M. Makiwane

Cognitive-behavioural health-promotion intervention increases fruit and vegetable consumption and physical activity among South African adolescents: a cluster-randomised controlled trial.

Rates of chronic diseases are high among Black South Africans but few studies have tested cognitive-behavioural health-promotion interventions to reduce this problem. We tested the efficacy of such an intervention among adolescents in a cluster-randomised controlled trial. We randomly selected 9 of 17 matched pairs of schools and randomised one school in each pair to the cognitive-behavioural health-promotion intervention designed to encourage health-related behaviours and the other to a human immunodeficiency virus (HIV)/sexually transmitted disease (STD) risk-reduction intervention that served as the control. Interventions were based on social cognitive theory, the theory of planned behaviour and qualitative data from the target population. Data collectors, blind to participants’ intervention, administered confidential assessments at baseline and 3, 6 and 12 months post-intervention. Primary outcomes were fruit and vegetable consumption and physical activity. Participants were 1057 grade 6 learners (mean age = 12.4 years), with 96.7% retained at 12-month follow-up. Generalised estimating equations revealed that averaged over the follow-ups, a greater percentage of health-promotion intervention participants than HIV/STD control participants met 5-a-Day fruit and vegetable and physical activity guidelines. The intervention also increased health-promotion knowledge, attitude and intention, but did not decrease substance use or substance-use attitude and intention. The findings suggest that theory based and contextually appropriate interventions may increase health behaviours among young adolescents in sub-Saharan Africa.

The Child Support Grant and teenage childbearing in South Africa

This paper examines data on teenage fertility and patterns of uptake of the Child Support Grant in South Africa from 1998 to 2005, to assess how far this Grant is associated with the trend in teenage childbearing. Teenage fertility was fairly high during the 1980s when state financial assistance to teenage mothers did not adequately serve the majority of South Africans. Since the first half of the 1990s, however, teenage fertility has steadily declined. This trend was already underway when the grant was expanded in 1998 to reach beneficiaries in all sub-groups of the national population. If teenage girls were having children primarily to benefit from the Child Support Grant, then more would be making claims than is in fact the case. The findings of this study do not suggest any significant positive association between the grant and the trend in teenage childbearing in South Africa during the past decade.

Older People as Resources in South Africa: Mpumalanga Households

Abstract The extended family used to be relied upon to provide subsistence and care for older people in sub-Saharan Africa. However, recently South Africa has seen a reversal of roles, where older people now provide subsistence and care to younger generations; this role reversal is being accelerated by HIV/AIDS deaths among young adults. In most rural households, the non-contributory old age pension (OAP) that is means-tested is an important factor in making older people breadwinners. Using data from the 2004 Mpumalanga Older Peoples Survey, we examined the changing role of older people, which has been influenced mainly by changes in household structure and old age pension. Findings show that in 63% of matrifocal, multigenerational households, 76% of older people are the sole providers of household necessities, caring for the sick and grandchildren in increasingly skip-generation households.

Youth and Well-Being: A South African Case Study.

This paper was a result of an analysis from various data sources with a purpose to develop a better understanding of the level of socio-economic well being of young people in South Africa. Such understanding is aimed at enabling government to plan and implement well-structured and integrated development programmes that are relevant to the socio-economic needs of the youth and that will enable them to fully participate in all aspects of society. Two main sources of data were used for this analysis. The first is the Status of the Youth (SYR) data set. The second data set used in this study is the South African Social Attitudes Survey (SASAS) which is a national representative sample of 5,000 households. The study shows that the quality of life among majority of young people remains low, reflecting the historical racial cleavages of South African society. This is mainly due to the emergence of the AIDS pandemic in South Africa, and the fact that many young people remain outside the labour market.

South Africa youths’ higher-risk sexual behaviour: an eco-developmental analysis

Despite their high levels of knowledge about HIV and AIDS, young people ages 15–24 years in South Africa remain disproportionately affected by the epidemic. Young peoples continued susceptibility to HIV infection has been consistently linked to intractable higher-risk sexual behaviours. This paper uses multivariate techniques and secondary data from two nationally representative surveys to illuminate individual and socio-structural factors that play a significant role in youths’ continued engagement in higher-risk behaviour, despite their high awareness about HIV and AIDS. The findings show that notwithstanding progress in terms of increased condom use and reduced incidence of other sexually transmitted infections, the average age of sexual debut remains low, multiple sexual partnerships are prevalent, and inconsistent condom use is widespread among young people. Factors significantly associated with these risk behaviours occur at the individual and structural levels and include issues of race, gender, poverty and susceptibility to peer pressure. The paper concludes by recommending that future HIV-prevention interventions in South Africa should aim at building resilience among youths by promoting affirmative, supportive interventions that emphasize the potentials of young people.

Homeless individuals, families and communities: The societal origins of homelessness

This article uses case histories to document the experiences of 30 homeless people from a range of backgrounds in Pretoria and Rustenburg, South Africa. Factors that contributed to their becoming homeless were poverty, unemployment, a lack of affordable accommodation, divorce, disability, illness and an underprivileged childhood. More than one-half of the interviewees reported growing up in dysfunctional families. There was evidence of solidarity among homeless people, especially those living in shelters, and there were informal networks for identifying job opportunities. Many of the interviewees hoped to improve their circumstances by finding affordable accommodation or some form of employment or receiving a state grant.

Gender, race and ageing in South Africa

abstract The proportion of persons 60 and older in South Africa is projected to almost double over the 30 year period between 2000–2030, from 7% to 12%, because of a marked decline in fertility in the last few decades. For Africans in particular, population ageing has meant that a larger proportion of females are reaching old age than their male counterparts (Makiwane, Schneider and Gopane, 2004), leading to a higher proportion of elderly households being headed by women. Through a secondary analysis of the General Household Survey data (2010) this paper explores the intersection between gender, race and ageing in South Africa. The findings from the analysis suggest that more than six out of ten older persons in South Africa are females who generally live longer than males. African females are the least educated and White males are the majority among the elderly with a matric and post-matric qualification. White women are the majority amongst women with secondary school and post-matric qualification and African women are least represented amongst elderly women in employment with the percentage of White women being much lower than that of elderly White men in employment. In feminist politics and theory the imbrication of gender, race and class in explicating womens experiences and development outcomes has been conceptualised in the notion of ‘intersectionality’, a term that denotes the ways in which race, gender and class interact to shape womens, and particularly, Black womens experiences in society. In South Africa, race, gender and class intersect in complex ways to shape elderly peoples experiences and development outcomes. This Article argues that state intervention is required to ensure that the most vulnerable group among the elderly population is ensured for a decent standard of living in their old age.

Effect of a Behavioral Intervention on Perpetrating and Experiencing Forced Sex Among South African Adolescents: A Secondary Analysis of a Cluster Randomized Trial

Key Points Question Can a 12-hour theory-based behavioral intervention culturally adapted for students in sixth grade in South Africa reduce forced sexual intercourse perpetration among adolescents? Findings In this secondary analysis of a cluster randomized clinical trial that included 1052 South African adolescents, the percentage reporting perpetration of forced sexual intercourse by 54 months postintervention was 9% in the intervention group and 14% in the control group, a significant difference. Meaning In settings with high rates of sexual assault the use of theory-based, culturally adapted interventions to reduce the prevalence of forced sexual intercourse perpetration may be warranted.

Predictors and psychological pathways for binge drinking among South African men

Objective: To develop targeted interventions for high-risk drinkers among South African men, we assessed whether sociodemographic factors and history of childhood sexual abuse predicted binge drinking at six-month follow-up assessment and their psychological pathways according to the extended Theory of Reasoned Action (TRA). Design: Survey responses with a sample of 1181 South African men from randomly selected neighbourhoods in Eastern Cape Province were collected at baseline and six-month follow-up. Multiple logistic regression analysis examined the baseline predictors of binge drinking. Serial multiple mediation analysis examined the psychological pathways. Main outcome measurements: Binge drinking at six-month follow-up. Results: Age (OR = 1.03, 95% CI: 1.01, 1.05), religious participation (OR = .73, CI: .65, .82) and history of childhood sexual abuse (OR = 1.82, CI: 1.32, 2.51) were significant predictors of binge drinking. Predictions of religious participation and history of childhood sexual abuse were partially mediated through attitude, subjective norm, descriptive norm and intention to binge drinking. Conclusion: South African men with childhood sexual abuse experience and low religious participation were at higher risk for binge drinking. The extended TRA model explains the associations of these factors to binge drinking and can contribute to the design and evaluation of interventions.

Family in a changing South Africa: structures, functions and the welfare of members

ABSTRACT The historical review of South African families reveals that the family has undergone significant transformations, resulting in a mosaic of family formations that have had an impact on family functions. Notwithstanding the importance of the family being one of the fundamental social units, however, there is limited data on how these families function in South Africa. This article analyses the change in family structures and community members’ perspectives about how these structures and living arrangements of members contribute to family functioning and wellbeing of members, with a specific focus on Mpumalanga, South Africa. Literature searches, quantitative analyses of the 2002 and 2009 General Household Survey, and qualitative analysis obtained through focus group discussions and in-depth interviews were used. The results confirmed that there is a disaggregation of families with young adults being heads of smaller families, while ageing parents are in charge of large multi-generational families. The role of the extended family has been diminished, and new forms of support such as churches and neighbours’ networks have become more important. The critical role of inter-generational care was confirmed and also the disjuncture between generations attributed to erosion of family norms and values. The results of the study emphasised the importance of attending to a simultaneous and comprehensive family policy that addresses psychosocial and material support, when assessing family wellbeing.