BACKGROUND: Despite benefits, structured mentorship needs to be better recognised within health profession training institutions (HPI) in Southern Africa (SA). Given the need to transform faculties and retain skilled personnel, mentoring programmes can be used to address these needs and warrant further exploration OBJECTIVE: To explore mentorship models within HPI in SA METHODS: During the annual South African Health Educationalists Conference (SAAHE) in 2022, five academics from HPIs in the region conducted an interactive national workshop on mentorship in health professions education. Following a presentation on mentorship models, participants were allowed to share their perspectives on current mentorship practices, gaps and recommendations for enhancing mentorship. Key concepts and themes generated are reported RESULTS: Three key approaches to mentorship models were identified during the workshop. These were 'top-down', 'ad-hoc' and 'supportive' approaches. Mentorship models were largely self-initiated and followed a traditional dyadic style with little innovation. Mandatory 'top-down', over-regulated programmes compared with 'grassroots' approaches were the two extremes reflected on the spectrum of models. While the benefits of mentorship were recognised, institution-wide implementation is lacking, reflecting varied or no widescale adoption. Mentorship could serve as a focused, formal strategy to ensure the demographic transformation of HPIs. Recommendations were made to measure the effectiveness of mentorship programmes against academic promotion criteria and research outputs CONCLUSION: While mentorship is positively viewed as a means to ensure improved equity and outputs, practical implementation is lacking. Mentorship programmes require further exploration of models and processes to facilitate successful implementation

There is growing recognition that climate change is a worldwide phenomenon with far-reaching effects and that it is linked to an increase in the frequency of extreme weather occurrences. In rural areas of most of the sub-Saharan countries and other developing countries in the world, the frequent occurrences of extreme weather events such as flooding, heat waves, and drought have significantly destroyed livelihood activities of poor communities. Unfavorable geographic characteristics, a lack of resources, and a higher reliance on climate-sensitive sources of income among many community members in poor nations all contribute to the impact. These include livelihood activities associated with land use and agricultural practices. Sadly, the population's capacity and incentive to stay in rural areas have been altered because of climate change and its detrimental impacts on agricultural output, income, and subsistence living; as a result, many rural dwellers are migrating to urban areas. Rural populations migrate to urban areas in search of economic opportunities to earn a living. It is evident that the expected opportunities in urban areas are not always available; thus, most of the rural migrants are stuck in informal settlements, shanty towns, and slums without access to services. Consequently, it is evident that climate change is somehow transferring poverty from rural to urban areas. This study adopted the push/pull theory as a theoretical framework to guide the discussion and analysis. Based on an extensive review of the existing literature using qualitative document analysis, the purpose of this article is to examine the role of climate change on rural-urban migration, which ultimately contributes to the increase in urban poverty. The article concludes by reviewing the current (limited) research on climate change and poverty and argues for a research agenda in the context of sub-Saharan Africa toward sustainable ways to respond to the challenges of climate-induced migration, urbanization, and poverty.

INTRODUCTION: The rising prevalence of stroke in sub-Saharan Africa necessitates the exploration of the role of occupational therapy in rehabilitation of stroke. In the southern African country of South Africa, occupational therapy aligns with healthcare policies and laws, and this article presents a review of synthesized evidence of occupational therapy intervention in stroke care and rehabilitation. METHOD: Rapid review methodology was used to develop a research question about cerebrovascular accident - intervention by occupational therapists., The Cochrane Library and MEDLINE databases were searched for relevant articles published between 2018 and 2023. Twenty four articles met the inclusion criteria and were analysed according to quantitative and qualitative parameters. RESULTS: Evidence of occupational therapy intervention with post-stroke upper limb impairment was found in 37,5% of articles. Occupational therapy for global improvement in function, cognitive rehabilitation, balance, social participation, work, and leisure comprised 45,8% of articles, and one article each reported evidence for occupational therapy addressing ADL and caregiver interventions. CONCLUSION: Evidence from the past five years reflect diverse occupational therapy interventions with clients with stroke. Gaps in recent evidence remain in relation to context-specific interventions, especially from low- and middle-income countries. IMPLICATIONS FOR PRACTICE Occupational therapists adopt a holistic approach to stroke rehabilitation, tailoring interventions to address the multifaceted needs and goals of individual stroke survivors. The effectiveness of individualised, occupation-based approaches across various domains are highlighted. • Therapists stay informed and up to date about emerging technologies and evidence-based practice to enhance their effectiveness in stroke rehabilitation. • This review provides evidence of the prevalence of upper limb impairments post-stroke, which will enable therapists to be well-versed in the diverse intervention approaches for upper limb rehabilitation as outlined in the literature reviewed, including technologies like Brain Computer Interface, Mental Practice, Mirror Therapy, and Action Observation Therapy. • Occupational therapy is vital in addressing cognitive impairments in stroke survivors, and practitioners can apply the evidence provided on interventions such as Virtual Reality and computer-assisted cognitive rehabilitation that have shown promise in improving cognition and ADL.

SIGNIFICANCE: A paper recently published in AIDS and Behavior on 20 February 2024, authored by Trickey et al.¹, argues that drought potentially increases HIV (Human Immunodeficiency Virus) transmission in sub-Saharan Africa. They established a positive correlation between drought, poverty, sexual behaviour, and HIV contraction. The study's methodology is problematic, and does not consider key confounding factors, utilises data which is subject to biases, and utilises inappropriate means to define drought. We do not dispute the possibility that links exist between these variables, but assert that the data and methods used in this study are insufficient to support such a claim.

Science investments should benefit everyone; however, research still predominantly lacks gender integration, resulting in incomplete findings and inequitable outcomes. Moreover, despite some progress, gender disparities persist in the research workforce. Research funders, including science granting councils, are pivotal in driving gender transformation through shaping knowledge production and research infrastructure. We report on key findings from the Science Granting Councils Initiative (SGCI) in Sub-Saharan Africa (SSA) Gender Equality and Inclusivity (GEI) Project - a multi-year participatory intervention aimed at strengthening the capacities of councils to integrate GEI across their functions. Participating councils were located in 13 African countries, and their actions spanned four domains: building organisational GEI infrastructure; reshaping norms, practices, and power relations that perpetuate gender inequality; implementing targeted measures to address women's unequal access to resources and research opportunities; and promoting collective ownership of efforts to advance GEI in the research and innovation ecosystem. SIGNIFICANCE: • Achieving gender transformation in research and innovation hinges on addressing two intertwined challenges: structural gender inequality in higher education and research institutions, and a lack of gender integration in research content and design. • Grant-makers influence decisions about who conducts and participates in research, the types of research approaches and topics prioritised, and the populations that benefit from research findings. Adopting a GEI lens in these decisions enhances research quality and promotes equity. • Our findings pinpoint entry points for leveraging grant-making practices to advance gender transformation and underscore the importance of rooting such interventions in context.

SIGNIFICANCE: We clarify several areas of misunderstanding raised by Waja and Motlogeloa's (S Afr J Sci. 2024;120(7/8), Art. #18588) critique of our previous publication analysing the associations between drought and acquiring HIV in several countries in sub-Saharan Africa.

SIGNIFICANCE: The introduction of large language models has transformed text generation and accessibility across the globe. Ubuntu provides a distinct philosophy that could be useful in addressing the cultural and geographical nuances within the context of sub-Saharan Africa. Existing guidelines help offer a framework to foster and nurture consistency across diverse regions and cultures. These guidelines alone may not be sufficient to address past inequalities and disparities. An inclusive approach that adopts the guidelines in tandem with ubuntu philosophy could help promote equitable development and sustainability of these models across the sub-Saharan region.

BACKGROUND. In sub-Saharan Africa, ocular surface squamous neoplasia (OSSN) is the most common ocular surface tumour and is strongly associated with HIV infection. This range of ocular malignancies can be managed early to prevent large tumours requiring invasive treatment, facial disfigurement and mortality. Primary healthcare workers (HCWs) play a critical role in the early identification of the lesion. In addition, the ocular lesion can also be the presenting sign of HIV infection in individuals who have not yet been diagnosed. The aim of the present study was to assess the management of suspicious conjunctival growths in HIV-infected patients in primary health facilities and a specialist eye clinic in South Africa. OBJECTIVES. To assess the knowledge, attitude and current practice of HCWs working in HIV clinics regarding ocular surface lesions and to evaluate the management of patients with ocular surface lesions at a tertiary hospital. METHODS. A cross-sectional study design was used (November 2020 - May 2021), for which 149 HCWs were invited to assessments about their knowledge, attitudes and practices regarding ocular surface lesions. In addition, files of patients with ocular surface lesions who presented between January 2018 and August 2020 to the eye clinic were reviewed using a data extraction sheet. RESULTS. One hundred-and-three HCWs agreed to participate in the survey (response rate 69.1%). Of these participants, 84.5% were experienced professional nurses (6 - 15 years of work experience) but had minimal experience with detection and management of eye complaints and lesions. Twenty-seven (26.2%) of the participants recognised some ocular surface lesions and 86 (83.5%) reported that they would refer patients with suspicious lesions. Sixty-two files were reviewed and 51 (82.2%) of the patients had an HIV-positive diagnosis. Fifty percent had carcinoma-in situ and squamous cell carcinoma of the conjunctiva. Thirty-one (50%) of the patients were lost to follow-up. CONCLUSION. OSSN is an important manifestation of HIV infection. It would be beneficial for patients to receive a basic ocular examination as part of the baseline clinical evaluation; this may contribute to early referral to an eye care facility. The health system would benefit from establishing an eye health support system with the nearby health facilities, thereby educating primary HCWs about the association between HIV and OSSN.

Resumen Desde finales de los años 1990, Libia ha experimentado una fase de crecimiento económico muy rápida y se ha convertido, gradualmente, en destino privilegiado de importantes flujos migratorios internacionales procedentes de otros países árabes, de varios países africanos al sur del Sahara e, incluso, de países asiáticos, como Bangladesh, India y China. Contrariando la visión de Libia como un país de tránsito, la realidad es que muchas personas migrantes se quedan en el país. Sin embargo, el espacio libio ha representado en las últimas tres décadas un auténtico laboratorio para las políticas migratorias aplicadas en la relación entre Libia y los países europeos, en primer lugar, Italia. En los 90 y en la primera década del siglo XXI, Libia se caracterizó por dos tendencias opuestas: por un lado, las políticas del régimen de Gadafi encaminadas a abrir el país a la importación de mano de obra barata del África subsahariana y los países árabes; y por otro, las políticas de contención aplicadas por Italia para detener los flujos migratorios irregulares a través del Mediterráneo, que eran relativamente pequeños en comparación con el número total de migrantes en Libia. Este artículo trata de analizar la génesis y el desarrollo de las políticas de contención de la inmigración, centrándose especialmente en las relaciones entre Italia y Libia, analizando sus efectos a mediano plazo y debatiendo cómo estas políticas no solo han ido en detrimento de los derechos de las personas migrantes, sino que también han sido la premisa para su explotación económica y marginación social en Libia e Italia.

Abstract Since the late 1990s, Libya has experienced a phase of rapid economic growth and gradually become a preferred destination for significant international migration flows from other Arab countries, various sub-Saharan African countries, and even Asian countries such as Bangladesh, India, and China. Contrary to the perception of Libya as a transit country, many migrants actually stay in the country. Over the past three decades, Libyan territory has served as a true laboratory for experimenting migration policies between Libya and European countries, especially Italy. In the 1990s and the early 2000s, Libya was characterized by two opposing trends: on one hand, Qaddafi’s policies aimed at importing cheap labour from sub-Saharan Africa and Arab countries, and on the other, containment policies implemented by Italy to halt irregular migration flows across the Mediterranean, which were relatively small compared to the total number of migrants in Libya. This article aims to analyse the genesis and development of immigration containment policies, focusing especially on the relations between Italy and Libya. It examines their medium-term effects and discusses how these policies have not only undermined the rights of migrant individuals, but also served as a premise for their economic exploitation and social marginalization in both Libya and Italy.

Resumen El presente trabajo tiene como principal objetivo analizar las dinámicas migratorias que se llevan adelante en África Occidental a partir del interrogante que se desprende de los discursos dominantes respecto de la supuesta invasión de migrantes africanos a Europa, especialmente después de 2015. Desde ese año, la consigna más frecuente ha sido “Grandes oleadas de refugiados arriban a Europa”. Sin embargo, la realidad muestra que no existe tal invasión en términos cuantitativos absolutos, además de profundizarse el discurso racista y xenófobo que habla de “crisis migratoria” para alertar sobre una presunta invasión de africanos al continente, cuando casi un 80% de quienes emigran de sus países se dirige a otro país del continente africano y tan solo el, aproximadamente, 20% restante “intenta” cruzar a Europa. Y este último dato representa un porcentaje de población extremadamente reducido en relación con la población europea. A partir del trabajo de campo en Senegal, Malí, Burkina Faso y Níger, realizado para una tesis de doctorado, las reflexiones en torno al problema planteado se orientan a desmontar ideas ampliamente difundidas por medios de comunicación y determinados ámbitos académicos en relación con las migraciones subsaharianas en dirección a Europa, en muchos casos fundamentadas por representaciones vinculadas a “la huida del continente”, “las guerras”, “los conflictos étnicos” y “la invasión de migrantes a Europa”, entre otras.

Abstract The main objective of this work is to analyze the migratory dynamics that are carried out in West Africa based on the question that emerges from the dominant discourses regarding the alleged invasion of African migrants to Europe, especially after 2015. Since that year, the most frequent slogan has been that of “Large waves of refugees arrive in Europe”. However, reality shows that there is no such invasion in absolute quantitative terms, but there is an increasingly racist and xenophobic discourse that speaks of the “migration crisis”, which alerts about an alleged invasion of Africans to the continent, when, in fact, almost 80% of those who emigrate from their countries go to another country on the African continent and only the remaining 20% “try” to cross to Europe. And this last figure represents an extremely small percentage of the population in relation to the European population. Based on fieldwork in Senegal, Mali, Burkina Faso and Niger carried out for a doctoral dissertation, the reflections on the problem posed are aimed at dismantling ideas widely disseminated by the media and certain academic fields in relation to migrations and sub-Saharan movements towards Europe, in many cases based on representations linked to “the flight from the continent”, “wars”, “ethnic conflicts” and “the invasion of migrants to Europe”, among others.

The structure of climate finance flows from donors (multilateral sources) to recipients (sub-Saharan African countries) was studied. This is the first study to provide a comprehensive network structure of the climate finance flows into Africa, based on the global public climate finance governance system. Network theory and decision tree techniques were employed. The results obtained generally fit the multilateral funding units (MFUs) into two categories: central funding units (CFUs), which simultaneously attend to the climate-related projects of many African countries, and the boundary funding units (BFUs), which cater to only a few countries at once. An isolated region with no BFUs was identified. African countries within this group could be more exposed to climate financial risk as they rely on only the CFUs. In general, with the exception of mitigation REDD (reducing emissions from deforestation and forest degradation) climate finance, a disproportionate distribution of climate themes, with particular reference to adaptation finance, was observed across sub-Saharan Africa. This has real implications for equitable resource allocation of climate funds. The need for African-bred region-wide MFUs is recommended. SIGNIFICANCE: Insights from this analysis expose the presence of contagion effects within the sub-Saharan African climate finance network structure and, consequently, the flow of climate finance-related risks. This knowledge is critical for future planning as it can provide African governments and interested stakeholders with informed evidence upon which they can make reliable and justifiable decisions, such as shaping of sectoral strategies and improving of climate finance flow coordination.

BACKGROUND: Autoimmune hepatitis (AIH) has scarcely been reported on in patients of black African descent. Similarly, few studies have focused on the relationship between AIH and HIV infection OBJECTIVE: To describe the presenting features of AIH from a single referral centre in a sub-Saharan African setting. We also compare the clinical and biochemical features of people with HIV to people without HIV METHODS: This study was a retrospective chart review. Patients were included if they fulfilled criteria for the International AIH Group simplified score for probable or definite AIH, were >18 years old at inclusion, and attended the adult gastroenterology clinic at a central referral hospital in South Africa for the period 1 January 2015 to 31 December 2020 on at least two occasions RESULTS: Forty cases were included, of which 33 (82.5%) were female and 33 (82.5%) were black African. Median age at diagnosis was 26 years. A diagnosis of a coexistent autoimmune disease was made in 22.5% of patients, with systemic lupus erythematosus being the most common (12.5%). There were 16 people living with HIV, all of whom were female (p=0.03), with a significantly older age of disease onset compared with people without HIV (median age 38 v. 17.5 years, p<0.001 CONCLUSION: AIH is a disease most commonly affecting young females. Female sex and older age of onset is associated with AIH in people living with HIV

INTRODUCTION: This rapid review aimed to synthesise evidence for occupational therapy intervention in the management of autism spectrum disorders. The review forms part of a series of rapid reviews commissioned by the Occupational Therapy Association of South Africa to help inform decision making as South Africa prepares for a new health system. METHOD: Level I and II research studies published from 2017 - 2022 were considered for inclusion. Electronic database searches were conducted on the Cochrane database. The identified records were screened in Rayyan according to inclusion and exclusion criteria. Quality assessment of the selected articles was done with the CASP appraisal tool. Data were extracted to a custom Microsoft Excel® worksheet and analysed quantitatively by percentage/frequency and qualitatively by thematic analysis of statements. RESULTS: Thirty-eight records were selected. These included 30 systematic reviews and eight randomised controlled trials. Twelve intervention domains across four age groups were identified with sensory integration and social skills interventions most frequently examined. Interventions were delivered across various venues, including mediation and technology (e.g., telehealth interventions). A number of different outcome measures were used. CONCLUSION: There is evidence to support the effectiveness of occupational therapy interventions for autism spectrum disorder across the lifespan for twelve different domains. IMPLICATIONS FOR PRACTICE: • Occupational Therapists are involved in the provision of therapy intervention across all age groups for people with ASD. • Intervention can successfully take place in a clinic setting, but also at home or through means of technology. • There is growing evidence for sensory integration therapy or techniques when considering functional outcomes when treating people with ASD. • There is a lack of Level I and II research in the form of randomised control trials and systematic reviews regarding ASD intervention in sub-Saharan Africa.

Thirty-eight years into the HIV and AIDS pandemic, the world is still striving to reduce global HIV infections towards zero new infections and AIDS-related deaths by 2030. Sub-Saharan Africa continues to carry the burden of global HIV infections as governmental and nongovernmental agencies try out different prevention strategies (UNAIDS, 2024b). Several scholars have argued that comprehensive sexuality education (CSE) is the best preventive strategy to reach youth and key populations with factual information regarding HIV and AIDS. This paper draws from the project, Mentoring as a Method to Promote Women's Health in the Context of HIV-Prevention and Unequal Gender Relations, which employed memory work, photo-voice, drama, drawings, and focus group discussions with third-year student teachers in a life orientation module. Focussing on the data generated through drama, I present an arts-based activity that was used to teach about HIV transmission to student teachers in a bid to equip them with alternative ways of teaching school-learners about HIV and AIDS. The findings highlight student teachers' lived experiences and how they have shaped their perceptions of HIV infections and living with AIDS. I argue from the findings, that arts-based pedagogies allow for enhanced understanding of complex phenomena due to their participatory and in-built intervention nature. Thus, I posit that pedagogies that employ participatory, arts-based, and visual methodologies should be extensively employed in teacher-education towards reducing new HIV infections among the youth.

Abstract Investigating the interplay of factors that result in a viral zoonotic outbreak is difficult, though it is increasingly important. As anthropogenic influences shift the delicate balance of ecosystems, new zoonoses emerge in humans. Sub-Saharan Africa is a notable hotspot for zoonotic disease due to abundant competent mammalian reservoir hosts. Furthermore, poverty, corruption, and an overreliance on natural resources play considerable roles in depleting biological resources, exacerbating the population's susceptibility. Unsurprisingly, viral zoonoses have emerged in Africa, including HIV/AIDS, Ebola, Avian influenza, Lassa fever, Zika, and Monkeypox. These diseases are among the principal causes of death in endemic areas. Though typically distinct in their manifestations, viral zoonoses are connected by underlying, definitive factors. This review summarises vital findings on viral zoonoses in Africa using nine notable case studies as a benchmark for future studies. We discuss the importance of ecological recuperation and protection as a central strategy to control zoonotic diseases. Emphasis was made on moderating key drivers of zoonotic diseases to forestall future pandemics. This is in conjunction with attempts to redirect efforts from reactive to pre-emptive through a multidisciplinary “one health” approach. difficult important ecosystems humans SubSaharan Sub Saharan hosts Furthermore poverty corruption populations population s susceptibility Unsurprisingly HIVAIDS HIV AIDS HIV/AIDS Ebola influenza fever Zika Monkeypox areas manifestations underlying pandemics preemptive pre emptive one health approach

Resumo Investigar a interação de fatores que resultam em um surto zoonótico viral é difícil, embora seja cada vez mais relevante. À medida que as influências antropogênicas mudam o delicado equilíbrio dos ecossistemas, novas zoonoses surgem em humanos. A África Subsaariana é um ponto crítico notável para doenças zoonóticas devido a abundantes reservatórios mamíferos competentes. Além disso, a pobreza, a corrupção e o excesso de confiança nos recursos naturais desempenham papéis consideráveis no esgotamento dos recursos biológicos, exacerbando a suscetibilidade da população. Sem surpresa, zoonoses virais surgiram na África, incluindo HIV/AIDS, Ebola, gripe aviária, febre de lassa, zika e varíola dos macacos. Essas doenças estão entre as principais causas de morte em áreas endêmicas. Apesar de serem tipicamente distintas em suas manifestações, as zoonoses virais estão conectadas por fatores subjacentes e definitivos. Esta revisão resume descobertas vitais sobre zoonoses virais na África usando nove estudos de caso notáveis como referência para estudos futuros. Discutimos a importância da recuperação e proteção ecológica como estratégia central para o controle de doenças zoonóticas. Foi dada ênfase à moderação dos principais impulsionadores de doenças zoonóticas para prevenir futuras pandemias. Isso ocorre em conjunto com tentativas de redirecionar os esforços de reativos para preventivos por meio de uma abordagem multidisciplinar de “uma só saúde”. difícil relevante ecossistemas humanos competentes disso pobreza biológicos população surpresa HIVAIDS HIV AIDS HIV/AIDS Ebola aviária lassa macacos endêmicas manifestações definitivos futuros pandemias saúde. saúde . saúde”