Browsing by Subject "Discrimination"

Now showing 1 - 9 of 9
  • No Thumbnail Available
    Item
    Metadata only
    Accents, Race and Discrimination: Evidence from a Trust Game
    (2017-06-06) Yagman, Ece; Keswell, Malcolm
  • Thumbnail Image
    Item
    Open Access
    Attitudes of primary health care providers towards people with mental illness: evidence from two districts in Zambia
    (2011) Kapungwe, A; Cooper, S; Mayeya, J; Mwanza, J; Mwape, L; Sikwese, A; Lund, C; Mental Health and Poverty Project Research Programme Consortium
    The aim of this study was to explore health care providers’ attitudes towards people with mental illness within two districts in Zambia. It sought to document types of attitudes of primary health care providers towards people suffering from mental illness and possible predictors of such attitudes. This study offers insights into how health care providers regard people with mental illness that may be helpful in designing appropriate training or re-training programs in Zambia and other low-income African countries. Method: Using a pilot tested structured questionnaire, data were collected from a total of 111 respondents from health facilities in the two purposively selected districts in Zambia that the Ministry of Health has earmarked as pilot districts for integrating mental health into primary health care. Results: There are widespread stigmatizing and discriminatory attitudes among primary health care providers toward mental illness and those who suffer from it. These findings confirm and add weight to the results from the few other studies which have been conducted in Africa that have challenged the notion that stigma and discrimination of mental illness is less severe in African countries. Conclusion: There is an urgent need to start developing more effective awareness-raising, training and education programmes amongst health care providers. This will only be possible if there is increased consensus, commitment and political will within government to place mental health on the national agenda and secure funding for the sector. These steps are essential if the country is improve the recognition, diagnosis and treatment of mental disorders, and realize the ideals enshrined in the progressive health reforms undertaken over the last decade.
  • Thumbnail Image
    Item
    Open Access
    Experience of and factors associated with violence against sexual and gender minorities in nine African countries: a cross-sectional study
    (2021-02-15) Müller, Alex; Daskilewicz, Kristen; Kabwe, Mc L; Mmolai-Chalmers, Anna; Morroni, Chelsea; Muparamoto, Nelson; Muula, Adamson S; Odira, Vincent; Zimba, Martin
    Objective The objective of this research was to assess physical and sexual violence experienced by sexual and gender minorities in nine African countries, and to examine factors associated with violence. Methods We conducted an exploratory multi-country cross-sectional study among self-identifying sexual and gender minorities, using a survey tool available in paper and online. Participants were sampled through venue-based and web-based convenience sampling. We analysed data using descriptive statistics and logistic regression, with Stata15. Findings Of 3798 participants, 23% were gender minorities, 20% were living with HIV, and 18% had been coerced into marriage. Fifty-six per cent of all participants had experienced physical or sexual violence in their lifetime, and 29% in the past year. Gender minorities had experienced significantly higher levels of violence compared to cisgender (sexual minority) participants. The variable most strongly associated with having experienced violence was being coerced into marriage (AOR, 3.02), followed by people living nearby knowing about one’s sexual orientation and/or gender identity (AOR, 1.90) and living with HIV (AOR, 1.47). Conclusion Sexual and gender minorities in Eastern and Southern Africa experience high levels of violence. Sexual orientation and gender identity need to be recognised as risk factors for violence in national and regional law and policy frameworks. States should follow the African Commission Resolution 275 and provide protection against violence based on real or perceived sexual orientation or gender identity.
  • Thumbnail Image
    Item
    Open Access
    Race, discrimination and diversity in South Africa
    (2007) Seekings, Jeremy
    The end of apartheid has brought a resurgence of research into racial identities, attitudes and behaviour in South Africa.? The legacy of systematic racial ordering and discrimination under apartheid is that South Africa remains deeply racialised, in cultural and social terms, as well as deeply unequal, in terms of the distribution of income and opportunities. ?South Africans continue to see themselves in the racial categories of the apartheid era, in part because these categories have become the basis for post-apartheid 'redress', in part because they retain cultural meaning in everyday life.? South Africans continue to inhabit social worlds that are largely defined by race, and many express negative views of other racial groups.? There has been little racial integration in residential areas, although schools provide an important opportunity for inter-racial interaction for middle-class children.? Experimental and survey research provide little evidence of racism, however.? Few people complain about racial discrimination, although many report everyday experiences that might be understood as discriminatory.? Racial discrimination per se seems to be of minor importance in shaping opportunities in post-apartheid South Africa.? Far more important are the disadvantages of class, exacerbated by neighbourhood effects: poor schooling, a lack of footholds in the labour market, a lack of financial capital.? The relationship between race and class is now very much weaker than in the past.? Overall, race remains very important in cultural and social terms, but no longer structures economic advantage and disadvantage.? Post-apartheid South Africa is thus the precise opposite of Brazil.
  • Thumbnail Image
    Item
    Open Access
    Scrambling for access: availability, accessibility, acceptability and quality of healthcare for lesbian, gay, bisexual and transgender people in South Africa
    (BioMed Central, 2017-05-30) Müller, Alex
    Background: Sexual orientation and gender identity are social determinants of health for people identifying as lesbian, gay, bisexual and transgender (LGBT), and health disparities among sexual and gender minority populations are increasingly well understood. Although the South African constitution guarantees sexual and gender minority people the right to non-discrimination and the right to access to healthcare, homo- and transphobia in society abound. Little is known about LGBT people’s healthcare experiences in South Africa, but anecdotal evidence suggests significant barriers to accessing care. Using the framework of the UN International Covenant on Economic, Social and Cultural Rights General Comment 14, this study analyses the experiences of LGBT health service users using South African public sector healthcare, including access to HIV counselling, testing and treatment. Methods: A qualitative study comprised of 16 semi-structured interviews and two focus group discussions with LGBT health service users, and 14 individual interviews with representatives of LGBT organisations. Data were thematically analysed within the framework of the UN International Covenant on Economic, Social and Cultural Rights General Comment 14, focusing on availability, accessibility, acceptability and quality of care. Results: All interviewees reported experiences of discrimination by healthcare providers based on their sexual orientation and/or gender identity. Participants recounted violations of all four elements of the UN General Comment 14: 1) Availability: Lack of public health facilities and services, both for general and LGBT-specific concerns; 2) Accessibility: Healthcare providers' refusal to provide care to LGBT patients; 3) Acceptability: Articulation of moral judgment and disapproval of LGBT patients’ identity, and forced subjection of patients to religious practices; 4) Quality: Lack of knowledge about LGBT identities and health needs, leading to poor-quality care. Participants had delayed or avoided seeking healthcare in the past, and none had sought out accountability or complaint mechanisms within the health system. Conclusion: Sexual orientation and gender identity are important categories of analysis for health equity, and lead to disparities in all four dimensions of healthcare access as defined by General Comment 14. Discriminatory and prejudicial attitudes by healthcare providers, combined with a lack of competency and knowledge are key reasons for these disparities in South Africa.
  • Thumbnail Image
    Item
    Open Access
    Scrambling for access: availability, accessibility, acceptability and quality of healthcare for lesbian, gay, bisexual and transgender people in South Africa
    (2017) MYller, Alex
    BACKGROUND: Sexual orientation and gender identity are social determinants of health for people identifying as lesbian, gay, bisexual and transgender (LGBT), and health disparities among sexual and gender minority populations are increasingly well understood. Although the South African constitution guarantees sexual and gender minority people the right to non-discrimination and the right to access to healthcare, homo- and transphobia in society abound. Little is known about LGBT people's healthcare experiences in South Africa, but anecdotal evidence suggests significant barriers to accessing care. Using the framework of the UN International Covenant on Economic, Social and Cultural Rights General Comment 14, this study analyses the experiences of LGBT health service users using South African public sector healthcare, including access to HIV counselling, testing and treatment. METHODS: A qualitative study comprised of 16 semi-structured interviews and two focus group discussions with LGBT health service users, and 14 individual interviews with representatives of LGBT organisations. Data were thematically analysed within the framework of the UN International Covenant on Economic, Social and Cultural Rights General Comment 14, focusing on availability, accessibility, acceptability and quality of care. RESULTS: All interviewees reported experiences of discrimination by healthcare providers based on their sexual orientation and/or gender identity. Participants recounted violations of all four elements of the UN General Comment 14: 1) Availability: Lack of public health facilities and services, both for general and LGBT-specific concerns; 2) Accessibility: Healthcare providers' refusal to provide care to LGBT patients; 3) Acceptability: Articulation of moral judgment and disapproval of LGBT patients' identity, and forced subjection of patients to religious practices; 4) Quality: Lack of knowledge about LGBT identities and health needs, leading to poor-quality care. Participants had delayed or avoided seeking healthcare in the past, and none had sought out accountability or complaint mechanisms within the health system. CONCLUSION: Sexual orientation and gender identity are important categories of analysis for health equity, and lead to disparities in all four dimensions of healthcare access as defined by General Comment 14. Discriminatory and prejudicial attitudes by healthcare providers, combined with a lack of competency and knowledge are key reasons for these disparities in South Africa.
  • Thumbnail Image
    Item
    Open Access
    The role of health and advocacy organisations in assisting female sex workers to gain access to health care in South Africa
    (2019-10-24) Makhakhe, Nosipho F; Meyer-Weitz, Anna; Struthers, Helen; McIntyre, James
    Abstract Background Globally, female sex workers (FSWs) are considered a key population group due to the high HIV prevalence. Studies show that there are various factors in some contexts that render FSWs marginalised, which limits their access to sexual reproductive health (SRH) services. Access to SRH services are particularly challenging in countries where sex work is criminalised such as is the case in South Africa. Evidently, there are alternative ways in which FSWs in this context receive non-stigmatising SRH care through non-governmental organisations. The aim of this study was to understand the functioning of these non-governmental health care services as well as to document the experiences of FSWs utilising these services. Methods Eleven focus group discussions were held with 91 FSWs. In addition, 21 in-depth individual interviews with researchers, stakeholders and FSWs were conducted. Interview guides were utilised for data collection. Informed consent was obtained from all participants. Data were analysed thematically. Results The FSWs expressed challenges related to SRH care access at public health facilities. The majority felt that they could not consult for SRH-related services because of stigma. The non-governmental health and advocacy organisations providing SRH services to FSWs through their mobile facilities utilising the peer approach, have done so in a way that promotes trust between FSWs and mobile health care providers. FSWs have access to tailored services, prevention materials as well as health information. This has resulted in the normalising of HIV testing as well as SRH seeking behaviours. Conclusion This study has established that health and advocacy organisations have attempted to fill the gap in responding to SRH care needs of FSWs amidst intersecting vulnerabilities. FSWs’ engagement with these organisations has encouraged their willingness to test for HIV. However, it is important to note that these organisations operate in urban areas, thus FSWs operating outside these areas are most likely exposed to compounding health risks and lack access to tailored services.
  • No Thumbnail Available
    Item
    Metadata only
    Two sides of the same coin: Re-examining nepotism and discrimination in a segmented society
    (Review of Social Economy, 2015-05-28) Hofmeyr, Andre; Burns, Justine
  • Thumbnail Image
    Item
    Open Access
    Validation of two prediction models of undiagnosed chronic kidney disease in mixed-ancestry South Africans
    (BioMed Central Ltd, 2015) Mogueo, Amelie; Echouffo-Tcheugui, Justin; Matsha, Tandi; Erasmus, Rajiv; Kengne, Andre
    BACKGROUND: Chronic kidney disease (CKD) is a global challenge. Risk models to predict prevalent undiagnosed CKD have been published. However, none was developed or validated in an African population. We validated the Korean and Thai CKD prediction model in mixed-ancestry South Africans. METHODS: Discrimination and calibration were assessed overall and by major subgroups. CKD was defined as 'estimated glomerular filtration rate (eGFR) <60ml/min/1.73m 2 ' or 'any nephropathy'. eGFR was based on the 4-variable Modification of Diet in Renal Disease (MDRD) formula. RESULTS: In all 902 participants (mean age 55years) included, 259 (28.7%) had prevalent undiagnosed CKD. C-statistics were 0.76 (95 % CI: 0.73-0.79) for 'eGFR <60ml/min/1.73m 2 ' and 0.81 (0.78-0.84) for 'any nephropathy' for the Korean model; corresponding values for the Thai model were 0.80 (0.77-0.83) and 0.77 (0.74-0.81). Discrimination was better in men, older and normal weight individuals. The model underestimated CKD risk by 10% to 13% for the Thai and 9% to 93% for the Korean model. Intercept adjustment significantly improved the calibration with an expected/observed risk of 'eGFR <60ml/min/1.73m 2 ' and 'any nephropathy' respectively of 0.98 (0.87-1.10) and 0.97 (0.86-1.09) for the Thai model; but resulted in an underestimation by 24% with the Korean model. Results were broadly similar for CKD derived from the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. CONCLUSION: Asian prevalent CKD risk models had acceptable performances in mixed-ancestry South Africans. This highlights the potential importance of using existing models for risk CKD screening in developing countries.