Implementation of a School-Based HIV Prevention Curriculum Following National Dissemination in Nyanza Province, Kenya

Background: Primary School Action for Better Health (PSABH) became the national HIV prevention curriculum of Kenya in 2005.Objective: To examined implementation of PSABH and student risk behaviours.Setting: Muhuru, a rural division of Nyanza Province.Subjects: One thousand one hundred and forty six students aged 9-21 years from six primary schools in Muhuru.Outcome measures: Anonymous surveys were administered to assess students’ exposure to PSABH curriculum components, sexual activity, condom use, and self-efficacy related to engaging in lower risk behaviours.Results: The six schools implementing PSABH were not implementing the full curriculum. Fifty-five percent of males and 44% of females reported a history of sexual activity. For females, condom self-efficacy was related to lower risk behaviour , while HIV education during pastoral instruction was associated with higher risk. Boys who reported higher self-efficacy and learning about abstinence strategies engaged in lower risk behaviour , while exposure to HIV education in assemblies and communication with relatives about HIV was associated with higher risk.Conclusion: Previous studies documented benefits of PSABH. However, it is unclear how effective the curriculum is after national scale-up. In this community, PSABH was implemented at a low level, with some curriculum components associated with higher risk behaviour , calling into question how PSABH is being delivered. Future studies should examine effective strategies for ongoing support, monitoring, and evaluation. Successfully disseminating evidence-based prevention strategies could reduce HIV incidence and the burden on healthcare providers struggling to care forpeople living with HIV/AIDS

The protective role of religious coping in adolescents' responses to poverty and sexual decision-making in rural Kenya.

In this study, we explored how adolescents in rural Kenya apply religious coping in sexual decision-making in the context of high rates of poverty and Human Immunodeficiency Virus (HIV). Semi-structured interviews were conducted with 34 adolescents. One-third (13) reported religious coping related to economic stress, HIV, or sexual decision-making; the majority (29) reported religious coping with these or other stressors. Adolescents reported praying for God to partner with them to engage in positive behaviors, praying for strength to resist unwanted behaviors, and passive strategies characterized by waiting for God to provide resources or protection from HIV. Adolescents in Sub-Saharan Africa may benefit from HIV prevention interventions that integrate and build upon their use of religious coping

Measuring attentiveness toward oral care needs: a comparative study of Indonesian care workers in Japan and Indonesia

Background: Japan has opened its labor market to care workers from Indonesia under the Japan–Indonesia Economic Partnership Agreement (EPA). However, few studies have examined the types of care skills transferred between countries. We therefore analyzed Indonesian care workers employed in Japan and Indonesia to identify discrepancies in their attentiveness toward oral care in older adults.Methods: A checklist comprising 42 items of universal oral care assessment was developed prior to the study and distributed via the Internet to 418 Indonesian EPA care workers in Japan and via a paper survey to 213 Indonesian care workers in Indonesia. The Mann–Whitney U test was used to compare the distribution of scores for each checklist item for each group.Results: The respondents were 110 Japan-based EPA care workers (response rate: 26.3%) and 213 Indonesia-based care workers (response rate: 99.1%). Japan-based care workers were significantly more likely to perform environmental observations of their older adult patients (p < 0.001) and to check items on the oral care checklist during feeding (p < 0.001) and post-meal (p = 0.001), while Indonesia-based care workers were more likely to check the overall condition of patients before meals (p = 0.021).Conclusions: Discrepancies in checking oral care between the two groups were attributed to the differences in laws and regulations governing the care environments. Indonesian care workers employed in Japan have the advantage of learning to employ a more systematic approach in caring for older adults, in accordance with Japan’s Long-Term Care Act. This approach could contribute toward lowering the risk of aspiration pneumonia in Indonesia. A training program designed for returning migrant workers to transfer newly developed oral care skills will thus be essential for Indonesia to diminish the negative impacts of its aging population