Depiction of Shona marriage institution in Zimbabwe local television drama, Wenera Diamonds

Marriage is a highly celebrated phenomenon among the African people. It is one of the important institutions among the Shona and Ndebele people in Zimbabwe as expressed in the saying ‘musha mukadzi’ and ‘umuzingumama’ (home is made by a woman) respectively. However with the coming of colonialism in Zimbabwe, marriage was not given the appropriate respect it deserves. This has given impetus to this paper where the researchers in the study through drama want to bring out the depiction of marriage institution in a post -independence television drama, Wenera Diamonds (2017). This paper therefore, aims to show the impact of neo-colonialism on Shona marriage institution. The neo colonial period is characterised with the perpetuation of Western imperial interests through protocols of diplomatic relations, treaties and existing bilateral agreements which marked a new phase of relationships with former colonisers. The aim of this article therefore is to depict marriage institution in neo colonial Zimbabwe in Wenera Diamonds (2017), a Zimbabwean television drama. Using qualitative research methodology, the research employs content analysis to elucidate the depiction in the said performance. Guided by the Africana womanist perspective, the article argues that the indigenous knowledge needed for African social development is rendered irrelevant by a dysfunctional set of values of the western hegemony. Against that, the paper establishes that the depiction of marriage institution in Wenera diamonds is a reflection of imperialist colonial forces on the black person hence the need to go back to basics and resuscitate their culture

Traditional household strategies to cope with food security in the SADCC region

A research review on the mechanisms being used in the SADCC region to cope with food insecurity in rural areas of Southern Africa.This paper reviews the literature on strategies for coping with food shortages in rural Africa and examines the available data on coping strategies used in the SADCC countries. Theoretical approaches to analysis of coping behaviour are compared, coping strategies are described and the structure of the coping behaviour discussed. This paper sets out the context for research being conducted by the authors into the nature of strategies for coping with recurrent food shortage in rural areas of Zimbabwe.This research is funded by the Ford Foundation, the University of Zimbabwe, Michigan State University, and the United States Information Service (USIS

Strategies For Coping With Food Deficits In Rural Zimbabwe

A GJZ research article.The resourcefulness of African smallholders in the face of recurrent food deficits is often overlooked by professionals and officials concerned with food security. Food scarcity has provoked a wide range of interventions by exogenous institutions but only rarely have the coping strategies maintained by small farmers been recognized as affording a basis for such action. Research has shown that rural production systems in different parts of sub-Saharan Africa incorporate a wide range of activities designed to reduce the incidence and impact of food shortage (e.g. Campbell, D.J., 1984; Walts, 1983a; Matiza et al. 1989). These activities are integral to rural production systems and are based on resources and relationships found in the social, economic and political institutions of society and on the generosity of the local physical environment

The cost‐effectiveness of prophylaxis strategies for individuals with advanced HIV starting treatment in Africa

Introduction Many HIV‐positive individuals in Africa have advanced disease when initiating antiretroviral therapy (ART) so have high risks of opportunistic infections and death. The REALITY trial found that an enhanced‐prophylaxis package including fluconazole reduced mortality by 27% in individuals starting ART with CD4 <100 cells/mm3. We investigated the cost‐effectiveness of this enhanced‐prophylaxis package versus other strategies, including using cryptococcal antigen (CrAg) testing, in individuals with CD4 <200 cells/mm3 or <100 cells/mm3 at ART initiation and all individuals regardless of CD4 count. Methods The REALITY trial enrolled from June 2013 to April 2015. A decision‐analytic model was developed to estimate the cost‐effectiveness of six management strategies in individuals initiating ART in the REALITY trial countries. Strategies included standard‐prophylaxis, enhanced‐prophylaxis, standard‐prophylaxis with fluconazole; and three CrAg testing strategies, the first stratifying individuals to enhanced‐prophylaxis (CrAg‐positive) or standard‐prophylaxis (CrAg‐negative), the second to enhanced‐prophylaxis (CrAg‐positive) or enhanced‐prophylaxis without fluconazole (CrAg‐negative) and the third to standard‐prophylaxis with fluconazole (CrAg‐positive) or without fluconazole (CrAg‐negative). The model estimated costs, life‐years and quality‐adjusted life‐years (QALY) over 48 weeks using three competing mortality risks: cryptococcal meningitis; tuberculosis, serious bacterial infection or other known cause; and unknown cause. Results Enhanced‐prophylaxis was cost‐effective at cost‐effectiveness thresholds of US$300 and US$500 per QALY with an incremental cost‐effectiveness ratio (ICER) of US$157 per QALY in the CD4 <200 cells/mm3 population providing enhanced‐prophylaxis components are sourced at lowest available prices. The ICER reduced in more severely immunosuppressed individuals (US$113 per QALY in the CD4 <100 cells/mm3 population) and increased in all individuals regardless of CD4 count (US$722 per QALY). Results were sensitive to prices of the enhanced‐prophylaxis components. Enhanced‐prophylaxis was more effective and less costly than all CrAg testing strategies as enhanced‐prophylaxis still conveyed health gains in CrAg‐negative patients and savings from targeting prophylaxis based on CrAg status did not compensate for costs of CrAg testing. CrAg testing strategies did not become cost‐effective unless the price of CrAg testing fell below US$2.30. Conclusions The REALITY enhanced‐prophylaxis package in individuals with advanced HIV starting ART reduces morbidity and mortality, is practical to administer and is cost‐effective. Efforts should continue to ensure that components are accessed at lowest available prices

Late Presentation With HIV in Africa: Phenotypes, Risk, and Risk Stratification in the REALITY Trial.

This article has been accepted for publication in Clinical Infectious Diseases Published by Oxford University PressBackground: Severely immunocompromised human immunodeficiency virus (HIV)-infected individuals have high mortality shortly after starting antiretroviral therapy (ART). We investigated predictors of early mortality and "late presenter" phenotypes. Methods: The Reduction of EArly MortaLITY (REALITY) trial enrolled ART-naive adults and children ≥5 years of age with CD4 counts .1). Results: Among 1711 included participants, 203 (12%) died. Mortality was independently higher with older age; lower CD4 count, albumin, hemoglobin, and grip strength; presence of World Health Organization stage 3/4 weight loss, fever, or vomiting; and problems with mobility or self-care at baseline (all P < .04). Receiving enhanced antimicrobial prophylaxis independently reduced mortality (P = .02). Of five late-presenter phenotypes, Group 1 (n = 355) had highest mortality (25%; median CD4 count, 28 cells/µL), with high symptom burden, weight loss, poor mobility, and low albumin and hemoglobin. Group 2 (n = 394; 11% mortality; 43 cells/µL) also had weight loss, with high white cell, platelet, and neutrophil counts suggesting underlying inflammation/infection. Group 3 (n = 218; 10% mortality) had low CD4 counts (27 cells/µL), but low symptom burden and maintained fat mass. The remaining groups had 4%-6% mortality. Conclusions: Clinical and laboratory features identified groups with highest mortality following ART initiation. A screening tool could identify patients with low CD4 counts for prioritizing same-day ART initiation, enhanced prophylaxis, and intensive follow-up. Clinical Trials Registration: ISRCTN43622374.REALITY was funded by the Joint Global Health Trials Scheme (JGHTS) of the UK Department for International Development, the Wellcome Trust, and Medical Research Council (MRC) (grant number G1100693). Additional funding support was provided by the PENTA Foundation and core support to the MRC Clinical Trials Unit at University College London (grant numbers MC_UU_12023/23 and MC_UU_12023/26). Cipla Ltd, Gilead Sciences, ViiV Healthcare/GlaxoSmithKline, and Merck Sharp & Dohme donated drugs for REALITY, and ready-to-use supplementary food was purchased from Valid International. A. J. P. is funded by the Wellcome Trust (grant number 108065/Z/15/Z). J. A. B. is funded by the JGHTS (grant number MR/M007367/1). The Malawi-Liverpool–Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine (grant number 101113/Z/13/Z) and the Kenya Medical Research Institute (KEMRI)/Wellcome Trust Research Programme, Kilifi (grant number 203077/Z/16/Z) are supported by strategic awards from the Wellcome Trust, United Kingdom. Permission to publish was granted by the Director of KEMRI. This supplement was supported by funds from the Bill & Melinda Gates Foundation