Next Article in Journal
A Joint Bayesian Optimization for the Classification of Fine Spatial Resolution Remotely Sensed Imagery Using Object-Based Convolutional Neural Networks
Next Article in Special Issue
Developing a 3D City Digital Twin: Enhancing Walkability through a Green Pedestrian Network (GPN) in the City of Imola, Italy
Previous Article in Journal
Applicable Framework for Evaluating Urban Vitality with Multiple-Source Data: Empirical Research of the Pearl River Delta Urban Agglomeration Using BPNN
Previous Article in Special Issue
Construction of Ecological and Recreation Patterns in Rural Landscape Space: A Case Study of the Dujiangyan Irrigation District in Chengdu, China
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Land
Volume 11
Issue 11
10.3390/land11111904
land-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Stakeholder Perceptions of the Ecosystem Services of Health Clinic Gardens in Settlements and Small- to Medium-Sized Cities in the North-West Province, South Africa

by
Nanamhla Gwedla
*,
Susanna Francina A. Cornelius
,
Marié J. Du Toit
and
Sarel S. Cilliers
Unit for Environmental Sciences and Management, North-West University, Potchefstroom 2520, South Africa
*
Author to whom correspondence should be addressed.
Land 2022, 11(11), 1904; https://doi.org/10.3390/land11111904
Submission received: 1 October 2022 / Revised: 18 October 2022 / Accepted: 19 October 2022 / Published: 26 October 2022
(This article belongs to the Special Issue Ecosystem Services of Rural Landscapes and Green Infrastructures)
Browse Figures
Versions Notes

Abstract

:
Gardens provide spaces for connectedness to nature, which contributes to human well-being and promotes pro-environmental behavior. However, the provision of ecosystem services (ES) in gardens of sub-Saharan Africa is challenged by a lack of knowledge, resulting in inefficient gardening practices. Stakeholders also influence the manifestation of ES provisioning through their perceptions, learning, and decisions. Health clinic gardens may be able to address some of these challenges where other types of gardens fail because of a lack of awareness of other garden benefits and a lack of gardening skills and knowledge, among other factors. Thus, this study aimed to assess stakeholder perceptions of ES provided by health clinic gardens in the North-West province, South Africa. Survey questionnaires were administered to 218 stakeholders across 105 health clinic gardens to ascertain their involvement and prioritization of the ES provided by the gardens and their perspectives on gardens in general. The diversity and abundance of stakeholders per clinic garden were enumerated based on the respondents’ reports. Stakeholder prioritization of ES was scored out of 5, where 1 is the least prioritization. Health clinic gardens have a diversity of one to five types of stakeholders per garden, and more than 80% of the gardens were reported to have a groundsman. Stakeholders spent 1.5 ± 0.5 to 4.7 ± 0.12 days/week engaged in garden activities. Groundsmen spent the most time (4.7 ± 0.12 days/week) in the gardens, while facility managers spent the least (0.90 ± 0.12). Regulating and cultural ES, each scoring an average of 3.7 out of 5, were perceived as the most valuable ES of health clinic gardens. A “garden” was mainly associated with vegetable cultivation and rarely linked with recreation or aesthetical appreciation. A case for establishing these gardens across the country and other developing countries of the Global South can be made through the assessment of their potential ES from the perspectives of stakeholders. This study addresses this topic and contributes to an understanding of the importance of a variety of stakeholders for maintaining functional health clinic gardens.

1. Introduction

Humans have a natural connection to plants and nature, which may contribute to their well-being [1]. Connectedness to nature has, therefore, the potential to promote pro-environmental behavior [2] and well-being [3]. This relationship relies heavily on the availability and productivity of land [4] and green spaces. These “people–plants” connections and interactions have become increasingly important in settlements and urban areas, especially in the face of the COVID-19 pandemic, when people worldwide were isolated with restricted mobility [5]. Urban green infrastructure (UGI), such as urban forests and parks, public and private open spaces such as gardens, and farmlands [6] provide spaces for such connections among urban communities, and some studies have estimated that gardens and private yards constitute just over 50% of UGI in many cities [7]. Gardens are essential components of urban areas, as they provide a myriad of ecosystem services (ES) [8] which enhance human well-being, reduce vulnerability to social and economic challenges [9], and contribute to human quality of life [10]. Moreover, a study in 2013 rigorously tested and proved the benefits of exposure to nature for human health, suggesting “that total exposure is important; all forms and quantities of exposure are helpful; and the greener the better” [11].
Ecosystem service definitions [12,13,14,15,16] primarily emphasize the dependence of human beings on the multiple benefits obtainable from nature and ecosystems [17]. However, the provision and optimization of ES in the gardens of sub-Saharan Africa are mainly challenged by a lack of knowledge, which may culminate in inefficient gardening practices [9]. Furthermore, the stakeholders involved in these gardens potentially optimize or hinder the manifestation of ES provision through their perceptions, learning, and, ultimately, decisions [18]. A diversity of stakeholders and actors are important in the community and government-funded gardens because they influence the management and functions of these garden systems and potentially provide technologies, strategies, concepts, and ideas that may enhance an ecosystem’s capacity to generate the relevant ES [9]. Despite this, many of these stakeholders, especially in instances where there is limited diversity in the stakeholders involved, are often not aware of the ES provided by such gardens [19]. This ignorance may lead to compromised efforts towards conservation, planting, and the maintenance of biodiversity in these spaces [20]. Therefore, it is important to understand the various types of ES provided by various types of gardens and how the stakeholders involved may contribute to their optimization. This understanding can lead to the implementation of mechanisms to better conserve and maintain the biodiversity of the gardens.
Gardens are classified according to forms of ownership and management, and their purpose determines the variety of ES they provide [9]. They can be privately owned and managed, including home gardens and domestic gardens, or managed by the government, private organizations, health centers, schools, or an organized group of community gardeners. These gardens are community gardens, such as botanical and school food gardens [9]. According to [21], home gardens and other types of community gardens often fail to deliver optimal ES, especially food provision, because of challenges associated with unreliable production [22]. Compromised production may be associated with limited knowledge of garden practices, limited space for agricultural activities [23], insecure land tenure, water accessibility, land use conflicts, weak regulatory frameworks to support agriculture in urban areas [24], and insufficient resources for garden development and maintenance [25]. In South Africa, health clinic gardens are a type of community garden in health centers that have the potential to address some of these challenges and are developed by a variety of stakeholders on government-owned land [9]. Post-1994, the democratic government established health clinics in urban and rural areas all over the country to provide “free, accessible, equitable and integrated” health services to communities [26]. Gardens were then developed at these clinics for the benefit of the local community, specifically by aiding in their nutritional needs [27] by providing fresh fruits and vegetables for patients struggling to maintain a healthy immune system [9]. Correspondingly, these gardens are meant to be accessible to the community within the jurisdiction of the respective clinics. This community garden model is reminiscent of community gardens that are associated with medical facilities in countries of the Global North (GN), which are usually established to “provide fresh produce to patients and their families, serve as platforms for clinic-based nutrition education, and help patients develop new skills and insights that can lead to positive health behavior change” [28].
Health clinic gardens in South Africa are an interesting lens through which to study ecology and biodiversity in the GS. Firstly, these gardens are found in both rural settlements and across the urban matrix and operate according to one framework. This framework makes them an ideal platform for studying and understanding the dynamics of the unique ecology of small towns, which warrants separate studies within a new discipline of town ecology [29]. Secondly, urban ecology can be studied in small- and medium-sized cities, and even in rural settlements, because “it is not always easy to distinguish between urban and rural areas spatially or by a clear reliance on either urban or rural income sources but rather a mix” [29]. In this regard, it is recommended [30] that small towns should be seen as organic parts of the rural region in which they are located rather than just as outcomes of rural economic development. However, only limited knowledge of the urban ecology of small- and medium-sized cities and their settlements is available in the literature, with most studies focusing on larger cities and economic hubs [31].
The provisioning of ES in gardens and agroecosystems has focused mainly on single-provisioning ES, namely food, which has eroded their capacity to deliver a diverse flow of other ES [32]. Provisioning ES directly benefit the people, and many of the poorest households depend on them for subsistence, especially in sub-Saharan Africa [33]. Admittedly, the greatest proportion of agriculture is practiced in domestic, home, and community gardens [34] and is undertaken as a survival strategy by individual households for subsistence or to augment household income [35]. However, considering the variety of potential ES of gardens, a broad spectrum of ES assessments is crucial if the integrity and support of other types of gardens, such as health clinic gardens, is to be championed. The aim of ES assessments is to provide useful knowledge for policies, strategies, and the management of ecosystems to stakeholders [36]. Thus, in the assessments, it is essential to involve a variety of stakeholders early on and explicitly [37]. Analyses and the mapping of ES perceptions by both experts and laymen can be valuable for landscape planning and ES governance that better complies with users’ and beneficiaries’ expectations of gardens [38], specifically those with multiple users and beneficiaries such as community gardens, school gardens, botanical gardens, or health clinic gardens.
While there is little doubt about the multiple ES provided by GI and gardens in particular, perceptions of the biodiversity and, thus, ES of these spaces, in general, are highly variable and may influence their composition and quality in the future [39]. Additionally, the valuation and assessment of ES may also vary with the role and perception of the respective stakeholders and the ES considered [40]. Despite social factors being the primary determinants of the success or failure of ES management strategies [41] and the increasing scientific interest owing to the importance of ES and human well-being in influencing sustainability [42], much scholarly research on ES has focused on biophysical and monetary approaches and on watersheds and forests [43] to evaluate and assess ES globally and in Sub-Saharan Africa. Perceptions on ES and poverty alleviation are emerging topics in ES research [42]. It has become increasingly important for such perceptions to be assessed in ecosystems, such as gardens, owing to their importance for poverty alleviation and dietary diversity [21].
Several studies focusing on ES in GI [33,44] and different types of gardens, such as allotment gardens [45], domestic gardens [46], and home gardens [47,48,49] in rural and urban areas, have been conducted across the globe. Furthermore, significant scholarly research has also been conducted on ES in community gardens, such as botanical gardens [50,51], school gardens [52], and community gardens in general [53,54]. However, there is currently limited scholarly research on health clinic gardens, both in terms of their status as ecosystems in general and their structure and potential for ES provision. Recently, [55] investigated the plant diversity and potential plant utilization in health clinic gardens and noted their resemblance to home and domestic gardens, earmarking them as potential alternative sources for various ES where other garden types fail. These garden types fail because of a lack of awareness of the benefits, a lack of gardening skills and knowledge, and the cultural loss of utilitarian gardens, among other reasons [21]. Health clinic gardens are potential alternatives because of the similarities in floristic composition and diversity between them and home gardens. Cilliers et al. (9) initially explored the role of gardens in Sub-Saharan Africa as ES providers for urban and peri-urban communities. They put forward the argument that health clinic gardens are examples of social-ecological systems that form an important part of GI in urban and peri-urban areas of Sub-Saharan Africa, potentially fulfilling different types of provisioning, supporting, regulating, and cultural ES which are often intertwined. In that study, they suggested that involving a variety of stakeholders in garden ecosystems may lead to the development of powerful social networks across different scales. They further proposed that the perceptions of different stakeholders involved in gardens in terms of ES provision should be determined as an initial step toward knowledge co-production and social learning. Furthermore, an understanding of stakeholders’ perceptions of gardens and the ES they provide may contribute to the design of better management mechanisms that will lead to efficient and productive health clinic gardens. Consequently, this current study aimed to assess stakeholder perceptions of ES provided by the health clinic gardens of different local municipalities in rural settlements and small- and medium-sized cities. Three distinct objectives are addressed:
  • To provide an overview of the stakeholders’ involvement, abundance, and diversity in health clinic gardens.
  • To evaluate stakeholders’ perceptions of the ES of health clinic gardens.
  • To assess the relationship between stakeholders’ expertise and their perceptions of ES of health clinic gardens.
We hypothesized that by virtue of being government-owned, located in the same province, and operating according to the same framework, all health clinic gardens would have a similar abundance and diversity of stakeholders. Furthermore, we hypothesized that the garden stakeholders that are directly involved over longer periods of time would be more cognizant and have positive perceptions of the ES provided by health clinic gardens.

2. Materials and Methods

2.1. Study Area

This study was conducted in 105 health clinic gardens in the Bojanala District Municipality of the North-West Province, South Africa. The province is located inland in South Africa, bordering Botswana (Figure 1), and covers 104,882 km2 of land [56]. The Bojanala District Municipality is the third largest of the four district municipalities in the province and covers an area of approximately 18,333 km2. There are five local municipalities in the district, namely Kgetlengrivier, Madibeng, Moretele, Moses Kotane, and Rustenburg. The largest, Rustenburg, has 626,522 people [56]. Each of these municipalities has varying numbers of health clinic gardens, namely Moses Kotane = 42; Moretele = 22; Madibeng = 21; Rustenburg = 17; and Kgetlengrivier = 3.
Bojanala District Municipality is in the Savanna Biome in the central Bushveld area, which includes 22 vegetation units [57]. The vegetation consists mainly of thorny woodland (Vachellia species dominant), which can be dense or open, with a herbaceous layer consisting of grasses and forbs [57]. The altitude of this area is 1000–1500 m above sea level, characterized by summer rainfall and dry, frosty winters, with approximately 550–650 mm of rainfall per year, but it can increase to 700 mm in the more eastern parts [58]. The mean maximum and minimum monthly temperatures are 36.7 °C in summer and −0.4 °C in winter, respectively [58].
The population of the Bojanala District (1,671,586 people) constitutes 44% of the total population of the North-West Province and is comprised of 501,696 households [56]. In the district, there are 121 healthcare facilities and 23 mobile clinics that provide primary health care [59]. While there are several assets, such as platinum mining, agriculture, and industrial development, as well as recreation and tourism (Sun City and nature reserves) in this area, which contribute to job creation [60], most of the district’s population experience poverty rates above 40% [58]. Recent statistics indicate that 53% of the population in the district are living in poverty [59].

2.2. Stakeholders in Health Clinic Gardens

Health clinic gardens typically have a variety of stakeholders who actively participate in their day-to-day running, including clinic personnel such as facility managers, medical personnel, groundsmen/gardeners, nutrition specialists, caregivers, patients, traditional health practitioners (THPs), and experts (Table 1). Typically, the most involved stakeholders are the clinic personnel, with at least one expert overseeing several clinics [9]. Stakeholders’ contribution to health clinic gardens includes leadership and facilitation; providing home-based care, whereby selected individuals are permitted to harvest produce from the garden to distribute it to patients in the home-based care program; maintaining social order and managing access to the gardens; and providing technical and scientific knowledge (Table 1).

2.3. Data Collection

The areas where the health clinics are situated were classified into three settlement types based on their population size and proximity to the largest urban center in the respective local municipalities. These classifications were: (1) small rural settlements representing areas with a population of less than 5000 people and beyond a 50 km radius of the closest urban center, (2) large rural settlements representing areas with a population of 5000–20,000 people within a 50 km radius of the closest urban center, and (3) small- and medium-sized cities representing areas with a population of over 20,000 people and within a 25 km radius of an urban center. These classifications were guided by Van Hysteen and Botha [61].
Data collection surveys took place in the health clinic gardens previously sampled by Cilliers et al. (9). The surveys were conducted in person with at least two stakeholders involved in the health clinic garden of each clinic who were available at the time and who consented to the interview. Stakeholders were identified using the guidelines provided by Cilliers et al. (9), as summarized in Table 1. Initial access to the clinics and gardens was negotiated with the provincial Department of Health and Primary Health Care managers of the various sub-districts (local municipalities). Informed consent (verbal and written) was sought prior to the interview. The interviews included questions on experiences in the health clinic garden and the perceptions of the benefits provided by the garden. These perceptions were tabled in a pre-populated list and were then grouped according to a variety of ES. The questions were both open- and closed-ended, mainly consisting of Likert scale questions that were then used to assign the respondents’ ratings of the respective ES. They included questions on the respondents’ roles in the garden, how many other people are involved in the garden and their roles, how much time the respondents spend doing work associated with the garden, and perceptions of the ES provided by the gardens. Perceptions included questions probing what respondents get from the garden and precisely what the garden produces, whether they had encountered any other organisms in the garden, how being in the garden space makes them feel, and how they perceive the garden in general. Responses to the questions were recorded directly on the questionnaire, and notes were taken regarding any statements that respondents made which were not part of the survey but were relevant. Demographic data were also recorded, such as the respondents’ gender, duration of involvement the garden, and the capacity in which they were involved. The interviews were conducted in the respondents’ preferred language (Setswana, English, or Afrikaans) with interpretation services where required and lasted approximately 45 min.

2.4. Data Analysis

The questionnaire data were translated into English before analysis. The questionnaires were then reviewed and quality-checked before analysis. The data on different types of stakeholders involved in the respective health clinic gardens were recorded based on respondents’ reports of the personnel involved in the gardens, their roles, and the frequency of their involvement. Stakeholder abundance was determined by enumerating the number of people who have been or are currently involved in the health clinic gardens within the broader population of people involved or associated with the health clinic. Diversity was determined by enumerating the number of people in each stakeholder category. The benefits associated with the health clinic gardens were categorized according to the different ES, namely provisioning services, regulating services, supporting services, and cultural services [14]. The responses to open-ended questions were coded and assigned to the related ES categories. The rating of ES was determined using the responses to the Likert scale questions, where a “strongly disagree” response corresponded to a score of 1, and a “strongly agree” response corresponded to a score of 5.
Preliminary data analyses were conducted using Microsoft Excel 2013, the Statistical Package for Social Sciences (SPSS 27), and interpolating techniques in ArcMap (ArcGIS). The inverse distance weighted (IDW) method was used to spatially interpolate data on the diversity, abundance, and perceptions of stakeholders onto the district map to demonstrate patterns of stakeholder distribution across the district. ANOVA tests were used to analyze the differences between independent variables, such as the differences in the time spent by stakeholders in garden activities in the various municipalities. Chi-square tests were used to analyze the association between the size of the health clinic garden and the diversity and abundance of stakeholders involved. The association between the time spent in gardens and the rating of ES was determined using Pearson’s r correlation analysis. The differences in the ratings of the selected ES between the municipalities were determined using t-tests. A thematic analysis was also used to identify the themes emerging from the discussions related to how the respondents perceive health clinic gardens. The themes were then coded, and quasi-statistics were performed to report on the dominant themes.

3. Results

3.1. Sample Profile

The study sample included clinics in and around rural settlements and small- and medium-sized cities. A total of 218 respondents across these clinics participated in this study. Of these participants, 61% were female and 44% were facility managers (Table 2). Their service at the clinics, in general, ranged from a few months to 30 years.

3.2. Diversity and Abundance of Stakeholders

The diversity of stakeholders ranged from one to five types of stakeholders per health clinic garden across all clinics, including groundsmen, caregivers, members of the CWP, facility managers, THPs, and others. Forty-five health clinic gardens had three different types of stakeholders involved, while five had only one stakeholder involved (Figure 2). Almost all health clinic gardens (93%) had a facility manager (or an assistant) involved in the garden, and 22 health clinic gardens did not have a groundsman tending to the garden. Of these, 59% were in Madibeng Local Municipality (Figure 2). Caregivers were reported to be involved in 48% of health clinic gardens, and 46% of those gardens were in small rural settlements. The settlement type in which the health clinic garden was situated had no significant bearing on the diversity of stakeholders involved in each garden (χ2 = 1.1; p > 0.05), and the diversity of stakeholders was not linked to the population size of the municipality (R2 = 0.21; p > 0.05).
The most abundant stakeholders across all health clinic gardens were the facility managers (100 clinics), groundsmen (84 clinics), and caregivers (49 clinics). Most health clinic gardens (64%) had up to 8 individual stakeholders per garden, while some clinics in the Moretele and Kgetlengrivier local municipalities had more than 40 stakeholders involved per garden (Figure 3). Despite these anomalies, there were no significant differences in the abundance of stakeholders in health clinic gardens between the various municipalities (χ2 = 8.7; p > 0.05).
The abundance of stakeholders in health clinic gardens located in small and large rural areas ranged from 1 to 41 stakeholders in a single health clinic garden. In contrast, a range of 1–38 stakeholders were located in a single health clinic garden in small- and medium-sized cities. As such, differences in stakeholder abundance were not significant (χ2 = 1.2; p > 0.05) between health clinic gardens located in small rural areas and those in small- and medium-sized cities (χ2 = 3.3; p > 0.05); between those in small and large rural areas (χ2 = 7.4; p > 0.05); and between those located in small- and medium-sized cities and large rural areas (χ2 = 4.2; p > 0.05). Of the eight health clinic gardens that had just one stakeholder involved, six were in Madibeng Local Municipality, and four of these were situated in large rural areas. The abundance of stakeholders in each health clinic garden could not be linked to the population size of the municipalities (R2 = 0.19; p > 0.05).

3.3. Time Spent in Gardens

The time that stakeholders spent engaged in garden activities in the gardens ranged from 1.5 ± 0.5 to 4.7 ± 0.12 days per week across all health clinic gardens, with an average of 2.7 ± 0.13 days per week spent by all stakeholders. Groundsmen spent more time (4.7 ± 0.12 days per week) in the health clinic gardens than all other stakeholders, while facility managers spent less time (0.90 ± 0.12) than other stakeholders. There was a weak correlation between the abundance of stakeholders and the time spent on garden-related activities (r = 0.052; p > 0.05), as well as between the diversity of stakeholders and the average time that stakeholders spent on garden activities (r = 0.12; p > 0.05). The duration of time that stakeholders spent engaged in gardening activities varied across the municipalities. Stakeholders in the Moretele and Moses Kotane local municipalities spent approximately 4.3 ± 0.10 days engaged in gardening activities, compared to those in the Rustenburg (3.6 ± 0.17), Katlengrivier (3.2 ± 0.2), and Madibeng (2.1 ± 0.33) local municipalities.

3.4. Stakeholders’ Perceptions of Ecosystem Services

Regulating and cultural ES, each scoring an average of 3.7, respectively, were perceived as the most valuable ES provided by health clinic gardens (Table 3). Within regulating services, the regulation of the local climate was perceived as the most valuable ES provided by health clinic gardens. At the same time, the spiritual/sense of place was the highest-rated cultural ES. Facility managers were the most vocal about health clinic gardens providing food, spiritual/sense of place, and social networking ES compared to all other stakeholders, as evidenced by their mean allocation of scores above 4 for these categories of ES. In total, 94% percent of respondents indicated that health clinic gardens were used for food, while 57% associated the gardens with the provision of medicinal plants. Supporting services were the least recognized ES provided by health clinic gardens (Table 3), and these were mainly recognized by facility managers.
Compared to other municipalities, more stakeholders in Moretele Local Municipality (76%) rated spiritual/sense of place higher than other ecosystem services compared to stakeholders in the Moses Kotane (65%), Madibeng (62%), and Rustenburg (51%) local municipalities. While Moretele Local Municipality had the highest proportion of stakeholders rating cultural services, regulating services, and provisioning services highly, Rustenburg Local Municipality had the lowest proportion. However, significant differences in these scores were only apparent between cultural services (t = 33.1 p < 0.05).
Facility managers perceived ES of health clinic gardens less positively than both groundsmen and caregivers (Figure 4). Most facility managers’ perceptions of ES scored 3 and below, compared to perceptions that scored 4 and above among groundsmen and caregivers (Figure 4). However, the differences in these perceptions were not significant (χ2 = 3.2; p > 0.05). Overall, groundsmen and caregivers had similar perceptions about the ES provided by health clinic gardens. There was a large margin in the opinions regarding ES between facility managers and the groundsmen. This margin may potentially lead to disagreements, or it could enrich the diversity of opinions for enhanced knowledge.
While regulating and cultural ES services were scored the highest, the most dominant theme regarding ES in health clinic gardens was related to growing food and was less linked with recreation or aesthetical appreciation. Specifically, facility managers scored the provision of food by health clinic gardens the highest (average score of 4.42), which, overall, was perceived as equally important with spiritual and sense of place ES. Most stakeholders showed great appreciation for the growing of plants, especially fruit and vegetables. Essentially, the concept of a “garden” was mainly associated with food or vegetable cultivation and rarely linked with recreation or aesthetical appreciation. In the instances where recreation and aesthetics were exalted, the appreciation was more about the cleanness, openness, and greenness of the garden than about beauty and ornamental plants.
Gardens were also referred to as places of education, where knowledge about which plants to cultivate and when to cultivate them is obtainable. Soil quality was predominantly less well-understood, and there was limited understanding of its importance for the health of plants. Similarly, stakeholders were less cognizant of the positive contributions made by earthworms to soil fertility. Groundsmen were more aware of these phenomena than other stakeholders, ranking biological control, soil quality, and local climate regulation as ES associated with health clinic gardens higher than other stakeholders.

4. Discussion

This study assessed stakeholder diversity, abundance, and perceptions of ES provided by health clinic gardens in rural and urban areas. The results help us to understand what aspects of health clinic gardens different stakeholders value the most and broadly contribute to our appreciation of health clinic gardens as valuable ecosystems which provide the natural connection to plants required by humans for their well-being.

4.1. Stakeholders in Health Clinic Gardens

Health clinic gardens are characterized by a variety of stakeholders who perform a variety of tasks. The diversity and abundance of stakeholders involved in the health clinic gardens assessed in this study are uniform and resemble the findings of Cilliers et al. [9]. They established that health clinic gardens in the North-West Province of South Africa have a variety of stakeholders involved, including clinic personnel, caregivers, traditional health practitioners, and community members. These stakeholders are involved in gardening practices that enhance ES in health clinic gardens. However, the diversity and abundance of stakeholders reported in this study are relatively lower than the levels that Cilliers et al. [9] suggested as typical. The differences in the diversity and abundance of stakeholders may be attributed to the varying sizes of the clinics and the different services they offer. Notwithstanding this, the distribution of stakeholders in these gardens is expected, because all the clinics are managed by the same provincial department of health and district. As social resources, some stakeholder types in clinics are predominantly allocated by the government by means of employment or as part of clinic committees [62]. Clinic committees are key structures that allow for community participation in the governance of primary healthcare facilities in South Africa and comprise of members nominated by the community [63].
As types of community gardens, health clinic gardens are heterogeneous systems which, in addition to providing food security, are characterized by community activism, social interactions, and cultural expression [18]. These characteristics are brought to life by various stakeholders who contribute to the smooth running of the gardens. Stakeholders are important social resources in health clinic gardens because “the flow of ES to people and the surrounding environment often does not occur autonomously but requires substantial human contributions” [64], which may affect the degree to which ES are produced in gardens. Human contributions are especially crucial for provisioning and cultural ES, where certain agricultural practices need to be employed in the cultivation of food or crops for general well-being, along with plants to preserve certain cultural landscape characteristics and fulfil the identified aesthetic appreciation of landscapes. This study revealed the importance of stakeholders, such as groundsmen, who tend to the gardens. The value of groundsmen in health clinic gardens was evidenced by the proportion of health clinic gardens that have groundsmen compared to those that do not. Only 18% of gardens did not have a groundsman explicitly dedicated to tending to the garden. However, the gardens without groundsmen were no different than those with at least one, and Cilliers et al. [9] suggested that this may be a case of redundancy, where the role of one type of stakeholder can be replaced by others in times of need. Furthermore, this may very well imply the presence and effectiveness of champions interested in building the resilience of health clinic gardens [9]. The champions may be any type of stakeholder, but they often take the lead in garden management.
According to Hoover et al. [65], some form of leadership in gardens engenders sustainability because this may make it easier to take up any challenges preventing the ecosystem from providing optimum ES. Furthermore, partnerships among stakeholders are another important aspect of the management and sustainability of gardens. Specifically, partnerships with the community are associated with thriving gardens [65]. Partnerships with the community were not evident in the current study, where only six respondents indicated the involvement of the community as part of the group of stakeholders in health clinic gardens. Notwithstanding this, health clinic gardens have the potential to contribute to community empowerment, cultural preservation, and expression [9]. As much as community involvement and engagement are appraised as potential contributors to successful community gardens [66], the extent and degree of this involvement and engagement differ based on the purpose and needs of the respective gardens [67]. Specifically, the intended purpose of health clinic gardens is to target a particular demographic within the broader community. As such, it may be unlikely that the broader community outside this demographic are aware of, or even involved in, activities associated with health clinic gardens. The limitation on broader community involvement illuminates the importance and usefulness of individual champions. According to Rogers [68], champions are charismatic individuals who provide enthusiastic support for innovation, thus overcoming indifference or resistance. While these individuals are important for the development of resilient governance systems in gardens, dependence on single individuals for the success and efficiency of health clinic gardens should be avoided [9].

4.2. Perceptions of Ecosystem Services

Our results on the perceived ES provided by health clinic gardens are reminiscent of those reported for urban gardens in Spain by Camps-Calvet et al. [69]. They identified 20 ES of urban gardens spanning the regulating, provisioning, cultural, and supporting ES. Furthermore, they suggested that ES of urban gardens are important for addressing some of the urban policy challenges, such as promoting the stewardship of urban ecosystems, providing opportunities for recreation and healthy lifestyles, and promoting social cohesion in cities. Camps-Calvet et al. [69] demonstrated an overwhelming dominance of cultural and regulating services. In terms of the health clinic gardens, cultural and regulating ES also scored the highest, and among these, spiritual/sense of place, social networking, and the regulation of the local climate were highly rated.
The high rating of spiritual/sense of place and social networking indicates that most stakeholders perceive these gardens as spaces where they experience a sense of belonging, tranquility, peace, and closeness to nature. Experiencing closeness to nature is increasingly important in modern urbanized settings, where concepts such as nature deficit disorder, i.e., “the growing gap between human beings and nature”, are well documented [70]. Sanyé-Mengual [71] also found similar patterns for urban agriculture in Bologna, Italy. They revealed that contact with nature and spirituality were some of the most important ES based on their ranking by project initiatives leaders, stakeholders, and the public. These results are contrary to those reported by Drillet et al. [72], who found that spiritual ES were the least commonly valued among residents in Singapore. These contradictions may very well be associated with the types of stakeholders and ecosystems in which the ES are provided, wherein the residents from Singapore were describing their perceptions of private urban gardens, compared to the stakeholders in this study, who relayed their perceptions based on community gardens. Ultimately, the acknowledgment of the value of an ES is variable and may be influenced by the role and perception of the respective stakeholders and the ES considered [40]. The variability in the acknowledgement of the value of ES was noticeable in this study.
Green spaces, including gardens, have been associated with “human emotions of tranquility, spirituality and solace which allows for a deep sense of introspection” [73], specifically around churches or places of worship [74,75]. The spiritual aspect of health clinic gardens, in this instance, may be associated with feelings of calm and fulfillment when stakeholders are within the garden spaces. Stakeholders who spend more time in the gardens and are directly involved in their establishment, management, and maintenance may find some form of fulfillment when performing these duties, which speaks to the prominence of cultural ES in these gardens. More noticeably, the facility managers who did not physically tend to the gardens scored spiritual/sense of place ES the highest compared to both the groundsmen and caregivers, which suggests that facility managers, who are rarely involved in the physical demands of the establishment and maintenance of the gardens, can experience them differently and may cultivate some spiritual or emotional connections with the gardens. In their assessment of the ES provided by home gardens in Vall Fosca, Catalan Pyrenees, Northeastern Spain, Calvet-Mir et al. [47] found that in discussing topics related to a gardener’s sense of place or their spiritual beliefs, the explanations ended with discussions about how home gardens provide a connection with spiritual feelings. Sense of place speaks to the “influences of natural environments on feelings of embeddedness in the local environment and of feeling at home” [76]. It addresses the emotional, symbolic, and spiritual aspects of places [77]. A strong sense of place may result in an increased willingness to protect a green space and foster feelings of responsibility towards the space [78]. It is essential that gardens are also used for enrichment purposes, such as creating a sense of place, rather than solely utilitarian goals, as this links public interests with public benefits and improves the ecological performance of the gardens [79].
The high ranking of local climate regulation in this study was associated with the trees and shrubs in health clinic gardens that provide shade and protection from strong winds. Shade provision and protection from strong winds are some of the most common ES that stakeholders usually associate with urban green spaces, motivating stakeholders to conserve them in Sub-Saharan Africa [80]. Similar to environmental factors experienced elsewhere [72], the high ranking of regulating ES, such as local climate regulation, can be associated with environmental pressures linked to climate change, which has led to a significant decrease in the levels of rainfall and an increase in average daily temperatures across South Africa [81]. The high appreciation of regulating ES, such as biological control, is also noteworthy, especially since these types of ES are not always readily identifiable among people who do not spend much time in garden ecosystems. In this study, groundsmen were more perceptive of these ES than other stakeholders. These perceptions are plausible, because these individuals work in the garden more frequently than others and are, therefore, able to understand a broader range of ES. Drillet et al. [72] reported similar perceptions among residents in the tropical city of Singapore, who considered ES associated with shade, air quality, and flood regulation as the most important regulating ES. The perceptions of soil quality resemble those found by Lamarque et al. [82], who reported that various stakeholders involved in grassland ecosystems associated soil quality, as a regulating ES, more strongly with the texture and physical appearance of the soil rather than the micro-organisms in the soil.
The use of plants as food [21,83,84] is a prominent provisioning ES of most types of gardens in sub-Saharan Africa [9]. While many of these gardens are characterized by cultivated plants used as vegetables [21], some of the plants in gardens are uncultivated and consumed as African leafy vegetables (ALVs), traditional leafy vegetables (TLVs), or indigenous wild food plants [85]. With the variety of potential plants, both cultivated and uncultivated, that can be used as vegetables, it is no surprise that stakeholders ranked food provision as one of the most critical ES provided by health clinic gardens. The recognition of food provision as a critical ES also speaks to the goal underlying the establishment of health clinic gardens, especially for the sick. This goal was further emphasized by facility managers, who manage the administration of these gardens and who have to ensure that the Department of Health’s missions are implemented. Health clinic gardens have the potential to contribute to the food security and health of some of the most vulnerable members of the community in both rural and urban areas. According to Ziso et al. [86], access to and consumption of healthy foods such as fresh fruits and vegetables are linked to a reduced risk of chronic illnesses, such as diabetes, heart disease, stroke, and obesity. The contribution of health clinic gardens to food security and improved health may be measured in terms of the number of people who harvest vegetables from these gardens [87], the consistency with which they harvest the vegetables, the number of patients who are given vegetables by caregivers and community health-care workers, and the frequency of these harvests. Health clinic gardens providing vegetables for nutritional purposes are reminiscent of private home gardens [21] and school gardens [88]. Du Toit et al. [21] found that despite the evidence of a very low consumption and dietary diversity of vitamin-A-rich vegetables and fruit, households in a peri-urban area in South Africa consumed an average of eight (range 4–11) vitamin-A-rich vegetables and fruits, including carrots, spinach, peaches, and apricots, in their lifetimes. These vegetables and fruit were mainly grown in home gardens. School gardens have also been found to enhance dietary outcomes in children [89], especially those suffering from malnutrition [90]. Many school-going children in poor communities in the Global South (GS) are susceptible to malnutrition [90] and nature deficit disorders [11]. Health clinic gardens can contribute to mitigating malnutrition and nature deficit disorders, especially in children, through cultivating and maintaining experiential key species (EKS). These species are common in urban areas, or nearby ecosystems, and can be used to stimulate familiarization with local fauna or flora among new generations that are progressively disconnected from nature [91]. As part of the education and science cultural ES, which scored 3.8 in the ES ranking in this study, stakeholders should identify EKS to foster children’s interest in the gardens.
Human culture has an essential influence on how ecosystems are utilized and, thus, the ES derived from them [92]. Differences in perceptions and cultural worldviews and, thus, priorities in regard to ES can potentially lead to conflicts or tensions between stakeholders [93]. Differences in perceptions of ES were apparent in this study, as evidenced by facility managers, who had fewer positive perceptions of ES than both groundsmen and caregivers. Different perceptions and cultural worldviews are valuable because they yield different opinions and because they provide different and innovative ways of managing the gardens, which is one of the benefits of having a variety of stakeholders in the effective governance of green spaces [94]. Garden management is an important factor in the provisioning of ES in these systems. Therefore, the awareness, ambition, perceptions, and skills of those involved in the gardens may greatly affect ES provisioning [95]. Cuni-Sanchez et al. [96] assessed the perceptions of the importance of livelihood strategies and ethnicity in forest ES of local communities in north-western Cameroon. They found that pastoralists identified fewer ES than farmers and used some ES differently (e.g., wildlife was only valued for aesthetics instead of as food). Differences in the valuation of an ES demonstrate that each stakeholder utilizes the ecosystem or envisages its use differently, which was also apparent in this study, where facility managers appraised the importance of food provisioning by health clinic gardens more than other stakeholders. This appraisal was expected, because the abovementioned purpose is the reason why the gardens were established.

5. Conclusions

We hypothesized that all health clinic gardens would have a similar diversity and abundance of stakeholders because they are all government-owned and managed, located in the same province, and operate according to the same framework. The results demonstrated that, indeed, there were no significant differences in the abundance and diversity of stakeholders between the various health clinic gardens across the district. Health clinic gardens in the North-West Province have a variety of stakeholders in varying proportions, including groundsmen, facility managers, caregivers, and members of the CWP and THP. The time spent in the gardens by these stakeholders varied between 1 and 5 days a week.
The ES perceived by stakeholders in health clinic gardens were similar to those classified by the Millennium Ecosystem Assessment [14]. The stakeholders, generally, were more appreciative of the cultural and regulating ES than the others. Among cultural ES, spiritual service and sense of place were highly recognized, while the regulation of the local climate was identified as a significant regulating ES. Additionally, food provisioning, among the provisioning ES, was as highly ranked as the sense of place, which corresponds to the intended function of health clinic gardens.
We also hypothesized that the stakeholders who are directly involved over longer periods in the gardens (through their establishment, maintenance, and overall management) would be more cognizant and have more positive perceptions of the ES provided by health clinic gardens than other stakeholders. The results of this study showed that the differences in stakeholder perceptions of ES based on their involvement in the gardens were not significant. However, facility managers were less positive in their perceptions than the groundsmen. Furthermore, there was less recognition of the importance of supporting ES, which shows that all the stakeholders were more cognizant of what they can physically or emotionally experience in gardens rather than how nature functions. If the importance of health clinic gardens is to be illuminated, all stakeholders involved should be aware of their full potential. The health clinic gardens with a larger diversity of stakeholders can collaborate with those with the lowest diversity. Experts, such as agricultural extension officers and scientists, can use digital tools to engage with other stakeholders across the district through citizen science approaches [97].
Health clinic gardens are important ecosystems with the potential to provide much-needed ES on the household and community scales where privately-owned gardens, such as home and domestic gardens, fail [9]. A case for the establishment of these gardens across the country and even in other developing countries of the GS can be made through the assessment of their potential ES, both from the perspectives of stakeholders and from the assessment of plant diversity and uses of plants that are commonly cultivated and maintained in these gardens. This study addresses the former and contributes to an understanding of the importance of a variety of stakeholders for the establishment and maintenance of health clinic gardens.

Author Contributions

Conceptualization, S.S.C.; methodology, N.G. and M.J.D.T.; software, M.J.D.T., S.F.A.C. and N.G.; validation, S.S.C. and M.J.D.T.; formal analysis, N.G., S.F.A.C. and M.J.D.T.; investigation, S.F.A.C.; data curation, N.G., S.F.A.C. and M.J.D.T.; writing—original draft preparation, N.G. and S.F.A.C.; writing—review and editing, N.G., M.J.D.T. and S.S.C.; visualization, N.G. and M.J.D.T.; supervision, S.S.C. and M.J.D.T.; funding acquisition, S.S.C. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Data Availability Statement

Not applicable.

Acknowledgments

S.F.A.C. was funded by the National Research Fund (NRF) and North-West University (NWU) for a Masters study. Appreciation is extended to S. Mishra for assisting with the data collection, M.J.D.T. for the language editing, and to the anonymous reviewers for their valuable comments contributing towards the improvement of this work. Any opinion, finding, conclusion, or recommendation expressed in this material is that of the authors, and the NRF and NWU do not accept any liability in this regard.

Conflicts of Interest

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

References

  1. Wang, D.; MacMillan, T. The benefits of gardening for older adults: A systematic review of the literature. Act. Adapt. Aging 2013, 37, 153–181. [Google Scholar] [CrossRef]
  2. Whitburn, J.; Linklater, W.L.; Milfont, T.L. Exposure to urban nature and tree planting are related to pro-environmental behavior via connection to nature, the use of nature for psychological restoration, and environmental attitudes. Environ. Behav. 2019, 51, 787–810. [Google Scholar] [CrossRef]
  3. Pritchard, A.; Richardson, M.; Sheffield, D.; McEwan, K. The relationship between nature connectedness and eudaimonic well-being: A meta-analysis. J. Happiness Stud. 2020, 21, 1145–1167. [Google Scholar] [CrossRef] [Green Version]
  4. Bélisle, A.C.; Wapachee, A.; Asselin, H. From landscape practices to ecosystem services: Landscape valuation in Indigenous contexts. Ecol. Econ. 2021, 179, 106858. [Google Scholar] [CrossRef]
  5. Beery, T.; Olsson, M.R.; Vitestam, M. COVID-19 and outdoor recreation management: Increased participation, connection to nature, and a look to climate adaptation. J. Outdoor Recreat. Tour. 2021, 36, 100457. [Google Scholar] [CrossRef]
  6. Pauleit, S.; Vasquéz, A.; Maruthaveeran, S.; Liu, L.; Cilliers, S.S. Urban green infrastructure in the Global South. In Urban Ecology in the Global South; Shackleton, C.M., Cilliers, S.S., Davoren, E., du Toit, M.J., Eds.; Springer: Cham, Switzerland, 2021; pp. 107–143. [Google Scholar]
  7. Gashu, K.; Gebre-Egziabher, T.; Maru, M. Drivers for urban green infrastructure development and planning in two Ethiopian cities: Bahir Dar and Hawassa. Arboric. J. 2019, 41, 48–63. [Google Scholar] [CrossRef]
  8. Gómez-Baggethun, E.; Gren, Å.; Barton, D.N.; Langemeyer, J.; McPhearson, T.; O’farrell, P.; Andersson, E.; Hamstead, Z.; Kremer, P. Urban ecosystem services. In Urbanization, Biodiversity and Ecosystem Services: Challenges and Opportunities: A Global Assessment; Elmqvist, T., Fragkias, M., Goodness, J., Güneralp, B., Marcotullio, P.J., McDonald, R.I., Parnell, S., Schewenius, M., Sendstad, M., Seto, K.C., et al., Eds.; Springer Nature: Dordrecht, The Netherlands, 2013; pp. 175–251. [Google Scholar]
  9. Cilliers, S.S.; Siebert, S.J.; Du Toit, M.J.; Barthel, S.; Mishra, S.; Cornelius, S.F.; Davoren, E. Garden ecosystem services of Sub-Saharan Africa and the role of health clinic gardens as social-ecological systems. Landsc. Urban Plan. 2018, 180, 294–307. [Google Scholar] [CrossRef]
  10. Martin-Lopez, B.; Church, A.; Başak Dessane, E.; Berry, P.; Chenu, C.; Christie, M.; Gerino, M.; Keune, H.; Osipova, E.; Oteros-Rozas, E.; et al. Nature’s contributions to people and quality of life. In The IPBES Regional Assessment Report on Biodiversity and Ecosystem Services for Europe and Central Asia; Secretariat of the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services: Bonn, Germany, 2018; pp. 57–185. [Google Scholar]
  11. “Ming” Kuo, F.E. Nature-deficit disorder: Evidence, dosage, and treatment. J. Policy Res. Tour. Leis 2013, 5, 172–186. [Google Scholar] [CrossRef]
  12. Daily, G. Introduction: What are ecosystem services? In Nature’s Services: Societal Dependence on Natural Ecosystems; Daily, G., Ed.; Island Press: Washington DC, USA, 1997; pp. 1–10. [Google Scholar]
  13. Costanza, R.; d’Arge, R.; de Groot, R.; Farber, S.; Grasso, M.; Hannon, B.; Limburg, K.; Naeem, S.; O’Neill, R.V.; Paruelo, J.; et al. The value of the world’s ecosystem services and natural capital. Ecol. Econ. 1998, 25, 3–15. [Google Scholar] [CrossRef]
  14. Millennium Ecosystem Assessment (MEA). Ecosystems and Human Wellbeing: Health Synthesis; World Health Organisation: Geneva, Switzerland, 2005; pp. 1–52. [Google Scholar]
  15. Haines-Young, R.; Potschin, M. Common International Classification of Ecosystem Services (CICES V4): Consultation Briefing Note. European Environment Agency. 2012. Available online: https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=0CAMQw7AJahcKEwjwy5nCkrf5AhUAAAAAHQAAAAAQAg&url=https%3A%2F%2Fcices.eu%2Fcontent%2Fuploads%2Fsites%2F8%2F2018%2F01%2FGuidance-V51-01012018.pdf&psig=AOvVaw3ZdVTlLWtFsm9Sq6txUrzR&ust=1660044632859023 (accessed on 31 January 2022).
  16. Brondizio, E.S.; Settele, J.; Díaz, S.; Ngo, H.T. Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services of the Global Assessment Report on Biodiversity and Ecosystem Services; IPBES Secretariat: Bonn, Germany, 2018; p. 1148. Available online: https://zenodo.org/record/6417333#.YvCs64RBy3A (accessed on 13 December 2021).
  17. Schröter, M.; Van der Zanden, E.H.; van Oudenhoven, A.P.; Remme, R.P.; Serna-Chavez, H.M.; De Groot, R.S.; Opdam, P. Ecosystem services as a contested concept: A synthesis of critique and counterarguments. Conserv. Lett. 2014, 7, 514–523. [Google Scholar] [CrossRef]
  18. Krasny, M.E.; Tidball, K.G. Community gardens as contexts for science, stewardship, and civic action learning. CITES 2009, 2, 18. [Google Scholar]
  19. Girma, Y.; Terefe, H.; Pauleit, S.; Kindu, M. Urban green infrastructure planning in Ethiopia: The case of emerging towns of Oromia special zone surrounding Finfinne. J. Urban Manag. 2019, 8, 75–88. [Google Scholar] [CrossRef]
  20. Roy, B.A.; Zorrilla, M.; Endara, L.; Thomas, D.C.; Vandegrift, R.; Rubenstein, J.M.; Policha, T.; Rios-Touma, B.; Read, M. New mining concessions could severely decrease biodiversity and ecosystem services in Ecuador. Trop. Conserv. Sci. 2018, 11, 1940082918780427. [Google Scholar] [CrossRef]
  21. Du Toit, M.J.; Rendón, O.; Cologna, V.; Cilliers, S.S.; Dallimer, M. Why Home Gardens Fail in Enhancing Food Security and Dietary Diversity. Front. Ecol. Evol. 2022, 10, 804523. [Google Scholar] [CrossRef]
  22. Modibedi, T.P.; Masekoameng, M.R.; Maake, M. The contribution of urban community gardens to food availability in Emfuleni Local Municipality, Gauteng Province. Urban Ecosyst. 2021, 24, 301–309. [Google Scholar] [CrossRef]
  23. Lowe, W.A.M.; Sinniah, J.; Jeyavanan, K.; Silva, G.L.L.P.; Pushpakumara, D.K.N.G. ‘Can home gardens assist in enhancing the domestic food security?’ A study in Jaffna Peninsula, Sri Lanka. Agrofor. Syst. 2021, 95, 1205–1216. [Google Scholar] [CrossRef]
  24. de Oliveira, J.A.P.; Ahmed, A. Governance of urban agriculture in African cities: Gaps and opportunities for innovation in Accra, Ghana. J. Clean. Prod. 2021, 312, 127730. [Google Scholar] [CrossRef]
  25. Bannor, R.K.; Sharma, M.; Oppong-Kyeremeh, H. Extent of urban agriculture and food security: Evidence from Ghana and India. Int. J. Soc. Econ. 2021, 48, 437–455. [Google Scholar] [CrossRef]
  26. Cullinan, K. Health Services in South Africa: A Basic Introduction. 2006. Available online: http://www.health-e.org.za/2006/01/29/health-services-in-south-africa-a-basic-introduction (accessed on 21 June 2021).
  27. Vorster, H.H.; Kruger, A.; Margetts, B.M. The nutrition transition in Africa: Can it be steered into a more positive direction? Nutrients 2011, 3, 429–441. [Google Scholar] [CrossRef] [Green Version]
  28. Milliron, B.J.; Vitolins, M.Z.; Gamble, E.; Jones, R.; Chenault, M.C.; Tooze, J.A. Process evaluation of a community garden at an urban outpatient clinic. J. Community Health 2017, 42, 639–648. [Google Scholar] [CrossRef]
  29. Shackleton, C.M.; Cilliers, S.S.; du Toit, M.J.; Davoren, E. The need for an urban ecology of the Global South. In Urban Ecology in the Global South; Shackleton, C.M., Cilliers, S.S., Davoren, E., du Toit, M.J., Eds.; Springer: Cham, Switzerland, 2021; pp. 1–26. [Google Scholar]
  30. Agergaard, J.; Tacoli, C.; Steel, G.; Ørtenblad, S.B. Revisiting rural-urban transformations and small town development in sub-Saharan Africa. Eur. J. Dev. Res. 2019, 31, 2–11. [Google Scholar] [CrossRef]
  31. du Toit, M.J.; Shackleton, C.M.; Cilliers, S.S.; Davoren, E. Advancing Urban Ecology in the Global South: Emerging Themes and Future Research Directions. In Urban Ecology in the Global South; Shackleton, C.M., Cilliers, S.S., Davoren, E., du Toit, M.J., Eds.; Springer: Cham, Switzerland, 2021; pp. 433–461. [Google Scholar]
  32. Nieto-Romero, M.; Oteros-Rozas, E.; González, J.A.; Martín-López, B. Exploring the knowledge landscape of ecosystem services assessments in Mediterranean agroecosystems: Insights for future research. Environ. Sci. Policy 2014, 37, 121–133. [Google Scholar] [CrossRef]
  33. Du Toit, M.J.; Cilliers, S.S.; Dallimer, M.; Goddard, M.; Guenat, S.; Cornelius, S.F. Urban green infrastructure and ecosystem services in sub-Saharan Africa. Landsc. Urban Plan. 2018, 180, 249–261. [Google Scholar] [CrossRef]
  34. Lin, B.B.; Egerer, M.H. Urban agriculture: An opportunity for biodiversity and food provision in urban landscapes. In Urban Biodiversity: From Research to Practice; Ossola, A., Niemelä, J., Eds.; Routledge Taylor & Francis: London, UK, 2017; pp. 71–86. [Google Scholar]
  35. Reuther, S.; Dewar, N. Competition for the use of public open space in low-income urban areas: The economic potential of urban gardening in Khayelitsha, Cape Town. Dev. S. Afr. 2006, 23, 97–122. [Google Scholar] [CrossRef]
  36. Cowling, R.M.; Egoh, B.; Knight, A.T.; O’Farrell, P.J.; Reyers, B.; Rouget, M.; Roux, D.J.; Wells, A.; Wilhelm-Rechman, A. An operational model for mainstreaming ecosystem services for implementation. Proc. Natl. Acad. Sci. USA 2008, 105, 9483–9488. [Google Scholar] [CrossRef] [Green Version]
  37. De Vreese, R.; Leys, M.; Fontaine, C.M.; Dendoncker, N. Social mapping of perceived ecosystem services supply–The role of social landscape metrics and social hotspots for integrated ecosystem services assessment, landscape planning and management. Ecol. Indic. 2016, 66, 517–533. [Google Scholar] [CrossRef]
  38. Fagerholm, N.; Käyhkö, N.; Ndumbaro, F.; Khamis, M. Community stakeholders’ knowledge in landscape assessments–Mapping indicators for landscape services. Ecol. Indic. 2012, 18, 421–433. [Google Scholar] [CrossRef]
  39. Cilliers, S.S.; Siebert, S.J.; Davoren, E.; Lubbe, C.S. Social aspects of urban ecology in developing countries, with an emphasis on urban domestic gardens. In Urban Ecology: A Global Framework; Richter, M., Weiland, U., Eds.; Wiley-Blackwell Publishing: Oxford, UK, 2012; pp. 123–138. [Google Scholar]
  40. De Groot, R.S.; Alkemade, R.; Braat, L.; Hein, L.; Willemen, L. Challenges in integrating the concept of ecosystem services and values in landscape planning, management and decision making. Ecol. Complex. 2010, 7, 260–272. [Google Scholar] [CrossRef]
  41. Mascia, M.B.; Brosius, J.P.; Dobson, T.A.; Forbes, B.C.; Horowitz, L.; McKean, M.A.; Turner, N.J. Conservation and the social sciences. Conserv. Biol. 2003, 17, e649–e650. [Google Scholar] [CrossRef] [Green Version]
  42. Wang, B.; Zhang, Q.; Cui, F. Scientific research on ecosystem services and human well-being: A bibliometric analysis. Ecol. Indic. 2021, 125, e107449. [Google Scholar] [CrossRef]
  43. Vihervaara, P.; Kumpula, T.; Tanskanen, A.; Burkhard, B. Ecosystem services–A tool for sustainable management of human–environment systems. Case study Finnish Forest Lapland. Ecol. Complex. 2010, 7, 410–420. [Google Scholar] [CrossRef]
  44. Russo, A.; Escobedo, F.J.; Cirella, G.T.; Zerbe, S. Edible green infrastructure: An approach and review of provisioning ecosystem services and disservices in urban environments. Agric. Ecosyst. Environ. 2017, 242, 53–66. [Google Scholar] [CrossRef]
  45. Cabral, I.; Keim, J.; Engelmann, R.; Kraemer, R.; Siebert, J.; Bonn, A. Ecosystem services of allotment and community gardens: A Leipzig, Germany case study. Urban For. Urban Green. 2017, 23, 44–53. [Google Scholar] [CrossRef]
  46. Clarke, L.W.; Li, L.; Jenerette, G.D.; Yu, Z. Drivers of plant biodiversity and ecosystem service production in home gardens across the Beijing Municipality of China. Urban Ecosyst. 2014, 17, 741–760. [Google Scholar] [CrossRef]
  47. Calvet-Mir, L.; Gómez-Baggethun, E.; Reyes-García, V. Beyond food production: Ecosystem services provided by home gardens. A case study in Vall Fosca, Catalan Pyrenees, Northeastern Spain. Ecol. Econ. 2012, 74, 153–160. [Google Scholar] [CrossRef]
  48. Mohri, H.; Landreth, N.; Lahoti, S.; Saito, O.; Hitinayake, G.; Gunatilleke, N.; Irham; Thang, H.V.; Takeuchi, K. Ecosystem services of traditional home gardens in South and Southeast Asia. In Resilient Asia: Fusion of Traditional and Modern Systems for a Sustainable Future; Takeuchi, K., Saito, O., Matsuda, H., Mohan, G., Eds.; Springer: Tokyo, Japan, 2018; pp. 95–121. [Google Scholar]
  49. Taylor, J.R.; Lovell, S.T.; Wortman, S.E.; Chan, M. Ecosystem services and tradeoffs in the home food gardens of African American, Chinese-origin and Mexican-origin households in Chicago, IL. Renew. Agric. Food Syst. 2017, 32, 69–86. [Google Scholar] [CrossRef]
  50. Qumsiyeh, M.; Handal, E.; Chang, J.; Abualia, K.; Najajreh, M.; Abusarhan, M. Role of museums and botanical gardens in ecosystem services in developing countries: Case study and outlook. Int. J. Environ. Stud. 2017, 74, 340–350. [Google Scholar] [CrossRef]
  51. Miller, J.S.; Lowry, P.P.; Aronson, J.; Blackmore, S.; Havens, K.; Maschinski, J. Conserving biodiversity through ecological restoration: The potential contributions of botanical gardens and arboreta. Candollea 2016, 71, 91–98. [Google Scholar] [CrossRef]
  52. Fischer, L.K.; Brinkmeyer, D.; Karle, S.J.; Cremer, K.; Huttner, E.; Seebauer, M.; Nowikow, U.; Schütze, B.; Voigt, P.; Völker, S.; et al. Biodiverse edible schools: Linking healthy food, school gardens and local urban biodiversity. Urban For. Urban Green. 2019, 40, 35–43. [Google Scholar] [CrossRef]
  53. Dennis, M.; James, P. Site-specific factors in the production of local urban ecosystem services: A case study of community-managed green space. Ecosyst. Serv. 2016, 17, 208–216. [Google Scholar] [CrossRef] [Green Version]
  54. Wu, C.; Li, X.; Tian, Y.; Deng, Z.; Yu, X.; Wu, S.; Shu, D.; Peng, Y.; Sheng, F.; Gan, D. Chinese Residents’ Perceived Ecosystem Services and Disservices Impacts Behavioral Intention for Urban Community Garden: An Extension of the Theory of Planned Behavior. Agronomy 2022, 12, 193. [Google Scholar] [CrossRef]
  55. Gwedla, N.; Cornelius, S.F.; Du Toit, M.J.; Elmqvist, T.; Cilliers, S.S. Health clinic gardens as models for social-ecological systems: Plant diversity and potential utilization in the North-West, South Africa. SciAf 2022. Accepted. [Google Scholar]
  56. Statistics South Africa (Stats SA). Provincial Profile: North-West Community Survey 2016 (Report 03-01-11). Statistics South Africa: Pretoria, South Africa, 2018. Available online: https://cs2016.statssa.gov.za/?portfolio_page=community-survey-2016-provincial-profile-north-west-2016 (accessed on 30 April 2022).
  57. Mucina, L.; Rutherford, M.C. (Eds.) The Vegetation of South Africa, Lesotho and Swaziland; South African National Biodiversity Institute: Pretoria, South Africa, 2006; p. 807. [Google Scholar]
  58. Cilliers, S.S.; Bouwman, H.; Drewes, J.E. Comparative urban ecological research in developing countries. In Ecology of Cities and Towns: Comparative Urban Ecological Research in Developing Countries; McDonnel, M.J., Hahs, A.K., Breuste, J.H., Eds.; Cambridge University Press: Cambridge, UK, 2009; pp. 90–111. [Google Scholar]
  59. Massyn, N.; Day, C.; Ndlovu, N.; Padayachee, T. District Health Barometer: District Health Profiles, 2019/2020; Health Systems Trust: Durban, South Africa, 2020; p. 526. Available online: https://www.hst.org.za/publications/District%20Health%20Barometers/DHB%202019-20%20Complete%20Book.pdf (accessed on 23 June 2022).
  60. North-West Provincial Profile (NWPP). North-West Provincial Government Economic Reports; North-West Provincial Government: Mahikeng, South Africa, 2017; p. 19. Available online: http://www.nwpg.gov.za/VTSDEconomy/Documents/VTSD%20Economic%20Reports/1710_North%20West%20Province%20Profile%20Summary%2031%20Nov_1.pdf (accessed on 12 April 2021).
  61. Van Huysteen, E.; Botha, A. A National Overview of Spatial Trends and Settlement Characteristics; Report: CSIR- Built Environment: Pretoria, South Africa, 2008; p. 63. [Google Scholar]
  62. Hunter, J.R.; Chandran, T.M.; Asmall, S.; Tucker, J.M.; Ravhengani, N.M.; Mokgalagadi, Y. The Ideal Clinic in South Africa: Progress and challenges in implementation. S. Afr. Health Rev. 2017, 2017, 111–123. [Google Scholar]
  63. Haricharan, H.J.; Stuttaford, M.; London, L. The role of community participation in primary health care: Practices of South African health committees. Prim. Health Care Res. Dev. 2021, 22, e31. [Google Scholar] [CrossRef] [PubMed]
  64. Jericó-Daminello, C.; Schröter, B.; Garcia, M.M.; Albert, C. Exploring perceptions of stakeholder roles in ecosystem services coproduction. Ecosyst. Serv. 2021, 51, 101353. [Google Scholar] [CrossRef]
  65. Hoover, A.; Vandyousefi, S.; Martin, B.; Nikah, K.; Cooper, M.H.; Muller, A.; Marty, E.; Duswalt-Epstein, M.; Burgermaster, M.; Waugh, L.; et al. Barriers, Strategies, and Resources to Thriving School Gardens. J. Nutr. Educ. Behav. 2021, 53, 591–601. [Google Scholar] [CrossRef] [PubMed]
  66. Kingsley, J.; Foenander, E.; Bailey, A. “You feel like you’re part of something bigger”: Exploring motivations for community garden participation in Melbourne, Australia. BMC Public Health 2019, 19, 745. [Google Scholar] [CrossRef] [Green Version]
  67. Booth, J.M.; Chapman, D.; Ohmer, M.L.; Wei, K. Examining the relationship between level of participation in community gardens and their multiple functions. J. Community Pract. 2018, 26, 5–22. [Google Scholar] [CrossRef]
  68. Rogers, E.M. Diffusion of Innovations, 5th ed.; Free Press Inc.: New York, NY, USA, 2003; p. 551. [Google Scholar]
  69. Camps-Calvet, M.; Langemeyer, J.; Calvet-Mir, L.; Gómez-Baggethun, E. Ecosystem services provided by urban gardens in Barcelona, Spain: Insights for policy and planning. Environ. Sci. Policy 2016, 62, 14–23. [Google Scholar] [CrossRef]
  70. Louv, R. Do our kids have nature-deficit disorder. Educ. Leadersh. 2009, 67, 24–30. [Google Scholar]
  71. Sanyé-Mengual, E.; Specht, K.; Vávra, J.; Artmann, M.; Orsini, F.; Gianquinto, G. Ecosystem services of urban agriculture: Perceptions of project leaders, stakeholders and the general public. Sustainability 2020, 12, 10446. [Google Scholar] [CrossRef]
  72. Drillet, Z.; Fung, T.K.; Leong, R.A.T.; Sachidhanandam, U.; Edwards, P.; Richards, D. Urban vegetation types are not perceived equally in providing ecosystem services and disservices. Sustainability 2020, 12, 2076. [Google Scholar] [CrossRef] [Green Version]
  73. Pratt, J.W. Worship on the Garden: Service for Outdoor Worship; Abingdon Press: Nashville, TN, USA, 2013; p. 137. [Google Scholar]
  74. De Lacy, P.; Shackleton, C. Aesthetic and spiritual ecosystem services provided by urban sacred sites. Sustainability 2017, 9, 1628. [Google Scholar] [CrossRef] [Green Version]
  75. Ngulani, T.; Shackleton, C.M. Use of public urban green spaces for spiritual services in Bulawayo, Zimbabwe. Urban For. Urban Green. 2019, 38, 97–104. [Google Scholar] [CrossRef]
  76. Riechers, M.; Barkmann, J.; Tscharntke, T. Perceptions of cultural ecosystem services from urban green. Ecosyst. Serv. 2016, 17, 33–39. [Google Scholar] [CrossRef]
  77. Žlender, V.; Gemin, S. Testing urban dwellers’ sense of place towards leisure and recreational peri-urban green open spaces in two European cities. Cities 2020, 98, 102579. [Google Scholar] [CrossRef]
  78. Hosseini, F.; Sajadzadeh, H.; Aram, F.; Mosavi, A. The impact of local green spaces of historically and culturally valuable residential areas on place attachment. Land 2021, 10, 351. [Google Scholar] [CrossRef]
  79. Ridgeway, N.; Matthews, J. Campus gardens: Food production or sense of place? Can. Food Stud. 2015, 2, 99–118. [Google Scholar] [CrossRef] [Green Version]
  80. Guenat, S.; Dougill, A.J.; Kunin, W.E.; Dallimer, M. Untangling the motivations of different stakeholders for urban greenspace conservation in sub-Saharan Africa. Ecosyst. Serv. 2019, 36, 100904. [Google Scholar] [CrossRef]
  81. Botai, C.M.; Botai, J.O.; Dlamini, L.C.; Zwane, N.S.; Phaduli, E. Characteristics of droughts in South Africa: A case study of free state and North-West provinces. Water 2016, 8, 439. [Google Scholar] [CrossRef]
  82. Lamarque, P.; Tappeiner, U.; Turner, C.; Steinbacher, M.; Bardgett, R.D.; Szukics, U.; Schermer, M.; Lavorel, S. Stakeholder perceptions of grassland ecosystem services in relation to knowledge on soil fertility and biodiversity. Region. Environ. Chang. 2011, 11, 791–804. [Google Scholar] [CrossRef]
  83. Abukutsa-Onyango, M. Seed production and support systems for African leafy vegetables in three communities in western Kenya. Afr. J. Food Agric. Nutr. Dev. 2005, 7, 1–16. [Google Scholar] [CrossRef]
  84. Baiyegunhi, L.J.S.; Makwangudze, K.E. Home gardening and food security status of HIV/AIDS affected households in Mpophomeni, KwaZulu-Natal Province, South Africa. J. Hum. Ecol. 2013, 44, 1–8. [Google Scholar] [CrossRef]
  85. Freedman, R.L. Indigenous wild food plants in home gardens: Improving health and income-with the assistance of agricultural extension. Int. J. Agric. Ext. 2015, 3, 63–71. [Google Scholar]
  86. Ziso, D.; Chun, O.K.; Puglisi, M.J. Increasing Access to Healthy Foods through Improving Food Environment: A Review of Mixed Methods Intervention Studies with Residents of Low-Income Communities. Nutrients 2022, 14, 2278. [Google Scholar] [CrossRef] [PubMed]
  87. Ruysenaar, S. Reconsidering the “Letsema Principle” and the role of community gardens in food security: Evidence from Gauteng, South Africa. Urban Forum 2013, 24, 219–249. [Google Scholar] [CrossRef]
  88. Laurie, S.M.; Faber, M.; Maduna, M.M. Assessment of food gardens as nutrition tool in primary schools in South Africa. S. Afr. J. Clin. Nutr. 2017, 30, 80–86. [Google Scholar] [CrossRef] [Green Version]
  89. Berezowitz, C.K.; Bontrager Yoder, A.B.; Schoeller, D.A. School gardens enhance academic performance and dietary outcomes in children. J. Sch. Health 2015, 85, 508–518. [Google Scholar] [CrossRef] [PubMed]
  90. Gonsalves, J.; Hunter, D.; Lauridsen, N. School gardens: Multiple functions and multiple outcomes. In Agrobiodiversity, School Gardens and Healthy Diets: Promoting Biodiversity, Food and Sustainable Nutrition, 1st ed.; Hunter, D., Monville-Oro, E., Burgos, B., Roel, C.N., Calub, B.M., Gonsalves, J., Lauridsen, N., Eds.; Routledge: Oxon, UK, 2020; pp. 1–32. [Google Scholar]
  91. Battisti, C. Experiential Key Species for the nature-disconnected generation. Anim. Conserv. 2016, 19, 485–487. [Google Scholar] [CrossRef]
  92. Cuni-Sanchez, A.; Imani, G.; Bulonvu, F.; Batumike, R.; Baruka, G.; Burgess, N.D.; Klein, J.A.; Marchant, R. Social perceptions of forest ecosystem services in the Democratic Republic of Congo. Hum. Ecol. 2019, 47, 839–853. [Google Scholar] [CrossRef] [Green Version]
  93. Peter, S.; Le Provost, G.; Mehring, M.; Müller, T.; Manning, P. Cultural worldviews consistently explain bundles of ecosystem service prioritisation across rural Germany. People Nat. 2022, 4, 218–230. [Google Scholar] [CrossRef]
  94. Lawrence, A.; De Vreese, R.; Johnston, M.; Konijnendijk van den Bosch, C.C.; Sanesi, G. Urban Forest governance: Towards a framework for comparing approaches. Urban For. Urban Green. 2013, 12, 464–473. [Google Scholar] [CrossRef]
  95. Teixeira, H.M.; Vermue, A.J.; Cardoso, I.M.; Claros, M.P.; Bianchi, F.J. Farmers show complex and contrasting perceptions on ecosystem services and their management. Ecosyst. Serv. 2018, 33, 44–58. [Google Scholar] [CrossRef]
  96. Cuni-Sanchez, A.; Ngute, A.S.K.; Sonké, B.; Sainge, M.N.; Burgess, N.D.; Klein, J.A.; Marchant, R. The importance of livelihood strategy and ethnicity in forest ecosystem services’ perceptions by local communities in north-western Cameroon. Ecosyst. Serv. 2019, 40, 101000. [Google Scholar] [CrossRef]
  97. Njue, N.; Kroese, J.S.; Gräf, J.; Jacobs, S.R.; Weeser, B.; Breuer, L.; Rufino, M.C. Citizen science in hydrological monitoring and ecosystem services management: State of the art and future prospects. Sci. Total Environ. 2019, 693, 133531. [Google Scholar] [CrossRef] [PubMed]
Land 11 01904 g001 550
Figure 1. Locations of surveyed health clinic gardens in the local municipalities of the Bojanala District Municipality, North-West Province, South Africa.
Figure 1. Locations of surveyed health clinic gardens in the local municipalities of the Bojanala District Municipality, North-West Province, South Africa.
Land 11 01904 g001
Land 11 01904 g002 550
Figure 2. Diversity of stakeholders involved in health clinic gardens across all municipalities in the Bojanala district.
Figure 2. Diversity of stakeholders involved in health clinic gardens across all municipalities in the Bojanala district.
Land 11 01904 g002
Land 11 01904 g003 550
Figure 3. Abundance of stakeholders involved in health clinic gardens across all municipalities in the Bojanala district.
Figure 3. Abundance of stakeholders involved in health clinic gardens across all municipalities in the Bojanala district.
Land 11 01904 g003
Land 11 01904 g004 550
Figure 4. Perceptions of ES at health clinic gardens among facility managers, caregivers, and groundsmen in the Bojanala district. Red and orange areas indicate a low score and less positive perception, while green areas indicate high scores and positive perceptions.
Figure 4. Perceptions of ES at health clinic gardens among facility managers, caregivers, and groundsmen in the Bojanala district. Red and orange areas indicate a low score and less positive perception, while green areas indicate high scores and positive perceptions.
Land 11 01904 g004
Table
Table 1. Different types of stakeholders involved in health clinic gardens and classifications of their contribution in the gardens (Adapted from [9]).
Table 1. Different types of stakeholders involved in health clinic gardens and classifications of their contribution in the gardens (Adapted from [9]).
StakeholderActual ContributionAdditional Information (Envisaged Roles)
Clinic personnel—facility manager, other medical staff, nutrition specialist, gardener (groundsmen)Leadership and facilitation role in gardening and knowledge transfer in knowledge networkWillingness to cooperate with traditional healers
Patients mainly from Batswana ethnic group—chronically ill (HIV Aids, TB)Indigenous knowledge (traditional ecological knowledge—TEK)—Tswana tshimo garden layout; use of indigenous crops—African leafy vegetables (ALVs)HIV-afflicted households more aware of nutritional value of vegetables; potential preservation of landraces of vegetables; ALVs
Rest of Community—municipal/tribal councilors, private gardeners, schools, churchesIndigenous knowledge (TEK)—Tswana tshimo garden layout; use indigenous crops—ALVsTswana tshimo; potential preservation of landraces of vegetables; ALVs; school curricula include gardening aspects
Caregivers—(stipend paid by Dept. Health)Provide home-based care, including fruit and vegetables from clinic gardens and transfer of knowledge to chronically ill and the elderlyRoles in terms of health promotion and education
Community Works Program (CWP) (stipend paid by Dept. of Works)Physical work in setting up food gardens and other community projectsA South African government program providing an employment safety net to supplement the social grant program
NGOs (may include caregivers)Provide mainly technical knowledge, support and funding, provide skill development and training coursesExample of community gardens supported by NGO Abalimi Bezekhaya; example of NGOs forming part of a larger network; Largest urban greening NGO in South Africa—Food and Trees for Africa
Traditional health practitioners
(THP’s)		Indigenous knowledge (traditional ecological knowledge—TEK); maintain social order and preserve cultural heritage; contribute to collaborative health care system; transmitting knowledge on plantsTraditional medicine still important in primary health care for local communities and, therefore, even THPs cultivate medicinal plants; TEK; positive views about incorporation in primary health care
Private companies (in partnerships with NGOs), e.g., minesIncrease financial and physical capital, e.g., finance bore holes and pumps, green houses, tools, skill development and training courses-
Experts—agricultural extension officersTechnical knowledge: agricultural practices and commercial crop varieties, including not only verbal instructions, but also demonstrative, innovative, and hands-on practical guidanceRole in transfer of technology, problem solving, education, and human development
Experts—scientistsContribute intellectual capital in terms of networking, organizational skills and scientific knowledge on ecology, conservation, agriculture, horticulture, soil science, nutrition, sociologyConservation of biodiversity and wildlife-friendly gardening; use alternative agricultural practices to increase biodiversity; develop nutrition education programs; contribute to environmental education; increase social interactions; determine soil health indicators; compost increases soil quality; social heterogeneity determines plant preferences
Table
Table 2. Characteristics of respondents and clinics included in this study.
Table 2. Characteristics of respondents and clinics included in this study.
Stakeholder Characteristicsn%
Gender
Female13361
Male8539
Stakeholder Type
Facility manager9644
Groundsman6831
Caregiver2813
Community works program participants130.1
Traditional health practitioner40.02
Patient30.01
Community member30.01
NGO member10.001
Other20.01
Number of years involved in garden
<2 years2812.8
2–5 years10648.6
5–10 years3717.0
>10 years4721.6
Settlement type of clinic location
Small rural settlement5653
Large rural settlement 3130
Small and medium-sized cities1817
Table
Table 3. Ecosystem services prioritized by stakeholders in health clinic gardens.
Table 3. Ecosystem services prioritized by stakeholders in health clinic gardens.
Types of Ecosystem ServicesProportion of Respondents (%)Average Score (0–5)
Provisioning ServicesFood944.4
Fodder603.4
Firewood593.0
Medicinal Resources572.8
Building Materials302.4
3.2
Regulating ServicesLocal Climate964.2
Biological Control943.9
Soil Quality663.3
3.7
Supporting ServicesHabitat Provision332.6
Genetic Diversity312.4
2.5
Cultural ServicesSpiritual/Sense of Place994.4
Social Network974.1
Education and Science933.8
Aesthetics783.4
Recreation/Mental Health553.1
3.7
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Share and Cite

MDPI and ACS Style

Gwedla, N.; Cornelius, S.F.A.; Du Toit, M.J.; Cilliers, S.S. Stakeholder Perceptions of the Ecosystem Services of Health Clinic Gardens in Settlements and Small- to Medium-Sized Cities in the North-West Province, South Africa. Land 2022, 11, 1904. https://doi.org/10.3390/land11111904

AMA Style

Gwedla N, Cornelius SFA, Du Toit MJ, Cilliers SS. Stakeholder Perceptions of the Ecosystem Services of Health Clinic Gardens in Settlements and Small- to Medium-Sized Cities in the North-West Province, South Africa. Land. 2022; 11(11):1904. https://doi.org/10.3390/land11111904

Chicago/Turabian Style

Gwedla, Nanamhla, Susanna Francina A. Cornelius, Marié J. Du Toit, and Sarel S. Cilliers. 2022. "Stakeholder Perceptions of the Ecosystem Services of Health Clinic Gardens in Settlements and Small- to Medium-Sized Cities in the North-West Province, South Africa" Land 11, no. 11: 1904. https://doi.org/10.3390/land11111904

APA Style

Gwedla, N., Cornelius, S. F. A., Du Toit, M. J., & Cilliers, S. S. (2022). Stakeholder Perceptions of the Ecosystem Services of Health Clinic Gardens in Settlements and Small- to Medium-Sized Cities in the North-West Province, South Africa. Land, 11(11), 1904. https://doi.org/10.3390/land11111904

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop