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INTRODUCTION: Mental distress is a global health concern. Studies show that the prevalence of mental distress is higher in students' population than in the general population. Therefore, there is need to understand the extent and factors associated with mental distress among students to help policymakers and practitioners in South Africa. AIM OF THE STUDY: The study was designed to investigate into the prevalence and factors associated with mental distress among students at universities in the Eastern Cape Province, South Africa. METHODS: A cross-sectional study was conducted among students from four universities in the Eastern Cape Province. The data were collected from 844 students using an online self-reporting questionnaire-20 to assess mental distress of students. Multivariable logistic regression modelling determined the association between socio-demographic and psychosocial factors with students' mental distress. FINDINGS: The prevalence of mental distress among students was 53.3% (95% CI 47.0%, 58.1%). Female students were more prone to mental distress than male students ([AOR]: 4.67; 95% CI 2.82, 7.72, P = 0.001). Field of study ([AOR]: 3.9; 95% CI 1.74, 5.50, P = 0.010), year of study ([AOR]: 4.29; 95% CI 0.86, 21.46, P = 0.002), academic workload ([AOR]: 4.66; 95% CI 2.81, 7.71, P = 0.003), poor sleep quality ([AOR]: 2.24; 95% CI 1.13, 3.67, P = 0.010) and using cannabis ([AOR]: 3.10; 95% CI 1.755, 5.51, P = 0.020) were other factors significantly correlated with students' mental distress. CONCLUSIONS AND RECOMMENDATIONS: The study found the level of mental distress to be higher among students than what is reported in most of the previous studies on the student population in South Africa. Being a female student, a user of cannabis, and field of study, academic workload and having poor sleep quality were predictors of mental distress. Findings point to the need to devise evidence-driven interventions and strategies to prevent and reduce the problem of mental distress among students.

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Unplanned pregnancy has adverse effects including unsafe and illegal abortions causing maternal morbidity and mortality. Despite the adverse impact of unplanned pregnancy on women's personal life, their families, and society, there is a dearth of knowledge on unplanned pregnancy in institutions of higher education and training in South Africa. As a result, the objective of this study was to assess unplanned pregnancy and underlying factors among unmarried female students in universities in Eastern Cape. This was a cross-sectional survey of 1269 unmarried female students from universities in Eastern Cape selected using multistage cluster sampling. The study found that the prevalence of unplanned pregnancy was 12.31%, Health Science student (AOR: 0.41, 95% CI [0.17, 0.99], p < 0.001) were less likely to experience unplanned pregnancy. Being financially supported by a family (AOR: 0.17, 95% CI: [0.07, 0.43], p< 0.001) and being aged less than or equal to 18 years during the first sexual intercourse (AOR: 6.32, 95% CI: [2.57, 15.54], p < 0.001) were associated with unplanned pregnancy. Rural residence (AOR=3.93; 95% CI: (1.21, 12.84), p < 0.001), not using contraceptives (AOR=10.63; 95%CI: 5.29, 21.37, p < 0.001) and having divorced parents (AOR=1.99; 95%CI: 1.14, 3.94), p < 0.001) were associated with unplanned pregnancy compared to their counterparts, respectively. The prevalence of unplanned pregnancy is high among unmarried female students in universities in Eastern Cape. Unplanned pregnancy was influenced by age at first sexual intercourse, non-use of contraceptives, divorced parents, the field of study, and the source of financial support. Universities and stakeholders should work together to support reproductive health programmes to prevent unplanned pregnancy.

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Studies in South African universities reveal that the prevalence of sexual risk behaviour is very high, putting many students at high risk of HIV infection. This study explored the biological influences on students' sexual taking behaviour at the University of KwaZulu-Natal, South Africa. A qualitative approach was used, comprising a total of 80 in-depth interviews and 4 focus group discussions. These were conducted between late 2008 and early 2010. The research had equal representation of male and female students, different races, two campuses and different levels of study. Factors associated with students' sexual behaviour were identified. The data were analysed using thematic analysis, and the themes identified form the basis for discussion in this paper. Students' sexual behaviour was positively associated with the influence of a range of biological factors. Factors such as age, judgement of the health of the partner by looking at appearances, pursuit of physical beauty, sexual debut, sexual fit, and search for sexual pleasure encouraged students to engage in sexual behaviour. Most students are young and lack experience in assessing the influence of biological factors on their sexual behaviours, and need education on biological factors. This poses a big challenge to controlling students' sexual behaviour, especially if HIV and sexually transmitted diseases prevention interventions are to be successful.

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Studies in South African universities reveal that the prevalence of sexual risk behaviour is very high; putting many students at high risk of HIV infection. This study explored the biological influences on students' sexual taking behaviour at the University of KwaZulu-Natal; South Africa. A qualitative approach was used; comprising a total of 80 in-depth interviews and 4 focus group discussions. These were conducted between late 2008 and early 2010. The research had equal representation of male and female students; different races; two campuses and different levels of study. Factors associated with students' sexual behaviour were identified. The data were analysed using thematic analysis; and the themes identified form the basis for discussion in this paper. Students' sexual behaviour was positively associated with the influence of a range of biological factors. Factors such as age; judgement of the health of the partner by looking at appearances; pursuit of physical beauty; sexual debut; sexual fit; and search for sexual pleasure encouraged students to engage in sexual behaviour. Most students are young and lack experience in assessing the influence of biological factors on their sexual behaviours; and need education on biological factors. This poses a big challenge to controlling students' sexual behaviour; especially if HIV and sexually transmitted diseases prevention interventions are to be successful

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The prevalence of sexual risk behaviour is high on campuses at South African universities, putting many students at risk of HIV infection. This study explores individual influences on students' sexual risk-taking behaviour at the University of KwaZulu-Natal. The study collected cross-sectional data obtained between late 2008 and early 2010. A total of 80 in-depth interviews and four focus group discussions were conducted, allowing for an equal representation of males and females and a mix of different races (black, white, Indian and coloured) among students at two campuses (Howard College and Pietermaritzburg) and at different levels of study (undergraduate and postgraduate). The data were analysed using thematic analysis to identify factors associated with the students' sexual risk behaviour. Sexual risk behaviour was found to be influenced by a range of individual factors, especially: personal beliefs about long-term relationships; attitudes towards sex for variety; a drive for material wealth; a lack of satisfaction in relationships; levels of trust and attention; pursuit of the long-term goal of marriage; and HIV denialism. As young adults, university students lack experience in assessing influences on their risk-taking behaviour, thus they require education on the individual risk factors that put them at risk of acquiring HIV infection. Likewise, the nature of these factors pose significant challenges to reducing sexual risk behaviour among university students.

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A dire health worker shortage in Zambia's national health programs is adversely impacting the quantity and quality of health care and posing a serious barrier to achieving Millennium Development Goals to improve population health. In 2005, Zambia's Ministry of Health developed a 10-year strategic plan for human resources for health to address the crisis through improved training, hiring, and retention. The plan has neither arrested nor reduced the shortage. We review the causes of the shortage, present results from a health worker survey showing that safe work conditions, manageable workloads, and career advancement opportunities matter more to respondents than financial compensation. We comment on the adequacy of government efforts to address the health worker shortage.

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