The prevalence of domestic violence among pregnant women in Nigeria: a systematic review.

To identify, appraise, and synthesize research evidence on the prevalence of domestic violence (DV) among pregnant women in Nigeria. We conducted a systematic review of all published studies between April 2004 and June 2016. Comprehensive searches were conducted on electronic databases such as PubMed, CINAHL, Global Health, MEDLINE, PsycINFO, Directory of Open Access Journals, Google Scholar, and electronic libraries of the authors' institution. Identified articles were screened in two stages against the inclusion criteria with titles and abstract screened first followed by full-text screening. Selected articles were assessed using the "guidelines for evaluating prevalence studies," and findings were synthesized narratively. Among 19 studies that met the inclusion criteria, two articles were excluded due to low methodological quality and 17 articles were included in the review. The prevalence of DV during pregnancy in Nigeria ranged between 2.3% and 44.6% with lifetime prevalence rates ranging between 33.1% and 63.2%. Physical, sexual, psychological, and verbal abuses were the most frequent types of DV reported in this review. The most common perpetrators were husbands, as reported in 11 of the 17 studies. Pregnant women between the ages of 20 and 30 years were the most common victims of DV. Our review suggests high prevalence of DV in pregnancy among women in Nigeria and higher lifetime prevalence. However, determining an overall, synthesized accurate prevalence rate of DV within this population based on existing evidence presents a challenge. The findings have important implications for stakeholders such as planners, policy makers, maternity care providers, and researchers in public health and social policy at national, regional, and international levels toward combating the issue. OBJECTIVE METHOD RESULTS CONCLUSIO

A Qualitative Exploration of the Meaning and Understanding of Male Partner Involvement in Pregnancy-Related Care Among Men in Rural South Africa

Male partner involvement (MPI) during antenatal care has been promoted as an effective intervention to improve maternal and newborn health outcomes. Although MPI is commonly defined as men attending antenatal clinic visits with their female partner, few men attend antenatal clinic visits in rural communities in the province of Mpumalanga, South Africa. The study aimed to qualitatively explore the meaning and understanding of MPI as perceived by men visiting primary health care clinics in rural communities in Mpumalanga. Six focus groups discussions (n = 53) were conducted, digitally recorded, simultaneously transcribed, and translated verbatim into English. Data were analyzed using thematic content analysis. Perceptions of male roles during and after pregnancy differed among men. Male involvement was understood as giving instrumental support to female partners through financial help, helping out with physical tasks, and providing emotional support. Accompanying female partners to the clinic was also viewed as partner support, including behaviors such as holding a spot for her in the clinic queues. Community attitudes, traditional beliefs, and negative experiences in health facilities were barriers for MPI. This study provides support for concerted efforts to work with both men and women within the cultural context to explore the important roles of all members of the family in working together to provide the best possible health outcomes for mother and infant. In particular, future interventions should focus on making antenatal care services more responsive to male partners, and improving male partner accessibility in health care facilities

Screening and brief interventions for hazardous and harmful alcohol use among patients with active tuberculosis attending primary care clinics in South Africa: a cluster randomized controlled trial protocol

<p>Abstract</p> <p>Background</p> <p>In 2008 the World Health Organization (WHO) reported that South Africa had the highest tuberculosis (TB) incidence in the world. This high incidence rate is linked to a number of factors, including HIV co-infection and alcohol use disorders. The diagnosis and treatment package for TB and HIV co-infection is relatively well established in South Africa. However, because alcohol use disorders may present more insidiously, making it difficult to diagnose, those patients with active TB and misusing alcohol are not easily cured from TB. With this in mind, the primary purpose of this cluster randomized controlled trial is to provide screening for alcohol misuse and to test the efficacy of brief interventions in reducing alcohol intake in those patients with active TB found to be misusing alcohol in primary health care clinics in three provinces in South Africa.</p> <p>Methods/Design</p> <p>Within each of the three selected health districts with the highest TB burden in South Africa, 14 primary health care clinics with the highest TB caseloads will be selected. Those agreeing to participate will be stratified according to TB treatment caseload and the type of facility (clinic or community health centre). Within strata from 14 primary care facilities, 7 will be randomly selected into intervention and 7 to control study clinics (42 clinics, 21 intervention clinics and 21 control clinics). At the clinic level systematic sampling will be used to recruit newly diagnosed TB patients. Those consenting will be screened for alcohol misuse using the AUDIT. Patients who screen positive for alcohol misuse over a 6-month period will be given either a brief intervention based on the Information-Motivation-Behavioural Skills (IMB) Model or an alcohol use health education leaflet.</p> <p>A total sample size of 520 is expected.</p> <p>Discussion</p> <p>The trial will evaluate the impact of alcohol screening and brief interventions for patients with active TB in primary care settings in South Africa. The findings will impact public health and will enable the health ministry to formulate policy related to comprehensive treatment for TB and alcohol misuse, which will result in reduction in alcohol use and ultimately improve the TB cure rates.</p> <p>Trial registration number</p> <p>PACTR: <a href="http://apps.who.int/trialsearch/trial.aspx?trialid=PACTR201105000297151">PACTR201105000297151</a></p

Predictors of tuberculosis (TB) and antiretroviral (ARV) medication non-adherence in public primary care patients in South Africa: A cross sectional study

Background: Despite the downward trend in the absolute number of tuberculosis (TB) cases since 2006 and the fall in the incidence rates since 2001, the burden of disease caused by TB remains a global health challenge. The co-infection between TB and HIV adds to this disease burden. TB is completely curable through the intake of a strict anti-TB drug treatment regimen which requires an extremely high and consistent level of adherence.The aim of this study was to investigate factors associated with adherence to anti-TB and HIV treatment drugs. Methods: A cross-sectional survey method was used. Three study districts (14 primary health care facilities in each) were selected on the basis of the highest TB caseload per clinic. All new TB and new TB retreatment patients were consecutively screened within one month of anti-tuberculosis treatment. The sample comprised of 3107 TB patients who had been on treatment for at least three weeks and a sub-sample of the total sample were on both anti-TB treatment and anti-retro-viral therapy(ART) (N = 757). Data collection tools included: a Socio-Demographic Questionnaire; a Post-Traumatic-Stress-Disorder (PTSD) Screen; a Psychological Distress Scale; the Alcohol Use Disorder Identification Test (AUDIT); and self-report measures of tobacco use, perceived health status and adherence to anti-TB drugs and ART. Results: The majority of the participants (N = 3107) were new TB cases with a 55.9% HIV co-infection rate in this adult male and female sample 18 years and older. Significant predictors of non-adherence common to both anti-TB drugs and to dual therapy (ART and anti-TB drugs) included poverty, having one or more co-morbid health condition, being a high risk for alcohol mis-use and a partner who is HIV positive. An additional predictor for non-adherence to anti-TB drugs was tobacco use. Conclusions: A comprehensive treatment programme addressing poverty, alcohol mis-use, tobacco use and psycho-social counseling is indicated for TB patients (with and without HIV). The treatment care package needs to involve not only the health sector but other relevant government sectors, such as social development.IS

Data Resource Profile: The World Health Organization Study on global AGEing and adult health (SAGE)

Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization's Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russia and South Africa, with a smaller sample of adults aged 18-49 years in each country for comparisons. Instruments are compatible with other large high-income country longitudinal ageing studies. Wave 1 was conducted during 2007-2010 and included a total of 34 124 respondents aged 50+ and 8340 aged 18-49. In four countries, a subsample consisting of 8160 respondents participated in Wave 1 and the 2002/04 World Health Survey (referred to as SAGE Wave 0). Wave 2 data collection will start in 2012/13, following up all Wave 1 respondents. Wave 3 is planned for 2014/15. SAGE is committed to the public release of study instruments, protocols and meta- and micro-data: access is provided upon completion of a Users Agreement available through WHO's SAGE website (www.who.int/healthinfo/systems/sage) and WHO's archive using the National Data Archive application (http://apps.who.int/healthinfo/systems/surveydata

Track D Social Science, Human Rights and Political Science

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138414/1/jia218442.pd

Predictors of condom use among South African youth aged 15-24 years

Paper presented at the 2011 HSRC Social Sciences Research Conference, Birchwood Conference Centre, Benoni, 7-8 Septembe

Determinants of HIV testing among young people aged 18 – 24 years in South Africa

Background: Although recent estimates of the HIV/AIDS burden in South Africa show the particular vulnerability of youth to HIV, HIV testing and its determinants are largely understudied in this age group. Objective: To investigate the prevalence and determinants of HIV testing among young people aged 18 to 24 years, as part of an evaluation of the impact of loveLife. Methods: South Africa’s national HIV prevention campaign for young people, on HIV and related risk behaviours. A cross-sectional population-based household survey was conducted using a multistage stratified cluster sampling approach. The total sample included 3123 participants, aged 18-24, 54.6% men and 45.4% women, from four provinces (Eastern Cape, Gauteng, KwaZulu-Natal and Mpumalanga). Results: The results indicated that over half (52.2%) of the youth reported testing for HIV, with more young females (60.1%) testing for HIV compared to their male counterparts (39.9%). In the multivariate analysis, older age, being female, HIV knowledge, having ever talked to the mother or female guardian about HIV and having ever been pregnant or made someone pregnant were found to be associated with testing for HIV. Conclusion: There is still room for improving the low proportion of young people who test for HIV. Specific attention needs to be paid to younger males, with lack of HIV knowledge, having never talked to the mother or female guardian about HIV and having never been pregnant or made someone pregnant were less likely to be tested. Outreach at individual and community levels and public health messages targeting these youth should be implemented

Psychological distress and associated factors among a sample of pregnant women in South Africa

We sought to identify the prevalence of psychological distress and associated factors among pregnant women who were patients at antenatal primary care clinics in a South Africa district. A cross-sectional study using systematic sampling was conducted among 1497 pregnant women (age range=18 to 47 years; mean age=26.6 years, SD=6.1; Black African=98%), with a mean gestational age of 6.5 months (SD=1.6). They completed the Kessler Psychological Distress Scale, a measure of psychological distress. Results showed high rates of severe psychological distress (26.5%). Increased distress was in multivariate analysis associated with having had an STI (other than HIV), being unhappy about current pregnancy, and HIV positive. Identification of pregnant women with psychological distress in public health clinics is crucial for effective and appropriate targeted interventions.