Research on the move: exploring WhatsApp as a tool for understanding the intersections between migration, mobility, health and gender in South Africa

An analysis of migration and implications for health in government policy of South Africa

For over a decade, the global health community has advanced policy engagement with migration and health, as reflected in multiple global-led initiatives. These initiatives have called on governments to provide universal health coverage to all people, regardless of their migratory and/or legal status. South Africa is a middle-income country that experiences high levels of cross-border and internal migration, with the right to health enshrined in its Constitution. A National Health Insurance Bill also commits the South African public health system to universal health coverage, including for migrant and mobile groups. We conducted a study of government policy documents (from the health sector and other sectors) that in our view should be relevant to issues of migration and health, at national and subnational levels in South Africa. We did so to explore how migration is framed by key government decision makers, and to understand whether positions present in the documents support a migrant-aware and migrant-inclusive approach, in line with South Africa's policy commitments. This study was conducted between 2019 and 2021, and included analysis of 227 documents, from 2002-2019. Fewer than half the documents identified (101) engaged directly with migration as an issue, indicating a lack of prioritisation in the policy discourse. Across these documents, we found that the language or discourse across government levels and sectors focused mainly on the potential negative aspects of migration, including in policies that explicitly refer to health. The discourse often emphasised the prevalence of cross-border migration and diseases, the relationship between immigration and security risks, and the burden of migration on health systems and other government resources. These positions attribute blame to migrant groups, potentially fuelling nationalist and anti-migrant sentiment and largely obscuring the issue of internal mobility, all of which could also undermine the constructive engagement necessary to support effective responses to migration and health. We provide suggestions on how to advance engagement with issues of migration and health in order for South Africa and countries of a similar context in regard to migration to meet the goal of inclusion and equity for migrant and mobile groups.

Religion, politics and COVID-19 risk perception among urban residents in Malawi

INTRODUCTION

Majority of Malawians have not yet adopted COVID-19 mitigation measures despite having knowledge about its infectivity, morbidity, and fatality. Understanding drivers of hesitancy to adoption of COVID-19 mitigation measures is critical as it can inform prevention programs. This study explores Malawians' COVID-19 risk perception, and the associated constraints in the adoption of mitigation efforts. A Health Belief Model (HBM) approach was used to understand perceived factors that undermine public health COVID-19 messages to reduce the spread of the pandemic in Malawi.

METHODS

The study applied rapid appraisal and photovoice qualitative inquiry to comprehend risk perception regarding COVID-19. We purposively selected 52 participants from three major cities in Malawi. Audio and video interviews were transcribed verbatim, and transcripts were coded manually to derive key themes and concepts.

RESULTS

The study identified that social factors particularly religious and political beliefs influenced COVID-19 risk perception. Specific religious beliefs pertaining to individuals recognizing signs of the 'Christian apocalypse' were particularly associated with lower risk perceptions. Politically, participants believed COVID-19 lockdown measures were a ploy by the then-ruling party to remain in power.

CONCLUSION

The study suggests that religious beliefs and political environment undermine self -perceived risk of contracting COVID-19 among urban dwellers in Malawi. We recommend that diverse actors in Malawi should collaborate to promote the dissemination of accurate COVID-19 discourses and reduce the severity of the pandemic's impact in Malawi.

Reimagining wellbeing: Using arts-based methods to address sexual, gender and health inequalities

The Creative Change Laboratory (CCoLAB) was conceived as an immersive learning space in which young people from the Western Cape province of South Africa could develop unconventional solutions to problems in their communities. Unlike most art-activism projects, CCoLAB harnessed a wide range of expressive forms (visual art, interactive drama, narrative writing and photography/videography) to identify, analyse and respond to social justice challenges. In many ways, CCoLAB was an experiment, asking what could be achieved if an art-activism project was held over a long period and was not constrained by a focus on just one theme/topic. Over eight months, CCoLAB's twenty collaborators were exposed to different ways of thinking and doing activism, culminating in the development of original creative prototypes. Many of the final artworks spoke to the nuances of sexuality, gender and health, exploring topics such as sexual- and gender-based violence, the everyday challenges facing queer and trans youth, and physical, mental and emotional wellbeing. Drawing on artworks produced during the project, facilitator/collaborator reflections, and audio and visual recordings made during the process, this paper investigates the benefits and challenges of long-term, well-resourced art-activism interventions.