Agincourt News

MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)
Agincourt News
Volume 7, Issue 1
Welcome to this news
letter for the MRC/Wits
January- June 2014
Census 2014
The preparation of round 20 Census was
very challenging because of the two new
big studies looking at chronic diseases
and genetics that will happen the same
time during the operation of the 2014
census. Because of this some of the long
term staff members joined the two studies and we recruited more
new staff for the census. We have three new supervisors, five new
migration reconciliation fieldworkers, four new quality checkers,
one new Verbal Autopsy fieldworker and five new Data typists. A
credit to our colleagues—the supervisors, Ryan, Bernard and everyone who contributed in the training of the new field workers, the first
week of the field work they were struggling to complete daily target. But now
they are managing to complete the daily target and census will be completed on time.
Rural Public Health and
Health Transitions Research Unit (Agincourt)
Community feedback meeting in Newington B
Community Feedback (CFB) Report
Every year we try to engage the community to attend the
feedback sessions that we hold in the June/July holidays. We
do the sessions during this time because the schools are
closed. Most people will be at home, and therefore free to
come to the meeting to discuss and ask questions about all
projects operating in the field. A date is set for each village,
and on this day, a group of seven staff members from MRC/
Wits Agincourt Unit go to that specific village. We invite the
entire community by going around with a megaphone to tell
people where the meeting will be held. All the stakeholders
(Community Development Forum, Community Development
Worker, home-based care workers, ward councilors, tribal
authorities, Induna, and regional managers) for each commu-
Census Launch 2014
nity receive a letter informing them about the
Community Feedback visit. This year, we managed to have meetings with the following 20
villages: Lillydale B, Huntington, Ireagh A,
Ireagh B, Somerset, Croquetlawn A, Dumphries
A, Dumphries B, Mp Stream, Agincourt, Cunningmore , Kildare A, Justicia Cunnigmore B
Kildare B, Kildare C, Belfast, Lillydale A, Cunningmore A. Because the community leaders
kept on postponing the date of the meeting, we
were unable to visit the following five villages:
Newington C, Croquetlawn B, Xanthia, Dumphries C. We also asked the communities to
evaluate our presentations, by giving them an
evaluation form. This will help us improve in the
future. We received good attendance from the
community, with maximum participation. When
we compare 2014 with 2013, we find that 2014
has seen an improvement in attendance.
MRC/Wits Agincourt Unit
PO Box 2, Acornhoek, 1360, South Africa
Phone: +27 13 795 5076/013 708 0003
Fax: +27 13 795 5076/013 708 1540
Please send any suggestions for improving this newsletter to
Rhian Twine and Simon Khosa at [email protected] and
[email protected]. We would sincerely welcome any
contributions, suggestions
and articles
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TREATING HYPERTENSION IN RURAL SOUTH AFRICA: A CLINIC-BASED LAY
HEALTH WORKER TO ENHANCE INTEGRATED CHRONIC CARE
– THE NKATEKO TRIAL
This article highlights the process and progress of the currently ongoing 18 months randomized
controlled trial – a research intervention into how a clinic based lay health worker (LHW) might improve chronic care in the Bushbuckridge sub-district. The study is being carried out by University of
Warwick in the UK, the University of Witwatersrand through MRC/Wits Rural Public Health and
Health Transitions Research Unit (Agincourt) with support from MRC UK.
The trial commenced with piloting - one clinic was chosen as the pilot site in order to test the intervention before starting in the randomized clinics. The piloting started on December 12, 2013, three
months before the intervention took place in the other 4 clinics. The 4 intervention clinics were randomly chosen from 8 clinics that are participating in the study. The facility managers and community members from different clinics in the Agincourt study site participated in the random selection
process.
This was followed by the recruitment process where Lay Health Workers were selected from community members who have passed grade
12, and have experience doing volunteer
work in the clinic or a community based organization. There were 5 clinic specific programme development workshops that were
attended by the research team and staff
from the clinics that aimed structuring the
intervention. The intervention is now underway alongside on going data collection process through clinic observations, interview
with clinic staff and interviews with patients.
Training Nkateko fieldworkers
AGINCOURT COMMUNITY ADVISORY GROUP (CAG) WORKSHOP
16/17/18 May 2014, Pine Lake Inn, White River
Aim of the workshop
Every year we try to gold a workshop for the Agincourt Community Advisory Group (CAG). The CAG consists of one representative from each
village, chosen by the CDF and/or indunas, who are the ears, eyes and mouth of the unit in the community, and the ears. eyes and mouth of
the community in the unit. The workshop is to make sure that all CAG members know about all the studies that are going on in the site, especially focusing on the Swa Koteka study.
CAG Achievements
This year at the workshop we reported on the achievements of
the CAG and these included:
1. Certificates , 2. Lots of experiences as a CAG member
3. Exchange of information ,4. Being part of community development and be part of what is going on in our community
5. Good communication skills with community members
6. Gain exposure to other people , 7. Empathy
8. Leadership skills , 9. Knowing the importance of research
10. Good working relationships with other communities
11. Recognition and respect of the community and 12. Self
confidence
CAG Challenges
We still have some challenges with the CAG and these include:
1. Poor attendance of community meetings , 2. Difficult for other
community members to understand research, 3. Research done
with people and not helping them in getting proper care but
CAG members at Pine Lake Inn workshop
referring them , 4. Perception of nepotism when coming to employment , 5. Ignorance by community members , 6. Not recognizing our efforts as CAG .
These challenges are reported to the management of the unit and are taken seriously. We as a unit believe that the current CAG members are
strong and give a good voice to the concerns of the community, and give good advise to the unit so that our relationship with the community
remains strong.
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The Swa Koteka Conditional Cash Transfer Study - what’s this study all about?
The research study called Swa Koteka started in 2011, by the MRC/Wits Agincourt Unit, University of North Carolina and the
Wits Reproductive Health & HIV Institute (WRHI). The study aims to find ways to reduce the spread of HIV (the virus that
causes AIDS) among young women in South Africa. We are not sure why HIV is spreading so fast among young South African
women, but one idea is that education provides some protection against getting infected. The study involves young women aged
13-20 in grades 8-11 and their guardians. The study will be run until the end of 2014. There are two groups in this study. One
group receives a monthly cash payment if the young woman attends school. The young woman gets R100 and her care giver gets
R200 if the young woman goes to school at least 80% of the time. The other group does not receive the payment. We want to see
whether if we encourage young women to stay in school by making cash grants conditional on their school attendance, their risk
of getting HIV is reduced. At the end of the study, we will be able to see if there is a
difference between the two groups.
So the Swa Koteka study started in 2011 – what’s the progress?
2537 young women aged 13-20 and their guardians agreed to be part of the
study. THANK YOU YOUNG WOMEN and GUARDIANS
Current status
There are now over 1200 young women in the ‘control’ group – and over 1200 in the
experimental group (the group that receives the cash payment if they go to school
80% of the time). We hope all these girls carry on being in this study until 2014 or
until they leave school. We need all girls to stay in the study so that at the end we
can see if there is a difference between the girls who received the cash transfer and
those who don’t.
Results
We cannot give you any results from the study yet as it only ends at the end of this
year and the analysis will take some time – and the results are ‘secret’ until then as
it will take that long to really know if the study is making any difference.
Can cellphones affect your health?
Well – the scientists are still debating if cellphones can directly affect your health if you use them too much. BUT – in
the Agincourt fieldsite – we are pleased to let you know that
more and more households are having access to cell
phones. We think that this is going to prove beneficial to
people’s health because researchers, including the MRC/
Wits Agincourt Unit, are busy finding out if they can use
cellphones to remind people to take their medicine, remind
people to come for their checkups, to send results of medical tests to people. There is already a programme called
MOM CONNECT that the clinics are using smses to remind
women to come for antenatal care. In a survey of about
11 700 households, we found that in 2001, +/_4100 of
those households had at least one cellphone – and then in
2013, +/_11 500 of them had access to at least one cellphone. From 37% to 98%.
We need to start finding out whether households have access to SMART cellphones now – because health service
providers are thinking of using apps like Facebook and MXit
to send out health messages – another step in using technology to improve the health of the South African population.
A young woman participating in the Swa Koteka
study having her blood taken for HIV and herpes
tests
TERTIARY ADMISSION PROGRAM (TAP)
Since 2012, we have started a program called TAP that we
are trying to assist the Grade 12 learners in our study site.
We were inspired by Nyiko Khosa from Somerset and Future Madalane from Xanthia. We have committed ourselves
in making sure that we do the tertiary admission presentations to 27 high schools in our study site. This program is to
assist the grade 12 learners who don’t have any information
regarding tertiary information e.g. the APS (Admission Point
Score), NBT (National Benchmark Test), NSFAS (National
Student Financial Aid Scheme and Bursaries. We are also
coordinating the National Benchmark Test (NBT) intake in
Bushbuckridge where it is written in two schools around
Bushbuckridge and the schools are Bunny Khosa High and
Acornhoek Academy.
It is very important for a learner to write NBT as it is a
placement test because in some of the institutions you can’t
get admission if you didn’t write the NBT – depending on
the career that you are pursuing. You also need to check with
the institution that you are applying to because it differs with
institutions and the rules are not the same. In 2014 we
planned to have 4 dates per year and we are planning to increase the number of test intake dates in 2015 onwards. You
need to register online when you
want to write NBT – just go to
Google and type NBT and book
for a test. Make sure that you
don’t forget the email address
and the password that you use
when registering to write NBT
because you will need it in future
when you want to access your
TAP presentation to grade 12s
results. For more information
about NBT – you can visit their website: [email protected]
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Where were YOU born?
Things are changing – ask your mother if you were born at home, in the clinic, the health centre or the hospital. Then think about where your children were born…..
We had a look at how things are changing and the numbers show that in the Agincourt health and socio demographic surveillance site (these villages: Agincourt, Belfast, Croquet Lawn A, Croquet Lawn B, Cunningmore A, Cunningmore B, Dumphries A, Dumphries B, Dumphries C, Huntington, Ireagh A, Ireagh B, Ireagh
C, Justicia, Khaya Lami, Kildare A, Kildare B, Kumani, Lillydale A, Lillydale B, Makaringe, MP Stream,
Newington B, Newington C, Rolle C, Somerset, Somerset C, and Xanthia) – women are choosing to have their babies more and more in hospital, and less and less at home.
In 1994, there were 520 babies born at home, and in 2012, only 75 babies were born at home. That’s a 700% decrease! In 1994, 761 babies
were born in the hospital, and in 2012, 1462 – nearly double - were born
in the hospital. Less babies are being born in the clinics – it seems that
mothers are choosing the hospitals over the clinics for delivering their
babies. 116 babies were born in the clinics in 1994, going down to 76 in
2012.
This is good for both the new mothers and the babies as if there are any
Nonhlanhla Heaven Shongwe with her
complications at the birth, the nurses can assist, and can call an ambubaby Katekani Xiluva Mbhombi (both
mother and child were born in a hospital)
lance if things get too difficult. This change is probably due to a few
things – an increase in education and understanding how important it is
to have medical care during delivery and also perhaps an increase in availability of transport.
NAMING OF THE NEW BUILDING IN
AGINCOURT
The Induna and his chairperson, representatives
of the Beare Foundation, a whole group of Tollman family members (from across the country
and the world), senior staff from Wits University
and staff of the unit all gathered on the 20th December 2013 to dedicate the new Wits Agincourt
offices to Prof Steve Tollman’s father, Ted. The
Foundation requested this to honour the name
and ideals of Ted Tollman, previously a trustee of
the Foundation which is based in Durban. Ted’s
The MRC/Wits Agincourt Unit muchongolo
team entertained guests
Induna Khoza and
the Director Steve
Tollman reading the
plaque
wife, Shirley, together with Induna Khoza,
cut the ribbon to the sound of the Agincourt
staff muchongolo team dancing and singing
in the background. Thank you speeches were
given to the Beare Foundation for funding
the building and to the Agincourt community
for supporting our application to Land Affairs
for title deeds. To great delight, further support was promised for the second phase of
building development on the Agincourt field
office site.

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