Exploring the lived experiences of first-time mothers and their partners affected by post-natal depression in rural Sanyati district, Zimbabwe

Background: There is an increased number of young people engaging in early sexual relationships worldwide. Furthermore, statistics for early pregnancy among young people has also increased especially in low and middle-income countries. This has health implications for both the parents and the baby. High uptake in family planning contraception among the young people can reduce early pregnancy and subsequent negative health outcomes on the young parents and the baby. This study was set to explore the factors influencing the uptake of family planning contraceptive services among young people (18-24 years) at community level in rural Budaka district, Uganda. Method: The study utilised an explorative qualitative approach. Eight focus group discussion were conducted followed by sixteen one to one follow up semi-structured interviews with young people. Each focus group comprised of 10 participants (N=80). Sixteen one to one follow up interviews were meant to further explore issues raised in the focus groups (N=16). A thematic approach underpinned by the four phases of The Silences Framework (TSF) was used to analyse the data. Results: The study found out that religion, partner resistance; perceived loss of libido, perceived barren, long waiting time and distance from the health facility, lack of privacy/confidentiality, excessive menstrual bleeding, cancer and fear of having disabled babies, limited the utilisation of family planning contraceptive services while contraception as HIV prevention and child spacing encouraged young people to use family planning contraceptive services. Conclusion: There is need for a culturally orientated community-based contraceptive health promotion approach to increase the uptake of family planning contraception services among young people

Barriers to uptake of bilateral tubal ligation family planning method among grand-multiparous women in the Copperbelt province, Zambia

Background: Use of Bilateral Tubal Ligation (BTL) family planning method has been met with resistance by some women owing to its clash with certain personal values in their lives. In some cases these barriers have led to unintended pregnancies, which in turn cause complications, especially in grand-multiparous women (women with many children). This qualitative study explored the barriers towards the uptake of BTL among grand-multiparous women. Methods: The study used an exploratory qualitative methodology to explore the barriers to uptake of BTL. Semi structured interviews were utilised to collect data. Twenty-five semi-structured interviews were held with grand multiparous women who were attending clinics for family planning services. All interviews were tape-recorded and transcribed verbatim. A thematic approach underpinned by some aspects of the silences framework was utilised for data analysis. Results: The study revealed that barriers to the uptake of BTL included desire to maintain productivity, pressure from spouses, stigmatization of family planning, safety fears and loss of self-esteem. Conclusions: There is need to engage all stakeholders in communities to make sure that fears and doubts on the use of BTL are allayed. Furthermore there is need to roll out more health promotion and raise awareness on the importance of family planning

COVID-19 lockdown and mental health: exploring triggers of mental health distress among women in the Copperbelt province, Zambia

More than 60,000 deaths from COVID-19 had been confirmed as of the 1st of August 2020. Concerns about physical and psychological wellbeing had increased across the world with women disproportionately being affected. This research was set to explore the triggers of mental health distress among women during COVID-19 lockdown. The research study utilized a qualitative descriptive approach. Forty (N = 40) women were recruited to take part in the research study. A one to one semi structured interview schedule was used to collect data. NVivo Version 11, QSR International Pty was utilized to organize data for analysis. Content analysis was used to identify, describe, and make inferences about the qualitative data generated. Findings from new interviews were compared for consensus and disagreement. Categories were then collapsed and analyzed into clusters from which concepts and themes were developed. The research study found that the triggers for mental health distress among the research participants included domestic violence, loss of employment, stress of managing children indoors, fear of COVID-19 infection, loneliness and poor access to health services. There is need to consider radical sensitive approaches in preventing triggers of mental health distress among women

Exploring the enablers of teenage pregnancy in Sub-Saharan Africa (SSA): a scoping literature review

Evidence from sub-Saharan Africa indicates that 35 percent of pregnancies among 15-19-year (s)-olds were unplanned, unwanted, or untimed and that the teenagers’ relationships were unstable. Teenage pregnancy is a global problem especially in developing countries. Teenage pregnancy is associated with several social issues: poverty, low education levels, and the lack of awareness about sex and pregnancy prevention. The contributing factors for teenage pregnancy are multiple and complex categorised as socio-demographic, familial, cultural, and reproductive behaviour. Different literature reported that factors associated with teenage pregnancy include living in rural areas, not attending school, early marriage, lack of communication between parents and adolescents about sexual and reproductive health (SRH) issues, educational level of the teenagers and family history of teenage pregnancy. A scoping review was conducted from February 2021 to August 2021 using the following specific subject databases: Google scholar, PubMed, EBSCOhost, and research gate. Special attention was paid to keywords during navigation to ensure consistency of searches in each database. English language, studies conducted in sub-Sahara Africa and articles published in the last 10 years (2011–2021), were the three limiters applied in the four databases. The researchers identified eight themes for inclusion in the findings. The themes fell into three major categories: individual related factors, family related factors and external factors. These themes reflect factors associated with teenage pregnancy. The review revealed that there are several risk factors that lead to teenage pregnancy. Therefore, there is urgency for strategic interventions aimed at improving teenage pregnancy through female education and sexual and reproductive health education must also be introduced or reinforced in schools. Policy makers, community leaders and school curriculum can act towards raising the age for marriage to after 20 years and make the methods of contraception accessible to teenagers. Qualitative techniques like focus group discussions in communities could be helpful in reflecting on the root cause of the problem

Exploring the risk factors of child malnutrition in Sub-Sahara Africa: a scoping review

Background: Malnutrition prevents children from reaching their full physical and mental potential. Health and physical consequences of prolonged states of malnourishment among children are: delay in their physical growth and motor development ; lower intellectual quotient (IQ), greater behavioural problems and deficient social skills; susceptibility to contracting diseases. According to the 2015 Millennium development goal (MDG) report, sub-Saharan Africa (SSA) accounts for one third of all undernourished children globally, highlighting that malnutrition still remains a major health concern for children under 5 years in the sub-region, thus buttressing the need for urgent intervention. Aim: The aim of this study is to explore the risk factors of child malnutrition in sub-Saharan Africa through a scoping review. Methods: The scoping review was conducted using the following specific subject databases: EBSCOhost, google scholar, Pub med, demographic research and research gate. Attention was paid to keywords during navigation to ensure consistency of searches in each database. Two limiters were applied in all five databases. These included the use of the English language and articles published on child malnutrition in sub Saharan Africa. Results: The researchers identified eight themes for inclusion in the findings. The themes fell into four major categories being maternal related, family related, child related as well as context related factors. These themes reflect factors associated with child malnutrition. Conclusion: This scop-ing review revealed that there are quite a number of risk factors that lead to child malnutrition. Therefore, there is an urgency for strategic interventions aimed at improving child nutrition through female education if the 2030 end malnutrition SDG 2.2 are to be achieved

Exploring the challenges of implementing COVID-19 guidelines: experiences of commuters in the Copperbelt Province, Zambia

Background: The first case of COVID-19 in Zambia was confirmed on the 18th of March 2020, to date 320, 412 people have been infected and 3983 Covid related deaths have been reported. In Zambia, public transport is mainly by road, dominated by intra-city minibuses. This mode of transport particularly involve serious human interaction and compliance with Covid -19 preventive measures, especially in urban areas had not been systematically evaluated. Aims: To explore the challenges to compliance in implementing the recommended WHO COVID -19 guidelines in Copperbelt Province, Zambia. Design: An explorative qualitative study.# Methods: Individual semi-structured interviews were conducted from February to April 2022 and, content analysis was used. Results: The following 5 major themes emerged: “perception and experiences about Covid 19; knowledge of prevention guidelines; attitudes towards implementation of the prevention guidelines; accessibility and availability of protective equipment; and, accessibility and availability of transport.” Drivers and conductors experienced tremendous reduction in income due to restricted movements of passengers as well as social distancing which called for a reduction in the number of passengers in a particular bus, cost of face masks and hand sanitizers. This left them with no profit and most of them were retrenched. Passengers reported discomfort caused by the face masks which prevented some of them from breathing properly, while others reported impact on their business and restriction in movements. A section of respondents felt that Covid was a hoax therefore prevention guidelines were an infringement on them. Conclusion: This study highlights the fact that creating an enabling environment for doing business is critical by ensuring Covid -19 prevention materials are subsidized or provided for free. In addition provision of loans to transporters to cushion the challenges are crucial. Furthermore there is need to maximize information dissemination to raise awareness and depoliticize the fight against Covid -19

Comparison of haemodynamic effects of a bolus of five units of oxytocin versus a bolus of ten units of oxytocin on parturients undergoing caesarean section at Parirenyatwa and Harare hospitals, Zimbabwe

Objectives: This study was done to compare the haemodynamic effects of an intravenous bolus of 5 IU oxytocin versus a bolus of 10 IU.Study Design: A prospective randomised clinical trial.Setting: The study was conducted at Harare Central Hospital Maternity Unit and Mbuya Nehanda Maternity hospitalStudy Subjects: The study was conducted in 86 ASA 1 and 2 parturients undergoing spinal anaesthesia for elective and emergency caesarean sectionMethods: The 86 patients were randomized to receive either five IU or ten IU of oxytocin post-delivery. Noninvasive monitoring of Heart rate, Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Mean Arterial Pressure (MAP) was done. Blood loss was also measured.Results: There was a statistically significant greater increase in mean Heart rate in patients who received 10 IU than in those who received 5 IU of oxytocin (p=0.028). There was a larger decrease in Mean Arterial Pressure, Diastolic blood pressure and Systolic blood pressure in patients who received 10 IU of oxytocin than in patients who received 5 IU of oxytocin (p<0.0001). There was no difference in blood loss between the two groups.Conclusions: During caesarean section, a bolus of 5 IU oxytocin results in less haemodynamic change than a bolus of 10 IU of oxytocin with no difference in the blood loss

Exploring barriers to antiretroviral therapy adherence among pregnant women: a scoping literature review

Background: Antiretroviral therapy (ART) is one of the most effective ways of preventing HIV-related maternal mortality. However, the rates of retention in care and long-term adherence remain extremely low. Objective: The aim of this study was to explore barriers to antiretroviral therapy adherence among pregnant women. Search strategy: The search for articles was conducted using EBSCO Host, PubMed, Google scholar, and Cumulative Index of Nursing and Allied Health Literature (CINAHL). Selection criteria: The studies included were conducted between 2000 and 2020 and covered barriers to antiretroviral therapy. Data collection and analysis: Data was collected from 8 selected articles and analyzed using Arksey and O’Malley five stages framework. Main results: Barriers to antiretroviral therapy adherence included side effects of the therapy and financial constraints limiting access to food, transport, and medication. Other barriers included cultural and religious factors, lack of spouse support, stigma, and discrimination. Conclusion: There is need to support pregnant women undergoing antiretroviral therapy to mitigate barriers associated with the uptake of the therapy