Research Articles (Business Management)

Permanent URI for this collectionhttp://hdl.handle.net/2263/2508

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A public sector reputation management framework for South Africa’s Eastern Cape Provincial Government
Msiya, Mgwebi; De Beer, Estelle (University of the Free State, 2025-12)
Reputation management was synonymous with the private sector until recently when public sector organisations, particularly in Europe and America, adopted the concept. This study's aim is to contribute to the scant body of knowledge on public sector reputation management, specifically in South Africa's Eastern Cape province. The study adopted a qualitative approach to gain an understanding of the public perceptions of the Eastern Cape Provincial Government's reputation. The findings were based on two participant observations and a purposively selected sample of 15 participants who were recruited from non-governmental organisations (NGOs), media institutions, government departments, youth structures, and business organisations. The study utilised semi-structured interviews and participant observations as data collection techniques. The collected data was analysed thematically through categorisation and Leximancer software analysis. The results of the study show that the Eastern Cape Provincial Government lacks the capacity to manage its reputation strategically, resulting in increasingly discontented communities. Furthermore, the findings reveal that the public held negative views of the Eastern Cape Provincial Government's reputation. The Public Sector Reputation Management Framework, which was developed in this study, provides an understanding of how the Eastern Cape Provincial Government's reputation could be strategically and sustainably managed.
Box-Jenkins modelling of inflation rates in Ghana : a data-driven approach
Essel-Mensah, Kojo A.; Ofori, Michael K.; Brocke, Naa N. J.; Ashiagbor, Albert Ayi (Pushpa Publishing House, 2025-11)
Inflation is a pivotal economic indicator that influences business activities and livelihoods. The escalating trend of inflation rates globally has led to business closures and widespread economic hardship. This study employs the Box-Jenkins methodology to develop predictive SARIMA and SARIMAX models for Ghana’s monthly inflation rates. The models capture both seasonal and non-seasonal inflation rate components, as well as the impact of external factors such as the Ghana-US exchange rates. Our findings indicate that the SARIMA model provides more accurate inflation rate predictions. The results have significant implications for monetary policy and inflation targeting in Ghana. Furthermore, the methodology is universally applicable to macroeconomic forecasting problems.
Catalysts of inclusive innovation : a multi-theoretical study of digital innovation hubs in Africa
Gumbo, Edwell; Moos, Menisha (AOSIS, 2025-12-10)
ORIENTATION : Africa continues to face structural challenges, including youth unemployment, digital exclusion and fragmented innovation ecosystems. Digital innovation hubs (DIHs) have emerged as strategic platforms that bridge these gaps by supporting entrepreneurship and digital transformation. RESEARCH PURPOSE : This study investigated how DIHs act as catalysts of inclusive innovation and economic development in Africa using a multitheoretical framework. MOTIVATION FOR THE STUDY : Despite their expanding presence, limited scholarly work explores the role of DIHs within African innovation systems. This study addresses that gap by assessing their ecosystemic, institutional and developmental contributions across diverse contexts. RESEARCH DESIGN, APPROACH AND METHOD : A qualitative, exploratory research design was adopted. Semi-structured interviews were conducted with DIH managers and startup founders across 12 African DIHs affiliated with the African European Digital Innovation Bridge Network initiative. Thematic analysis was used to derive insights into their structure, function and influence. MAIN FINDINGS : The study identified six thematic impact areas, namely startup empowerment, inclusive participation, ecosystem integration, transformative education, sustainability orientation and policy alignment. Digital innovation hubs serve not only as startup enablers but also as institutional anchors that facilitate knowledge exchange, derisk entrepreneurship, and expand access to digital tools and markets. PRACTICAL/MANAGERIAL IMPLICATIONS : The DIHs should be supported through sustained investment, policy integration and inclusive programming. Their role as conveners of public–private collaboration positions them as key agents of development. CONTRIBUTION/VALUE-ADD : By applying the Knowledge Spillover Theory of Entrepreneurship, Institutional Theory and Cluster Theory, this study offers a novel conceptual framing of DIHs in African contexts. It contributes empirical evidence and strategic insights for designing scalable and context-sensitive innovation ecosystems.
Measurement approaches for corporate impacts on ecosystem condition : current landscape and future priorities
Bedford, Jacob; Houdet, Joel Robert Auguste; Berger, Joshua; Grigg, Annelisa; Harrison, Michelle; Calhoun, Emma; Brooks, Sharon (Wiley, 2026)
1. Ecosystem condition is an important concept for understanding the impacts and dependencies of business on biodiversity and consideration of it is recommended by assessment and disclosure frameworks, including the Corporate Sustainability Reporting Directive, Taskforce on Nature-related Financial Disclosures (TNFD) and Global Reporting Initiative (GRI). 2. Approaches for measuring corporate impacts on ecosystem condition vary in their underlying methods and metrics. This creates uncertainty in their use by business. Here, we discuss the appropriateness of different approaches in different decision-making contexts, including the selection of appropriate reference conditions and granularity of metrics. 3. The assessment of company impacts on ecosystem condition should be seen as an iterative process with flexibility to continually improve approaches over time as new methods and data emerge to fill key knowledge gaps.
Exploring strategy message affordance as mediator to strategy translation for enhanced implementation
Serfontein-Jordaan, Muriel; Pretorius, Marius; Kunz, Leanne; Letsholo, Rebaona (AOSIS, 2026-01-13)
ORIENTATION : Strategy implementation remains a persistent challenge in strategic management, with many organisations failing to bridge the gap between formulation and execution. RESEARCH PURPOSE : This study introduces the concept of strategy message affordance and investigates its role in enabling effective strategy translation, which is posited as a precursor to enhanced implementation outcomes. MOTIVATION FOR THE STUDY : Given the ongoing implementation gap observed in organisations, there is a need to explore alternative explanatory mechanisms better understand and address implementation failures. RESEARCH DESIGN, APPROACH AND METHODS : Using a qualitative research design, the study draws on semi-structured interviews conducted across two case organisations. Thematic analysis was used to identify patterns relating to message interpretation, strategic alignment and implementation dynamics. MAIN FINDINGS : The study finds that enhanced implementation is enabled when the strategy message is consistently and personally conveyed, supported by inclusive organisational culture, cohesion and open communication. Furthermore, a management team that engages directly, demonstrates contextual awareness and recognises employees as individuals fosters trust, leading to improved strategic alignment at lower levels. PRACTICAL/MANAGERIAL IMPLICATIONS : Organisations aiming to improve strategy execution should invest in deliberate, contextualised communication strategies and foster leadership behaviours that build interpersonal trust and collective understanding of the strategic agenda. CONTRIBUTION/VALUE-ADD : This study advances the strategic management literature by conceptualising SMA and linking it to implementation success via the mediating role of strategy translation.
Volitional competencies and behavioral dynamics of early-stage youth new venture teams : crossing the entrepreneurial Rubicon
Taruona, Honest; Botha, Melodi (Emerald, 2026-12)
PURPOSE : Volitional competencies, specifically self-regulation and self-control, are recognized as critical during the early stages of new venture creation, when New Venture Teams (NVTs) actively engage in business formation. Similarly, behavioral dynamics such as team collaboration and cohesion also play a crucial role in business venture creation. Yet, the specific individual volitional competencies and their relationship to the behavioral dynamics within youth NVTs remain underexplored. The purpose of this paper is to explore these volitional competencies and behavioral dynamics after NVTs cross the entrepreneurial Rubicon. DESIGN/METHODOLOGY/APPROACH : Quantitative data was collected on a sample of 515 South African early-stage youth team members regarding seven self-regulation and five self-control volitional competencies and team collaboration and cohesion as the behavioral dynamics. These youth NVTs have crossed the entrepreneurial Rubicon stage, as they created new businesses and are owners/founders of these businesses. FINDINGS : Drawing on the Mindset theory of action phases and the self-regulation theory, this study empirically tested the correlational relationship through structural equation modeling. The findings indicate that the self-regulation volitional competencies, particularly attention focusing, self-motivation, emotion regulation, decision regulation and self-determination, as well as the self-control volitional competencies, planning skill and initiating control, significantly influence team collaboration and cohesion. This study challenges the distinction between collaboration and cohesion and combines them as a single construct. ORIGINALITY/VALUE : This study presents a novel theoretical framework that supports eight volitional competencies and two behavioral dynamics that are particularly necessary for early-stage youth NVTs to create new ventures. The findings could contribute to new theoretical construct development, policy formulation, measuring instruments and training programme design.
Impact of ethical leadership on organizational citizenship behaviour : group- and individual-level mediators
Mapena, William Lekgoa; De Jongh, Derick (African Sun Media, 2025-12)
Numerous occurrences of unethical conduct by leaders over the last decade, as well as the proliferation of unethical conduct, have had detrimental effects on their respective organisations and businesses. The undesirable behaviour affects the ability of followers to voluntarily perform beyond contractual obligations. The article examines the impact of ethical leadership on organisational citizenship behaviour (OCB), focusing on individual- and group-level mediators. The domain of ethical leadership and its impact on OCB is not sufficiently investigated. The research focused on a South African state-owned company in the water services industry using a qualitative case study approach. The research findings identified group- and individual-level mediators and found thatethical leadership positively influences employee OCB. The research findings add to the literature on ethical leadership–OCB by examining how followers respond to the sequential mediation effect and by offering insight on integrating mediation variables.
Corporate sustainability in Africa : a review, trends and future direction
Monkge, Tshegofatso A.; Le Roux, Catherine; Letsholo, Rebaona Gladness (Taylor and Francis, 2025-11-19)
As the world grapples with grand challenges, Africa remains the most affected yet receives the least research focus. This study adopts a systematic scoping review to analyze the extent of corporate sustainability research in Africa. Using a predetermined search strategy applied to the comprehensive ABI/INFORM Global database, 107 articles were analyzed. This paper's contribution is threefold: (1) it reviews literature to provide an African perspective of corporate sustainability; (2) it critically synthesizes findings in the dataset to illuminate contributions and research gaps; and (3) it provides recommendations for potential future studies and policy implications to enhance management scholarship and practice.
Advancing scholarship where Africa-based scholars dominate : a systematic review of migrant entrepreneurship in Africa
Fubah, Clavis Nwehfor; Barnard, Helena (Taylor and Francis, 2025-11-07)
Migrant entrepreneurs are generally assumed to come from rather than settle in Africa. This paper systematically reviews scholarship on immigrant entrepreneurs operating on the continent, a topic of interest to Africans more than the general scholarly community. Using Scopus and two Africa-focused databases, Africa Journals Online and Sabinet, we identified 123 relevant papers. Papers cross various disciplines are generally descriptive, theory-poor, from unranked journals, and with South Africa strongly overrepresented. Currently, papers mostly mirror themes from work in high-income contexts, with resourcing an important exception. We highlight opportunities to further advance research on the challenges of and diverse types of resources in a resource-poor context. The need to include Africans into scholarly endeavors is often expressed, but in this case African scholars dominate. We discuss how African scholars can improve the quality and impact of their work, both by facilitating the emergence of a community around the topic and thematically.
Leadership emergence and missional theology : a biographical leadership study of Nelus Niemandt
Steenkamp, Yolande (AOSIS, 2025-09-03)
This article explores the emergence of leadership within ecclesial and secular contexts through a biographical case study of Prof. Nelus Niemandt, a prominent South African church leader and theologian. Drawing on leadership emergence theory and social constructionist perspectives, the study investigates how leadership identities are collectively granted, individually internalised and contextually shaped. By analysing Niemandt's own reflections on his life, ministry and leadership journey, the article provides empirical insight into the relational, adaptive and often subversive nature of leadership in faith communities navigating systemic change. The study traces Niemandt's development from a conventionally socialised Afrikaner youth to a leading proponent of relational and missional leadership. It highlights his formative influences, his resistance to hierarchical structures and his role in institutional innovation, particularly in integrating systems theory, Trinitarian theology and the missional turn into church life. Rather than portraying leadership as individual heroism, the study foregrounds communal discernment, shared agency and the importance of marginal voices. The narrative arc culminates in a vision of anticipatory leadership - marked by trust, vulnerability and agility - as demonstrated in Niemandt's final leadership role at Hugenote Kollege. INTRADISCIPLINARY AND/OR INTERDISCIPLINARY IMPLICATIONS : By situating this journey within the broader theological and social transformations of post-apartheid South Africa, the article contributes to both leadership studies and missional ecclesiology. It argues that the future of leadership in the church lies in relational networks of trust and discernment rather than centralised authority, and calls for renewed theological reflection on leadership as a collective vocation.
Integrating climate and environmental data with Bayesian models for malaria prediction
Sehlabana, Makwelantle Asnath; Maposa, Daniel; Das, Sonali (International Academic Press, 2025-09)
Malaria remains a notable public health challenge in endemic regions, with an estimated 263 million cases and 579,000 malaria-related deaths globally in 2023. Climate and environmental factors, such as temperature, rainfall, and the Normalised Difference Vegetation Index (NDVI), play a crucial role in malaria transmission. While statistical models aid in malaria prediction, Bayesian methods remain underutilised despite their ability to incorporate prior knowledge into predictive models. The major contribution of this study is to develop a Bayesian malaria prediction model incorporating climate and environmental data. Both objective and subjective prior distributions are evaluated to determine their effectiveness in improving model performance. The results indicate that a subjective prior outperforms other priors. Additionally, Ehlanzeni (Mpumalanga), Vhembe and Mopani districts (Limpopo) are identified as high-risk malaria regions. The findings suggest that malaria transmission peaks in summer and autumn, particularly in areas where temperatures during the night range from 12°C-20°C, rainfall is moderate (100–200 mm), and NDVI exceeds 0.6. Malaria risk intensifies following months of accumulated rainfall, creating optimal mosquito breeding conditions. These insights may assist malaria control programmes in developing targeted interventions, such as early warning systems and vector management strategies. Future research will explore Bayesian machine learning for malaria prediction.
Technology acceptance model – related antecedents and the performance outcome of financial technology adoption in small and medium enterprises
Nyanga, Taguma; Eresia-Eke, Chukuakadibia E. (AOSIS, 2025-10-31)
BACKGROUND : Despite the increasing value of FinTech in emerging markets, empirical research pertaining specifically to South Africa's small and medium enterprises (SME) sector remains scant. Consequently, this quantitative study explores factors affecting the adoption of financial technology (FinTech) solutions by SMEs in South Africa and also interrogates the relationship between FinTech adoption and organisational performance. AIM : The purpose of the study was to investigate factors affecting adoption of FinTech by SMEs in South Africa and the relationship between FinTech adoption and organisational performance. SETTING : Leveraging the technology acceptance model (TAM), the study interrogated the nexus of the constructs of perceived usefulness, perceived ease of use, FinTech adoption and organisational performance of SMEs. METHODS : Data were collected from a purposive sample of 1036 respondents across the country and were analysed using structural equation modelling (SEM), among other statistical tools. RESULTS : Results obtained revealed that both perceived usefulness and perceived ease of use significantly affect FinTech adoption, which subsequently was shown to positively affect organisational performance. CONCLUSION : The findings of the current study affirm that the TAM offers a veritable framework for comprehending FinTech adoption, with perceived usefulness and perceived ease of use as pivotal elements, and further illustrate that FinTech adoption substantially enhances organisational performance among the studied SMEs in South Africa. CONTRIBUTION : Instructively, the research enhances the theoretical comprehension of technology adoption and provides practical insights for policymakers, FinTech developers and SMEs, highlighting the necessity for user-centric and value-oriented solutions in the FinTech sector.
A store-level analysis of frontline employees as enhancers of store loyalty
Kotze, Theuns G.; Mostert, P.G. (Pierre) (Springer, 2025-08)
This study examined the relationships between frontline employees’ (FLEs’) shared perceptions of service-oriented high-performance work systems (SO-HPWSs), work engagement, and service climate. It also investigated how these shared perceptions related to store managers’ assessments of FLEs’ collective in-role and extra-role service performance, customer satisfaction, and store loyalty in the same retail chain. Data were collected from 781 FLEs, 70 store managers, and 803 customers from 70 stores in the same retail chain. Findings showed that SO-HPWSs predict work engagement and service climate; work engagement predicts service climate; and service climate predicts in-role and extra-role service performance and customer satisfaction.
Climate-informed malaria prediction models : a Bayesian approach for South African endemic provinces
Sehlabana, Makwelantle Asnath; Maposa, Daniel; Boateng, Alexander; Das, Sonali (Natural Sciences Publishing, 2025-05)
In this study, we predict malaria cases using climate factors and Bayesian methods. Climate change plays a pivotal role in determining both the geographic spread and severity of malaria outbreaks. Recent research underscores that climate-related factors outweigh other contributors, such as epidemiological, socio-economic, and environmental factors, in the resurgence of malaria cases. The coronavirus disease of 2019 (COVID-19) pandemic have caused a setback in the global strides made towards malaria control and elimination. South Africa has not met its malaria elimination targets, despite strategic plans like the National Malaria Elimination Strategic Plan (NMESP), which emphasises strengthening surveillance systems. Researchers are developing malaria forecasting and prediction models incorporating climate factors, primarily using time series and machine learning techniques. While time series models exhibit shortcomings in long-term forecasting, machine learning models have shown promise in prediction but did not prove granularity in delineating critical malaria seasons or providing climate-specific predictions. This study seeks to edify these models using a Bayesian framework to predict malaria in South Africa’s endemic provinces based on climate and environmental factors. The study found that malaria transmission is high in regions with temperatures of 20-30◦C, rainfall of 0-200 mm, and normalised difference vegetation index (NDVI) levels of 0.5-0.8, predicting 200 to 1000 malaria cases in these conditions. The Ehlanzeni district in Mpumalanga and the uMkhanyakude district in KwaZulu-Natal are identified as high-risk areas with elevated malaria counts. Targeted prevention and control measures are recommended for these districts. Future research should explore malaria prediction using subjective informative prior distributions for deeper insights.
Capital structure decision-making for business turnarounds based on distress severity and reasonable prospect confluence
Van Beek, Coenraad J.S.; Pretorius, Marius (AOSIS, 2025-07-24)
BACKGROUND : The relationship between financial distress severity and the prospect for rescuing a distressed company significantly impacts capital structure decisions. When a company faces distress, its interactions with funders change, directly affecting rescue prospects. AIM : This research proposes objective frameworks to assess distress severity and rescue prospects, aligning them with practical capital decisions. SETTING : This study, set in South Africa with its nascent financial distress legislation and industry, proposes new frameworks to assess distress severity and the likelihood of company rescue. These findings align with capital structure theory and have applications beyond South Africa. METHOD : Using Q-methodology to understand how the confluence between distress severity and rescue potential is crucial for capital structure decisions in business turnarounds. RESULTS : The factor array and loadings point to a confluence of distress severity and the prospects to rescue a business and align with the three main capital structure theories of irrelevance, trade-off and pecking order theories. CONCLUSION : The findings link theories of the severity of distress, reasonable prospect and capital structure in an alternative way and provide a framework for capital structure decision-making in financially distressed companies. This research aims to stimulate further academic research and to have practical applications. CONTRIBUTION : For the first time, this study by using Q-methodology explored different stakeholder perspectives and proposed expanded frameworks for determining the severity of distress and the prospects for rescue. It adapted existing frameworks to be less subjective and more aligned with practical capital structure decisions.
Water management optimization challenges : a supply-side perspective
Jojozi, Fani Nicholas; Mbhele, Thokozani Patmond; Eresia-Eke, Chukuakadibia E. (Springer, 2025-09-01)
Potable water supply interruption is a reality in KwaZulu-Natal and is fast becoming the case for the rest of South Africa. From a supply-side perspective, water management faces significant barriers that hinder the effective and sustainable distribution of water resources. These challenges encompass ageing infrastructure, inefficiencies in resource allocation, and complex operating environments, all of which deflate the capacity to meet rising water demands. Disturbingly, such water supply interruptions, sometimes, leave water consumers without any substitute, which makes the situation more critical and collaterally emphasises the need for water supply to be managed optimally. It is in this backdrop that this study explores the optimization challenges water authorities and suppliers encounter by analyzing the technical, social, economic, and policy-driven barriers that encumber effective water resource management. Furthermore, it highlights red flags on water management and the effects of the decreasing water resources that have encouraged the continued implementation of water shedding, to the detriment of the population. The situation appears to be exacerbated by a growing population, climate change and dwindling water resources. In exploring supply-side limitations affecting the sustainable delivery of water, this study found limited resources, water loss, increasing costs, deteriorating and insufficiently maintained infrastructure, and complex administrations as hinderances to optimal water management.
Strategic critical success factors for multinational enterprises operating in the fast moving consumer goods industry in Nigeria
Ashley, Natasha Lynne; Vogel, Adolf Johan (Adonis & Abbey Publishers, 2025-03)
With a large market and the fourth biggest economy in Africa, Nigeria has attracted the attention of many enterprises in the fast-moving consumer goods industry (FMCG). However, Nigeria presents many challenges, as can be attested to by several multinational enterprises (MNEs) that have in recent times pulled out of this market. Consequently, this study set out to determine what the strategic critical success factors (SCSF) are for MNEs that operate in the FMCG industry in Nigeria. Conducting semi-structured interviews with 13 senior managers of MNEs operating in the Nigerian FMCG industry, the researchers identified 19 SCSFs. Of these, adapting to the external environment, understanding and adapting to consumer needs, and building relationships with stakeholders were found to be the most prominent.
Bayesian prior elicitation for malaria modelling
Sehlabana, Makwelantle Asnath; Maposa, Daniel; Boateng, Alexander; Das, Sonali (Elsevier, 2025-09)
Subjective Bayesian methods, which incorporate expert knowledge into disease modelling, remain underutilised in epidemiology. This is despite the growth of knowledge in statistical approaches to disease analysis. Objective priors are often favoured for their simplicity. However, subjective Bayesian approaches can produce more informative models by using expert insights, such as those related to malaria transmission. This study focuses on translating expert knowledge into prior probability distributions through a process known as prior elicitation. Prior elicitation presents several challenges. Converting expert judgments into probability distributions is complex and often requires specialised tools. Established methods like the Sheffield approach are resource-intensive, requiring considerable time and cognitive effort from both experts and researchers. To address these limitations, this study makes a major contribution by integrating the Analytic Hierarchy Process (AHP) with statistical validation techniques to quantify expert knowledge into prior probability distributions. Expert knowledge was collected through questionnaires and structured as pairwise comparisons. These were quantified into AHP weights, representing the relative importance of environmental factors influencing malaria transmission. The weights were then fitted to various probability distributions and evaluated using goodness-of-fit tests. Results showed that the beta, gamma and normal distributions best represented the elicited expert knowledge. These findings suggest that beta, gamma and normal distributions are suitable as prior distributions in Bayesian models of malaria transmission. By simplifying the elicitation process and reducing technical complexity, this approach offers a practical framework for applying subjective Bayesian methods in epidemiology. Future research will compare these elicited priors with objective priors to evaluate their impact on model performance across domains. HIGHLIGHTS • Innovative Approach: Study uses AHP and statistical methods to enhance expert-informed Bayesian malaria models. • Expert Knowledge Gathering: Expert input on malaria factors was quantified as AHP weights via pairwise comparisons. • Fitting and Validation: AHP weights were fitted to distributions and assessed using goodness-of-fit tests. • Practical Method for Epidemiology: The method simplifies elicitation, aiding practical subjective Bayesian modelling in epidemiology. • Future Research Directions: Future work will compare elicited and objective priors to evaluate Bayesian model performance.
Factors influencing top management team dynamics for successful strategy implementation
Mvubu, Yoliswa S.; Madziva, Tonderayi Jafias; Mathibe, Motshedisi Sina (AOSIS, 2025-09)
PURPOSE : This study explores the factors influencing top management team (TMT) dynamics to successfully implement an organisation’s strategy. It seeks to understand how such factors influence the TMT’s decision-making regarding strategy implementation. DESIGN/METHODOLOGY/APPROACH : A qualitative research approach was utilised for the study, and data were gathered through semi-structured interviews with six C-suite executives and 12 chief executive officers of large corporates across South Africa. Thematic analysis was used to analyse the data. FINDINGS/RESULTS : The study found that emotional acumen and TMT relationships drive successful strategy implementation; the management style that displays effective communication and accountability leads to successful strategy implementation; work gratification propels innovation in strategy implementation; and diversity of group characteristics drives or thwarts collaboration for successful strategy implementation. PRACTICAL IMPLICATIONS : This study enables business leaders, C-suite executives and senior and middle managers to better comprehend the impact of TMT dynamics on strategy implementation. Additionally, the study provides managers and leaders with insights on which TMT dynamics are best to focus on for their respective firms to enhance strategy implementation and ultimately organisational performance. Originality/value: This study is significant and necessary in bridging the aforementioned theoretical gaps on TMT dynamics and strategy implementation.
Informed consent and ethical issues pertaining to female sterilization-scoping review
Maila, Sharol Malekobane; Castelyn, Camille De Villebois; Adam, Sumaiya (Wiley, 2025-06)
BACKGROUND : Female sterilization, a safe, permanent method of contraception that blocks the fallopian tubes, has been in use since the 19th century. The procedure necessitates informed consent, a critical step that has been marred by reports of forced sterilization since World War II. These incidents often stem from inadequate consent processes where ethical principles are overlooked or deliberately flouted. The persistent issue of forced sterilization, primarily attributable to a flawed informed consent process, highlights significant ethical concerns. OBJECTIVES : This scoping review aimed to identify the ethical challenges associated with the informed consent process for female sterilization, including instances of forced sterilization. SEARCH STRATEGY : The review employed a comprehensive electronic search across multiple databases, including PubMed, Scopus, Web of Science, Google Scholar, and ProQuest Central, targeting literature published in English between January 2000 and December 2021. The search strategy utilized key terms related to informed consent, ethical issues, and female sterilization, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) methodology for database search and screening. SELECTION CRITERIA : The search resulted in the inclusion of 55 published articles for this review. Studies were selected if they focused on informed consent for female sterilization and reported on forced or coerced sterilization involving mentally competent women aged 18 years and older. Exclusions were made for studies on women younger than 18 years, those related to emergency procedures, and non–English language publications. DATA COLLECTION AND ANALYSIS : A two-stage screening process was used to assess the relevance of the identified studies, with independent reviewers evaluating titles, abstracts, and full texts. Data were extracted using a predefined tool, and discrepancies were resolved through discussion. The analysis focused on summarizing the ethical issues identified and recommendations for improving the consent process. MAIN RESULTS : The review identified vulnerable populations, particularly women reliant on the state or government for health care, as being at higher risk of forced sterilization. Cases of sterilization without consent, under coercion, sedation, or through inducements/incentives have been reported. Recommendations from international obstetrics and gynecology societies, health organizations, human rights bodies, and local governments have been issued in an attempt to improve the consent process. Notably, the United States implemented a Medicaid consent form in the 1970s, which has yet to be revised, attracting significant criticism for some of its components. Meanwhile, low- and middle-income countries lack standardized tools to address complaints related to this issue. CONCLUSION : This review identifies persistent ethical challenges in the informed consent process for female sterilization globally, with forced sterilization disproportionately affecting vulnerable populations. The review underscores the urgent need for the development and implementation of standardized consent tools, with ongoing review, to protect women's autonomy and prevent unethical practices, especially in low- and middle-income countries.

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