anti-inflammatory diets reduce the risk of excessive gestational weight gain in urban South Africans from the Soweto First 1000-Day Study (S1000). European Journal of Nutrition. Online ahead of print

61. Xaba, M. B. (2022). Examining the meanings of ‘restitution’ for beneficiaries of the Macleantown and Salem restitution cases in the Eastern Cape, South Africa. Social Dynamics, 1–19. https://doi.org/10.1080/02533952.2022.2103617

Books & Book Chapters

1. Gordon, S. L. (2022). Immigration Policy in South Africa: Public Opinion, Xenophobia and the Search for Progress. In P. Rugunanan & N. Xulu-Gama (Eds.), Migration in Southern Africa (Chapter 5, pgs 57–75). Springer International Publishing.

2. Khambule, I. B. (2022). COVID-19 and the Counter-Cyclical Responses of the BRICS Countries. In S. Zondi (Ed.), The Political Economy of Intra-BRICS Cooperation (pp. 205–230). Springer International Publishing

ProtectingSouth Africa’sHumanCapital

Howearlylifeadversitycancurbourpotentialforproductivity,healthandwellbeing

Investmentinhumancapital,bothinresearchandin dollars,hasgrowninrecentdecadesaswerecogniseits importanceforsustainableeconomicdevelopmentand reducinginequality.TheWorldBank’sHumanCapital Index(HCI)estimatesthatglobally,childrenborntoday willonlyreach56%oftheirhumancapitalpotential becauseoftherisksofpoorhealthandeducation.Achild borninSouthAfricatodaywouldreach41%oftheir potentialproductivityasanadultcomparedtoifshe wouldhavecompletedhereducationandhadfullhealth. Thepillarsofhumancapital–healthandeducation–mustbestrengthenedtocultivateaskilled,healthy, happyandproductiveworkforcetoenhanceacountry’s inclusiveeconomicgrowthpotential.Thisisespecially importantinAfrica,theyoungestcontinent,withabout 70%ofourpopulationundertheageof30.Research showsthatgivingchildrenthebestpossiblestartinlifeis centralindevelopingacountry’shumancapital.

Poordevelopmentinchildhoodcouldbeattributedto thepreventableriskfactors,suchasexposuretoviolence andneglect.Recentestimatesoftheeconomicimpact andsocialburdenofexposuretoviolenceinchildhood putitscosttoSouthAfricansocietyatalmost5%ofits GDP.However,experiencesofviolencearerarelytheonly

adversityachildfaces.Adversitiestendtocluster,and sometimesindiscerniblepatterns,andwhereone adverseexperienceispresent,therearelikelytobe others.Thisaccumulationofadverseexperiencesover timeleadstocumulativeortoxicstress.Thesnowball effectofexposuretocumulativeadversitiescould eventuallyleadtodisruptionsinphysiologicalstress responsesthatchangehowwereacttotheworldaround usandhamperourhealthandwellbeing.

Astudyentitled“TheLong-TermHealthandHuman CapitalConsequencesofAdverseChildhoodExperiences intheBirthtoThirtyCohort:Single,Cumulative,and ClusteredAdversity”wasconductedbytheDSI-NRF CentreofExcellenceinHumanDevelopmentatthe UniversityoftheWitwatersrand.Thestudyuseddata fromtheBirthtoThirtystudywhichcontains comprehensivelongitudinaldataonarangeofexposures andoutcomesfrombirthtoage28.Thestudyaimedto estimatetheimpactofearlylifeadversityonhuman capitaloutcomes.UsingtheACEsindex–atallyof individualadversechildhoodexperiences–adjustedfor theSouthAfricancontext,thestudymeasuredthe numberandtypeofadversitiesexperiencedinchildhood. TheACEsrangedfromphysical,sexualandemotional

abuseandneglect,tochronicunemployment,substance abuse,exposuretoviolenceandotherindicatorsof householddysfunction.TheseACEswerethenlinkedtoa selectionofhumancapitaloutcomesmeasuredwhenthe samplewas28yearsold.

KeyFinding(s):Exposuretoadversityinchildhoodcanbe linkedtopoorhumancapitalinyoungadulthood,and themoreadversityexperienced,thegreatertheriskfor pooroutcomes.Thisdemonstratesthecumulativeeffect

thatmultipleadverseexperienceshaveonhumancapital –aseachadditionalACEisaddedtoachild’slife,their riskforpoorhumancapitalincreasesinagraded manner.Thoseindividualswhoexperience6ormore ACEsinchildhoodhaveagreaterriskforcriminality, psychologicaldistress,unemploymentandincomplete schoolinginadulthood.

IndividualACEsorexperiencesofasingulartypeof adversitywerealsoimportant;theseareeventsor experiencesinchildhoodthatcanbelinkedtohuman capitaloutcomesindependentlyofallotherACEs.Key Finding(s):(1) Unemployment inadulthoodwas associatedwithchildhoodphysicalabuse,household death,andsubstanceabuseinthehome.(2)Individuals whoexperiencedphysical,sexualoremotionalabuse/ neglectwereallmorelikelyto notcompletesecondary school.(3)Individualswhoexperiencedsexualabuseor hadchroniclevelsofunemploymentintheirhomewere morelikelytobecollecting welfarereceipt intheformof theChildSupportGrant.(4)Sexualabusesurvivorsand thosewholivedwithasubstanceabuserinthehomeasa childhadahigherriskfor HIVinfection.(5) Engagingin criminalbehaviourinadulthood waslinkedto emotionalabuse/neglectasachildandexposureto intimatepartnerviolenceinthehome.(6)Exposureto

Figure1:ImpactofcumulativeACEsonhumancapitaloutcomes

Figure2:Impactof singleACEsonhuman capitaloutcomes

communityviolenceoutsidethehomeasachildwas linkedto psychologicaldistress and substanceuse in adulthood.(7)Otherchildhoodadversitieslinkedto psychologicaldistress asanadulthoodweresexual abuse,emotionalabuse/neglect,substanceabuseinthe home,andsevereillnessordisabilityinthehome.

Manyofthesehumancapitaloutcomesaredirectly relatedtoproductivity–forexample,incomplete schoolingandunemploymentdirectlyaffectan individual’scapacitytoengageinthelabourmarket. Othersaredirectlyrelatedtohealthandwellbeingbut indirectlyrelatedtoproductivity.Forexample,HIV/AIDs andinterpersonalviolencearetwooftheleadingcauses ofyearsoflifelost,orprematuremortality,inSouth Africa.Further,substanceabuseandmentalhealth problems,includingdepressivedisorders,aretwoofthe topriskfactorsforthemostdiseaseburdeninSouth Africathatcontributetothecountry’sdisability-adjustlife years. Overall,adversityinchildhoodislinkedto unrealisedpotentialinhumandevelopment. Allofthe

adversitiesmeasuredinthisstudywerepreventableor treatable.Ensuringthatchildrenareprotectedfrom abuse,thatexposuretoviolenceinsideandoutsidethe homeisreduced,andthathouseholddysfunctionis mitigatedcanleadtohealthy,happier,andmore productiveyoungadults.ArecentLancetstudy¹ charting humancapitaldevelopmentsince1990showsSouth Africa’sslipfrom129thto144thin2018outof195 countries,andalongwithothercountriesinthisbottom quartile,experienced50%lessannualgrowthintheir GDP.Investinginhumancapitalisthekeytounlocking SouthAfrica’sindividualpotentialandsubsequent economicgrowth.Whilehealthandeducationarethe cornerstonesofhumancapital,socialprotectionfroma rangeofadversitiesthatallowchildrentogrowinsafe, secure,stableandlovingenvironmentswillhelpthem reachtheirfullpotential.Theexperiencesthatundermine ourhumandevelopmenthavetheirgreatesteffectinour childhood.Andtheseeffectsaremosteasily,costeffectively,andsustainablereversedinourearliestyears.

Reference:

TheLong-TermHealthandHumanCapitalConsequencesof AdverseChildhoodExperiencesintheBirthtoThirty Cohort:Single,Cumulative,andClusteredAdversity SaraN.Naicker¹,MarilynN.Ahun²,³,SahbaBesharati⁴,⁵, ShaneA.Norris¹,⁶,⁷,MassimilianoOrri⁸,andLindaM.Richter¹ Affiliations

¹DSI-NRFCentreofExcellenceinHumanDevelopment,Universityof theWitwatersrand,Johannesburg2050,SouthAfrica; ²Departmentof GlobalHealthandPopulation,HarvardT.H.ChanSchoolofPublic Health,Boston,MA02115,USA; ³SchoolofPublicHealth,Université deMontréal,Montreal,QCH3C3J7,Canada; ⁴Departmentof Psychology,SchoolofHumanandCommunityDevelopment, UniversityoftheWitwatersrand,Johannesburg2050,SouthAfrica; ⁵CIFARAzrieliGlobalScholarsProgram,CIFAR,Toronto,ONM5G 1M1,Canada; ⁶SAMRCDevelopmentalPathwaysforHealthResearch Unit,UniversityoftheWitwatersrand,Johannesburg2050,South Africa; ⁷HubertDepartmentofGlobalHealth,RollinsSchoolofPublic Health,EmoryUniversity,Atlanta,GA30322,USA; ⁸McGillGroupfor SuicideStudies,DepartmentofPsychiatry,DouglasMentalHealth UniversityInstitute,McGillUniversity,Montreal,QCH3A0G4,Canada

1stFloor,SchoolofPublicHealth, UniversityoftheWitwatersrand YorkRoad,Parktown, Johannesburg2193, SouthAfrica

Director:ProfShaneNorris

www.facebook.com/CoEHuman

twitter.com/CoEHuman

www.wits.ac.za/coe-human

1Lim,S.S.,Updike,R.L.,Kaldjian,A.S.,Barber,R.M.,Cowling,K.,York,H.,...&Murray,C.J.(2018).Measuringhumancapital:asystematicanalysisof195countries andterritories,1990–2016.TheLancet,392(10154),1217-1234.

Sociallyvulnerable groupsatgreaterrisk forfoodinsecurity

SouthAfrica’ssociallyvulnerablegroupsareatagreaterriskofexperiencingfoodinsecurity

Althougheveryoneisinherentlyatriskofsufferingina naturaldisaster,ordevelopinginfectiousandchronic diseases,andexperiencingfoodinsecurity,somepeopleare atgreaterriskthanothersduetohavingpooror unfavourablesocial,economic,andenvironmental outcomes.Thisphenomenonisknownassocial vulnerabilityanditisdefinedastheattributesofsocietythat makepeopleandplacessusceptibletonaturaldisasters, adversehealthoutcomes,andsocialinequalities.Interms ofincomedistribution,SouthAfrica(SA)isthemostunequal countryintheworld.Unfortunately,theimpactofthe COVID-19pandemiconthecountry’seconomyhasfurther exacerbatedthisinequality,wideningthegap,forexample, betweenBlackAfricansandWhites,richandpoor,and employedandunemployed.Despitesocialinequalities beingwelldocumentedinSA,thereisalackofstudiesthat havemeasuredtheprevalenceofsocialvulnerabilityusinga

nationalrepresentativesamplewithkeysocio-demographic factors;andexaminedtheassociationbetweensocial vulnerabilityandfoodinsecurity.

Therefore,toinvestigatesocialvulnerabilityprevalenceand itsrelationshipwithfoodinsecurityinSA,we,attheDSI-NRF CentreofExcellence(CoE)inHumanDevelopmentatthe UniversityoftheWitwatersrand,conductedasurveyof3402 SouthAfricansacrossthecountry,aged18andolder,in October2021.Wecalculatedsocialvulnerabilityindex(SVI) scoresusinganSVIdevelopedbytheUSCentreforDisease ControlandadaptedforaSouthAfricancontext.ThesociodemographicindicatorsusedinthecalculationofSVIscores arepresentedin Figure1.Wealsomeasuredfoodinsecurity usingamodifiedCommunityChildhoodHunger IdentificationProject.

SocialVulnerabilityIndex(SVI)

Whatistheprevalenceofsocialvulnerability andfoodinsecurityinSA?

Overall,wereportedthat20.6%and20.4%ofparticipants wereclassifiedassociallyvulnerableandfoodinsecure, respectively.

WhichgroupsaresociallyvulnerableinSA?

Highsocialvulnerabilitywasreportedinrespondents residinginMpumalanga,ruralareas,includingthosewho wereolder(theprevalenceincreasedexponentiallyfrom45 yearsofage),inBlackAfricansandfemales,andinthose withouthighschoolcertificate,poor,andunemployed (Table1).

Poorsocio-economiccircumstancescontribute togreaterriskofexperiencingfoodinsecurity Wealsoshowedthattheriskoffoodinsecuritywasalmost 3-foldhigherinthesociallyvulnerablegroupcomparedto theircounterparts.Outofthetensocialvulnerability indicatorsrepresentedin Figure1,weshowedthatsocioeconomicstatus(SES)indicatorscontributedtoagreater riskofexperiencingfoodinsecurity.Thismeansthat participantslivinginpoorhouseholds,whowere unemployedanddidnotcompletehighschoolweremost likelytoexperiencefoodinsecurity.

Whataretheimplicationsofourfindings?

Socio-economicfactorsarewellestablishedasthemain driversofpoverty,foodinsecurity,andsocialinequalitiesin SA.Likemanypreviousstudies,ourcurrentfindingsalso reportSESfactorsasthemajordeterminantsoffood insecurity.Consequently,variousinitiatives(policiesand programmes)centredaroundproduction,accessand utilisationoffoodincludingsocialgrantshavebeen implementedtoaddresspoverty,foodinsecurityand inequalitiesinSA.Outofalltheseinitiatives,thesocialgrant systemremainsthelargestsourceofsupportformany vulnerablegroupsandthegovernment’sprimaryresponse topovertyandfoodinsecurityinSA.Itiswellestablished withawidereachof18.4millionbeneficiaries.Despitesuch efforts, povertyandfoodinsecurityhasremainedhighin SA,largelydrivenbyaseriesofcomplexfactorsincluding thefactthatsocialgrantshavenotkeptupwithinflationof foodpricesandareusedformanyhouseholdneeds.Our findingssuggestthatSAneeds comprehensiveand effectivesocialinitiativestoimprovetheeconomy,job market,andeducationsystems,andsubsequentlyreduce oreliminatesocialinequalities.

Table1.SouthAfrica’smostvulnerablegroups

Onepointisallocatedforeachofthecriterialmetabovecreatingscores

“Socialvulnerability”ifSVIscoreisinthehighestquartileforthegroup(≥4)

Figure1.Socialvulnerabilitydomainsandindicators

Whatarethepossiblesolutionsor recommendations?

UsetheCOVID-19pandemicasareference

TheCOVID-19pandemicsawacollaborationbetween governmentandvariousexternalpartnerssuchas corporate,NGOsandfaith-basedorganisationsthatworked togethertoprovidegoodsandfinancialassistanceto vulnerableindividualsandcommunities.Thispartnership canberetainedinthefightagainstfoodinsecurity.Through thispartnership,therelevantorganizationscanusethe COVID-19pandemicasareferencetolearnfromthe mistakes(e.g.,mismanagementoffundsandresources), identifyareasofimprovement,andmakeuseofthenew extensivedatabaseofsocialreliefrecipientstoeffectively directefforts(e.g.,socialassistanceinitiativesandjob opportunities)tothosemostvulnerable.

Takeadvantageofthedynamicnatureofsocial vulnerabilityandfoodinsecurity

Sincesocialvulnerabilityandfoodinsecurityareinterlinked, andbothdynamicinnature,weproposemonitoringtheir patternsovertime.Thiswillguidegovernmentandaffiliated partnerstore-evaluateanddevelopnewinitiativesto combatcurrentandfuturefoodinsecurity.Also,this approachwillenablegovernmentandaffiliatedpartnersto alwaysdirectsocialreliefeffortstotherelevantpeopleor communities,thuscreatinganefficientsocialsupport system.

ImplementationoftheBasicIncomeGrant

Althoughmanymightarguethatsocialgrantsarenot feasibleandsustainableconsideringthepooreconomic stateofthecountry,however,ourfindingssuggestthatthey areneededtohelpmitigateanddealwiththeeffectsof foodinsecurity,particularlyinthosewhoarepoor, unemployedanddidnotcompletehighschool.Ourresults supporttheproposalbytheDepartmentofSocial Developmenttointroducethe“BasicIncomeGrant”,which willprovideincomesupportfortheunemployedindividuals between18and59yearsofage,andtothosewhoare currentlynotreceivingsocialgrant.Untilthe“BasicIncome Grant”isimplemented,wecallonthegovernmentto increaseallsocialgrantsandtomaketemporaryrelief measuressuchassocialreliefofdistressgrant(SRDG,also knownasthe“COVID-19grant)andfoodparcels/vouchers permanenttovulnerablegroupsuntiltheyreachalow vulnerabilitystateorarenolongervulnerableorqualifyfor theoldagegrant.

Conclusion

Insummary,governmentrequiresanurgentandinnovative frameworktogrowastableeconomy,createjobs,improve theeducationsystem,anddevelopneweffectivesocial initiativesthatwillreduceoreliminatesocialinequalitiesin SA,inparticularfoodinsecurity.

Reference:

Socialvulnerabilityanditsassociationwithfood insecurityintheSouthAfricanpopulation:Findingsfrom aNationalSurvey

AsandaMtintsilana¹*,SiphiweNDlamini¹,Witness Mapanga¹,²,AshleighCraig¹,JustinDuToit³,LisaJWare¹,³, ShaneANorris¹,³,⁴

Affiliations

¹SAMRC/WitsDevelopmentalPathwaysforHealthResearchUnit, DepartmentofPediatrics,FacultyofHealthSciences,Schoolof ClinicalMedicine,UniversityoftheWitwatersrand,Johannesburg, SouthAfrica

²NoncommunicableDiseasesResearchDivision,WitsHealth Consortium(PTY)Ltd,Johannesburg,SouthAfrica

³DSI-NRFCentreofExcellenceinHumanDevelopment,University oftheWitwatersrand,Johannesburg,Gauteng,SouthAfrica

⁴GlobalHealthResearchInstitute,SchoolofHumanDevelopment andHealth,UniversityofSouthampton,UK

*Correspondingauthor,email: Asanda.Mtintsilana@wits.ac.za

1stFloor,SchoolofPublicHealth, UniversityoftheWitwatersrand YorkRoad,Parktown, Johannesburg2193, SouthAfrica

Director:ProfShaneNorris

www.facebook.com/CoEHuman

twitter.com/CoEHuman

www.wits.ac.za/coe-human

Foodinsecurityand copingstrategies

Foodinsecurityandcopingstrategies,andtheirassociationwithanxietyanddepression:anationally representativeSouthAfricansurvey

Scopeoftheproblem

Accordingtosection27(1)(b)oftheSouthAfrican constitution,everyonehasarighttohaveaccessto sufficientfood.However,highprevalenceoffoodinsecurity haslongbeenSouthAfrica’sbiggestproblem.Withthe countrybeingthemostunequalintheworld,itremains unclearhowSouthAfricanhouseholdsdealwithfood insecurityfromanationalperspective.Thereisavarietyof copingstrategiesthathouseholdsoftenusetodealwith foodinsecurity,andexamplesincludeeatingless,borrowing orusingcredit,andevenbeggingforfoodonthestreets. However,theimpactofsuchcopingstrategiesonmental healthislessdocumented.

ArecentstudyfundedbytheDSI-NRFCentreofExcellence inHumanDevelopmentattheUniversityofthe Witwatersrand,recentlyinvestigatedthenational

prevalenceoffoodinsecurityandrelatedcopingstrategies, andtheirpossibleimpactontheriskofanxietyand depressionamongSouthAfricanadults.Usingstandard questionnaires,face-to-faceinterviewswereconductedin October2021(duringalow-levelCOVID-19lockdown)ina nationallyrepresentativesampleof3402adults,whichwas statisticallyweightedtorepresentover39millionSouth Africanhouseholds.

Whatthestudyfound

Thestudyfoundthatmorethan20%(1in5)ofSouthAfrican householdslackaccesstosufficientfood,andthatthis prevalencevarieswidelyacrossthenineprovinces (Figure1).Unsurprisingly,thepooresthouseholdswerethe mostaffected,andfoodinsecuritywasmuchmorecommon amongColoured(24%)andBlack(23%)SouthAfricans, comparedtotheirWhite(5%)andAsiancounterparts(4%).

Allinvestigatedcopingstrategieswereusedtosomeextentwithinthehouseholds,withthemostcommonbeing“relyingon lesspreferredandlessexpensivefoods”(usedby46%),andtheleastcommonbeing“sendinghouseholdmemberstobegfor food”(usedby21%)(Figure2).

Thinkingofthepast2weeks,howo�enhaveyouhadto:

OfallSAhouseholds, 20.4% arefoodinsecure.

Figure2:CopingstrategiesusedbySouthAfricanhouseholdstodealwithfoodinsecurity

Figure1:PrevalenceoffoodinsecurityamongSouthAfrican(SA)households

Thefindingsconfirmedthatlivinginafoodinsecure householdinSouthAfricaduringCOVID-19wasassociated withahigherriskofanxietyanddepression.Thestudyalso foundthatallcopingstrategiesthatarecurrentlyusedby SouthAfricanstodealwithfoodinsecuritydifferentially associatewiththeriskofanxietyanddepression.

Importantly,thefindingssuggestedthatbeggingforfood maybethemostharmfulcopingstrategy.

Conclusionandimplications

TheauthorsconcludedthatfoodinsecurityinSouthAfrica remainsamajorhealthproblem,andthatpoorer householdsaredisproportionallyaffected.Livinginfood insecurehouseholdmaybeforcingpoorerSouthAfricansto useavarietycopingstrategiesthatultimatelyleadto anxietyanddepression.

Inthe2022StateoftheNationAddress,thepresidentstated thattherewillbeseveralfundamentalreformsprimarily aimedatrevivingeconomicgrowthinSouthAfrica,which wouldultimatelyassistincombatingthechallengesofhigh employmentandfoodinsecurityrates.Giventhesenew findings,foodinsecurityandrelatedcopingstrategies

shouldbeconsideredasriskfactorsforimpairedmental health.Accordingly,theproposedpublicmeasuresto reducefoodinsecurityarelikelyimprovethementalhealth qualityofSouthAfricans.

Reference: Foodinsecurityandcopingstrategies,andtheir associationwithanxietyanddepression:anationally representativeSouthAfricansurvey SiphiweN.Dlamini¹,²,AshleighCraig¹,²,Asanda Mtintsilana¹,²,WitnessMapanga¹,²,JustinDuToit²,LisaJ. Ware¹,²,ShaneA.Norris¹,²,³

Affiliations

¹SAMRC/WitsDevelopmentalPathwaysforHealthResearchUnit, SchoolofClinicalMedicine,FacultyofHealthSciences,University oftheWitwatersrand,Johannesburg,SouthAfrica.

²DSI-NRFCentreofExcellenceinHumanDevelopment,Schoolof PublicHealth,UniversityoftheWitwatersrand,Johannesburg, Gauteng,SouthAfrica.

³GlobalHealthResearchInstitute,SchoolofHealthandHuman Development,UniversityofSouthampton,Southampton,United Kingdom.

Correspondingauthoremail: Siphiwe.dlamini2@wits.ac.za

Shorttitle:Foodinsecurity,copyingstrategies,andmentalhealth.

1stFloor,SchoolofPublicHealth, UniversityoftheWitwatersrand YorkRoad,Parktown, Johannesburg2193, SouthAfrica

Director:ProfShaneNorris

www.facebook.com/CoEHuman twitter.com/CoEHuman

www.wits.ac.za/coe-human

MentalHealthRisk inSouthAfrica

Nearly20%ofSouthAfricanadultssufferfromimpairedmentalhealth,withlessthanaquarterof thispopulationeverseekingmentalhealthtreatment.

Whatisknown

Depressionamongyoungadultsinlow-to-middleincome countriessuchasSouthAfricahasbecomeaneverincreasingpublichealthconcern.Ithasbeenreportedthat nearly20%ofSouthAfricanadultssufferfromimpaired mentalhealth,withlessthanaquarterofthispopulation everseekingmentalhealthtreatment.Anxiety,adverse childhoodevents(ACE)thatisabuse,neglectorhousehold dysfunctionexperiencedinchildhoodandsocio-economic anddemographicdeterminantshaveallbeenimplicatedin theonsetofdepression.

In2013,itwasreportedthatthelifetimeprevalencerateof depressionwashighestintheEasternCape(31.4%),oneof thepoorestprovincesinSouthAfrica.Anotherstudy conductedin2018inyoungSouthAfricanadultsfounda highrateofmoderatetoseverelevelofanxiety(18.6%)in femalesfromurbaninformalsettlements.Additionally,ithas beenreportedthatmorethanhalfofSouthAfricanadults haveexperiencedemotionalorsexualabuseandabout40% haveexperiencedsomesortofemotionalneglectbeforethe ageof18yrs.

Itiswelldocumentedthatdepressionismorefrequently reportedamongolderadultswhoreportamaritalstatusof single,widowedordivorced.Depressionhasalsobeen foundtobemoreprevalentinlaterlifepresumably attributedtochangesinlifeconditionssurrounding retirement,adeclineinhealthandtheriskofsocialneglect. Thelevelofeducationattainedhasalsobeenreportedto associatewithdepressionoutcomes.Higherlevelsof educationhavebeenassociatedwithbettermentalhealth outcomeswhile,lowlevelsofeducationhavebeenlinkedto poorermentalhealthoutcomes.

Furthermore,aboutathirdoftheSouthAfricanpopulation, and74%ofpoorSouthAfricansresideinruralareas.Whileit isbelievedthatindividualsinpoorerruralareasaremore susceptibletoexperiencingadversementalhealth outcomes,ithasrecentlybeenreportedthatyoungadultsin urbanareasseemtoexperienceahigherlevelofdepression whencomparedtotheirruralcounterparts.

Findingsfromthestudy

Fromourdata,theprevalenceofprobabledepression acrossSouthAfricain2021wasreportedat25.7%.More thanaquarterofrespondentsreportedmoderatetosevere symptomsofdepression,whichismorethandoublethe datareportedfromseveralothernationalsurveys conductedworldwide(US:6.9%(2011);Germany:5.6% (2013);Australia:10.0%(2014).Wealsoconcludethat17.8% ofrespondentsreportedprobableanxiety(GAD-7score≥10) and23.6%ofrespondentsreportedanaccumulativeACE scoreof4ormore(highrisk).

Ourdataalsoshowedthattheprevalenceofdepression andanxietyvariedacrossallnineprovincesinthecountry, withhigherprevalencebeingreportedintheNorthernCape, EasternCape,WesternCape,Gauteng,andMpumalanga provinces(Figure1).Probabledepressionwasalsomore frequentlyreportedamongolder(>65yrs),widowed, divorced,orseparatedadultswhoareretired;inalower socio-economicgroup(householdassetsscoreinthelowest tertile);livinginthemetropolitanarea;withabasiclevelof educationsuchasprimaryschool(Figure2).Thisstudy foundastrongassociationbetweenanxietyandACEscore withdepressionoutcomesacrossvariousmodels,even

afteradjustingforsocio-demographicfactors.Anxietywas alsofoundtoincreasetheoddsofprobabledepression. Fromourdata,58.1%ofrespondentswithprobable depressionalsoreportedanxiety.Furthermore,wealso foundthelikelihoodofhavingprobabledepression increaseswitheachstandarddeviationincreasein accumulativeACEscore.

Figure1:PrevalenceofmentalhealthriskacrossSouthAfrica.PHQ9:PatientHealthQuestionnaire;GAD7:GeneralisedAnxiety Disorder.

Conclusion

Theprevalenceofprobabledepressionamong respondentsinSouthAfricavariessignificantly acrossallnineprovinceswiththeNorthernCape reportingthehighestprevalenceofboth probabledepressionandanxiety.Additionally, thedegreeofanxiety,ACEscoreandseveral socio-demographicdeterminantswere associatedwithhigherlikelihoodofdepression outcomesacrosstheSouthAfricapopulation.

Ourdatathereforesuggeststhatinterventionand counsellingprogrammesarerecommendedfor older,widowed,divorced,orseparated respondents,especiallyinprovinceswitha relativelyhigherprevalenceofdepression,witha specificfocusonthoselesseducatedandwho fallinalowersocio-economicgroup.

Reference:

Theprevalenceofprobabledepressionand thepossibleassociationsofanxiety, adversechildhoodeventsandsociodemographics:ANationalSurvey conductedinSouthAfricain2021

CraigA*;NaickerS;MapangaW;Mtintsilana A;DlaminiSN;WareLJ;DuToitJ;DraperC; RichterL;RochatT;NorrisSA

CorrespondingauthorAshleighCraig,PhD email: ashleigh.craig@wits.ac.za

1stFloor,SchoolofPublicHealth, UniversityoftheWitwatersrand YorkRoad,Parktown, Johannesburg2193, SouthAfrica

Director:ProfShaneNorris www.facebook.com/CoEHuman twitter.com/CoEHuman www.wits.ac.za/coe-human

Figure2.MentalhealthriskstratifiedbyA)maritalstatus;B)employment status,C)agecategories,D)householdassetscore,E)urbanicityand F)educationlevel.

Rethinkingwater, sanitation,and hygieneforhuman growthand development

TheidentificationofageappropriatebiologicaloutcomesandWASHindicators,whileanticipatingthe timingoflife-coursesuitabilityoftheinterventionsbeingoperationalised

Conditionsinearlylifecanleadtolong-termconsequences forhealthandwellbeing.Itisthereforeimportanttoprotect andsupportgrowthanddevelopmentduringthistimeby reducingrisksofexposuretoinfectiousdiseases,optimising infantnutrition,andstimulatingandsupportingcognitive andemotionaldevelopmenttoavertbothshort-term (stunting,cognitivefunctioning)andlong-term(noncommunicablediseases,humancapital)consequences. Linksbetweenhumangrowthanddevelopmenttowater, sanitation,andhygiene(WASH)areevidentintheUNICEF ConceptualFramework,aswellasnumerousstudieslinking WASHandnutritionalstatus,andmaternalandchildhealth. Thesestudieshavehelpedsummarisetheknowledge,gaps andactionsneededtoreduceinfantmorbidityand mortality,favouring,amongstothers,lineargrowth/normal growth.Unfortunately,recentfindings,evaluatingprogress madeinaddressingmaternalandchildundernutritionhave highlightedthelackofprogressutilisinglow-costwaterand sanitationinterventionsonchildgrowth,suggestingthat morecomplexpathways,includingtheroleof environmentalentericdysfunction,andassociatedchronic inflammationareimportantfactorscontributingto persistentgrowthfaltering.

Studiesandreportscontinuetostresstheimportanceof WASH,particularlyduringthefirst1000days,which demandsashiftinhowwethinkaboutWASHinterventions.

HealthOutcomesandInterventionTiming

Howandwhenmaternalandchildbiologyrespondto interventionsisacriticalpointtoconsiderwhenthinking aboutoptimisingandappropriatelytargetingWASH interventions.Differentdevelopmentaloutcomesinearly childhoodmayberesponsivetodifferentstimuliatdifferent ages.TheWASHsectorneedstore-evaluateitsapproachfor howbesttooperationaliseWASHinserviceofoptimised childhoodgrowthanddevelopment,startingwithrethinking whichhealthoutcomestoconsiderinthefirst1000days, whileremainingmindfulofchildren’sbiologicaldisposition, andidentifyingcircumstancesandrelevantWASHindicators sensitivetoaugmentation.

ArecentstudyinSouthAfricaexploringtheeffectofearly lifeexposuresrelatedtospecificWASHriskfactorsand nutritionalstatusbetweenbirthandoneyearofage, highlightedthatvariousWASHcomponentshave differentiatedeffectsatdifferentages.Thebiggestimpact relatingtowaterwasseentoaffectweight-for-age(WAZ) around12monthspostpartum,whilethegreatestimpactof hygienewasseenaround1monthpostpartumandaffected height-for-age(HAZ)andWAZ.Accesstosafelymanaged sanitationfacilitieswascriticalthroughoutthefirstyear,and impactedHAZ,WAZ,andweight-for-height(WHZ).Thismay beindicativeofWASHfactors,suchassanitation,havinga

greaterimpactonweight,ratherthanheight,duringthis periodofearlychildhoodgrowth.

WesuggestthatinterventionstargetingWASHshould,track changesinfatlevelsthroughoutinfancyandchildhood.This resultsfromchangesintheenvironmentalcausingshort termadaptationswithlongtermconsequences.

Inaddition,thereisanenergytrade-offbetweengrowthin heightandbraingrowthduringinfancyandchildhoodare madeinresponsetoenvironmentalstimulitoprotectthe growthanddevelopmentofthebrain.Undernutritionin infancyandchildhood,anditsrelativeresultantenergy deficiency,maythereforetriggeradaptivephysiological mechanismsprioritisingbraingrowthattheexpenseof bodygrowth.

ThereisincreasinginterestinthehypothesisthatWASH interventionsmayimprove,notonlygrowth,butalso neurodevelopmentaloutcomes.Thepotentialimpactof WASHonneurocognitivedevelopmentissuggestedto operatethroughmultipleinterlinkedpathways,including effectsonmalnutrition,enteropathy,andinfection.Poor cognitive,sensorimotor,andsocioemotionaldevelopment arehypothesisedtobemediated,inpart,throughanaemia ofchronicdiseaseandstunting,resultingfrompoorgut healthandchronicimmunestimulation,inadditiontoother well-establishedcausesofdevelopmentaldeficits. Furthermore,WASHmaymodulatethecompositionand functionofthegutmicrobiota,therebyalsoinfluencing braindevelopmentthroughthemicrobiota–gut–brainaxis. Thecomplexityandheterogeneityintheeffectsonneural developmentsuggeststhatacentralfocusonneural developmentisrequired.

Forbraingrowthandneurodevelopment,key developmentalstagesandmilestonesshouldbemonitored duringinfancyandchildhoodaswellasbraingrowth.For length/height,thefirst2to3yearsisthekeyperiodas plasticityisatitspeak,afterwhich,length/heightis canalised.ThebenchmarktowhichthesuccessofWASH interventionsshouldbemeasuredinthefirst5yearsand pre-pubertalperiodshouldthereforebebraingrowthand development.

Conclusion

WASHisacomplexconcept,withmanycomponents,both individualfactors(water,sanitation,andhygiene),aswellas withineachfactor(quality,quantity,access,infrastructure, etc.)allinteractinginvariousenvironmentsandatdifferent scales.Thishighlightstheimportanceofselectingwhich componentsandfactorsarerelevantforspecificgrowthand developmentoutcomestoenhanceinterventionsinvarious contexts,atspecificstagesinearlychildhooddevelopment.

WASHcannotbethesolesolutionforsolvingallthe problemsrelatingtochildhoodgrowthanddevelopment, ratherthedevelopmentoftransformativeWASH interventionsandstudiesshouldseektomaximisereturnon investmentsbytargetingprecisegrowthanddevelopmental outcomesatspecificages.Interventionsintendingto addressissuessurroundingWASHinearlychildhoodin serviceofoptimisedgrowthanddevelopmentwouldbenefit fromtakingtimingintoaccountandidentifyingspecific timeframesinearlychildhood,andassociatedWASHfactors forintervention.

Reference:

Rethinkingwater,sanitation,andhygiene(WASH)for humangrowthanddevelopment

D.J.Momberg¹²,L.E.Voth-Gaeddert²,L.M.Richter³, S.A.Norris²³,R.Said-Mohamed¹²

Affiliations

¹ DepartmentofArchaeology,BiologicalAnthropology,Universityof Cambridge,UK

² SAMRC/WitsDevelopmentalPathwaysforHealthResearchUnit, DepartmentofPaediatricsandChildHealth,SchoolofClinical Medicine,FacultyofHealthSciences,Universityofthe Witwatersrand,SouthAfrica

³ DSI-NRFCentreofExcellenceinHumanDevelopment.University oftheWitwatersrand,SouthAfrica

1stFloor,SchoolofPublicHealth, UniversityoftheWitwatersrand YorkRoad,Parktown, Johannesburg2193, SouthAfrica

Director:ProfShaneNorris www.facebook.com/CoEHuman twitter.com/CoEHuman www.wits.ac.za/coe-human

COVID-19andthe informaleconomy inSouthAfrica

Theprecariousnatureoftheinformaleconomyneedsmoreattentionandinnovativepoliciesto alleviatepressureonlow-incomehouseholdsduringpandemics/contractionaryperiods

Therehasbeenagrowingconsensusamongstglobal policymakersthatworkersandbusinesseswill disproportionallyfeelthesocio-economicconsequencesof thepandemic,withtheInternationalLabourOrganisation placingparticularemphasisoninformalworkers, marginalisedgroups,theyouthandthedisabled.This concernisunderpinnedbytheprecariousnessofthe informalsectorbroughtbythelackofsocialsecurityand livelihoodprotectionmeasuresagainsttheeconomic impactofCOVID-19.Theseconcernsareworrisomein developingnations,wheremostofthepopulationmakesa livingintheinformaleconomy,estimatedtobejustover 90%indevelopingnations.InSouthAfrica,theseconcerns areintensifiedbypre-existingsocio-economicdeprivations ofunemployment,povertyandinequality.Inthese difficulties,low-incomehouseholdsaregenerally overrepresentedintheinformaleconomyandsuffera viciouscycleastheyaretheworkingpoor.Thisstudy contributedtothegrowingbodyofworkonthesocioeconomicimpactofthepandemicthroughcasestudiesof twoSouthAfricanmunicipalities.

TheImpactoftheCOVID-19Pandemiconthe InformalEconomyandPossibleFutureOptions

MostliteratureonCOVID-19tendstofocusonthemacroeconomicimpactofthepandemicbasedonnationaldata linkedtotheGrossDomesticProduct,unemploymentand povertylevels.Somestudiesalsofocusonthegovernments’ responsestothepandemicandtheeffectivenessofcountercyclicalpoliciesonpoverty,incomeandunemployment.

Thereisanacuteneedtobuildonstudiesfocusingonthe territorialimpactandresponsestothepandemicas informedbyeachlocality’ssocial,politicalandeconomic dynamics.Inthisstudy,weexploredtheimpactofCOVID-19 inSouthAfricaandtheresponsesadoptedbylocal governments.

Frombothmunicipalities(96%inKwaDukuzaand100%in eThekwini),theparticipantshighlightedthelossofincome astheleadingsocio-economicimpactofthepandemicon theirlivelihoods.Thefirststringentlockdownmeasures (betweenMarchandJune2020)werethehardestperiodsin theirlivelihoodsbecauseofthelimitedeconomicactivities andalackofsustainedincome.Thelossofincomealso meantthelossofemploymentbecausetheinformalsector istheironlymeansofgeneratinganincomeand contributedtothelossofassets,particularlyforthose sellingperishablegoods.Similartrendswerealsoobserved inBangkok,wheremanyinformalworkerscouldnotmake anincomeduringthehardestlockdownperiodsand struggledtorecovertheirpre-COVID-19income.

Onthelivelihoodimpactofthepandemiconinformal workers,over75%oftheparticipantsinKwaDukuzaand over80%ineThekwinistruggledtoaffordtobuyfoodand payfordailylivingexpenses.Strugglestopayrent,business premisesandemployeesbecauseofthelackofeconomic activitiesduetothelockdownmeasureswerealso recorded.

Intermsofeconomicsupport,mostinformalworkersdid notreceivefinancialsupportfromthenationalgovernment ortheirrespectivemunicipalities.Themainreasonforthis predicamentisthatthegovernment’sfundingcriteria focusedonpro-formalbusinessrequirements,suchastax registrationandincomestatements.Participantsfromboth municipalitiescitedthecumbersomerequirementsasone oftheleadingreasonsfornotapplyingforfunding.These requirementsinevitablyledtotheexclusionofinformal workersfromaccessingthesegrants.Essentially,thelackof socialsecuritydisproportionatelycontributestothe precariousnessoftheinformalsector.

Basedontheabovefactors,therelianceoftheinformal sectorasanunemploymentbuffershouldbereconsidered aftertheevidencefromtheCOVID-19era.Thereisalsoagap intransformingandformalisingtheinformalsectorto withstandpandemics/contractionaryperiodsasnoted duringtheEbolapandemic.Thisgapresultedinthe informalsectornotreceivingpriorityfromgovernment responsestothesocio-economicimpactofthepandemic. Assuch,thegovernmentneedssmartpoliciestocatertothe informaleconomyandtheworkingpoorduringpandemics asmanyworkersdependondailyincome.

Thereisaneedtoensuretheinformaleconomyisnotleft behindinthedigitaleconomy.Thegovernmentneedsto promotetheuseofICTintheinformalsector.Furthermore, informalworkersmustbetrainedtomanagetheir businessesandsavingsbettertowithstandunexpected economicshocks.Lastly,therehasneverbeenatimewhen thewelfarenatureofthestatemustbereconsideredamid growingpovertylevels,withadireneedtocraftpolicies

capableofunlockingthehiddenpotentialofthelocal economy.

Conclusion

TheCOVID-19pandemicrequiredinnovativecountercyclicalpoliciestobeimplementedduetotheimmediate publichealthrisksthatforcedsocialdistancingandthe lockdownofnationaleconomicactivitiestocombatthe spreadofthedeadlyvirus.Manystudiesfocusonthemacro impactandresponsestothepandemic,whichdoesnot sufficeinexplainingtheterritorialimpactofthepandemic. Infocusingonthelocalisedimpactofthepandemiconthe mostprecarioussector(informaleconomy)oftheeconomy, wedemonstratedhowtheimpactofthepandemicwas worsenedbythepre-existingprecariousnessoftheinformal economy.

Theformalsectorhasgreatercapabilitiestowithstand economicshocksbecauseofhigherlevelsofsocialsecurity andgovernmentinterventions,whereasthoseinthe informaleconomyandwithoutsocialsecurityfacethe greatestriskoffallingintoextremepoverty.Whilelocalised interventionswereessentialinsanitisingpublicspaces, identifyingindigentcitizenstoreceivefoodparcelsand creatingsafespacesforthehomeless,greaterfiscalcontrol ofeconomicresponsesisneededatthelocallevel.

Reference:

COVIDandtheInformalEconomyinSouthAfrica. Khambule,I1

Affiliations

¹ SchoolofBuiltEnvironmentandDevelopmentStudies,University ofKwaZulu-Natal

Director:ProfShaneNorris

www.facebook.com/CoEHuman

twitter.com/CoEHuman

www.wits.ac.za/coe-human

1stFloor,SchoolofPublicHealth, UniversityoftheWitwatersrand YorkRoad,Parktown, Johannesburg2193, SouthAfrica

COVID-19and adolescentsexual andreproductive healthinAfrica

TheCOVID-19pandemicsignificantlycompromisedthehealthandwellbeingoftheyouthpopulation globally,whereexpertshavecalledattentiontothedetrimentalimpactofthelockdownrestrictions onthesexualandreproductivehealthofadolescents.

Adolescentsexualandreproductivehealth(SRH)isan importanthumanrightsissue.Itrelatestoyoungpeople’s freedomandrightstoaccesssupportiveinformation, programmesandservicesthatpreventandaddressvarious factorsthatmaycompromisetheirSRH.Thisincludes individual,collectiveandsystemicpracticesthatplace youngpeopleatincreasedriskforunwantedsex,sexual violence,unwantedorunplannedpregnancies,unsafe abortionsortransmissionofsexualinfectionsanddiseases. Overthepastfewdecades,therehasbeenremarkable globalgainsinthepromotionofsexualandreproductive healthrightsandimprovingaccesstoSRHservices. However,thegainshavebeeninequitable,particularly withindevelopingcountrieswhereserviceshaveoftenfallen shortincoverageandquality.TheCOVID-19pandemichas alsosignificantlycompromisedthehealthandwellbeingof theyouthpopulationglobally,whereexpertshavecalled attentiontothedetrimentalimpactofthelockdown restrictionsontheSRHofadolescents.Thus,tounderstand theimplicationsofthepandemicontheSRHofadolescents inAfrica,thisstudyconductedasystematicrapidreviewof theliteraturepublishedbetweenJanuary2020andAugust 2021withinthreedatabasesnamelyEBSCO-hostweb,SAGE journalsandGoogleScholar.Theintentionwasto

understandhowthepandemichasimpactedthelivesof youngpeopleinAfricaandtoidentifysolutionstoprevent SRHchallengesandpromoteadolescentSRHduringthe pandemicandbeyond.

Keyfindings

TheliteraturerevealedthevariousSRHchallengesthat adolescentshadtocontendwithduringtheCOVID-19 pandemic.Particularly,itprojectedandobservedincreases inteenagepregnanciesandchildmarriage,increased reportsofchildsexualabuseandviolence,andheightened risksofunsafeabortionsduetotheinaccessibilityofSRH serviceswhichweredivertedtowardstheCOVID-19 response.Thereviewalsohighlightedtheimplicationsthat barrierstoaccessingSRHserviceshadonadolescentSRH. Forexample,giventherestrictedaccesstohealthcare facilities,womenwereunabletoadequatelyaccess antenatalcareorcontraceptives.Womenalsoexperienced difficultiesinaccessingfemininehygieneproductsdueto lockdownrestrictionsandthefinancialimplicationsofthe lockdown.Consequently,limitedaccesstocontraceptives leadstoincreasedlikelihoodofunplannedandunwanted pregnancies.

Keyconclusions

Inlightoftheshort-andlong-termimplicationsthatthe pandemichad,andwillhave,foradolescentSRHandSRH ofwomenmoregenerally,ahumanrightsperspectiveto addresstheneedsofadolescentgirlsandyoungwomen becomesimperative.WhenSRHisapproachedasahuman rightsissue,“itwillemphasizetheimportanceofSRHand significantlyimprovetheresponseofpolicymakersand governmentandaccesstorelatedservicesduringthe COVID-19pandemic”(Groenewaldetal.,2022,p.5).Further, innovativesolutionstobothidentifyatriskadolescentgirls andyoungwomenandgenerateknowledgesharingand awarenessraisingonkeyissuesthatimplicateadolescent SRHisrequired.Similarly,alternativewaysofcreating accesstoSRHservicesandhealthcareprovidersis necessary,consideringalsotheintersectionalimplications

ofvariousapproachesforadolescentsindiverse communities.Whilethesignificanceofpoliciesandlawsto protectadolescentsisalsoextremelyimportant,itisnot enoughtoensureadolescentshealthandsafetywithin communities.

Reference:

Adolescentsexualandreproductivehealthduringthe COVID-19pandemic:aminireview CandiceGroenewald1,2;NazeemaIsaacs3;DaneIsaacs3

¹ CentreforCommunity-BasedResearch,HumanSciencesResearch Council,Durban,SouthAfrica

² PsychologyDepartment,RhodesUniversity,Grahamstown,SouthAfrica

³ HumanandSocialCapabilities,HumanSciencesResearchCouncil,Cape Town,SouthAfrica

1stFloor,SchoolofPublicHealth, UniversityoftheWitwatersrand YorkRoad,Parktown, Johannesburg2193, SouthAfrica

Director:ProfShaneNorris

www.facebook.com/CoEHuman

twitter.com/CoEHuman

www.wits.ac.za/coe-human

RuralHouseholds’ Perceptionsof RooftopSolar Photovoltaics

Globally,about2.7billionrelyontraditionalfuelstomeet householdenergyneeds.Thisproblemismorepronounced inruralareas.Toimprovetheaffectedpeople’squalityof lifeandreducedependenceontraditionalbiomass, governmentsandotherstakeholdersarepushingtowards transitioningruralandunelectrifiedpopulationsfromusing traditionalbiomasstorenewableenergysources.InSouth Africa,ruralhouseholdsareconnectedthroughIntegrated NationalElectrificationProgramme(INEP)viaafee-forserviceprogramme.Inpartnershipwiththeprivatesector, anindigentisconnectedtoasolarhomesystemwitha capacityof50kWh.Theprogrammewasestablishedtohave covered300000householdsby2012withthecapacityof generating10000GWhby2013.Strikingly,by2012only46 000familieswereusingthesolarhomesystems.Thisfailure ispartlyblamedonthefailureofprogrammeplannersto factorincommunities’views,attitudes,andperceptionsof thetechnology.Thisresearchunpackscurrentenergy sources,typesandruralcommunities’perceptionofusing solarhomesystemsasanalternativeenergysourceinthe scattedandunelectrifiedcommunitiesofSouthAfrica.

Methodology

ThestudywasconductedinDhuvhuledza,Mbaheand Tshamutilikwa,ruralvillagesinThulamelaMunicipalityof VhembeDistrictinSouthAfrica.Thirty(30)households,ten

(10)pervillagewerepurposivelysampledviaacasestudy design.Themaininclusioncriteriawerepriorparticipation intheSolarHomeSystem(SHS)ElectrificationProgramme implementedbytheThulamelaLocalMunicipalityandSolar VisionPrivateLimited.Beforetheactualdatacollection,the SHSElectrificationprogrammewereidentifiedineach village.Outoftheidentifiedonly10wererandomlyselected pervillage.ThedatawasanalysedusingThematicNetwork Analysis(TNA)inAtlastiversion8.Alltherecorded interviewsweretranscribedfirstonaworddocument.Inall instanceswherethelocallanguage(Venda)wasused,itwas translatedintoEnglish.Thedatawereanalysedusingopen coding,codebylist,andinvivo.Therelationshipandlogical patternexplainingtheperceivedadvantagesand disadvantagesofadoptinganSHSwereextractedfromthe datausingthelinkingandrelatedfunctionsunderNetwork ViewManager.

Keyresults

Resultsrevealedthatruralfamiliesusevariousenergy sources,includinggridelectricity,paraffin,solar photovoltaics,firewoodandcandles.Additionally,itwas revealedthatenergyneedsatthehouseholdlevelranges fromcooking,waterheating,indoorandoutdoor illumination,refrigeration,fabricstrengthening,air conditioningentertainmentandspaceheating.

RuralcommunitiesinSouthAfricahavethepotentialtoadoptrenewableenergyresourcessuchas solarphotovoltaics,buttheyarenotadequatelyharnessed.

Table1:EnergytypesandtheirusesinahouseholdintheruralareasoftheVhembeDistrict

Table2:Ruralhouseholds’perceptionsofsolarhomesystems(SHS)

Table2:Ruralhouseholds’perceptionsofsolarhomesystems(SHS)continued

Conclusionsandimplications

Eventhoughtheparticipatingfamiliesindicatedpositive perceptionsofsolarphoto-voltaictechnology,its proliferationinruralareasishinderedbyhighcapitaland maintenancecosts.Ithasbeenobservedthat,inthedistrict, themajorityofthefamiliesintheseruralcommunitiesrely ongovernmentgrants.Suchpeoplearenot consideredforessentialfinancialservices likeinsurance,bankloansandothers astheydonothaveasteady income,ownapersonalbank accountandreliablecredithistory. Thus,SHSprovidersshouldnotonly leveragethefinancialimplicationsof usinguncleanenergysourceslike fossilfuelsandbiomassbutalsothe financialcapabilitiesoftheend-users ofthetechnology.Thus,itis recommendedthatsolarhomesystems innovatorsneedtailor-madeservicecharges inlinewiththefinancialsituationofthe communitiestheyintendtoelectrify.

RuralcommunitiesinSouthAfricahavethe potentialtoadoptrenewableenergyresources

suchassolarphotovoltaics,buttheyarenotadequately harnessed.Currently,thegovernmentissubsidisingmore on-gridconnectionsattheexpenseofoff-gridconnections. Centraltothisisthepoliticisationofruralelectrificationin SouthAfrica.Inaddition,theSHSimplementation programmeneedsanawarenessofthecapacityand thesystemtypes.Besidesthesystemcapacity, theWorldBankemphasisesthatSHSshould beevaluatedtoimproverural communities’energyaccessregarding availability,reliability,quality,costeffectiveness,legal,health,andsafety.All thisinformationshouldbesharedwith ruralfamilieswhointendorarewillingto adoptanSHS.

Reference:

RuralHouseholds’Perceptionsofthe AdoptionofRooftopSolarPhotovoltaicsin VhembeDistrict,SouthAfrica RanganaiChidembo¹

Affiliations

1stFloor,SchoolofPublicHealth, UniversityoftheWitwatersrand YorkRoad,Parktown, Johannesburg2193, SouthAfrica

Director:ProfShaneNorris

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www.wits.ac.za/coe-human

The Council

University of the Witwatersrand, Johannesburg

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Wits

South Africa

Purpose of this Agreed- Upon Report

AGREED-UPON PROCEEDURES REPORT IN RESPECT OF THE NATIONAL RESEARCH FOUNDATION (NRF) AWARDS RECEIVED BY THE UNIVERSITY OF THE WITWATERSRAND FOR THE CENTRE OF EXCELLENCE IN HUMAN DEVELOPMENT FOR THE YEAR ENDED 31 DECEMBER 2022

We have performed the procedures agreed with you and enumerated below with respect of the National Research Foundation (NRF) awards received by the University of the Witwatersrand (“the University”) for the Centre of Excellence in Human Development for the year ended 31 December 2022

Our report is solely for the purpose of assisting the University of the Witwatersrand in in reporting to the NRF on the Cash Flow Analysis relating to the Centre of Excellence in Human Development for the year ended 31 December 2022 and may not be suitable for another purpose

R Responsibilities of the Engaging Party and the Responsible Party

The University of the Witwatersrand has acknowledged that the agreed -upon procedures are appropriate for the purpose of the engagement.

NRF, as identified by the University of the Witwatersrand is responsible for the subject matter on which the agreed -upon procedures are performed

P Practitioners Responsibilities

We have conducted the agreed-upon procedures engagement in accordance with the International Standard on Related Services (ISRS) 4400 (Revised), Agreed-Upon Procedures Engagements. An agreed-upon procedures engagement involves our performing the procedure s that have been agreed with the University of the Witwatersrand and reporting the findings, which are factual results of the agreed-upon procedures performed. We make no representation regarding the appropriateness of the agreed-upon procedures.

This agreed-upon procedures engagement is not an assurance engagement. Accordingly, we do not express an opinion or assurance conclusion.

Deloitte & Touche

Agreed upon procedures report in respect of the National Research Foundation awards received by the University of the Witwatersrand for the Centre of Excellence in Human Development for the year ended 31 December 2022

Had we performed additional procedures, other matters might have come to our attention that would have been reported.

Professional Ethics and Quality Control

We have complied with the ethical and independence requirements as described in the Independent Regulatory Board for Auditors’ Code of Professional Conduct for Registered Auditors (IRBA Code) and in accordance with other ethical requirements applicable to performing audits in South Africa. The IRBA Code is consistent with the corresponding sections of the International Ethics Standards Board for Accountants’ International Code of Ethics for Professional Accountants (including International Independence Sta ndards).

The firm applies the International Standard on Quality Management 1, Quality Management for Firms that Perform Audits or Reviews of Financial Statements, or other Assurance or Related Services Engagements, which requires the firm to design, implement and operate a system of quality management, including policies or procedures regarding compliance with ethical requirements, professional standards and applicable legal and regulatory requirements.

P Procedures and findings

We have performed the procedures described below which were agreed upon with the University of the Witwatersrand on with respect to the NRF awards received by the University of the Witwatersrand for the Centre of Excellence in Human Development for the year ended 31 December 2022.

Procedures

1. Inspect that the declared income and expenditure is correct and that all income and expenditure as per the general ledger has been declared by agreeing the Centre of Excellence in Human Development Cash flow Analysis to the general ledger for the period. The transactions, both expenditure and income will be subject to the procedures stipulated below.

2. Inspect that:

a) Two steering Committee Board meetings were held in the period of funding, and minutes for both meetings have been adopted and signed by the Chairperson of the Board

b) The Steering Committee approved the Business Plan, and those minutes of the meeting as well as the Business Plan was submitted to the NRF.

Findings

1. We obtained the Centre of Excellence in Human Development Cash Flow Analysis and general ledger for the period under review and inspected that all income and expenditure as per the general ledger was declared by agreeing the Centre of Excellence in Human Development cash flow analysis to the general ledger. Refer to Appendix B for the cash flow analysis.

No exceptions were noted.

2. Inspected that:

a) Two Steering Committee meetings were held in the period of funding, and minutes for both meetings were adopted and signed by the Chairperson of the Board.

No Exceptions were noted.

b) Through the inspection of the Steering Committee meetings minutes, we noted that the approved Business Plan and the minutes of the meetings were submitted to the NRF.

No exceptions were noted.

Deloitte & Touche

Agreed upon procedures report in respect of the National Research Foundation awards received by the University of the Witwatersrand for the Centre of Excellence in Human Development for the year ended 31 December 2022

Procedures Findings

3. Inspect that the grant funds were used to advance the research agenda by:

a) Selecting a sample being ten percent of the expenses per the general ledger.

3. We inspected that the grant funds were used to advance the research agenda and performed the following procedures:

a) Selected a sample being ten percent of the expenses per the general ledger.

No exceptions were noted.

b) Agreeing with Beverley Manus (University of the Witwatersrand: Finance Manager Research Office) that the transactions selected in procedure 3(a), are appropriate.

b) We agreed with Beverley Manus (University of the Witwatersrand: Finance Manager Research Office) that the transactions selected in procedure 3(a), are appropriate.

No exceptions were noted.

c) For the samples selected, perform the following procedures:

a. Obtain the source documents (invoices, payslips, expense breakdowns and travel claim expense forms, etc.) for items selected from the general ledger and agree the details per general ledger to the supporting documentation inspected.

b. Inspect the nature of expenses as per the supporting documents description and compare the nature of expenses to the purpose of research, as stipulated in the business plan.

c. Inspect the date as per the source documentation and agree that it was recorded in the correct financial period, 1 January 2022 –31 December 2022 based on when the goods or services were received.

d. Inspect the source documentation and agree that it is in the name of the University of the Witwatersrand.

c) For the samples selected, we performed the following procedures:

a. We obtained the source documents (invoices, payslips, expense breakdowns and travel claim expense forms, etc.) for items selected from the general ledger and agreed the details per general ledger to the supporting documentation inspected.

No exceptions were noted.

b. We inspected the nature of expenses as per the supporting documents description and compared the nature of expenses to the purpose of research, as stipulated in the business plan.

No exceptions were noted.

c. We inspected the date as per the source documentation and agreed that it was recorded in the correct financial period, 1 January 2022 – 31 December 2022 based on when the goods or services were received.

No exceptions were noted.

d. We inspected the source documentation and agreed that it is in the name of the University of the Witwatersrand.

No exceptions were noted.

Deloitte & Touche

Agreed upon procedures report in respect of the National Research Foundation awards received by the University of the Witwatersrand for the Centre of Excellence in Human Development for the year ended 31 December 2022

A APPENDIX A

S Student Nominations List CoE: Centre of Excellence in Human Development

Approval of the Report

This will be done electronically by the Designated Authority

Professor Lynn Morris

Deputy Vice-Chancellor: Research and Innovation

Date: 12 April 2023