This paper looks at the evolution of urbanization in Zambia. The country has a population of just over 15 million people with about 35% living in urban areas. The population in the urban areas is projected to increase driven by both natural population growth and rural-urban migration. This population growth is expected to put pressure on the provision of services in urban areas. The country has been implementing a decentralization programme that is meant to devolve vital tasks to the local authority. If this happens, the local authorities will have the pressure of ensuring that people in their cities have decent standards of living. The localized city development index will assist local authorities with information to use in assessing their performance. The index adopts the Alkire Foster multidimensional measurement approach.

This study explored community-based Palliative Care nurses’ experiences of their work. The aim of this study was to explore the positive aspects of working in palliative care, as well as the challenges that community-based nurses experience in their work. The coping strategies that are employed by these nurses to deal with the difficulties of their work were understood, and the participants provided recommendations to their organisations to improve their working experiences. The research was conducted in two research settings, St Luke’s Combined Hospices and Tygerberg Hospice, which are both non-profit organisations providing Palliative Care in the community. Permission was gained to conduct research by the St Luke’s Combined Hospices Research Ethics Committee, and the Palliative Care Manager at Tygerberg Hospice. A qualitative research design was used to conduct this study, and purposive sampling was used to select the sample. Fourteen nurses were interviewed using a semi-structured interview schedule, and a digital recorder was used so that interviews could be recorded accurately. Qualitative data analysis was used to arrange the data into themes, categories and subcategories. Findings from the study indicate that there is a great sense of satisfaction from working in Palliative Care and positive aspects include feelings of honour and privilege, making a difference, appreciation from patients and families, life lessons learnt, having a role in the community and working in a team. The perceived challenges were emotional challenges such as persistent rumination about work, feelings of helplessness and dealing with challenging families. Organisational challenges pertained to demanding workloads and a lack of organisational support. Personal challenges were seen as having a negative impact on the physical health and family lives of participants. Lastly, environmental challenges included issues around safety and driving to communities. Coping strategies were the support from family and friends, avoidance coping and self-care as well as group support and debriefing and support from colleagues. Lastly, recommendations include an open-door policy within the organisation, improved training and education, a better understanding of community Palliative Care, improved interaction with staff and staff reward and recognition.

Three novellas exploring the short and long-term implications of Martian colonisation and an explication. The first part examines the necessity of a robust and mentally-fit crew along with the relationships between corporatism. The second, which happens a century later, explores the health effects of long-term living on Mars along with the Earth disconnect by Martian-born humans. In the third part, another century later, the long-term strains of sustaining such a project are examined on Earth and how Martians are used as scapegoats. The explication describes the scientific motivations behind some aspects of the novel, including how the conditions of Mars necessitates certain survival protocols.

The timeline of the Millennium Development Goals (MDGs) elapsed in 2015, global indicators showed that Africa still accounts for almost half of all child deaths globally and has the world’s highest maternal mortality rates. By the year 2015, Africa as a continent was unable to meet the maternal and child health MDG targets. This study seeks to retrospectively compare, the progress made on the maternal and child health related Millennium Development Goals namely: MDG4- Reduce child mortality and MDG5- Improve Maternal Health, in Burundi, Rwanda and Uganda. Indicators show that, only Rwanda was able to achieve the maternal and child health MDGs. Specifically, the study provides a contextual understanding of the policy interventions implemented by Rwanda, despite starting from a lower base in comparison to Burundi and Uganda due to the 1994 Genocide against the Tutsi. The study also sought to understand how broad governance indicators specifically, government effectiveness and control of corruption vary between the three countries: Rwanda, Burundi and Uganda as well as their impact on maternal and child health trends. The study illustrates how Rwanda’s governance is underpinned by a system that is strongly hinged on ideological clarity, good leadership, country ownership for effective policy execution and enforcement of accountability through home grown solutions like imihigo. The integration of imihigo within the health sector has, in addition to other innovative interventions, like the implementation of the Community Health Insurance Policy, deployment of over 60,000 community health workers, innovative use of ICT in health like rapid short message service (sms), drones among others. In contrasting the governance of the health sectors in Rwanda and Uganda, one of the striking differences is that in Rwanda, there are strong linkages between the local and central levels for policy implementation and evaluation, and between the health sector and finance ministry. These are indicative of strong intra-governmental accountability. Uganda on the other hand, despite having good laws and policies in place, still faces poor implementation and lack of strong accountability mechanisms, due to low levels of ownership. The contrast is also sharply illustrated by Rwanda’s higher score in the indicative measures of “government effectiveness and control of corruption”. In short, better quality governments usually have positive effect on development outcomes thanks to overall efficiency in the delivery of public services. Specific recommendations include for Uganda to generate good local governance, effective implementation of decentralisation, follow through of policies and enforcement of accountability for performance failures, the use of community health workers to address existing scarcity of health sector personnel as well as the adoption of ICT policies to support the implementation of health interventions.

Soon after independence, in 1964, Zambia’s urbanisation proceeded very rapidly presenting significant housing problems to the independence government. In the last five decades, Zambia’s Capital City, Lusaka has been growing most rapidly. Unfortunately, most of this growth has been in informal settlements on insecure land because most residents cannot afford formal lowincome housing. Since 1964, government has undertaken several initiatives to bridge this low-income housing crisis. These include; providing complete housing, providing housing subsidies, providing serviced land, enacting new laws, establishing new institutions and even giving away housing for free. But all these initiatives, designed around the ruling political party governance system, have not yielded the desired results. As a result, the urban housing backlog which was estimated to be around 24,000 housing units at independence may now grow to over 3.0 million by 2030 if urgent action is not taken. Government has an opportunity to transform the urban housing sector by addressing weaknesses in the current laws and institutions, providing specific support to low-income households and encouraging private sector involvement. In all this, government must remember that context matters.

South Africa is ranked number one in the world as the most unequal society by the World Bank. Inequalities are largely manifested in income, education and spatial arrangements, as well as access to opportunities and public services. My dissertation examines the impact of the City of Johannesburg's Rea Vaya Bus Rapid Transit (BRT) system, and the transit-oriented development programme, known as Corridors of Freedom, in transforming the mini-bus taxi industry; providing safe and reliable public transport to previously marginalised communities; and to mitigate the legacy of apartheid spatial planning. The research examines the policy objectives of the Rea Vaya BRT system as part of the larger Corridors of Freedom capital programme, which aims to create development nodes to densify the City and improve mobility, and in turn enhance social integration. The research outlines the implementation of Rea Vaya over the past ten years, and explores the impact of the service on the City's commuters and the mini-bus taxi operators. A key argument of the paper is that while anecdotal evidence exists that the Rea Vaya BRT functions optimally, an evaluation study of the City's continued public investment is critical to ascertain whether the project is achieving its intended socio-political and economic objectives.

Over the past few years, there has been rising interest in the field of Early Childhood Care and Education (ECCE). The interest is evident at international, regional and national levels. Given the widely documented benefits of ECCE, and through the lobbying of various stakeholders, the government of Botswana resolved to provide a one-year pre-primary programme at all government schools. In this study, ECCE and pre-primary education programme are used interchangeably. This pre-primary education programme was initially piloted at a few select schools in 2012. After the successful run of the programme, it was then scaled-up to all government primary schools in Botswana starting in 2014. This programme is the basis of this study, in which the researcher examines two of its main indicators namely accessibility and quality. The study was conducted using a qualitative research approach. It used the following research methods: document analysis, observation and structured and in-depth interviews with teachers, school heads and education officers from the Ministry of Basic Education (MoBE), the Department of Curriculum Development Evaluation (DCDE) and the Regional Education Office (REO). Twelve (12) schools were chosen out of a total of twenty – four 24 schools in the Gaborone sub-region. The data collected from the interviews and observations was analysed using thematic analysis. It was triangulated with the data obtained from documents. The study made three (3) key findings. First the study reveals that although the government achieved 86% scale-up rate of the programme, the student enrolment rate remains low, at an estimated 25%. Second the study also reveals inconsistency in resource allocation, in-service training of teachers and general support offered to the teachers and the schools among the studied schools. Finally, the study reveals that there is no quality framework, that the teachers improvise by using the expected learning outcomes contained in the Integrated Early Childhood Development (IECD) curriculum of 2013. Informed by the Lev Vygotsky's socio-cultural constructive theory, the recommendations were made based on the findings. The implications of the recommendations are that they could improve the equitable and uniform universal allocation of resources ensuring that the quality and access of the programme is standard throughout the country. Also, the researcher proposed some quality assurance guidelines, which would ensure the standardisation of the quality matrix.

In 2009 Zimbabwe experienced a cholera outbreak of unprecedented magnitude where over 90 000 cases where recorded an at least 4 500 people lost their lives. It is argued that this outbreak created the impetus for implementation of water sanitation and hygiene (WASH) sector reforms which would contribute towards addressing service level challenges and gaps. Through this study the researcher sought to understand the WASH sector reforms implemented and the extent to which they had resulted in the anticipated improvements in service delivery amongst targeted rural communities. The study adopted a mixed methodology descriptive survey to understand the practical aspects and intricacies of policy implementation and reform in the Zimbabwean WASH sector, with emphasis on the benefits of policy reform for enhancing access and management of rural WASH service delivery initiatives. Three empirical data sources were used, comprising of desktop review of documents on WASH policy implementation processes and guidelines, qualitative interviews carried out with four key informants from WASH coordinating committees and the case methodology to study three districts implementing the sector reforms using a semi-structured questionnaire administered to various district and community stakeholders. The researcher found that the WASH sector reforms have not fully achieved the intended objectives, although some strides have been made in terms of improving water and sanitation access to selected communities. However, the researcher notes that the gains in service coverage that have been made in the case districts are proving short-lived and unsustainable as issues such as limited funding, sustainability of the WASH coordination structures, operation and maintenance of infrastructures remain a real challenge. Considering these challenges the researcher recommends that the government explore alternative innovative sources for WASH funding including streamlining the WASH coordinating committees to improve efficiency and effectiveness, strengthening sector financing through adoption of user-pays initiatives and inclusion of community-based management structures in WASH planning and decision making to enhance effective community participation.

Lorcaserin represents a new serotonergic medication used as an adjunct to a reduced-calorie diet and increased physical activity treatment plan for chronic weight management in adult patients with an initial body mass index ≥ 30 kg/m 2 or in adult patients with an initial body mass index ≥ 27 kg/m 2 who have ≥ 1 comorbid condition associated with weight (eg, hypertension, dyslipidemia, or type 2 diabetes mellitus). In 2012, lorcaserin became the first obesity treatment medication to gain US Food and Drug Administration (FDA) approval since 1999. Lorcaserin is a centrally acting, selective serotonin C (5-HT2C) receptor full agonist that is associated with increased satiety and decreased food consumption in patients. The selectivity of lorcaserin for 5-HT2C receptors should reduce patient risk for the serious adverse complications that are associated with nonselective 5-HT agonist therapies, such as cardiac valvulopathy and pulmonary hypertension. The safety and efficacy of lorcaserin (10 mg twice daily) for ≥ 52 weeks has been evaluated in 3 separate Phase 3 trials. The primary outcome of patient weight loss in the 3 trials satisfied the FDA categorical benchmark but patient outcomes in the trials failed to achieve the FDA mean benchmark of patient weight loss. Secondary patient outcomes after lorcaserin therapy were favorable. Lorcaserin appears to be well tolerated in patients and the most common adverse events reported did not include serious complications. The incidence of FDA-defined valvulopathy in patients after 1 year of treatment was low and nonsignificant, but the statistical analysis of this safety endpoint was limited due to the small size of the study populations and high patient dropout rates. Continued post-marketing surveillance of patients taking lorcaserin is warranted.

Lorcaserin represents a new serotonergic medication used as an adjunct to a reduced-calorie diet and increased physical activity treatment plan for chronic weight management in adult patients with an initial body mass index ≥ 30 kg/m 2 or in adult patients with an initial body mass index ≥ 27 kg/m 2 who have ≥ 1 comorbid condition associated with weight (eg, hypertension, dyslipidemia, or type 2 diabetes mellitus). In 2012, lorcaserin became the first obesity treatment medication to gain US Food and Drug Administration (FDA) approval since 1999. Lorcaserin is a centrally acting, selective serotonin C (5-HT2C) receptor full agonist that is associated with increased satiety and decreased food consumption in patients. The selectivity of lorcaserin for 5-HT2C receptors should reduce patient risk for the serious adverse complications that are associated with nonselective 5-HT agonist therapies, such as cardiac valvulopathy and pulmonary hypertension. The safety and efficacy of lorcaserin (10 mg twice daily) for ≥ 52 weeks has been evaluated in 3 separate Phase 3 trials. The primary outcome of patient weight loss in the 3 trials satisfied the FDA categorical benchmark but patient outcomes in the trials failed to achieve the FDA mean benchmark of patient weight loss. Secondary patient outcomes after lorcaserin therapy were favorable. Lorcaserin appears to be well tolerated in patients and the most common adverse events reported did not include serious complications. The incidence of FDA-defined valvulopathy in patients after 1 year of treatment was low and nonsignificant, but the statistical analysis of this safety endpoint was limited due to the small size of the study populations and high patient dropout rates. Continued post-marketing surveillance of patients taking lorcaserin is warranted.