Perceptions and Beliefs of University and College Students Towards Male Circumcision in Lusaka

Background: Data from a range of observational epidemiological studies, conducted since the mid 1980s, showed that circumcised men have a lower prevalence of HIV than those who are uncircumcised. Furthermore recent randomized controlled trials conducted in Uganda, Kenya and South Africa have presented a myriad of data pointing to a 60 – 70% protection against HIV transmission. This evidence supports the notion that there are substantial health benefits from scaling-up male circumcision in Zambia,  due to the country's high HIV prevalence and low rates of male  circumcision.Study Objective: To gain insights into the perceptions and beliefs about Male circumcision among University and college students in Lusaka,  Zambia. The study was purely qualitative, was conducted with an iterative approach.Results: Manifest content of the study findings suggests that there is a remarkable and consistent trend in the way that Medical Male Circumcision is perceived amongst college and university student. They present virtuallyuniversal knowledge about the procedure, its practice, where it should be conducted, the facts about circumcision and what the prevailing untruths are about the procedure. The female respondents approve of male circumcision for males of all ages. They were quite conservative in their speech where to express themselves adequately they would have to be coerced for example, into explicitly referring to the male sex organ as a penis.Conclusions: The results from this particular study suggest that most young male adults are willing to go for circumcision and for the correct reasons as stipulated in the clearing house on “Basic facts about  Circumcision”. In their opinion the main aspect which may limit scale upof circumcision would be lack of services as near to the prospective clients as possible and lack of sufficient information about male circumcision in various sections of society. The female students have grasped the opportunity and have become partners in their counterpart's health seeking behavior. They are aware that there are indirect benefits for them when their male partners have undergone circumcisio

Cost of abortions in Zambia: a comparison of safe abortion and post abortion care

Unsafe abortion is a significant but preventable cause of maternal mortality. Although induced abortion has been legal in Zambia since 1972, many women still face logistical, financial, social, and legal obstacles to access safe abortion services, and undergo unsafe abortion instead. This study provides the first estimates of costs of post abortion care (PAC) after an unsafe abortion and the cost of safe abortion in Zambia. In the absence of routinely collected data on abortions, we used multiple data sources: key informant interviews, medical records and hospital logbooks. We estimated the costs of providing safe abortion and PAC services at the University Teaching Hospital, Lusaka and then projected these costs to generate indicative cost estimates for Zambia. Due to unavailability of data on the actual number of safe abortions and PAC cases in Zambia, we used estimates from previous studies and from other similar countries, and checked the robustness of our estimates with sensitivity analyses. We found that PAC following an unsafe abortion can cost 2.5 times more than safe abortion care. The Zambian health system could save as much as US$0.4 million annually if those women currently treated for an unsafe abortion instead had a safe abortion

Reductions in abortion-related mortality following policy reform: evidence from Romania, South Africa and Bangladesh

Unsafe abortion is a significant contributor to worldwide maternal mortality; however, abortion law and policy liberalization could lead to drops in unsafe abortion and related deaths. This review provides an analysis of changes in abortion mortality in three countries where significant policy reform and related service delivery occurred. Drawing on peer-reviewed literature, population data and grey literature on programs and policies, this paper demonstrates the policy and program changes that led to declines in abortion-related mortality in Romania, South Africa and Bangladesh. In all three countries, abortion policy liberalization was followed by implementation of safe abortion services and other reproductive health interventions. South Africa and Bangladesh trained mid-level providers to offer safe abortion and menstrual regulation services, respectively, Romania improved contraceptive policies and services, and Bangladesh made advances in emergency obstetric care and family planning. The findings point to the importance of multi-faceted and complementary reproductive health reforms in successful implementation of abortion policy reform

Development of a curriculum for training in One Health analytical epidemiology at the University of Zambia

Recently, the world has witnessed emergence of novel diseases such as avian influenza, HIV and AIDS, West Nile Virus and Ebola. The evolution of these pathogens has been facilitated mainly by a constantly evolving animal-human interface. Whilst infectious disease control was previously conceptualised as either public health or animal health related issues, the distinction between disciplinary foci have been blurred by multiple causal factors that clearly traverse traditional disciplinary divides. These multiple evolutionary pressures have included changes in land use, ecosystems, human-livestock-wildlife interactions and antibiotic use, representing novel routes for pathogen emergence. With the growing realisation that pathogens do not respect traditional epistemological divides, the ‘One Health’ initiative has emerged to advocate for closer collaboration across the health disciplines and has provided a new agenda for health education. Against this background, the One Health Analytical Epidemiology course was developed under the auspices of the Southern African Centre for Infectious Diseases Surveillance by staff from the University of Zambia with collaborators from the London School of Hygiene and Tropical Medicine and the Royal Veterinary College in London. The course is aimed at equipping scientists with multidisciplinary skill sets to match the contemporary challenges of human, animal and zoonotic disease prevention and control. Epidemiology is an important discipline for both public and animal health. Therefore, this two-year programme has been developed to generate a cadre of epidemiologists with a broad understanding of disease control and prevention and will be able to conceptualise and design holistic programs for informing health and disease control policy decisions