The South African Institute of Race Relations (SAIRR) says that childbirths as a proportion of the total South African population are at a record low for the first time in more than two decades.
In a press statement, SAIRR researcher, Thuthukani Ndebele, points out that, "Women are choosing to delay childbirth and ultimately have fewer children, so that the number of babies born per 1 000 people in a given year is shrinking."
Ndebele says a shrinking proportion of births, coupled with better life expectancy, will result in the proportion of young people dropping while that of older persons will grow.
To read the article titled, “Fewer births in SA - survey,” click here.Source:News 24
In 2013, Creative Consulting & Development Works was appointed by an international donor to evaluate the achievements and impact of ethics activities employed in 75 ethics programmes across sub-Saharan Africa. The evaluation led to a deeper look at the impact of clinical trials in developing countries and the ethics behind such medical trials and their implementation.
In recent years, large-scale multinational research in developing countries has become the order of the day. In African countries where sociological, epidemiological and developmental contexts are of interest to various disciplines - and where there is a greater prevalence of diseases with a global impact, such as HIV, tuberculosis (TB) and malaria - research activities are carried out at an amplified scale.
This intensified research activity, competition in research and the attractive research environment, may sometimes result in dishonest and fraudulent practice. In particular, research in Africa generates intricate ethical issues such as possible exploitation, the use of incentives, informed consent, involving vulnerable populations and benefit sharing for local participants (Van Niekerk 2013, pers. comm., 26 June 2013)1.
(South) Africa was indeed for many years regarded as a ‘researcher’s paradise’ by Western researchers who worked in Africa and were seemingly exempt from the stringent regulations for ethical research applicable in their home countries (Van Niekerk and Benatar, 2011: 144). In the midst of the current increase in multinational research, it is important to consistently hold practitioners to the highest ethical standard, monitor implementation of research studies and ensure the well-being of participants.
Research ethics become predominantly challenging when there is an economic gap between researchers and subjects. For instance, in the case of HIV and AIDS in Africa, the burden is so great that subjects are often eager to participate, regardless of the infringements of their rights, in the hope of getting treatment. This involvement of vulnerable populations, especially when HIV and AIDS patients may not have access to other forms of treatment, requires great care to conduct ethically. It is therefore important for researchers to acknowledge that the processes involved in ethical research may be compromised in African countries where wide social disparities and weak social welfare systems exist along with therapeutic misconceptions and illiteracy (Mamotte et al., 2010).
Further to the research conduct itself, major concerns over the practices and capacity of ethical review committees’ operations also remain2. Most African research ethics committees do not have the adequate resources, expertise and capacity of institutional and national research committees, required to conduct ethical reviews and subsequent monitoring of health research. Due to this lack of resources, expertise and capacity at the institutional level, ethics review committees are at risk of accepting even ethically challenged research, considering the financial benefit the organisation and community may get from the research.
Throughout the evaluation conducted by Creative Consulting & Development Works, the team strived to address challenges faced in this sector and identify clinical trials and ethics review committees best practice.
The organisation evaluated was established in 2003, to address the global health crisis caused by HIV and AIDS, TB and malaria. In all sub-Saharan African countries where the organisation is facilitating clinical trials, funding is also provided for the establishing, development and support of ethics review capacity. The 75 ethics programmes reviewed in the 2013 evaluation were involved in the parent organisation’s intervention to build capacity for ethical review and increase the relevance of clinical trials for indigenous populations, cultural sensitivity and quality of life.
Strengthening ethics committees with capacity, knowledge, infrastructure and effective review and monitoring tools provides countries with the ability to independently lend oversight of national and multi-site international research in Africa. Knowledge dissemination is in turn encouraged through the organisation, and the facilitation of ethical issues workshops for researchers, policy formulators, clinicians, municipality representatives, research regulators, academics, civil society and opinion leaders in the field of human subjects research.
Our team confirmed that building the capacity of ethical review boards has contributed to a number of improvements in the sector. Best practices are identified, research studies are conducted by qualified investigators and there is a fair selection of research participants into studies.
Fair selection and use of qualified researchers leads to a higher quality of research to be approved by the National Ethics Committees (NECs) and Institutional Review Boards (IRBs), and to the development of relevant conclusions and recommendations derived from study results on HIV, TB and Malaria. NECs are in turn better able to ensure that international research conducted in their respective countries benefits the local population, emphasising benefit sharing in the developing world.
Creation of clinical trial databases and registries by IRBs, provides the general population and other researchers with information on studies taking place in the country. Research subjects are able to ensure the study has received ethics approval, while investigators can follow research results in order to promote best practices in ethical research conduct and prevent the duplication of studies. This, coupled with increased reporting of serious and adverse events during research procedures, raises the general public’s level of trust towards the research community.
Promoting collaborative research partnerships between communities and investigators facilitates community rights and community ownership, both fundamental benchmarks for the conduct of ethical research in developing countries. In addition, trained community members play a critical role when Community Advisory Boards (CAB) are established as a voice for study participants and the community. The CAB ensures community concerns are considered during clinical research studies, while advising investigators on target community demographics, culture and how to efficiently obtain informed consent.
There are potentially countless innovations ready to be developed to address global challenges in both the social and physical sciences. As the research ethics field continues to grow, we need to ask how we as development researchers can remove barriers to ethical participatory research while ensuring that the research produced in Africa is scientifically and contextually relevant. This evaluation suggested that investing in comprehensive ethical review enhances the development of academia, society (specifically in developing countries), and human rights in general.
- Creative Consulting and Development Works, The Benefits of Ethical Review in African Research Prof. Anton van Niekerk, Centre for Applied Ethics, Stellenbosch University. Training on 26 June 2013: Research Ethics Committees in Africa: background, constitution and assessment. Department of Health. 2006. Guidelines for Good Practice in the Conduct of Clinical Trials with Human Participants in South Africa. Pretoria.
- International Organisation for Migration (IOM)Please note: this opportunity closing date has passed and may not be available any more.Opportunity closing date:Sunday, September 15, 2013Opportunity type:Employment
IOM South Africa Migration Health Unit seeks to recruit a Consultant to do a systematic review of published peer reviewed articles on migration and malaria in eight countries of southern Africa, four of which are high malaria transmission and four low malaria transmission countries. In addition, the consultant will conduct mapping of institutions that provide malaria control services (such as treatment, distribution of long lasting insecticidal nets, vector control and education programmes and training of community health workers in migration affected communities)to migrants and mobile populations within countries and at the borders of the eight malaria-elimination countries.
Under the direct supervision of the Migration Health Research Officer and with support from IOM research team, the consultant is expected to do a systematic review of published peer reviewed articles on population migration patterns in relation to malaria risk in the region as well as categories of migrants in need of malaria control services in the eight countries. The review should, in addition, document existing government policies in health and non-health sector (environment, transportation, social welfare etc.), programmes and legislature on malaria, especially as they affect migrants and mobile populations in the eight malaria elimination countries (E8) of SADC. Furthermore, the assignment would involve mapping of institutions that provide malaria control services highlighted above, to migrants and mobile populations within the countries and at the borders of the E8 countries. This mapping would document who the different players are in provision of malaria control services to migrants and mobile populations, specific services offered, and where the services are being offered.
The Consultant will work from IOM’s Pretoria Offices. S/he will work with the Regional Migration and Health Unit.
This is a three-month contract from date of signing contract.
Starting date: As soon as possible.
IOM’s Migration Health vision is “to ensure that migrants and mobile populations benefit from an improved standard of physical, mental and social well-being, which enables them to substantially contribute towards the social and economic development of their communities, in their countries of origin and destination. Guided by the World Health Assembly Resolution (WHA61.17) on the Health of Migrants adopted in May 2008, IOM supports its governments and partners to “promote migrant-sensitive health policies” and “to promote equitable access to health promotion and care for migrants”. IOM’s Migration Health programmes in East and Southern Africa address the health needs of individual migrants as well as the public health needs of migration affected communities by assisting governmental, non-governmental and civil society partners in the development and implementation of relevant policies and programmes.
Since 2003 IOM started its regional programme, “Partnership on HIV and Mobility in Southern Africa”. As from July 2010 the programme entered its third phase and includes East Africa and is known as the “Partnership on Health and Mobility in East and Southern Africa” (PHAMESA).
Partnership on Health and Mobility in East and Southern Africa (PHAMESA)
The overall objective of PHAMESA is to contribute to the “improved standards of physical, mental and social well-being of migrants by responding to their health needs throughout all phases of the migration process, as well as the public health needs of host communities”, using IOM’s network of regional and country missions, and partnerships with Regional Economic Communities, National AIDS Councils, Ministries of Health, Ministries of sectors dealing with mobile and migrant workers, Private Sector Companies, Unions, UN Partners, and International and local NGOs.
Introduction and Background
Malaria is one of the most severe public health problems worldwide. It is a leading cause of death and disease in many developing countries where young children and pregnant women are the groups most affected. Malaria mortality constitutes a great percentage of deaths in Africa. In 2010 more than 219 million of malaria cases were reported, with more than 650000 deaths due to this epidemic, of which approximately 81%; 174 million cases were in Africa. These deaths occur mainly among pregnant women and children under the age of five. In the SADC region the total number of reported malaria cases in 2011 were 34,978,680; with Zimbabwe at 247,379 cases, Mozambique at 1,522,577, Namibia at 556, Botswana at 1046, Zambia at 13,500,000 and South Africa at 3875 cases1. In southern Africa, Malawi, Mozambique and Zambia are among the high transmission areas, while Botswana, Namibia, South Africa, Zimbabwe and Swaziland are considered low transmission areas. Seasonal migration of workers has been associated with malaria epidemics in Kenya (Bloland & Williams, 2003). Meade and Earickson (2000) reported the effect of population movement on the extent of malaria drug resistance as migrants that move from areas where resistance strains of the parasite have been identified introduced the strain into areas where resistance had not been acquired yet. Most recently migration is believed to have initiated malaria transmission in African highlands where there were no malaria parasites previously (Castro, 2002). Pindolia et al (2012)reviewed human movement data for malaria control and elimination. The review documented human population movement in relation to malaria transmission to be both internal (rural to rural or rural to urban) and international. The authors suggested that “neglecting human population movement from high to low transmission areas can lead to re-emergence in areas where low transmission had been previously achieved but receptivity to infection remained high”5.
The transmission of malaria is strongly influenced by population movements and by the process of urbanisation. Whether malaria risk increases depends on the social, economic and behavioural characteristics of migrants, the type of ecological setting, availability of malaria vectors in the area and the changes people impose on the environment (Castro, 2002)4. Increase in malaria infection has been documented in all newly opened frontiers for economic development in agriculture and mining, in those areas affected by war, lawlessness and open conflicts and in locations that are a focal point for refugee migrations (Knudsen & Slooff, 1992). A good picture is the case of Dar es Salaam, which is characterised with endemic and perennial malaria resulting in transmission occurring through the year4.
The most common malaria parasite is plasmodium falciparum with 90% of all cases, and Anopheles mosquito is the vector of Plasmodium falciparum. Other malaria vectors include Anopheles gambiae and Anopheles funestus. These vectors breed in permanent water, especially near inland marshes , presence of creeks, areas where agricultural actives are undertaken, raised planting beds, salt pans, paddy fields, sand pits, seepage, swamps, mangrove swamps, pits for house construction, roadside rubbles to mention a few. These factors describe some of the characteristics of urban informal settlements in sub-Saharan Africa where many migrants live due to high cost of living in more developed urban areas. Urban informal settlements therefore create a conductive environment for high larval breeding of malaria vectors and increase the risk of malaria infections among migrants and mobile population within urban settings with malaria vectors.
Justification of Assignment
Migrants and mobile populations travelling to, from and within different parts of Southern Africa face various social, climatic, economic as well as political determinants of health. As case fatality due to malaria is high among the general population in Africa, especially pregnant women and children under 5 years of age, in countries of high malaria transmission in southern Africa (WHO, 2012), one would equally expect the case fatality due to malaria to be high among migrants and mobile populations of similar demographics, especially, those from areas of high malaria transmission. Available evidence on the case fatality and morbidity due to malaria among migrants and mobile populations in southern Africa is scarce, neither is there a policy that clearly articulates malaria prophylaxis or regimen for migrants and mobile populations in transit or in destination countries. Migrants and mobile populations as well as their families from a country of high malaria transmission to a country of low malaria transmission could be faced with obstacles in accessing malaria control services and/or essential health care services either in transit or in their countries of destination; whilst migrants from countries of low transmission moving into or through countries of high transmission may face similar challenge. With escalating human mobility; large numbers of people are travelling from malaria endemic to non-endemic areas, and malaria non-endemic areas to malaria endemic area more regularly. Undocumented migrants face many obstacles in accessing essential health care including malaria prevention, screening as well as treatment.
African Ministers of Health declared malaria elimination a priority in 2007. In 2009, SADC Ministers of Health approved the SADC Malaria Strategic Framework and a subsequent Malaria Elimination Framework, which urged member states to identify potential areas for elimination and to develop national malaria elimination strategic plans. In order to implement the framework, SADC supported the development of malaria elimination 8 countries, subsequently called “SADC E8”, a coordinated, multi-country programme that seeks to work in the 8 countries most affected by malaria in the region. This initiative seeks to support the elimination of malaria in four low transmission countries at the fore-front of malaria elimination (Botswana, Namibia, South Africa, and Swaziland); and the other four (second-line) high transmission countries (Angola, Mozambique, Zambia and Zimbabwe). A SADC malaria elimination resolution (SADC 2009) with action points on elimination of malaria in the eight countries was agreed upon. One of the action points agreed upon was the need to strengthen existing cross-border collaboration and establishment of additional initiatives between front-line and second-line countries. IOM believes that this goal cannot be achieved without policies that are cognisant of mobility and migration dynamics, which also support the treatment and prevention of malaria among migrants and mobile populations, especially in high and low transmission SADC countries.
In the same vein, strategies and policies to prevent and treat malaria among mobile populations and migrants could reduce the introduction of resistant strains of Plasmodium falciparum from mobile populations with resistant strains. Pindolia et al (2012) suggested the implementation of cross-border initiatives between countries linked by significant human population mobility from high to low transmission areas are more likely to succeed in both achieving and maintaining elimination than single country strategies, which would face challenges through imported infections5.
In order to advocate for increased funding for malaria control for migrants and mobile populations in the E8 countries, there is need for coordinated effort by government, international organizations, non-governmental organizations and regional bodies working with migrants and mobility affected populations. Information that provides a better understanding of malaria transmission as well as the adverse effect of malaria on migrants, mobile populations and affected communities becomes vital. In addition, mapping available institutions or organisations currently providing malaria services to migrants and mobile populations within the E8 countries and at the borders will show existing gaps in malaria control service provision in the E8 countries.
Objectives of Assignment
The main objective of this assignment is to provide information and better understanding of the link between malaria and human mobility in order to improve access to malaria prevention and treatment for migrants, mobile and trans-border populations, and migration affected communities through a comprehensive review of published literature on migration and malaria in the E8 countries. The assignment will show population mobility pattern in relation to migrants risk for malaria in the region, review existing policies, programmes and legislature on malaria treatment provision to migrants and mobile populations, as well as map existing malaria control services available to migrants, mobile and cross border populations within and at the borders of the E8 countries.
Scope of work
The assignment will be divided into two stages:
Stage 1: Desk review
This review will:
- Document population mobility patterns in relation to malaria risk in the region. This will include available literature on mobility pattern of migrants and mobile populations (rural/urban, rural/rural, international migration), from areas of high malaria density to areas of low malaria density and vice versa;
- Document different categories of migrants and mobile populations in southern Africa in need of malaria services;
- Document malaria morbidity and mortality related evidence among mobile populations;
- Document existing government policies, programmes and legislature on malaria, especially as they affect migrants and mobile populations in the E8 countries.
This mapping exercise should document the different stakeholders involved in the provision of malaria control services to migrants and mobile populations in the E8 countries. It should include details of the type of malaria control services that are being offered, who can access these services and where the services are being offered to migrants and mobile populations within countries or at the borders. This should include those currently offering malaria initiatives at the borders in the E8 countries are the Lubombo spatial development, Trans-Zambezi, Zam-Zim and Trans-Kunene malaria initiatives as well as all others.
Successful completion of this assignment will involve answers to the following research questions:
- How do mobility patterns within and across international borders contribute to risk of malaria transmission in the E8 countries?
- What categories of migrants in southern Africa are in need of malaria services?
- What are the existing policies and programmes on malaria control especially for migrants and mobile populations in the E8 countries?
- Which institutions are providing malaria control services to migrants and mobile populations within and at the borders in the E8? What specific services are provided, where and who are the beneficiaries?
The research will be in two stages. The first stage of the research will be a desk review of existing literature, on migration and malaria; followed by a mapping exercise in the E8 countries, which will involve focus group discussions as well as structured interviews with key informants from institutions providing malaria control services to migrants and mobile populations. This will elucidate the type of malaria control services provided, who is providing the services, where the services are being provided (within countries or at the borders) and whom the beneficiaries are.
Stage 1 Comprehensive Review:
The literature review is expected to investigate:
- Population mobility patterns in relation to malaria risk
- Categories of migrants and mobile populations in the E8 countries in need of malaria services
- Review of existing health and non-health sector policies, programmes and legislature on malaria in the E8 countries
This will involve mapping of, and gathering information from institutions providing malaria control services to migrants and mobile populations within countries and at the borders of the E8 countries. These will include institutions already providing cross border malaria initiatives such as the Lubombo spatial development, Trans-Zambezi, Zam-Zim and Trans-Kunene malaria initiatives; as well as other institutions, international organizations, NGOs, FBOs etc. providing malaria control services within the countries. The information gathered will detail the type of malaria control services provided, by who, where and the beneficiaries.
Focus group discussions will be held with key informants from institutions providing malaria control services to migrants and migration affected communities within countries and at the borders of the E8 countries and with migrants and mobile populations.
Analysis and report writing
All the data collected during the focus group discussions will be analysed in order to produce a comprehensive report that answers all research questions above, including key policy and programmatic recommendations at a regional and country level.
Consultants are expected to provide a brief response to this Terms of Reference (not more than 2 pages). This response should include brief description of the scope as well as a detailed work plan, itemised budget and curriculum vitae.
The key expected deliverables from the selected service provider are:
- A draft review of stage 1 of the assignment and focus group discussion guides
- A draft report of mapping exercise
- Presentation of report
- Final report consisting of the desk review and mapping, incorporating comments from stakeholders.
Payments will be based on submission of deliverables
5% on signature of contract and submission of a work plan
30% on submission of draft review
30% on submission of interview tools
35% on submission of consolidated report including review and mapping
- Advance degree in social sciences, public health or related field;
- Understanding of and experience in migration and malaria dynamics of the region;
- Demonstrated skill in and qualitative field research and related report writing;
- Experience in migration health research;
- Experience in formal report writing;
- Language skills- excellent command of English (spoken and written);
- Ability to deliver under tight time frames.
To apply, submit a CV, brief response describing how you intends to undertake the assignment and budget to firstname.lastname@example.org.
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Statistics South Africa (Stats SA) says that South Africa’s population has increased by more than one million people since the 2011 census.
In a press statement, statistician general, Pali Leholhla, says according to its mid-year estimate, the country now has a population of 52.98 million people.
Lehohla explains that the total number of people living with HIV is estimated at approximately 5.26 million this year. He says that for adults aged 15-49 years, an estimated 15.9 percent of the population is HIV-positive.
To read the article titled, “SA population up by 1-million people,” click here.Source:Sowetan Live
According to Accenture South Africa, food production in sub-Saharan Africa must rise by 50 percent to feed an estimated population of 1.3 billion by 2030.
Managing director of strategy and sustainability at Accenture South Africa, Grant Hatch, points out that investment of about US$93 billion a year is needed to develop the infrastructure required to support the region’s agricultural sector.
Hatch warns that, "Failing to address production to meet growing demand has potentially dire consequences for many African countries; the challenge is to break dependence on resource exports and food imports."
To read the article titled, “Food production faltering in sub-Saharan Africa,” click here.Source:Business Day Live
According to Census 2011, incomes of black South African households have surged 169 percent in a decade, but whites still take home six times more money 18 years into all-race democracy.
Released by Statistics South Africa, the census, which puts the population at 51.8 million people, an increase of 6 950 782 million since the 2001 count, also found that the household incomes are more than doubled in the last 10 years.
The report further states that, "Black African-headed households were found to have an average annual income of R60 613 in 2011."
To read the article titled, “Whites earn 6 times more than blacks,” click here.Source:Fin24
Africa's population is projected to peak at 2.7 billion in the year 2060, according to the State of the Future report, which was launched in Johannesburg.
Chairperson of the South African Node of the Millennium Project, Geci Karuri-Sebina, says the question that should be asked is, "What will those people be doing for a living then?"
Karuri-Sebina says there are steps that the continent could take to try and pave a way forward in preparing for the continent's expected population.
To read the article titled, “Africa’s population expected to increase,” click here.Source:SABC News
The Land Bank has warned that a ‘population boom’ across the world will undermine food security and that urgent counter-measures are needed.
The bank’s chief executive, Phakamani Hadebe, argues that a new approach is needed to sustain food security as the world moved towards the 22nd century.
Briefing reporters at the signing of a multi-billion rand agricultural loan deal between the bank and agricultural services and food group, Afgri, in Pretoria, Hadebe, stated that, "For the world to be able to produce sufficient food, we will need to improve our technology. We need new systems to enhance our productivity. We also have to work smarter."
To read the article titled, “Food security threat looming: Land Bank,” click here.Source:The Citizen
Experts say nearly all the expected surge in the world's population from seven to nine billion people by 2050 will come in urban areas of Asia and Africa.
They say planning for it will be crucial to limit the spread of slums and related social and environmental problems.
According the International Institute on Environment and Development, many fast-growing cities today have informal settlements and black-market economies "Is in part a testament to failure to accommodate and plan for urban growth effectively and fairly."
To read the article titled, “Planning for urban population surge will limit crises – experts,” click here.Source:All Africa
The world’s surging population is a big driver of environmental woes but the issue is complex and solutions are few. This is according to experts attending a four-day meeting on Earth’s health, Planet Under Pressure.
Director of the Institute of Population Ageing at the University of Oxford, Sarah Harper, states that, “If you have economic development and you educate women, and women get labour market opportunities, they tend not only to reduce the number of children but crucially to delay when they start having children.”
In the same vein, Asian Cities Climate Change Resilience Network’s Stephen Tyler, is of the view that such changes can have a ‘surprisingly fast’ effect on reducing birth rates.
To read the article titled, “Population adds to planet’s pressure cooker, but few options,” click here.Source:Dawn.Com