Exploring urban compactness impact on carbon emissions from energy consumption: A township-level case study of Hangzhou, China.

Given that cities are the major contributors to carbon emissions, studying urban compactness (UC) and its impact on carbon emissions from energy consumption (CEECs) is crucial. This study calculated Hangzhou's township-level urban UC and CEECs using a hybrid subjective-objective weighted regression model on integrated panel datasets. By employing a geographically weighted regression (GWR) model, the spatio-temporal heterogeneity of the UC-CEEC relationship from 2006 to 2019 was uncovered. The results indicated an overall increase in UC, with significant variations across different counties. CEECs were higher in the central region, shifting eastward due to distinct urban development levels and policies. Moreover, the effects of various UC factors exhibited significant spatiotemporal inconsistency, with the impact intensity gradually diminishing. Additionally, the explanatory power of these factors declined and diversified over time. These findings emphasize the need for a comprehensive understanding of the relationship between UC and CEECs within the complex metropolitan environment and the importance of regulating their coordinated development. The research not only offers a more scientific approach to managing the growth of county-level cities and supporting balanced urbanization but also presents policy recommendations.

Spatial distribution of Japanese encephalitis cases and correlated geo-environmental factors in southern and northern counties of China.

Japanese encephalitis (JE) is a mosquito-borne disease with a spatial distribution that is linked to geo-environmental factors. The spatial distribution of JE cases and correlated geo-environmental factors were investigated in two critical counties in southern and northern China. Based on maps, enhanced thematic mapper (ETM) remote sensing datasets from Landsat and spatial datasets of JE cases, spatial distribution and spatial cluster analyses of JE cases at the village scale were performed by using the standard deviational ellipse and Ripleys K-function. Global and regional spatial cluster analyses of JE cases were also performed by using Moran's index. Regression analysis was used to analyze the relationships between geo-environmental characteristics and the risk of JE cases. At the study sites, the JE cases were not spatially clustered at the village or district (global) level, whereas there was a spatial cluster at the district (local) level. Diversity-related features for JE patients at the district and village levels were detected at two sites. In the southern counties, the distance of a village from a road was related to the village-level JE risk (OR: 0.530, 95 CI: 0.297-0.947, P = 0.032), and the number of township-level JE cases was linked to the distance of the district center from the road (R =-0.467, P = 0.025) and road length (R = 0.516, P = 0.012) in the administrative area. In northern China, the modified normalized difference water index (MNDWI) in the 5 km buffer around the village was related to village-level JE risk (OR: 0.702, 95% CI: 0.524-0.940, P = 0.018), and the number of township-level JE cases was related to the MNDWI in the administrative region (R =-0.522, P = 0.038). This study elucidates the spatial distribution patterns of JE cases and risk, as well as correlated geo-environmental features, at various spatial scales. This study will significantly assist the JE control efforts of the local Centers for Disease Control and Prevention (CDC), which is the base-level CDC, particularly concerning the allocation of medicine and medical staff, the development of immunological plans, and the allocation of pesticides and other control measures for the mosquito vectors of JE.

Core competence of midwives in township hospitals and its influencing factors-A cross-sectional study.

Objective: This study aimed to assess the core competence of midwives in township hospitals through a self-assessment questionnaire. The relationship between professional identity and core competence and the factors influencing midwives' core competence was also investigated. Method: Convenience sampling was conducted in 77 township hospitals in Ganzhou, Jiangxi Province, China, with 150 participants. The questionnaires were distributed online in November 2021. We conducted a descriptive data analysis, a correlation analysis of the two variables of professional identity and core competencies, and multivariate linear regression to analyse the influencing factors, including the sociodemographic information, the Midwife Core Competence Scale, and the Nurses' Professional Identity Scale scores. Results: The mean score for the core competence was 206.43 (±37.45) out of 270. The highest score was for pregnancy care (3.97 ± 0.70) and the lowest was for newborn care (3.72 ± 0.78). The independent sample t-test results and one-way analysis of variance showed that qualifications, midwifery training situation, and midwifery working years had differential effects on midwives' core competencies (P < 0.05). Multiple linear regression showed that qualifications, midwifery working years, and level of professional identity were influencing factors (P < 0.05). Conclusions: The core competencies of midwives in township hospitals were lower than those reported in other studies. Advancements in education, midwifery working years, and professional identity may increase midwives' core competencies.

Dynamic distribution, regional differences and convergence of health workforce allocation in township health centers in China.

This study evaluated the dynamic distribution, regional differences, and convergence of health workforce allocation in Township Health Centers in China during 2011-2020 using data obtained from the China Health Statistics Yearbook (2012-2021). The Gini coefficient and kernel density estimation were chosen to examine the dynamic distribution and regional differences in health workforce allocation in Township Health Centers in China and their components. σ convergence and ß convergence were used to investigate the change trend of health workforce allocation in Township Health Centers. The results show that between 2011 and 2020, the number of licensed doctors and registered nurses per thousand population in Township Health Centers both increased largely and regional disparities still exist. In 2020, the largest differences in the density of licensed doctors and registered nurses were found in the eastern and central regions, respectively, and the intensity of trans-variation contributed the most to the overall disparities. The allocation of licensed doctors and registered nurses both exhibited σ convergence, absolute and conditional ß convergence, indicating that the regional differences in health workforce in THCs among provinces will decrease. The growth of healthcare workforce was positively impacted by the urbanization rate, growth rate of government health expenditures and growth domestic product per capita, but negatively impacted by population density in rural areas and fiscal self-sufficiency.

Predicting low carbon pathways on the township level in China: a case study of an island.

Carbon prediction on the township level is usually difficult due to a lack of necessary information. To fulfil the research gap, the study focused on a town located in a nearshore island (Lingshan) in China. A questionnaire survey was performed to collect essential information about the future development of the town, followed by validating interviews with the island management committee. The carbon prediction of the town was established by the Low Emissions Analysis Platform (LEAP) model. The baseline scenario reflecting the existing method of carbon management was compared with an alternative low-carbon scenario. The prediction from 2020 to 2060 covers the periods of the planned carbon emissions peak in 2030 and carbon neutrality in 2060. It is found that energy-related activities and electricity consumption are the primary contributors to carbon emissions on the island. The carbon emission of Lingshan Island increases from -1333 tCO2e in 2020 to 2744 tCO2e in 2060, and the carbon peak target cannot be achieved in the baseline scenario. However, the carbon emission of the low-carbon scenario is predicted to have a peak of -850 tCO2e in 2029. The prediction model developed in this study, along with the proposed policy recommendations, can be applied to other towns or regions where data availability is limited to promote carbon reduction.

Spatiotemporal evolution of healthcare service capacity at township health centers in China.

Introduction: This study analyzes the efficiency, spatiotemporal evolution, and influencing factors of provincial township health centers' healthcare service capacity in China. Method: It utilizes an unexpected output super-efficiency slacks-based measure (SBM) model, exploratory spatiotemporal data analysis methods, and a quantile regression model. Results: The results show that the healthcare service capacity of township health centers is better in provinces with a larger proportion of hierarchical diagnoses and treatments pilot projects in cities, and the regional efficiency trend is ordered central > eastern > western > northeastern. The healthcare service capacity of provincial township health centers mainly shows significant spatial correlation and a spatiotemporal distribution pattern of "high agglomeration, low differentiation." Discussion: Rural population density and per capita GDP significantly improve the healthcare service capacity of township health centers, while local governments' healthcare and health expenditure increases the healthcare service capacity of township health centers in certain quantiles. The urbanization rate and per capita disposable income inhibit the improvement of the healthcare service capacity of township health centers in certain quantiles. The provinces should accelerate the promotion of hierarchical diagnoses and treatment pilot projects in cities and establish national cooperative development models to promote public health.

Distribution of iodine concentration in drinking water in China mainland and influence factors of its variation.

OBJECTIVE: To identify the current spatial distribution of iodine concentration in drinking water (dWIC) at the township-level across China and its influencing factors through visualization and spatial statistical analysis by the geographic information system. METHODS: The dWIC for each township was used to describe the distribution by ArcGIS 10.7. The spatial aggregation characteristics were analyzed by spatial auto-correlation analysis. The inverse distance weight method was used to predict the dWIC at nonsampling sites. The correlation between the dWIC and the distance from each township to the Yellow River as well as the depth of tube wells were analyzed by ordinary least squares and geographically weighted regression, respectively. RESULTS: A total of 37,541 townships were included in this study. dWIC ranged from 0 to 1113.7 µg/L, and the median was 3.3 µg/L. There were 35,606 townships < 40 µg/L (94.85 % of surveyed townships), 40 µg/L ≤ 1015 townships ≤100 µg/L (2.70 % of surveyed townships), and 920 townships > 100 µg/L (2.45 % of surveyed townships). The results were statistically significant of global autocorrelation analysis (Moran's I = 0.43, Z = 922.15, P < 0.01). Local Moran's I showed that 3128 townships (8.33 % of surveyed townships) belong to H-H cluster areas. The dWIC was partially negatively correlated with the distance from each township to the Yellow River, as well as positively correlated with the depth of tube wells in partial areas. CONCLUSIONS: The dWIC varied widely across mainland China (from 0 µg/L to 1113.7 µg/L). 94.85 % of surveyed townships were below 40 µg/L and 2.45 % of surveyed townships were exceeding 100 µg/L. Moreover, the distance from each township to the Yellow River may be one of the geneses of iodine-excess areas. Finally, this study has provided a visible reference of dWIC for the precise control strategy and focused monitoring in China.

Effects of Environmental Factors on Bird Communities in Different Urbanization Grades: An Empirical Study in Lishui, a Mountainous Area of Eastern China.

The rapid development of urbanization has changed landscape patterns and biological habitats severely and, therefore, affected biodiversity. In this study, we selected 75 townships in Lishui, a mountainous area in eastern China, to conduct bird surveys for two years. We analyzed the birds' composition characters in townships with different levels of development in order to identify the effects on bird diversity of the urban development level, land cover pattern, landscape pattern, and other factors. In total, 296 bird species from 18 orders and 67 families were recorded between December 2019 and January 2021. A total of 166 species of birds belonged to Passeriformes (56.08%). The seventy-five townships were divided into three grades by K-means cluster analysis. The average number of bird species, richness index, and diversity index were higher in G-H (highest urban development level) compared with the other grades. At the township level, landscape diversity and landscape fragmentation were the key factors that positively affected the bird species number, diversity index, and richness index. Landscape diversity had a greater effect than landscape fragmentation, particularly on the Shannon-Weiner diversity index. The diversity and heterogeneity of urban landscapes could be improved by constructing biological habitats in future urban development planning to maintain and increase biodiversity. The results obtained in this study provide a theoretical basis for urban planning in mountainous areas, and a reference for policymakers to formulate biodiversity conservation strategies, construct reasonable biodiversity patterns, and solve practical biodiversity conservation problems.

The impact of natural environment on human alveolar echinococcosis: A township-level modeling study in Qinghai-Tibet Plateau.

Human alveolar echinococcosis (AE) is a lethal helminthic infection caused by the tapeworms Echinococcus multilocularis. The Qinghai-Tibet Plateau has the greatest endemicity of human AE globally, but the natural risk factors and its impact mechanism are still unclear. Generalized linear models and generalized additive models are used to select key linear and non-linear environmental factors associated with cases of AE. The interactive effect between different factors is identified using concurvity test. From fifty-nine variables analyzed, four key factors and one interaction term were identified associated with AE. Considering interaction terms between climatic and geographical landscape factors can significantly improve model fitting. Minimum winter precipitation, percentage of grassland cover, and minimum elevation have significant positive linear relationship with human AE incidence. The relationship between maximum summer precipitation and human AE is non-linear with high AE incidence associated with moderate precipitation. The interaction term of maximum summer precipitation and number of patches of grassland on human AE indicates that human AE incidence is highest when both factors were high. The climatic and landscape risk factors together are associated with the local transmission of human AE in Qinghai-Tibet Plateau. This study provides a scientific basis for human intervention in AE from fine-scale ecological environment.

The impact of job-related stress on township teachers' professional well-being: A moderated mediation analysis.

This study aimed to explore the relationship between job-related stress and township teachers' professional well-being. Based on Job Demand-Resource Model, this study examined the mediating role of teachers' professional identity and the moderating role of perceived organizational support in this relationship. A total of 24,276 township teachers in China responded to the Teacher Stress Scale, the Teachers' Professional Identity Scale, the Teachers' Professional Well-Being Structure Questionnaire, and the Perceived Organizational Support Scale. Results showed that: (1) the professional well-being of township teachers differed significantly in terms of school type and demographic characteristics like age and gender; (2) job-related stress negatively predicted township teachers' professional well-being, with teachers' professional identity playing a mediating role; (3) the relation between job-related stress and teachers' professional identity was moderated by perceived organizational support; and (4) in the moderated mediation analysis, job-related stress positively predicted township teachers' professional well-being. These findings indicated that township teachers' professional well-being was influenced by both organizational and individual factors, which provided a theoretical basis and intervention pathways for improving township teachers' professional well-being.

Risk factors for alcohol use among adolescents: The context of township high schools in Tshwane, South Africa.

Background: Risk factors for alcohol use originate from many interconnected factors to an interplay of social and physical environments. However, there is a scarcity of data on the contextual risk factors of alcohol use among the adolescents regarding high schools located in townships in South Africa. This study aimed to determine the risk factors for alcohol use among adolescents attending selected township high schools in Tshwane, South Africa. Method: A validated researcher-administered questionnaire was used to collect data on the demographics, as well as current alcohol use, types, quantity, and frequency among adolescents (n = 403) in the three high schools. Data were analyzed using STATA 17. Results: The response rate was 97%, with the mean age of 16 ± 2 years for the adolescents. Forty-eight % (48%) of the adolescents reported current alcohol use, which was associated with sex, age, number of children, school grade, repeated grade, spare time job and types, having a pocket money to school, child social grant, transport mode to school, and smoking. The odds of current alcohol use were higher for adolescents in grade 10 [AOR = 6.71; 95% CI: 3.16-14.24], grade 11 [AOR = 4.45; 95% CI: 2.21], grade 12 [AOR = 3.05; 95% CI: 1.47-6.31], repeating a grade [AOR =2 .20; 95% CI: 1.32-3.67), and working during a spare time [AOR = 2.91; 95% CI: 1.33-6.37]. Both sexes had higher odds of alcohol use in the ages of 15-17 and 18-21 years, than adolescents aged 13-14 years. Conclusion: Key risk factors for alcohol use among learners were sex, age, school grade, repeated grade, and working during a spare time. More evidence-based interventions that would have a greater impact in addressing alcohol use among adolescents, such as focusing on availability, marketing, and taxation of alcoholic beverages, are necessary.

Development of a framework of carbon accounting and management on the township level in China.

The regional management on greenhouse gas (GHG) emissions is essential to the success of global carbon reduction. However, previous studies mostly focused on the city or country levels, while the management of GHG emissions on the township level has not been fully studied. This study proposed a framework of carbon management on the township level and developed a calculation tool for accounting GHG emissions. The case study of Lingshan Island, located in eastern China, was conducted through a site visit and interviews. A questionnaire survey was performed to collect data for carbon accounting. It is found that the island had a negative carbon emission of -1336 t CO2e in 2020, which is mostly contributed from energy and electricity consumption. Due to the COVID-19 pandemic, the number of tourists decreased in 2020 and the carbon emission was 224 t CO2e lower than in 2019. The proposed framework consists of five steps and requires the collaboration of the government, the locals, researchers and other stakeholders. The framework was validated through a focus group meeting and the suggestions on carbon management at township level were provided. This study paves a way of carbon accounting and management for the less urbanized regions.

Exploring the contextual factors that impact the dementia family caregiving experience in Soweto township, South Africa.

Townships and rural areas endure difficult circumstances such as poverty, unemployment, low educational levels, unstable income sources, socioeconomic deprivation and the lack of transportation. Furthermore, psychosocial issues such as crime, violence and substance abuse are additional contextual factors prevalent within South African townships. There has been a paucity of research focussing on the impact of contextual and socioeconomic conditions on the dementia family caregiver experience. This qualitative study aimed to address this gap. Semi-structured interviews were conducted with 30 family caregivers via purposeful sampling methods. Data analysis using Reflexive Thematic Analysis (RTA) generated four broad themes, namely - (1). Poverty, (2). Crime, Violence and Substance Abuse, (3). Practical Challenges and (4). A Sense of Normalcy. The findings of this study depict the socioeconomic conditions of family caregivers living in Soweto and its impact on dementia caregiving. The majority of the family caregivers in this study were unemployed and identified the financial aspects of caregiving as a significant strain. Beyond financial aspects, practical challenges that some family caregivers reported included spatial constraints and insufficient material resources. Caregivers raised safety concerns due to the dangers that this socioeconomic context posed. However, there was an implied sense of normalcy and a reluctance to identify challenges that caregivers endured. Recommendations for further research and its implications for public health policies and important initiatives to advocate for dementia caregivers and their family members are outlined.

The relationship between organisational support for career development, organisational commitment, and turnover intentions among healthcare workers in township hospitals of Henan, China.

BACKGROUND: Township hospitals in China face the challenge of shortage and turnover of healthcare workers. This study aims to evaluate the relationship between organisational support for career development (OSCD), organisational commitment, and turnover intentions among healthcare workers in township hospitals. METHODS: The data in this study were obtained from the Health Service Capacity Survey of Primary Health Institutions (2020), one of the special surveys of rural health poverty alleviation in Henan, China. The sample comprised 298 healthcare workers. Three standardised instruments were used: the turnover intention scale, OSCD scale, and organisational commitment scale. Descriptive statistics, One-way Analysis of Variance, Pearson correlation analysis, and the simple mediation model were used for data analysis. RESULTS: The results showed that the mean score of the healthcare workers' turnover intentions was 2.21 ± 0.77, which was low. The healthcare workers' turnover intentions had significant differences in gender, age, marital status, education, professional title, and organisational tenure. OSCD had no significant direct relationship with turnover intentions, while having a significant positive direct relationship with organisational commitment. Organisational commitment had a significant negative direct relationship with turnover intentions, and played a fully mediating role in the relationship between OSCD and turnover intentions. CONCLUSIONS: OSCD had an indirect negative effect on healthcare workers' turnover intentions in township hospitals through the full mediation of organisational commitment. The findings of this study suggest the importance of policymakers and organisation managers to improve OSCD practice and pay attention to 'humanistic management'. In addition, the formulation and implementation of talent retention policies should consider socio-demographic differences.

Job satisfaction and associated factors among health care staff in township health centers--a cross-sectional survey in rural Central China.

Township health centers play a cornerstone role in the primary healthcare in China while it's development is largely limited by the brain drain. Job satisfaction is closely related to brain drain, investigating the relevant factors of job satisfaction can provide strategies to reduce brain drain. This research was conducted in Huangpi, China. Convenience sampling methods and self-administereded questionnaires were used. We collected 1370 valid samples, with an effective rate of 97.72%. Descriptive statistics are used to describe sociodemographic information. The Pearson Chi-square statistical was used to test the binary association between job satisfaction and another categorical variable. All the sociodemographic information was applied to the binary logistic regression model using the stepwise selection method. The mean age was 36.98 (SD = 9.84), factors that affect job satisfaction include educational background (x2 = 7.99, p< 0.05), marital status (x2 = 8.96, p< 0.05, monthly income (x2 = 51.43, p< 0.01), hire form (x2 = 7.64, p< 0.05), hours worked per week (x2 = 33.48, p< 0.01), parent had a stable job (x2 = 10.65, p< 0.01). Government and management should consider the impact of current policies on job satisfaction. Increasing the welfare of healthcare staff and promoting equity are potential strategies for improving low levels of job satisfaction.

Rat Infestation in Gauteng Province: Lived Experiences of Kathlehong Township Residents.

BACKGROUND: Rat infestation is a major public health issue globally, and particularly in poor urban communities in South Africa. Rats pose significant threats to residents in the form of disease spread and sustained physical injuries. The dearth of knowledge about the experiences of affected residents may curtail the initiation of rat control programs. This study aimed to explore the lived experiences of rat infestation among residents of Katlehong Township in Gauteng Province. METHODS: This was a qualitative research study where data were gathered from selected community participants from Katlehong Township in Gauteng Province. A semi-structured interview guide was used to collect data through in-depth interviews. The interviews were digitally recorded and transcribed verbatim, and thematic data analysis was conducted using NVivo12 data processing software. The data were presented in themes and quotations that reflect the views of the participants. RESULTS: Exactly 20 community members aged between 18 and 56 years participated in the study, 80% being females. Over half of the participants were unemployed (60%), inclusive of students. Majority of the participants were either Zulu or Xhosa speakers. Several themes emerged from the data, which included the residents' experiences of rat infestation, troublesome rats, dirty rats, reasons for rat infestation, and sustained physical injuries. Participants intimated that waste in the environment and overcrowding in homes contributed to rodent infestation. CONCLUSION: Rat infestation remains a problem that causes severe distress among the residents of Katlehong Township. The experiences reported varied from psychological trauma to bite injuries and destruction of household property. Effective rodent control strategies need to be put in place to manage both the physical and mental risks posed by rat infestation in socially underprivileged communities.

Assessment of rural ecological environment development in China's moderately developed areas: a case study of Xinxiang, Henan province.

The reforming and opening-up has brought about the rapid development of China's economy, greatly improved the living standards of rural residents, and also caused the destruction of the rural ecological environment. Due to the backward production technology and pollution control technology, many township enterprises discharge excessive pollutants, and excessive application of chemical fertilizers and pesticides in agricultural production causes serious agricultural non-point source pollution. These pollution sources that cannot be effectively controlled cause a large number of water and land resource function decline. Not only the loss of agricultural production, but they also bring hidden danger to the survival of many rural residents. Taking Xinxiang city of Hunan province as an example, this paper selects 28 indicators and mainly uses AHP, entropy weight method, and fuzzy comprehensive evaluation method to evaluate and analyze the development level of rural ecological environment. This study can provide a reference for the Chinese government to formulate rural development planning and can also be used as a reference for the evaluation of rural ecological environment in developed and underdeveloped areas.

[Study of the Workload and Human Resources Demand of Basic Public Health Services in Township Hospitals of Sichuan Province].

OBJECTIVE: To understand the basic public health service (BPHS) tasks and workload of the township hospitals in Sichuan Province and to provide empirical evidence for improving the allocation of human resources (HR) and the quality of BPHS in township hospitals. METHODS: Retrospective survey was conducted to collect information regarding the actual working hours per unit time of service of BPHS. Information on the service volume and unit service time of BPHS tasks for 2018 was collected in 7 township hospitals in an economically developed area and an area of moderate economic development. Estimated HR required to cover the BPHS tasks was calculated based on the survey data of actual work time. RESULTS: The time required for the basic units of various BPHS tasks varied greatly. The top four most time-consuming services showing consistent results in the the two regions were health education, health supervision and coordination, management of children aged 0-6 and maternal care management. Institutions in the area of moderate economic development reported higher per capita service volume in the registration of children for vaccination, management of hypertension, and health supervision and coordination than those in the economically developed area, but lower service volume for other services. There is a shortage of full-time staffs in both areas. CONCLUSION: Differences in the service volume of BPHS exist in regions of different levels of economic development. The shortage in HR could be related to the lower quality and volume of the service. Comprehensive exploration of policies to recruit and retain competent personnel, the strengthening of grassroots professional training, and optimization of information technology will help improve the competence and quality of grassroots services.

Whether high government subsidies reduce the healthcare provision of township healthcare centers in rural China.

BACKGROUND: China's government launched a large-scale healthcare reform from 2009. One of the main targets of this round reform was to improve the primary health care system. Major reforms for primary healthcare institutions include increasing government investment. However, there are insufficient empirical studies based on large sample to catch long-term effect of increased government subsidy and lack of sufficient incentives on township healthcare centers (THCs), therefore, this study aims to provide additional empirical evidence on the concern by conducting an empirical analysis of THCs in Shaanxi province in China. METHODS: We collected nine years (2009 to 2017) data of THCs from the Health Finance Annual Report System (HFARS) that was acquired from the Health Commission of Shaanxi Province. We applied two-way fixed effect model and continue difference-in-difference (DID) model to estimate the effect of percentage of government subsidy on medical provision. RESULTS: A clear jump of the average percentage of government subsidy to total revenue of THCs can be found in Shaanxi province in 2011, and the average percentage has been more than 60% after 2011. Continue DID models indicate every 1% percentage of government subsidy to total revenue increase after 2011 resulted in a decrease of 1.1 to 3.5% in THCs healthcare provision (1.9% in medical revenue, 1.2% in outpatient visit, 3.5% in total occupy beds of inpatient, 1.1% in surgery revenue, 2.1% in sickbed utilization rate). The results show that the THCs with high government subsidy reduce the number of medical services after 2011. CONCLUSIONS: We think that it is no doubt that the government should take more responsibility for the financing of primary healthcare institutions, the problem is when government plays a central role in the financing and delivery of primary health care services, more effective incentives should be developed.

"Theyabduct usand rapeus": Adolescents' participatory visual reflections of their vulnerability to sexual violence in South African townships.

The abduction and sexual violation of adolescents, especially in township contexts, has increasingly made headlines in South Africa. These incidents are evocative of jackrolling, a phenomenon that plagued townships during the apartheid upheavals in the late 1980s. The abduction of adolescents on their school journeys has been reported in several South African townships. In this paper, we report on a study in which we used participatory visual methods (i.e., cellphilms: short videos made with cellphones) to explore how 19 adolescent girls and boys living in the Inanda, Ntuzuma, and KwaMashu (INK) township precinct, outside Durban reflected on their vulnerability to sexual violence. Although the question was broad, our analysis of the visual data suggests that adolescents believed that their vulnerability to abduction and rape was almost inevitable. As such, in their cellphilms, they chose to portray their risk and vulnerability to abduction, rape, and even murder on their daily journeys to and from school. We found that through this methodology, adolescents were able to illustrate and/or articulate their fear of sexual violence. For them, violence was an inescapable reality that created fear and helplessness. This underscores the need for interventions, including the provision of safe scholar transport and visible policing in the community.