Community Mobilization as a tool against sexual and gender-based violence in SADC region

SADC has continued to register high rates of Sexual and Gender-based Violence. This violence is usually in the form of physical aggression, psychological abuse, social exclusion, sexual coercion, rape, economic and legal violence. Evidence shows that women, adolescent girls, persons with disabilities, and the LGBTQIA2S+ (Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex, Asexual and Two-Spirit) community are particularly at risk. The mainstream mitigation strategies have traditionally focused on interventions that are necessary but not sufficient in addressing the unique conditions that perpetuate violence in the region. Community Mobilization has been suggested as useful response to this scourge. There is however lack of well documented evidence on the relevance of Community Mobilization as a tool against SGBV in SADC. This manuscript aims to fill these gaps by interrogating and documenting the relevance of Community Mobilization as a tool against SGBV in SADC. By doing so, it will also be providing grounds for creating better responses to this scourge. Through a process of systematic literature review, our findings demonstrate that Community Mobilization contributed to creating a protective and transformative social environment to fight SGBV. The three elements of Community Mobilization provided the lens through which this transformation could be realistically imagined. More specifically, Community Mobilization created possibilities of combating SGBV through the following ways: a) by building collective agency, b) by utilizing locally available resources, c) by combating inequities, and d) by creating local ownershi

Reorientation of the teacher education curriculum for sustainability at David Livingstone college of education in Livingstone, Zambia.

ThesisThe purpose of this study was to investigate the quality of the reorientation of the teacher education curriculum for sustainability at David Livingstone College of Education (DALICE) in Livingstone-Zambia. It was located in the Third Action Area of the Global Action Programme on Education on Sustainable Development, a follow-up to the United Nations Decade of Education for Sustainable (2005-2014). Its specific objectives were to: examine the quality of curriculum content; assess the quality of the teaching approaches; establishing existing potential opportunities and development of a model for quality reorientation of teacher education curriculum towards sustainability at DALICE. Literature on the quality of the reorientation of teacher education for sustainability emphasized the importance of developing holistic curriculum content, use of theory, practice and field based teaching approaches, creation of spaces of learning. However, there was little information on the quality of the reorientation of teacher education for sustainability at DALICE. A phenomenological research design with qualitative approaches was employed and participants who were purposively selected comprised: 3 officials from Teacher Education and Specialised Services (TESS) and 2 from Zambian National Commission for UNESCO. Other participants were; 4 Heads of Departments, 8 Lecturers and 20 Students from DALICE. The data was generated through semi-structured interviews, observation checklist and document review. Thematic and content techniques were used to analyze data. The results showed that efforts were made in the 2013 Zambian teacher education reform to reorient the teacher education curriculum for sustainability and keep-up with sustainability educational needs of the pre-service student teachers. However, the desired teaching professional competencies in ESD were not clearly defined in a functional way and ESD was presented in a globalized manner. It was also noted that, a holistic approach to the development of the teacher education curriculum reoriented for sustainability at all the stages was not adopted, as there was no evidence of interdisciplinary view where the social, ecological and economic dimensions of sustainability are well balanced in all the study areas and forms of the teacher education curriculum. The overall conclusion was that, the quality of the reorientation of teacher education curriculum for sustainability at DALICE was partial, as it lacked relevant knowledge and competences to adequately prepare students for sustainability teaching. To maximize the benefits of preparing the students for sustainability teaching, this study recommended the use of a holistic approach, a philosophy of ESD to the development of the teacher education curriculum with the aim, goal and vision of the college, nation and ESD in mind. A shift from disciplinary to interdisciplinary view of the teacher education curriculum where the social, ecological and economic aspects of sustainability are well balanced and clarified to the target audience in the cultural contexts was also recommended. Furthermore, a model which illustrates how the whole-institutional approach could greatly contribute to the improvement of quality agendas in the reorientation of the teacher education curriculum for sustainability was suggested in this study. Key words: Reorientation, Education for Sustainable Development and Teacher Educatio

"You cannot eat rights": a qualitative study of views by Zambian HIV-vulnerable women, youth and MSM on human rights as public health tools

Background Human rights approaches now dominate the HIV prevention landscape across sub-Saharan Africa, yet little is known about how they are viewed by the populations they are designed to serve. Health interventions are most effective when they resonate with the worldviews and interests of target groups. This study examined local Zambian understandings of human rights approaches to HIV-prevention among three highly HIV-vulnerable groups: women, youth, and men-who-have-sex-with-men (MSM). Methods Focus groups included 23 women, youth, and MSM who had participated in activities organized by local non-governmental organizations (NGOs) using rights-based approaches, and interviews included 10 Zambian employees of these NGOs. Topics included participants’ experiences and views of the utility of these activities. Thematic analysis mapped out diverse ways participants viewed the concept of human rights in relation to HIV-prevention. Results Whilst NGO workers noted the need for human rights programs to address the complex drivers of the HIV epidemic, they struggled to tailor them to the Zambian context due to donor stipulations. Women program beneficiaries noted that the concept of human rights helped challenge harmful sexual practices and domestic abuse, and youth described rights-based approaches as more participatory than previous HIV-prevention efforts. However, they criticized the approach for conflicting with traditional values such as respect for elders and ‘harmonious’ marital relationships. They also critiqued it for threatening the social structures and relationships that they relied on for material survival, and for failing to address issues like poverty and unemployment. In contrast, MSM embraced the rights approach, despite being critical of its overly confrontational implementation. Conclusions A rights-based approach seeks to tackle the symbolic drivers of HIV—its undeniable roots in cultural and religious systems of discrimination. Yet, it fails to resonate with youth and women’s own understandings of their needs and priorities due to its neglect of material drivers of HIV such as poverty and unemployment. MSM, who suffer extreme stigma and discrimination, have less to lose and much to gain from an approach that challenges inequitable social systems. Developing effective HIV-prevention strategies requires careful dialogue with vulnerable groups and greater flexibility for context-specific implementation rather than a one-size-fits-all conceptualization of human rights

Exploring health workers’ experiences of mental health challenges during care of patients with COVID-19 in Uganda: a qualitative study

OBJECTIVES: The aim of this study is to qualitatively investigate the lived experiences of mental health among frontline health workers providing COVID-19-realted care in Uganda. This study provides insights into the contextual realities of the mental health of health workers facing greater challenges given the lack of adequate resources, facilities and health workers to meet the demand brought about by COVID-19. RESULTS: All in all, our findings suggest that healthcare workers are under enormous stress during this pandemic, however, in order to effectively respond to the COVID-19 pandemic in Uganda, it is important to understand their challenges and sources of these challenges. The government thus has the reasonability to address most of the sources that were highlighted (long working hours, lack of proper equipment, lack of sleep, exhaustion, and experiencing high death rate under their care). Further, the Ugandan social fabric presents an opportunity for coping through its strong communal links and networks. Scaling these forms of local responses is cheap but contextually useful for a country with limited resources like Uganda. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13104-021-05707-4

Evaluation of antibiotic prescribing patterns for empirical therapy of neonatal sepsis at women and new born hospital, Lusaka, Zambia.

Antibiotics are the most commonly prescribed and used drugs in the treatment of neonatal sepsis. Inappropriate use of antibiotics is associated with increased microbial resistance and neonatal mortality. Therefore, this study was set out to determine the antibiotic prescribing patterns for empirical therapy of neonatal sepsis at Women and Newborn Hospital in Lusaka, Zambia. This will help public health to combat inappropriate antibiotic prescribing and prevent antibiotic resistance and reduce mortality. This was a cross-sectional study conducted at the Women and Newborn Hospital, Neonatal intensive care unit Lusaka, Zambia, from May 2018 to August 2018. Data on 134 neonates were collected using a structured questionnaire. Data on demographic characteristics, appropriateness of dose, the frequency of administration, duration of treatment, and most prescribed antibiotics and conditions affecting the neonates were collected. Systematic sampling was used for the selection of participants. Before initiation of treatment, a single blood sample was collected from each neonate for culture and susceptibility testing. Samples were cultured on blood agar, chocolate and MacConkey. The organisms isolated from positive culture were identified using conventional biochemical techniques. Data analysis was conducted using STATA version 13. Of the 134 neonates studied, total inappropriateness was 39.1(29.2%) The dose inappropriate was 10(7%), inappropriate frequency of administration 15(11%) and inappropriate duration of treatment 15.01(11.2%). The most inappropriate prescribed drug was imipenem at least 11times out of 134. The most common condition associated with inappropriateness was sepsis with respiratory distress 14(10.4%) other conditions 12(9.0%) and sepsis with low birth weight 8(6.0%). Of all the samples that were cultured only 22(16.4%) samples had bacterial growth (12Coagulase Negative-Staphylococcus, 5Gram-negative bacilli, 2Escherichia coli and 3 Klebsiella). Coagulase Negative-Staphylococcus was susceptible to amikacin, gentamycin chloramphenicol, and vancomycin and intermediately susceptible to ciprofloxacin and resistant to co-trimoxazole and penicillin. Gram-negative bacilli were susceptible amikacin, imipenem and resistant to ceftriaxone, penicillin gentamycin and ciprofloxacin. While Escherichia coli and Klebsiella sp were resistant to ceftriaxone, gentamycin and penicillin and susceptible to amikacin, chloramphenicol and Imipenem. In the multivariate logistic analysis, only antibiotics and disease state were significantly associated with inappropriateness. In conclusion: There seems to be inappropriate prescribing of antibiotics in neonates with sepsis at Women and Newborn Hospital in Zambia. There is a need for the hospital (NICU) to enforce adherence to treatment protocols by the prescriber. Key words: Inappropriate, Antibiotic prescribing, Neonates, Sepsi

Prevalence of and risk factors for active tuberculosis in migrants screened before entry to the UK: a population-based cross-sectional study

SummaryBackgroundAn increasing number of countries with low incidence of tuberculosis have pre-entry screening programmes for migrants. We present the first estimates of the prevalence of and risk factors for tuberculosis in migrants from 15 high-incidence countries screened before entry to the UK.MethodsWe did a population-based cross-sectional study of applicants for long-term visas who were screened for tuberculosis before entry to the UK in a pilot programme between Oct 1, 2005, and Dec 31, 2013. The primary outcome was prevalence of bacteriologically confirmed tuberculosis. We used Poisson regression to estimate crude prevalence and created a multivariable logistic regression model to identify risk factors for the primary outcome.Findings476 455 visa applicants were screened, and the crude prevalence of bacteriologically confirmed tuberculosis was 92 (95% CI 84–101) per 100 000 individuals. After adjustment for age and sex, factors that were strongly associated with an increased risk of bacteriologically confirmed disease at pre-entry screening were self-report of close or household contact with an individual with tuberculosis (odds ratio 11·6, 95% CI 7·0–19·3; p<0·0001) and being an applicant for settlement and dependant visas (1·3, 1·0–1·6; p=0·0203).InterpretationMigrants reporting contact with an individual with tuberculosis had the highest risk of tuberculosis at pre-entry screening. To tackle this disease burden in migrants, a comprehensive and collaborative approach is needed between countries with pre-entry screening programmes, health services in the countries of origin and migration, national tuberculosis control programmes, and international public health bodies.FundingWellcome Trust, Medical Research Council, and UK National Institute for Health Research