The Role and Significance of Traditional Leadership in South African Local Governance

Traditional leadership in South Africa pre-existed both the colonial and apartheid systems of governance and was the main known system of governance amongst indigenous people. In any case, as opposed to the current political pattern of discrediting traditional leadership, Africans have their own comprehension of democracy, which is pointedly from the liberal democracy of the West. Traditional leadership was democratic based on its own unique way in what we these days allude to as ‘consensus'. This chapter contends that the institution of traditional leadership is still significant as a trusted institution for governance by most of the people living in rural South Africa. The chapter contends as revered in the Basotho aphorism, mooa khotla ha a tsekisoe maxim, that traditional leadership is a sine qua non in rural areas. The South African post-apartheid government has neglected to conclusively characterize and unambiguously explain the role and significance of traditional leaders in local governance.

The Evolution of Rural Tourism in South Africa: An Historical Lens

This paper utilises archival research to provide a glimpse into the historical development of rural tourism in South Africa. It points to the minimal focus on historical studies in international scholarship on rural tourism. The analysis demonstrates rural tourism in South Africa is not a new phenomenon with a recorded history going back as far as the late 19th century. Different rural spaces are shown to be associated with different niche products of rural South Africa. The earliest forms of rural tourism were promoted to both groups of domestic and international visitors. Arguably, the evolutionary pathway of rural tourism in South Africa is different to that which has been documented in the Global North. Overall, the paper represents a contribution to the limited international literature on rural tourism in its historical aspects as well as to evolving rural tourism scholarship in South Africa. In addition, it offers an historical window on issues of tourism and change in the Global South.

Youth’s participation in agriculture: A fallacy or achievable possibility? Evidence from rural South Africa

Background: The realisation of more youth involvement in the agricultural sector has proved to be elusive, so the question of the possibility of a youth-led agriculture needs further investigation.Aim: The aim of the study was to assess whether there is potential for the rural youth to participate in agriculture by employing the typology formulation approach.Setting: The study is premised on recent calls for strategies to reduce youth unemployment in sub-Saharan Africa by involving and enhancing the agricultural sector.Method: A survey in questionnaire form was conducted with 224 youths from two districts in KwaZulu-Natal, South Africa. The Principal Components Analysis and K-Means Clustering were performed to determine the youth typologies and assess their potential.Results: Five typologies were identified. Most youths (59.3%) were found in Typology 1 (those that see no benefits in farming) and in Typology 2 (older, experienced and with access to land). Typology 5 (male youths in agricultural cooperatives) had the lowest proportion of youths (5.7%). Participants in typologies 2, 3 and 5 were deemed to have high to moderate potential for successful engagement in farming. The highest potential was found in the typology with the least percentage of youths.Conclusions: The typologies showed that youths have varying perceptions and aspirations regarding agriculture. While some show an interest and have the potential to participate in farming, others do not. Therefore, the blanket notion of the youth’s lack of interest in agriculture should be qualified as it does not always hold. The heterogeneity in characteristics among the youths in these typologies, including their potential to participate in agriculture, expresses the differences in the kinds of support needed to increase their participation.

Hypertension incidence among middle-aged and older adults: findings from a 5-year prospective study in rural South Africa, 2010–2015

ObjectivesThere is a scarcity of longitudinal cohort studies in sub-Saharan Africa to understand the epidemiology of cardiovascular disease as a basis for intervention. We estimated incident hypertension and associated sociodemographic, health and behavioural risk factors in a population aged 40 years and older over a 5-year period.DesignWe assessed the association between incident hypertension and sociodemographic, health and behavioural factors using Poisson regression. We adjusted for non-response in 2015 using inverse probability sampling weights from a logistic regression including sex and age at baseline.SettingRural South Africa.ParticipantsWe used a population-based cohort of normotensive adults in 2010 who were aged 40 years and older at retest in 2015.ResultsOf 676 individuals completing baseline and 5-year follow-up, there were 193 incident cases of hypertension. The overall hypertension incidence rate was 8.374/100 person-years. In multivariable analyses, those who became hypertensive were more likely to be older, have a high waist circumference (incidence rate ratio (IRR): 1.557, 95% CI: 1.074 to 2.259) and be employed (IRR: 1.579, 95% CI: 1.071 to 2.329) at baseline. Being HIV positive and not on antiretroviral therapy at baseline was associated with lower risk of incident hypertension.ConclusionsOver a 5-year period, 29% of respondents developed hypertension. Given the high burden of hypertension in South Africa, continued longitudinal follow-up is needed to understand the complex interplay of non-communicable and infectious diseases and their underlying and modifiable risk factors to inform public health prevention strategies and programmes.

Echocardiographic and Electrocardiographic Abnormalities Among Elderly Adults With Cardiovascular Disease in Rural South Africa

Background: Sub-Saharan Africa is undergoing an epidemiological transition fueled by the interaction between infectious and cardiovascular diseases. Our cross-sectional study aimed to characterize the spectrum of abnormalities suggesting end-organ damage on ECG and transthoracic echocardiograms (TTE) among older adults with cardiovascular diseases in rural South Africa. Methods: The prevalence of ECG and TTE abnormalities was estimated; χ 2 analyses and multivariable logistic regressions were performed to test their association with sex, hypertension, and other selected comorbidities. Results: Overall, 729 ECGs and 155 TTEs were completed, with 74 participants completing both. ECG evaluation showed high rates of left ventricular hypertrophy (LVH, 36.5%) and T wave abnormalities (13.6%). TTE evaluation showed high rates of concentric LVH (31.6%), with moderate-severe (56.8%) diastolic dysfunction. Participants with hypertension showed more cardiac remodeling on ECG by LVH (45.4% versus 22.1%, P <0.01), and TTE by concentric LVH (42.5% versus 8.2%, P <0.01) and increased left ventricular mass (58.5% versus 20.4%, P <0.0001). In multivariable logistic regression, systolic blood pressure remained significantly associated with LVH on ECG (adjusted odds ratio, 1.03 per mm Hg [95% CI, 1.03–1.04], P <0.0001) and increased left ventricular mass on TTE (adjusted odds ratio, 1.04 per mm Hg [95% CI, 1.01–1.06], P =0.001). Male participants (n=326, 40.2%) were more likely than females (n=484, 59.8%) to show ECG abnormalities like LVH (45% versus 30.8%, P <0.01), whereas females were more likely to show TTE abnormalities like concentric LVH (40.8% versus 13.5%, P <0.01) and increased left ventricular mass (58.4% versus 23.1%, P <0.0001). Similar results were confirmed in multivariable models. Conclusions: Our findings suggest that cardiovascular diseases are widespread in rural South Africa, with a larger burden of hypertensive heart disease than previously appreciated, and define the severity of end-organ damage that is already underway. Local health systems must adapt to face the growing burden of hypertension, as suboptimal rates of hypertension diagnosis and treatment may dramatically increase the heart failure burden.