Experiences of the health care delivery system in a rural South African setting

This exploratory study aimed to examine health care provider work-related experiences in a rural South African context. Participants were a convenient sample of 12 medical practitioners (private sector = 55%). The practitioners responded to an open-ended question on their health care delivery-related experiences. Thematic analysis of the data revealed that the medical officers experienced both care provider fatigue and satisfaction from their work roles. Experiences of care provider fatigue were characterised by stress, anxiety, hopelessness, depression, burnout, frustration, and anger. Care provider satisfaction was associated with happiness, ability to cope, security, conscience, and commitment. Job retention and satisfaction of the health care providers were dependent on material and manpower resourcing of health services.     

Educational struggles and political community in South Africa

Democracy is often said to rest on some form of deeper argument, some self-understanding amongst people as belonging to a common political community. This paper explores this issue in the situation of South Africa. The policies of Apartheid have left a legacy of a morally fractured society with little by way of a shared moral discourse, and the paper raises the question of whether the concepts of democracy and community which emerged out of educational struggles in South Africa might provide a basis for the development of a shared moral discourse. The answer provided in the paper is that, although such concepts cannot provide the basis for democracy at a national level, they do provide some hints of how schools might contribute to the emergence of a shared moral discourse, and, thus, the starting point for building a unified political community.     

Experiences of supervising postgraduate community psychology students at Wits university,South Africa

In this article, the authors discuss problems and challenges of supervising postgraduate community psychology students at the University of the Witwatersrand, South Africa. As part of their community work, students developed community projects in schools in Alexandra Township, aimed at dealing with social ills such as HIV/AIDS, gangs, violence, substance abuse and teenage pregnancy. Students found community work to be extremely exhausting, stressful and demanding. Therefore, community psychology supervision became an important space in helping students to reflect on the experiences, anxieties and frustrations. This article discusses key themes that have emerged in community supervision, including gender, race and class issues. In conclusion, recommendations are provided on how to improve community psychology supervision based our experiences. Supervisors need to be proactive in helping students to reflect on their experiences and actively engage with some of the theoretical and practical issues that emerge in community work. Copyright © 2010 John Wiley & Sons, Ltd.     

Teaching Community Psychology into Obscurity: A Reflection on Community Psychology in South Africa

The terms “community” and “community psychology” need to be examined within the context of human diversity in order to understand the apparent marginalisation of community psychology in South Africa. Community psychology might be marginalized as the term “community” tends to be associated with black, poor individuals. Current teaching practices in community psychology in South Africa may unwittingly reinforce these stereotypes by having predominantly junior, black and female staff teach community psychology, by generally introducing community psychology at post-graduate level only, and by making community psychology courses predominantly elective. These common teaching practices might contribute to producing raced, gendered and classed student perceptions of community psychology which would devalue psychological activity in communities as less important than individual psychotherapeutic practice in middle class communities. South African psychology would be better able adequately prepare psychologists for public mental health service with a more thoughtful infusion of community psychology teaching into most graduate programmes. Some of the ways in which our teaching can challenge our own and others' views about community psychology in local and international perspectives are discussed.     

Social determinants of subjective well-being among young adults living in the Eastern Cape,South Africa

We investigated the relationships between certain social determinants (age, gender, marital status, education, income, and employment) and subjective well-being (SWB) in a young adult population in the Eastern Cape Province in South Africa. The participants consisted of 977 persons aged 18 to 40 years living in the historically deprived Eastern Cape, South Africa (females = 48%; age range = 18 to 40; rural dwellers = 15%). We measured their SWB utilising the World Health Organization (Ten) Well-Being Scale. Results following analysis of variance showed that age, education, and income were predictors of SWB. Higher SWB was associated with being older, having a higher level of formal education, and having a higher level of income. However, employment status did not have a significant relationship with SWB, suggesting the relative importance of other social indicators of social functioning in this population.     

Unemployment experiences in context: A phenomenological study in two townships in South Africa

This study aimed to explore the unemployment experience of residents of a historically disadvantaged South African neighbourhood. Informants were twelve black community members (females?=?75%; age ranges: 20 to 29?=?58.3%, and 30 to 39?=?33.3%). Individual interviews were conducted with the participants. Thematic analysis of the data revealed that participants valued employment despite their present unemployment. They indicated that being unemployed is a painful experience, but that they also held an optimistic view of a future in which they would have employment. The findings further suggest that diminished social support by the community and public social welfare agencies aggravate negative experiences of unemployment. Employment support programmes are needed to connect the unemployed to job networks; as well as to empower those who are unemployed to fulfil their positive work participation expectations.     

Support Group Needs for People Living with HIV and AIDS (PLWHA) in Communities around Durban,South Africa

The study constructed a participant centred perspective of what members of a support group for people living with HIV and AIDS (PLWHA) desired from their group meetings. The study sample (n = 34) was from three support groups of PLWHA in a province of South Africa (males = 7, female = 27, mean age = 34.2 years, SD = 6.8 years). Participants completed a brief survey and participated in focus group discussion on views on the ideal support group, actual experience with the support group, and solutions for effective support groups. Findings suggest most members of the support group experienced a high degree of stigma at home and needed a so-called ‘safe space’ to escape to and discuss issues with people experiencing similar problems. Respondents wanted to acquire skills to allow them to help themselves and others in the community. They also desired HIV education so that they could properly understand the virus and help the community understand it to reduce stigma.     

Values in children's stories in South Africa: an exploratory discourse analysis

This study explored the presentation and construction of the values in story texts for children in South Africa. The data were from five children's stories from a widely-circulated weekly newspaper. The story content was analysed for value-laden themes child readers are exposed to. The themes to emerge from the study suggest the endorsement of values such as delighting in one's natural beauty, the importance of education, martyrdom, inclusivity, telling the truth, gratitude, appreciating one's own talent, truthfulness, respecting one's elders, community unity and forgiveness. Some of the stories touched on family structure, including the absent father as well as gender stereotypes, gender inequalities and social norms.     

Family structure and community connectedness: Their association with teenage pregnancy in South Africa

This study aimed to examine the relationships between family structure and community connectedness on the one hand, as well as risk for teenage pregnancy on the other. Data were from the South African General Household Surveys 2011, 2012, 2013; N = 279 042, female teenagers = 9.9%, age range 10 to 19; black teenagers = 81%. We applied multilevel binary logistic regression to predict risk for teenage pregnancy by family structure and community affinity variables. Findings suggest teenage female teenagers from single-headed households and with higher numbers of male relatives are at elevated risk for teenage pregnancy. Similarly, female teenagers from families with parental divorce were at higher risk for pregnancy as were those from communities with lower coherence.     

Resourcing single parents in a South African community rural setting: an exploratory study

This study investigated the resource needs of single parents as child carers. Participants were a purposive sample of 40 single parents (female?=?70%, Black?=?95%, rural 80%; age range 30 to 55 years old). Data on resource needs of single parents were collected using semi-structured individual interviews. The data were thematically analyzed. The findings indicated that single parents need relationship and socio-emotional, material and time use supports to be successful in their carer roles. Resourcing single parents in their child care roles requires a holistic approach addressing both material and socio-relational support needs.     

Prevalence and social and health correlates of insomnia symptoms among middle-and older-age persons in rural South Africa

This study investigated the prevalence and social and health correlates of insomnia symptoms among middle-and older-adults in rural South Africa. We analysed baseline survey data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH community in South Africa (HAALSI) (N = 5 059; females = 53.6%; largely African Shangaan/Tsonga-speaking). In all, 8.0% of the adults had three insomnia symptoms, 8.9% of participants had difficulty initiating sleep, 13.6% had difficulty in sleep maintenance, and 6.5% had poor sleep quality. In adjusted logistic regression, lower education, perceived unsafe neighbourhood, poorer self-rated health status, vision difficulty, pain, depressive symptoms, and posttraumatic stress disorder (PTSD) symptoms increased the odds of having insomnia symptoms. Insomnia symptoms are common in middle-and older-age adults in rural South Africa, and various risk factors were identified. This can help in improving insomnia prevention treatment in this population.     

Narrating survival and change in Guatemala and South Africa: the politics of representation and a liberatory community psychology

Peace accords and international interventions have contributed to the suspension of armed conflict and the censuring of repressive regimes in many parts of the world. Some governments and their opposition parties have agreed to the establishment of commissions or other bodies designed to create historical records of the violations of human rights and foster conditions that facilitate reparatory and reconciliatory processes. This paper explores selected roles that community psychologists have played in this process of remembering the past and constructing new identities towards creating a more just future. With reference to two community groups (in Guatemala and South Africa) we show how efforts to speak out about one's own experiences of political and military repression involve complex representational politics that go beyond the simple binary opposition of silencing versus giving voice. The Guatemalan group consisted of Mayan Ixil women who, together with the first author, used participatory action research and the PhotoVoice technique to produce a book about their past and present struggles. The South African group, working within the ambit of the Truth and Reconciliation Commission and in collaboration with the third author and others, explored ways of speaking about their roles in apartheid and post-apartheid society. Although both these initiatives can be seen as moments in on-going struggles to overcome externally-imposed repressive practices that censor the voices of marginalized communities, they also serve to dispel overly romanticized notions of univocal communities now liberated to express themselves in an unmediated and unequivocal fashion. The paper discusses how each group of women instead entered into subtly nuanced relationships with community psychologists involving a continual interplay between the authenticity of their self-representational accounts and the requirements of the discursive technologies into which they were being inducted and the material conditions within their sites of struggle. In both cases the group's agenda also evolved over time, so that what emerged was not so much a particular account of themselves, or even the development of a particular voice for speaking about themselves, but an unfolding process—for the groups and for the community psychologists who accompanied them—of becoming active players in the postmodern, mediated world of self-representational politics and social struggle.     

High-functioning depression among women in South Africa: An exploratory study

The study estimated the prevalence and trends of chronic depressive symptoms among women in South Africa from the National Income Dynamics Study (NIDS) data collection waves (2008, 2010, 2012, 2014/2015). NIDS utilised the Center for Epidemiological Studies Depression (CES-D) scale to assess depressive symptoms among adults. From the trend analysis, we observed a decrease in self-reported significant depressive symptoms over the eight-year period in black women (2.66%), followed by mixed-race (coloured) women (1.15%). Across race, significant depressive symptoms were associated with socioeconomic status variables such as income, education, and occupational status. Within race, prevalence rates were higher among individuals with low socioeconomic status (lower income, less educated, and less skilled occupations). Black women were at a higher risk of exhibiting high-functioning depression due to their overrepresentation among low socioeconomic status individuals. Symptom prevalence may be explained largely by psychosocial stressors in patriarchal legacy communities.     

Gendered adversity and mental health of adolescents orphaned by AIDS in a rural South African community: An exploratory study

This study explored gender differences in adversity and mental health among South African adolescents orphaned by AIDS. Adolescents (N = 121; females = 45.5%; mean age 14.14 years, SD = 2.09) self-reported their childhood adversities and probable mental ill health on the Child Trauma and General Health Questionnaire. Results revealed that female participants orphaned by AIDS were significantly more likely to report childhood adversity at total score level as compared to male participants. However, both male and female participants reported comparable scores on subscales of childhood adversity (emotional abuse, physical abuse, sexual abuse, and physical neglect). Moreover, female participants displayed higher composite mental ill health and all its subscales except for social dysfunction. Our findings suggest that gender-sensitive programmes and policies to address the effect of childhood adversity and mental ill health among adolescents orphaned by AIDS, are urgently needed.     

Contrast and contradiction: Being a black adolescent in contemporary South Africa

This study aimed to gain in-depth understanding of the lived identity of black African adolescents in a contemporary South African setting. A purposive sample of 59 adolescents (females = 47%; Sesotho = 46%, Setswana = 36%, Other = 18%) from the Motheo district of the Free State, South Africa, participated in focus group discussions and in-depth individual interviews. Thematic analysis suggested that black South African adolescents experience transitional identities characterised by contrasts and contradictions. Altruism, autonomy, religiosity and cultural experiences were important to their lived identities. The interplay between African rituals, Christian principles, Western values and the globalisation of cultures provided fertile ground for developing a nuanced and multi-dimensional identity as an adolescent living in contemporary South Africa.     

Politics and emotion: Working with disadvantaged children in South Africa

This paper discusses the experience of consulting to organizations involved in the provision of care to disadvantaged groups of children in South Africa. It draws particular attention to the impact of South Africa's painful political history on the emotional life of these organizations. This has created an additional burden for organizational staff who often work under difficult conditions with very troubled groups of children. The paper highlights the common experiences of deprivation and loss, fears around the abuse of power and problems with acknowledging differences between people, which are a part of South Africa's political legacy. These kinds of issues were found to have a powerful impact on the functioning of organizations and also on the quality of the consultancy relationship itself. We argue that it is important to recognize the emotional demands of child-care work generally, but also that it is equally necessary work, through our political experiences, to achieve some kind of understanding of these. Lack of containment for these experiences will impact on the quality of care organizations are able to offer to children in our context.     

Perceptions of alcohol risk among people on antiretroviral treatment in South Africa: a qualitative study

This study explored perceptions of alcohol abuse risk among people on antiretroviral treatment (ART) who self-identified as alcohol users. Twenty six people receiving ART from an out-patient setting were interviewed on their alcohol abuse risk perception. Data were thematically analysed. Findings suggest participants developed routines to drink alcohol around the times they took their antiretroviral medications to reduce adverse impact. They also reported alcohol abuse risk reduction strategies such as reducing alcohol use because of the event of an HIV positive diagnosis and/or getting on antiretroviral treatment, and alcohol use reduction following health education or counselling by health care staff. These findings suggest a need for alcohol interventions tailored to ART patients.     

Counselling psychology in South Africa

The origin and development of counselling psychology in South Africa has been profoundly influenced by the country’s sociopolitical history and the impact of apartheid. As a result of this, counselling psychologists in the country face a number of challenges and opportunities for the future. In this paper we provide a portrait of counselling psychology in South Africa by describing the current character of the specialty and the context in which South African psychologists work. We critically discuss the challenges that the specialty faces to meet the country’s mental health care needs, contest the current Scope of Practice; affirm multiculturalism without essentialising or reifying race and ethnicity, and build an evidence base for community interventions in the country. We also consider how, in the future, counselling psychologists in South Africa may make a more meaningful contribution within public health and the country’s health care and education systems.     

The feminization of psychology: data from South Africa

In many countries, women outnumber men in psychology, both as students and as professionals. Much of this information is drawn from Europe and the USA, and the information available about the situation in developing countries is a lot less detailed. The steady increase in the presence of women in psychology in South Africa is examined, via access to two large national databases and telephone interviews. These sources are the most reliable available, and are comprehensive enough to give a very good snapshot of women in psychology in this country over the last 12 years. The data indicate that psychology as a profession in South Africa is dominated by women. Although the applied practical aspects of the discipline attract women disproportionally, women are also over-represented in research psychology and academia (except at the professorial level). The racial composition of the profession remains skewed, with white psychologists in the majority. Although the data in this regard are incomplete, approximately 5% of registered psychologists are black. An examination of student enrolments suggests that this situation will continue in future, as women (and white students) enrol in much greater numbers for both undergraduate and postgraduate degrees. In 2002, 74% of psychology majors were women, and 78% of all Master's degrees in psychology were awarded to women. Thus it would appear that the feminization of psychology in this country is further advanced than in Europe and the USA. It is not a question of men abandoning the profession, but rather that women entered the profession at a much higher rate in recent years.