OpenUCT is the open access institutional repository of the University of Cape Town (UCT). It preserves and makes UCT scholarly outputs digitally and freely available, including theses and dissertations, journal articles, book chapters, technical and research reports, as well as open educational resources.
Recent Submissions
Item
Open Access
Folate intake and associated predictors among pregnant women living with and
without HIV in the Klipfontein-Mitchells Plain sub-district, South Africa: A cross
(2026) Nhlapo, Pieriette; Madlala, Hlengiwe
Objectives: The objectives were to describe dietary folate intake and folic acid supplementation status among pregnant women living with HIV (WLHIV) and without HIV (WLWHIV), to identify predictors of intake including but not limited to socio-economic status, food security, anxiety disorder and gastrointestinal (GI) tract symptoms, and to identify predictors of meeting recommended levels. Design: This cross-sectional study used secondary data from the Obesogenic Origins of Maternal and Child Metabolic Health involving Dolutegravir (ORCHID), longitudinal cohort study. Setting: The study was conducted at two maternity obstetric units in the Klipfontein-Mitchells Plain sub-district. Participants: Pregnant women (n =1920, ≥ 16 years, ≤ 22 weeks' gestation) from the ORCHID study's enrolment visit were included. Results: Among the participants, 41.9% were WLHIV and 58.1% WLWHIV. The median gestational age was 13 weeks (IQ, 9.0-15.0). Only 8.2% met folate levels through diet alone. While 63.6% reported daily folic acid supplementation, this was more prevalent among WLHIV. Multivariable linear and logistic regression analyses indicated that WLHIV consumed more dietary folate (0.02 μg/day; CI -18.5, 18.6) and had a higher adjusted odds of daily folic acid supplementation (aOR: 1.5; CI 1.3, 1.9). Dietary folate intake was associated with age, gestational age (GA) and total energy intake, while supplementation associated with GA, education and anxiety disorder. No significant association was found with hunger. Conclusion: The women showed a significant gap in meeting recommended dietary folate levels, with many missing the critical window for folic acid supplementation. Interventions focusing on improved food systems, promoting preconception care and early antenatal attendance are urgently needed.
Item
Open Access
Navigating the green economy in South Africa: A perspective from Black women sustainable business owners
(2026) Nomoyi, Khanyisa; Seedat, Fatima; Clarke Yaliwe
This research explores the experiences of Black women sustainable business owners and their navigation of the South African green economy. The study sought to understand how their businesses, which function as green micro-businesses, contribute towards building the national green economy. This research used ecofeminism and feminist economics as a theoretical basis to understand their experiences, unpack the development of the green economy and explore the possibilities of feminist economics in practice through their businesses. As South Africa continues to grapple with the effects of climate change on the economy, there are various national policies and financing instruments which aim to boost the developing green economy. With a focus on the Small, Medium and Micro Enterprises (SMME) sector, this study prioritised Black women leading green microbusinesses. Current literature dominantly represents the experiences of Global North adaptation of the green economy. In Africa, research continues in understanding the impacts of climate change on economies and the potential for SMMEs to drive critical aspects of economies that are climate responsive and resilient. Black feminist research methodologies were used in the study to understand the experiences of participants. The study was conducted with four microbusinesses operating in various townships in East London and eGqeberha in the Eastern Cape. Research participants were selected using snowball sampling to ensure that their responses align with the objectives of this study. Key findings from this research revealed the importance of solidarity in how black women conceptualise the economy, a need for feminist economic understanding of the green economy and possibilities for alternative economic frameworks for a climate resilient future. This research contributes to growing literature in the field by offering a feminist critique and economic alternatives on how Black women in the green economy envision sustainability.
Item
Open Access
Adapting to Drought: An Ethnographic Study of the 2020-2023 prolonged drought in Samburu County, Kenya
(2026) Mwangi, Elizabeth; Solomon, Nikiwe
Between 2020 and 2023, Kenya experienced its worst prolonged drought in the last four decades. Many communities, particularly those located within Arid and Semi-Arid Lands (ASAL) of Northern Kenya bore the heaviest brunt of this climate change induced disaster. This study took place in Ngari Village, Samburu County one of the most impacted ASAL regions by the drought. The aim was to explore the extent to which socioeconomic and political factors exacerbate the impacts of drought on agro-pastoral communities that occupy the region. Through an ethnographic study conducted over five weeks, I sought to explore the lived experiences of the Samburu community living in Ngari Village during the drought. Given that post-colonial narratives of Samburu County continue to portray it as one of extreme economic hardships, ongoing tribal conflicts, and a recipient to many development aid projects, this research revealed that such narratives and imaginations continue to play a significant role in the drought management systems employed. In this research, I argue that drought is more than a hydro-meteorological event – it encompasses the biophysical and social realities of a community which in turn produces lived experiences. I explore several of the economised and technical solutions that have been employed and argue for the need of these interventions to move beyond viewing drought as a physical phenomenon, and to also center the complex and vast networks of relations within communities. Drawing on interdisciplinary environmental humanities scholarship, I foreground the ecological flows within Samburu landscape and the interplay of these with local histories and cultures, calling for a more nuanced approach to drought interventions that can address the lived experiences of both human and more-than-human worlds.
Item
Open Access
Transforming Gender Norms, Attitudes, and Behaviours through Participatory Mobile Phone Video-Making
(2026) Mwenzva, Booker; Cain, Julia; Smit Alexia
Southern Africa grapples with an alarmingly high prevalence of violence against women. This dissertation proposes a novel approach: leveraging participatory video (PV) to encourage behavioural and attitudinal change within men, transforming them into allies for gender equality. Despite the existing body of research on PV methods, a gap exists in terms of its theoretical and practical application within the Southern African context, particularly for film and community development initiatives focused on men. This dissertation aims to bridge this gap. The research examines the transformative impact of PV on peer educators participating in the "conversations with men" program, a 3-phase gender equality initiative led by STEPS, a Cape Town-based media company. Executed in partnership with nine non-profit organizations across seven Southern African countries, the program spanned three years. This study focuses on Phase 3 (documenting change) and explores the experiences of 44 peer educators trained to create "change stories" using readily available mobile phone technology. These cell phone videos documented their program participation and personal journeys towards transformed attitudes and behaviours related to gender norms. Through this analysis, the research sheds light on the potential of PV to empower men as agents of positive social change in the fight against gender-based violence. The researcher facilitated one-day workshops during onsite fieldwork visits to partner organizations in Zimbabwe (2), Malawi (2), Lesotho (1), and Botswana (1). In addition, one day online workshops were conducted with partner organisations in Uganda and Zambia. Employing a qualitative approach, the research collected the experiences of peer educators through 8 in-depth interviews workshops, 44 reflective writing responses, and an analysis of 14 change stories they produced. The research unearthed powerful personal narratives within the program's findings. Engaging in its multi-faceted activities, which included community film screenings and workshops on cell phone filmmaking, ignited a transformative journey for peer educators. Through self reflection, increased sense of ownership, and a heightened awareness of local cultural gender issues, these individuals discovered their own agency and commitment to personal growth. This newfound empowerment inspired them to create genuine, hyper-local video content that not only resonated with their personal experiences of conducting community dialogue on gender, but also the embodied experience of creating these narratives served as a powerful testament to their own transformed perspectives and behaviours in dismantling harmful gender norms and values. The creation of change stories with accessible "simple media tools" provided participants with spaces for co-creating narratives that addressed pressing gender issues. Peer educators transcended their traditional film facilitator role, becoming "impact igniters" by both modelling positive behaviours and using cell phones to documenting local voices that inspire collective representation and participation within their local communities. These findings suggest the transformative potential of PV methods in challenging entrenched gender norms and promoting observable personal shifts in attitudes and behaviours. The research recognizes and emphasises the importance of prioritizing impact within PV interventions, advocating for clear goals that shape both the process and the product. The study points out the crucial role of collaborative partnerships and locally driven narratives in ensuring the effectiveness of PV initiatives. While acknowledging the absence of a universally accepted theoretical framework for PV, this dissertation contributes to the field by demonstrating how the use of simple media tools in multi-layered grassroots participation encourages localised representation and authorship, leading to observable impacts such as enhanced personal agency. Lastly, the study advocates for impact-driven iterative approaches as a means to strengthen the sustainability of PV interventions in promoting lasting social change and community empowerment.
Item
Open Access
Percutaneous Endoscopic Gastrostomy (PEG) tube placement: indications, management, complications, outcomes, and care applied to endoscopy unit patients in a tertiary care hospital.
(2026) Mutura, Dominic; Setshedi, Mashiko; Scriba, Matthias
Background: Enteral access is preferred as the most physiological and beneficial feeding route. Percutaneous endoscopic gastrostomy (PEG) is a widely used access route for enteral feeding in patients with a functional gastrointestinal system, but who are unable to maintain sufficient oral intake to meet daily nutritional and metabolic needs. PEG-related complications can be significant, but reported rates are variable. Aim: To investigate the use, complications, and outcomes associated with PEG insertion in a South African tertiary-level centre. Methods: This was a retrospective study including all patients who underwent PEG insertion at the Groote Schuur Hospital Gastroenterology Unit between March 2018 to June 2023. Variables obtained included patient demographics, comorbidities, PEG insertion details, and complications. Results: A total of 149 patients undergoing 158 PEG-insertion procedures were included with a median age of 54 years (IQR: 38-64) with the majority being male (91; 61.1%). The most common indication for PEG insertion was cerebrovascular accident (CVA) at 25.5% (38). PEG-related complications were divided into insertion-related, early (within 30 days of insertion) and late (after 30 days of insertion) and observed in 64 patients (43.0%). The only factor found to be associated with an increased early complication rate was the size of the PEG, with 24Fr tubes having a higher complication rate compared to smaller tubes (25.5% vs 3.7%, p <0.001). Conclusions: Local indications and high complication rates of PEG placement are highlighted, advocating for the judicial placement of PEGs. Early complications are notably higher with increased diameter tubing, and we recommend that the use of 24Fr tubes be avoided if possible.