South Africa failing people displaced by xenophobia riots

Household Factors Associated with Self-Harm in Johannesburg, South African Urban-Poor Households

Introduction

Low and middle income countries bear the majority burden of self-harm, yet there is a paucity of evidence detailing risk-factors for self-harm in these populations. This study aims to identify environmental, socio-economic and demographic household-level risk factors for self-harm in five impoverished urban communities in Johannesburg, South Africa.

Methods

Annual serial cross-sectional surveys were undertaken in five impoverished urban communities in Johannesburg for the Health, Environment and Development (HEAD) study. Logistic regression analysis using the HEAD study data (2006–2011) was conducted to identify household-level risk factors associated with self-harm (defined as a self-reported case of a fatal or non-fatal suicide attempt) within the household during the preceding year. Stepwise multivariate logistic regression analysis was employed to identify factors associated with self-harm.

Results

A total of 2 795 household interviews were conducted from 2006 to 2011. There was no significant trend in self-harm over time. Results from the final model showed that self-harm was significantly associated with households exposed to a violent crime during the past year (Adjusted Odds Ratio (AOR) 5.72; 95% CI 1.64–19.97); that have a member suffering from a chronic medical condition (AOR 8.95; 95% 2.39–33.56) and households exposed to indoor smoking (AOR 4.39; CI 95% 1.14–16.47).

Conclusion

This study provides evidence on household risk factors of self-harm in settings of urban poverty and has highlighted the potential for a more cost-effective approach to identifying those at risk of self-harm based on household level factors.

Violence, resilience and solidarity: The right to education for child migrants in South Africa

This article examines the psychology of migrant learners’ resilience, their right to education, and how migrant organizations and South African civil society are supporting and reinforcing the agency of migrant learners and their parents. It is based on a year-long study conducted by researchers at the University of Johannesburg’s Centre for Education Rights and Transformation (CERT), funded by the Foundation for Human Rights. Testimonies, participatory workshops, surveys, interviews, and focus groups with learners, parents, educators, officials, and civil society activists in three South African provinces were studied––Gauteng, Limpopo, and the Western Cape––spanning rural, urban, and township areas. The article is framed by the traumatic experiences of migrant learners before entering South Africa, during their stay, and often when they are deported. Topics covered in the testimonies include children’s rights to, and in education, they also traverse gender issues, the travails of unaccompanied minors, and obstacles preventing migrants’ participation in schooling and society.

Applying upstream interventions for interpersonal violence prevention: an uphill struggle in low- to middle-income contexts

In South Africa's Western Cape province, interpersonal violence was identified among the key prevention priorities in the provincial government's Burden of Disease (BoD) Reduction project. To date, there are no adequate systematic reviews of the full range of potential intervention strategies. In response, available data and the literature on risk factors and prevention strategies for interpersonal violence were reviewed with a view to providing policy makers with an inventory of interventions for application. Given the predominance of upstream factors in driving the province's rates of interpersonal violence, efforts to address its burden require an intersectoral approach. Achievable short-term targets are also required to offset the long-term nature of the strategies most likely to affect fundamental shifts. Documentation and evaluation will be important to drive long-term investment, ensure effectiveness and enable replication of successful programmes and should be considered imperative by interpersonal violence prevention policymakers in other low- to middle-income contexts.

Good treatment outcomes among foreigners receiving antiretroviral therapy in Johannesburg, South Africa

Foreigners, including displaced persons, often have limited health-care access, especially to HIV services. Outcomes of antiretroviral therapy (ART) in South Africans and foreigners were compared at a Johannesburg non-governmental clinic. Records were reviewed of 1297 adults enrolled between April 2004 and March 2007 (568 self-identified foreigners, 431 South Africans citizens and 298 with unknown origin). Compared with citizens, foreigners had fewer hospital admissions (39%, 90/303 versus 51%, 126/244; P < 0.001), less missed appointments for ART initiation (20%, 39/200 versus 25%, 51/206; P < 0.001), faster median time to ART initiation (14 versus 21 days, P = 0.008), better retention in care (88%, 325/369 versus 69%, 155/226; P < 0.001) and lower mortality (2.5%, 14/568 versus 10%, 44/431; P < 0.001) after 426 person-years. In logistic regression, after controlling for baseline CD4 count and tuberculosis status, foreigners were 55% less likely to fail ART than citizens (95% CI = 0.23–0.87). These findings support United Nations High Commissioner for Refugees recommendations that ART should not be withheld from displaced persons.