Voluntary medical male circumcision and condoms for HIV prevention among school youth: marginal voices for a coherent sexual and reproductive school health policy in Zimbabwe.

Doctoral Degrees. University of KwaZulu-Natal, Durban.Background: Voluntary medical male circumcision (VMMC) is a component of HIV prevention. It is important to the HIV prevention agenda in priority settings; characterised by hyper endemic and generalised epidemics coupled with low percentages of circumcised males. Literature relating to school youth vis-à-vis VMMC and condoms is sorely missing. The study sought to fill this gap. Method: The study adopted a qualitative research design and an interpretivist paradigm. It used focus group discussions (FGDs) with learner participants, and key informant interviews (KIIs) with adults drawn from four schools (two per district: Mberengwa and Zvishavane). Seven sex-segregated FGDs were conducted. In terms of KIIs, a total of nine adults participated in one-on-one in-depth interviews. Adult participants were either Guidance and Counselling educators or health workers. Seven educators and two health workers participated in the KIIs. Data were thematically analysed. Findings: Both FGDs and KIIs produced rich and thick data indicating that school learners have limited knowledge and comprehension of basic facts related to HIV and AIDS. Many of the learner participants were ignorant of facts around VMMC for HIV prevention. Findings suggest that the acceptability of VMMC is high, but there is need for improving access to VMMC services. Furthermore, the need to make VMMC more comprehensive through increasing access to condoms and robust sex education, were some of the prominent findings. The study revealed that HIV prevention options, particularly for female learners were too limited, and those for boys were largely fragmented. Participants also identified several challenges that confront educators, the education system, and other stakeholders in their attempt to mitigate HIV among school adolescents, and adolescent sexual and reproductive health. These include a discriminatory, judgmental and narrow focused legal and policy framework. Conclusion: The study’s findings suggest that learners tend to prefer risk reduction methods to risk avoiding strategies such as abstinence. As such, most of the learner participants framed abstinence as being Utopian. Both data sets advance a discourse of a rights-based approach to adolescent sexual and reproductive health that is not dismissive of the agency of young people in enhancing sexual health and well-being

'Just a snip?' : Lemba circumcisers' perspectives on medical male circumcision for HIV prevention in Mberengwa district of rural Zimbabwe.

M.A. University of KwaZulu-Natal, Durban 2014.Medical Male Circumcision (MMC) is an HIV ‘prevention technology’ hailed for holding the promise to containing the epidemic. MMC augments the vision of the Joint United Nations Programme on HIV/AIDS (UNAIDS) that pins hope on the possibility of zero new infections through the adoption of a comprehensive prevention approach. This study’s impetus stems from the view that the success of MMC is anchored not only on the premise that its wide-scale implementation subsequently lowers HIV incidence in heterosexual men practicing vaginal penetrative sex, but is also dependent on the readiness of the target population to undergo circumcision. From a culture-centred approach which holds that health promotion programmes should be planned, implemented and evaluated within the context of the relevant socio-cultural beliefs and value systems prevalent in a particular community, the study is a qualitative exploration of perceptions on MMC for HIV prevention among the Lemba people of Mberengwa. The Lemba are a traditionally circumcising cultural group. In light of the culture-centred approach, how they perceive MMC is worth investigation if success has to be achieved in its implementation among this cultural group. The objective of the study is to identify factors influencing collaboration of Lemba traditional circumcisers and medical institutions rolling out voluntary MMC. Purposively selected Lemba surgeons and elders participated in this study. Findings suggest that the Lemba practise male circumcision not as a mere surgical operation but as a symbolic cultural ritual that is value laden. However, they are ready to embrace MMC provided that it is done in a way that does not compromise the cultural values they attach to male circumcision. A deeper insight into Lemba perspectives generated in this study has been used to suggest ways in which the Ministry of Health and Child Care in Zimbabwe can scale-up roll out of voluntary MMC in Mberengwa through creating synergies between cultural and medical perspectives. For example, the majority of participants suggested that making use of Lemba initiates with medical training to conduct circumcisions in Murundu camps can help increase uptake of VMMC

“Brutal murder scenes are traumatising, and they’re mostly indelible” : occupational stressors and mental health among South African police service murder detectives at a selected station in Durban, South Africa

Occupational stress is rampant across various professions. The process of murder case investigation culminates in a plethora of challenges, including mental health concerns among murder detectives, which can trigger occupational stress. Stress reduces productivity and is detrimental to a worker’s health and well-being. This study explored trauma contributing to occupational stress among murder detectives in the South African Police Service. The study adopted a case study design and a qualitative approach within the constructivist paradigm. To generate rich and thick data, participants were purposively selected. Data were collected using in-depth interviews with eight (n = 8) murder detectives and two (n = 2) employees from the SAPS’ Employee, Health, and Well-being Services (EHWS) department. Data were analysed using thematic analysis. The sources of stress identified were attributed to the nature of police work, namely long work hours and exposure to traumatic crime scenes. Murder cases involving children and women were among the most emotionally challenging sources of stress. Further, most detectives reported resorting to defensive mechanisms in dealing with trauma. Although most detectives knew EHWS, high workloads were reported to be an insurmountable challenge. The findings have important implications for intervention programmes to improve the mental health and well-being of SAPS murder detectives.https://www.tandfonline.com/loi/oass20am2023Social Work and Criminolog

Coping strategies and support provided by educational centres to teenage mothers re-engaging with education post-pregnancy: a case study of a township school in South Africa

Teenage girls who conceive while in school are often confronted with a number of health, social and economic hardships. As a result of the pregnancy related hardships, some of the teenagers drop out of school and fail to re-enter the school system after giving birth. However, a growing body of literature show some of these teenagers re-enter the school system after giving birth to continue with their studies. We employed a qualitative approach to explore the coping strategies by teenage mothers when they returned to school following childbirth and the support mechanisms used by the schooling system to meet their learning needs. We adopted a single case study design of a South African township school in Gauteng Province, South Africa. We collected data using in-depth one-on-one interviews involving teenage mothers. The findings revealed that consultations with educators and participation in after-school programs, with the aim of catching-up on missed content was some of the coping strategies used by teenage mothers re-engaging with education following childbirth. In addition, sympathetic educators provided extra consultation time slots and also motivated the teenagers to persevere and focus on their studies. A call is made for schools to enhance learner support programs, especially those aimed at supporting teenage mothers who decide to return to school to complete their studies after giving birth

Early childbearing experiences of young university student‐parents in South Africa: A qualitative study

Abstract Background Early childbearing is a major concern especially in developing countries. This study sought to understand student‐parents’ perspectives of early childbearing, describe their individual experiences and identify the types of support required for such young parents. Methods This was an exploratory qualitative study with semi‐structured in‐depth interviews among 20 purposively selected participants. All the participants were young parent‐students at the University of KwaZulu‐Natal in Durban, South Africa. The interviews were conducted in 2018. Results The young parent‐students identified a lack of adequate information and knowledge about safe sex, contraceptive methods and prevention of pregnancies that led to early childbearing. The common misinformation that prevented the adoption of contraception methods were societal beliefs among men promoting early childbearing, coupled with the negative attitudes of healthcare workers in providing adequate information and reproductive health services. Both male and female parents suffered life‐changing consequences after early childbearing leading to financial burdens to support their new‐born and the interruption of their education. Government financial schemes and bursaries helped these young parents to financially support their new‐born, whereas family support in terms of taking care of the new‐born allowed them to continue with education. In addition, most participants identified having a child as a motivation for pursuing higher education. There is a need for Life Orientation programmes to be tailor‐made to provide adequate knowledge and sensitise the youth on appropriate life choices and access to contraceptives. Conclusion Early childbearing resulted from a lack of adequate knowledge on safe sex and contraceptive methods, poor access to contraceptives, the negative attitudes of healthcare workers in proving adequate sexual and reproductive health services to the youth. Schemes to financially support the young parents and support from family members were key to helping the young parents to continue with university education

An exploration of female healthcare workers’ experiences during the COVID-19 pandemic in Bindura, Zimbabwe

This study explores the experiences and coping strategies of female frontline healthcare workers (HCWs) fighting the COVID-19 pandemic in resource-constrained settings. Female frontline HCWs face an elevated risk of contracting the COVID-19 infection and infecting their loved ones because when they return from work. The study adopted a qualitative approach to explore the experiences of female frontline HCWs working in high-volume departments at Bindura provincial hospital in Zimbabwe. Using purposive sampling, 15 participants were recruited. HCWs were asked to share their views and perspectives on COVID-19 and their work environment. The study focused on HCWs’ experiences of stigma and discrimination once infected; access to treatment; understanding of transmission; and life experiences of living with COVID-19. The findings suggest that female HCWs working in high-volume departments experience a higher risk of exposure to infection, barriers to assessing personal protective equipment (PPE) and stigma, which impact their mental health. However, despite the complex interrelated challenges female frontline HCWs face in Zimbabwe, there are limited interventions to ameliorate this burden, a knowledge gap this research aims to illuminate

Risk Factors of Substance abuse among University Students: An Exploratory Study

Substance abuse is a significant problem among tertiary level students, with alcohol/drug use associated with increased prevalence of negative outcomes, including diminished academic performance, social-interpersonal difficulties, and engaging in risky behaviours. To explore risk factors associated with substance abuse among university students, a qualitative approach was adopted. Twenty on-campus residents were selected through purposive sampling. To elicit their views in-depth interviews were used. Data were thematically analysed, and engendered themes were identified. The findings revealed that various kinds of substances are abused by university students, which include codeine, marijuana (weed), and alcohol. Substance abuse is a kind of behaviour that students either learn or do intentionally, despite their foreknowledge of the negative effects and the risk factors such as peer pressure, stress, and depression. The study concludes that university students are aware of the various negative effects of substance abuse, but they mostly justify it as a way of coping with academic pressure