Browsing by Subject "Accessibility"

Now showing 1 - 4 of 4
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    Open Access
    Bridging the health inequality gap: an examination of South Africa’s social innovation in health landscape
    (2021-03-01) de Villiers, Katusha
    Background Despite the end of apartheid in the early 1990s, South Africa remains racially and economically segregated. The country is beset by persistent social inequality, poverty, unemployment, a heavy burden of disease and the inequitable quality of healthcare service provision. The South African health system is currently engaged in the complex project of establishing universal health coverage that ensures the system’s ability to deliver comprehensive care that is accessible, affordable and acceptable to patients and families, while acknowledging the significant pressures to which the system is subject. Within this framework, the Bertha Centre for Social Innovation & Entrepreneurship works to pursue social impact towards social justice in Africa with a systems lens on social innovation within innovative finance, health, education and youth development. The aim of this study is to demonstrate the capacity for social innovation in health with respect for South Africa, and to highlight some current innovations that respond to issues of health equity such as accessibility, affordability, and acceptability. Methods Different data types were collected to gain a rich understanding of the current context of social innovation in health within South Africa, supported by mini-case studies and examples from across the African continent, including: primary interviews, literature reviews, and organisational documentation reviews. Key stakeholders were identified, to provide the authors with an understanding of the context in which the innovations have been developed and implemented as well as the enablers and constraints. Stakeholders includes senior level managers, frontline health workers, Ministry of Health officials, and beneficiaries. A descriptive analysis strategy was adopted. Results South Africa’s health care system may be viewed, to a large extent, as a reflection of the issues facing other Southern African countries with a similar disease burden, lack of systemic infrastructure and cohesiveness, and societal inequalities. The evolving health landscape in South Africa and the reforms being undertaken to prepare for a National Healthcare Insurance presents the opportunity to understand effective models of care provision as developed in other African contexts, and to translate these models as appropriate to the South African environment. Conclusions After examining the cases of heath innovation, it is clear that no one actor, no matter how innovative, can change the system alone. The interaction and collaboration between the government and non-state actors is critical for an integrated and effective delivery system for both health and social care.
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    Open Access
    Development of context-sensitive accessibility indicators: a GIS-based modelling approach for Cape Town
    (2019) Aivinhenyo, Imuentinyan; Zuidgeest, Mark
    Adequate public transport infrastructure and services are essential to facilitate access to basic opportunities, such as jobs, healthcare, education, recreation or shopping, especially in low-income cities where the majority of the low-income population have no access to the car. In the context of transport exclusion and urban poverty, access and accessibility metrics can serve as good indicators for the identification of transport-disadvantaged zones or population groups in a city. In Cape Town, accessibility-based planning is being embraced by the authority as a means of addressing the planning defects of the past apartheid regime, which created a city that is spatially fragmented by race and income levels. Among the agenda outlined in its 5-year Integrated Transport Plan of 2013-2018, is the need to develop a highly integrated public transport network in which all households would have equitable access to the public transport system, especially for the majority of the urban poor who reside in the city outskirts far from major economic centres. Although planning efforts are being made to redeem the defects of the past, there is still the need for tools and indicators to understand the current situation, as well as to further aid planning and decision making about land-use and transport. The objective of this research, therefore, is to develop suitable indicators of accessibility, identify possible spatial and socioeconomic drivers of accessibility and evaluate equity in the distribution of accessibility benefits for various population groups in Cape Town. In the study, transport network data of Cape Town are utilised to develop GIS-based indicators of network access and origin accessibility to various opportunities like jobs, healthcare and education, across various modes of travel. An Access Index measures public transport service presence within a zone, based on route and stops availability. The index is used to compare the coverage levels provided by each mode of public transport in the city. Also, an Accessibility Index is proposed, that measures the number of opportunities 'potentially reachable' within a specified 'reasonable’ travel time. A key consideration in measuring accessibility by public transport is the monetary cost of overcoming distance, based on the pricing structure that exists in Cape Town. Equity in accessibility is further evaluated both vertically and horizontally. Vertical equity is evaluated using a proposed Accessibility Loss Index, which analyses the potential implication of affordability and budget restrictions on accessibility, based on the income level of the poor households. GINI type of measures is also proposed to evaluate horizontal equity across the various population groups for various travel modes. To further understand the likely drivers of accessibility, an exploratory OLS regression technique is employed to investigate the relationship between accessibility and a combination of socioeconomic and built environment features of the study area. The study reveals among other things that potential accessibility achievable by car is far higher than that achievable by public transport. The paratransit mode provides the most extensive access coverage, and the highest level of accessibility among all the public transport modes investigated. However, this mode shows to be one of the most expensive options of travel, especially for low-income households who are likely to be restricted by travel monetary budgets. The train turns out to be the most affordable travel option, although the level of accessibility achievable with the train is much lower compared to the paratransit or regular bus. From a vertical equity perspective, the consideration of transport affordability drastically reduces the opportunity space and potential accessibility for the poorest population group compared to the higher income groups. The study further interrogates the distance-based tariff model of public transport services in Cape Town, which it considered to be detrimental to the welfare of poor households, regarding the potential to access essential opportunities. The contribution of this study to the body of research on accessibility is twofold: methodological and contextual. On the methodological dimension, it presents a GIS based approach of modelling accessibility both for the car and for a multimodal public transport system that combines four modes; bus, train, BRT and a minibus taxi (paratransit). It also builds on existing gravity-based potential accessibility measure by incorporating an affordability dimension. The consideration of affordability adds a further layer that enables vertical equity evaluation by judging the potential for destination reachability by the monetary out-of-pocket cost of travel. This approach is considered to be more sensitive to the context of low-income cities like Cape Town, where low-income household’s daily travel decisions are likely to be more guided by monetary cost.
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    Open Access
    How can mobile technology enhance students' learning in technical vocational training in South Africa?
    (2020) Moses, Lea-Anne; Nilsson, Warren
    Education and skills training are proven remedies in overcoming poverty and unemployment and creating equitable, prosperous and sustainable economies. The government has recognised the critical role post-school education plays in ensuring South Africa realises Vision 2030 which has set a lofty target of 1.25 million student enrolments in Technical and Vocational Education and Training institutions by 2030. While considerable success has been achieved in enrolment rates, student throughputs at these institutions are weak; on average, only 20% of all students who enter these institutions graduate with a qualification. However, despite all these challenges, there is also reason to be optimistic. The dramatic impact of technology on the world today; how we learn and connect with others and the affordability and accessibility of mobile devices have meant that knowledge acquisition is now available to almost everyone. The purpose of this case study is to explore how mobile technology can be used to enhance the learning experience for students at post-school institutions such as Technical and Vocational Education and Training (TVET) colleges. Research participants are drawn from False Bay College in the Western Cape. These 50 young people ranged in age from 18 to 29 years and are split across two study disciplines; namely, Travel and Tourism, and Hospitality. A qualitative case study is conducted, using an inductive approach in a constructivist paradigm. Different data sources (observations, interviews, and WhatsApp group chats) were used to provide an understanding of how mobile technology made the learning experience richer and more rewarding to participants. Data were analysed using Thematic Analyses. The findings indicate that participants feel positive about the use of mobile technology for learning as well as its contribution to the enrichment of their overall learning experience. The accessibility of the technology used in the study, as well as the accessibility afforded by the technology (access to experts, rewards, support services, and industry information) were considered by participants to be the main contributory reasons for the positive enhancement of their learning. However, factors that detract from the use of mobile technology for learning are also listed. Given the increased focus on improving TVET graduate throughput rates, against a backdrop of cost-cutting and demands for a workforce armed with 21st Century skills, educational leaders need to further explore and better understand how ubiquitous technology, like mobile phones, can be used to enhance learning for students to be better equipped to meaningfully participate in the knowledge economy.
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    Safe spaces for beneficiaries of a combination HIV prevention intervention for adolescent girls and young women in South Africa: access, feasibility, and acceptability
    (BioMed Central, 2022-05-21) Mathews, Catherine; Duby, Zoe; Bunce, Brittany; van Blydenstein, Nathanael; Bergh, Kate; Ambrose, Anthony; Mpungu, Fiona; Jonas, Kim
    Background Safe Spaces are a feature of combination HIV prevention interventions for adolescent girls and young women (AGYW) in South Africa. We investigated whether AGYW at risk for adverse sexual and reproductive health (SRH) outcomes accessed Safe Spaces that were part of an intervention, as well as their feasibility and acceptability. Methods In December 2020 to February 2021, as part of a process evaluation of a combination HIV prevention intervention, we randomly sampled 2160 AGYW intervention beneficiaries aged 15–24 years from 6 of the 12 intervention districts. We invited them to participate in a phone survey, with questions about their vulnerability to adverse SRH outcomes, and participation in intervention components including Safe Spaces. We examined factors associated with use of Safe Spaces using bivariate analyses and Pearson’s chi squared tests. We also conducted in-depth interviews with 50 AGYW beneficiaries, 27 intervention implementers, 4 health workers, 7 social workers, and 12 community stakeholders, to explore perceptions and experiences of the intervention. Thematic analysis of the qualitative data was performed. Results At least 30 Safe Spaces were established across 6 districts. Five hundred fifteen of two thousand one hundred sixty sampled AGYW participated in the survey of whom 22.6% visited a Safe Space, accessing HIV testing (52.2%), mobile health services (21.2%) and counselling for distress (24.8%) while there. Beneficiaries of lower socioeconomic status (SES) were less likely to have visited a Safe Space, compared with those of higher SES (13.6% versus 25.3%; p < 0.01). Implementers described political, structural and financial challenges in identifying and setting up Safe Spaces that were safe, accessible and adequately-resourced, and challenges with AGYW not utilising them as expected. AGYW shared positive views of Safe Spaces, describing benefits such as access to computers and the internet, support with homework and job and education applications, and a space in which to connect with peers. Conclusion AGYW are attracted to Safe Spaces by educational and employment promoting interventions and recreational activities, and many will take up the offer of SRH services while there. The poorest AGYW are more likely to be excluded, therefore, an understanding of the obstacles to, and enablers of their inclusion should inform Safe Space intervention design.