Globally, urban areas are viewed with great optimism and suspicion, as potential engines for development and destabilising vortexes of violence and degeneration. Both visions have traction in South Africa. Urban living has offered opportunities for some to better their economic standing, strengthen capabilities and expand freedoms. However, given the pace of urbanisation and problematic urban governance, urban areas remain spaces of inequality, degradation, crisis and conflict. This is particularly true for those on the margins, whose lives are profoundly shaped by the need to negotiate security and justice. The welfare of urban Others and their long-term prospects for socioeconomic development are intimately bound up in the outcomes of these negotiations, as recent waves of xenophobic violence demonstrate. Positive urban transformation requires understanding how multiple marginalities interact in urban areas. At present, this intersection has been neglected. This South Africa-UK Partnership forges an international academic network to build capacities to rigorously and innovatively address this issue. Our ambitious agenda focuses primarily on (internal and external) migrants and lesbian-gay-bi-trans-queer (LGBTQ) communities. Although the freedom to embrace diversity and difference is at the heart of a democratic city, these urban Others face the stresses of everyday prejudice and spectre of severe violence, like xenophobic riots or acts of 'corrective rape'. Security threats facing migrants and LGBTQ people are comparable, but the logics animating them are distinct, making them conducive to comparison. Our Partnership will strengthen capacities in South Africa to explore strategies individuals use to negotiate these varied marginalities, embedded in wider economic, social and political systems. It will also particularly build skills to explore roles that digital technologies play in this process, shaping flows of power, resources, and information in urban areas; and how policymakers and civil society groups are responding to complex challenges of urban wellbeing. The Partnership develops skills, knowledge, and networks, supporting cutting edge research that actively engages communities, civil society groups and government agencies. We will identify research synergies; provide methods training in Big Data, Social Network Analysis, Remote Event Mapping, and Visual Methods to push the boundaries of urban research; fund 'urban lab' pilot projects to encourage innovative methods and questions; organise visiting fellowships to provide time and space for meaningful collaboration; and provide impact training to ensure that our timely interdisciplinary research agenda has effective and wide-reaching influence. ODA statement: The primary purpose of this project is to promote the welfare and development of the partner country. It will do this in three primary ways. First, the topic of the collaborative research is crucially important for South Africa, where rapid urbanisation, entrenched inequities and uneven development risk positive urban transformation, especially in relation to vulnerable groups such as migrants or LGBTQ communities. Secondly, we will address these key concerns through drawing on the comparative and complementary strengths of our two partners, Wits University's strengths in detailed local historical, ethnographic and qualitative research and generating impact in South African policy networks and Edinburgh's strength in methods, especially interdisciplinary approaches. Thirdly, the project will draw on Edinburgh's expertise in quantitative methods and data science, and the project is designed to build the research capacity of Wits University researchers in new approaches and generate future collaborative research.

Abstracts are not currently available in GtR for all funded research. This is normally because the abstract was not required at the time of proposal submission, but may be because it included sensitive information such as personal details.

Because it increases the morbidity and mortality of bacterial infection, as well as the duration and cost of antibacterial treatment, antibiotic resistance constitutes a significant threat to global public health. The problem is even more critical in low- and middle-income countries which have higher infectious disease burdens, often higher rates of antibiotic resistance, less access to diagnostic tools, and fewer financial resources to purchase newer more effective antibiotics. In South Africa, antibiotic resistance is particularly high, despite an effective drug regulatory system and various initiatives to tackle the problem. Antibiotic resistance is accelerated by the overuse and over-prescription of antibiotics, which is the product of complex interactions between providers' decisions and knowledge, and patients' expectations. Yet research on the determinants of prescribing behaviours from LMICs in general, and South Africa in particular, is limited, and has been criticised for being too descriptive and superficial, with limited insight into the relative importance of different behavioural determinants to be able to prioritise interventions. In South Africa, most research efforts have focused on hospitals rather than primary care, despite the fact the majority of antibiotics are prescribed in primary care, mostly for respiratory infections. This study aims to explore how the interactions between providers and patients influence inappropriate antibiotic prescribing for URTIs in public and private primary care in South Africa. The study will include three components. First, drawing on medical anthropology, we will explore qualitatively providers' and patients' perceptions an experiences of antibiotic prescribing. This will be done through observations of consultations, interviews with providers and focus group discussions with patients. Second, building on the first part and drawing on methods from marketing research, we will design a survey consisting of a series of hypothetical clinical cases where clinical and patient characteristics will be systematically varied; for each case, the providers taking part will be asked indicate what drugs they would prescribe in a list of proposed drugs. The results will allow us to quantify the relative importance of the factors influencing antibiotic prescribing, with a view to inform policy-makers design future interventions. Finally, drawing on recent economics and medical education research, we will move beyond observational research and design a small randomised field study to test the impact of patients' knowledge and financial incentives on the prescribing practices of public and private primary care providers. This will be achieved with the use of standardised patients, who are healthy subjects trained to portray specific symptoms and disclose a rehearsed medical history. These patients will be sent to visit providers who agreed to take part in the research, at a time and under an identity unknown to them. The standardised patients will only differ in their expectations of antibiotics and the insurance status they will disclose. This will allow us to test the impact of these different characteristics on the likelihood of antibiotic prescription. We anticipate that the results will provide invaluable insights into our understanding of prescribing decisions in the public and private sector in South Africa, thereby informing the stewardship programmes for antimicrobial resistance in this country. Beyond this setting, these findings will be useful to other middle-income countries with a similar mix of public and private providers. More generally, we aim to produce high-quality research and develop innovative methods that could be replicated in other low-income settings to study antibiotic prescribing.

The private sector provides a large proportion of health services in many low- and middle-income countries (LMICs), particularly for primary health care (PHC), even for poor patients. But the role of the private sector in expanding universal health coverage (UHC) in LMICs remains contentious. Proponents argue that the private sector could increase patient choice and PHC access, and that competition incentivises private providers to be more responsive and provide better quality care than public providers. However, evidence suggests that these advantages may not materialise. Arguments supporting the role of the private sector rely on the assumption that private providers compete for patients. Yet many factors influence market performance and health markets are often not competitive. Effective competition also requires that patients respond to changes in price or quality. Although these dynamics are critical in determining the health system impacts of private PHC provision in LMICs, they have received little attention in the literature. Understanding the role and impact of private sector provision is especially important in South Africa as policy proposals for achieving UHC promote the contracting of private providers to expand access to quality PHC for uninsured patients. There are concerns about the current performance of private PHC providers, and the functioning of the PHC market, with little empirical evidence to inform current debates. Expanding the role of the private sector as part of efforts to achieve UHC requires a more thorough understanding of the potential risks and benefits, and the likely responses of both the supply and demand sides of the market. The aim of this study is to undertake a detailed empirical investigation of the market for public and private primary care services. It will focus on the determinants of provider performance on the one hand, and demand for private services from uninsured cash-paying patients on the other. The study will be conducted in Soweto, Johannesburg, and it will include five components. Firstly, we will undertake a detailed description of the local PHC market through a census, mapping and interviews of all providers, an analysis of market concentration, and investigation of the strategies which private providers use to compete for patients. Secondly, using 'fake' standardised patients (SPs), we will compare the performance of private and public providers in terms of accessibility to services, technical quality of care and cost of treatment recommended. Thirdly, we will establish the relationship between competition and performance outcomes, testing if greater competition leads to better outcomes. Fourthly, using linked data on provider performance and cost, we will investigate if accessibility, quality and cost are important determinants of the demand for services by uninsured patients. Finally, in a small randomised pilot, we will test study how populations would react to the introduction of subsidised access to private services, and explore if information about quality influences demand. The study will provide important information on whether the private PHC market can contribute to better health system access, quality and efficiency. The results are relevant to many LMICs trying to expand UHC within mixed health care systems.

Over a three year period, the Academy for African Migration Research will undertake two key activities: (1) Four 'institutes' to provide capacity building for doctoral students and early-career researchers who are a maximum of 3-years post-PhD, to refine their research focus and promote professional development and scholarly contributions. (2) A series of research visits/exchanges for established academics and postdoctoral fellows to support building research capacity and strengthening the intellectual project for migration research in Africa. The Academy currently includes seven institutions in 5 countries [TBC]. Applications for the institutes will be accepted from doctoral students and early-career researchers from any African institute. 1. University of Addis Ababa and/or OSSREA, Ethiopia 2. University of Ghana, Legon, Accra, Ghana 3. Makerere University, Kampala, Uganda 4. Eduardo Mondlane University, Maputo, Mozambique 5. University of the Western Cape, Cape Town, South Africa 6. University of Cape Town, South Africa 7. University of the Witwatersrand, Johannesburg, South Africa Institutes: A series of four 'institutes' will be held at different locations across the ARUA network, each focusing on a different thematic area: migration and urbanization; migration, health and wellbeing; belonging, difference and diaspora; and, the knowledge politics of migration research in Africa. These institutes will also incorporate professional development training, including the development of peer-support and mentorship mechanisms. A final event will be held in the final/third year. This will take the form of a conference for early career researchers and postgraduate students - including those who have participated in the institutes - working on migration and mobility in Africa. The institutes will be designed to: - Support African migration scholars to embrace theory building, engagement with migration/social theory, and the knowledge politics associated with migration research in Africa. Participants will benefit from rigorous theoretical and methodological foundations in inter-disciplinary migration studies in addition to disciplinary perspectives from resource persons. - Offer practical professional advice/professional development including: academic publishing; project management; organising and managing data; consulting colleagues and others in the field; and the risks and benefits of interdisciplinary work in an academic universe still largely organised in disciplinary formations. - Provide mentorship and peer support by facilitating engagements between doctoral students, early career researchers and established academics both virtually and in-person. These structures will provide support for the required outputs associated with the institutes, including written work; presentation skills; and the development of professional CVs and online profiles. Research visits/exchanges: The Academy will fund various activities for established and early career researchers. Funds will be awarded on a competitive basis, and will be assessed by a review panel made up on their planned activities and outputs. Preference will be given to proposals aiming to support research capacity building and strengthening of the intellectual project for migration research in Africa. All proposals will need to demonstrate collaboration/partnership building as a central activity. - one-week visits for established researchers to travel to another institution to undertake teaching/supervision/research exchanges; - one-month visiting postdoctoral fellowships; and - symposiums and/or proposal development workshops to support the establishment of new research partnerships.