The informal trading of contraceptive pills in Kadoma, Zimbabwe

M.A. (Anthropology)Abstract: The intended purpose of family planning is to allow men and women the right to decide how many children they want to have, when they want to have those children, how to have them and if they want to have them. This paper draws from an ethnographic study that investigates the informal buying and selling of contraceptive pills in Kadoma, Zimbabwe with the main focus of trying to find out why some women would opt for informal means of access. Through the journey of coming to an understanding of this behaviour, a vital theme emerged from the interactions and it is that of autonomy, as some women utilised alternative pathways to access contraceptive pills to ensure they fulfilled their desired outcomes. The investigation of this informal trade was qualitative in nature, with a particular use of participant observation, in-depth semi-structured interviews and field notes. 13 key informants consisting of 12 women who used an array of family planning methods and a population centre ambassador, helped fuel the information that contextualised this dissertation. The experiences the women had with contraceptive devices in relation to their bodies portrayed the individual, social, cultural and political nuances that exist in Kadoma. Also, the existence of pharmaceutical products in the informal space is an indication of the social nature of contraceptive pills in Kadoma

Coping with racism: Exploring experiences of the post-apartheid generation of Black students at an historically Whites-only university in South Africa

This study explored how the post-apartheid generation of Black students cope with institutional racism and overt acts of racism at an historically Whites-only university. The experiences reported by Black students indicate that racism can manifest in various forms across different aspects of their lives. These experiences encompass institutional, academic, social, and emotional realms of their lived realities. N=6 Black students were interviewed to explore their experiences of racism and their coping mechanisms, using semi-structured interviews. A transcendental phenomenological research design underpinned the study in its focus on the shared lived racial experiences of post-apartheid Black students in an historically Whites-only university. Thematic analysis (TA) was used as a method of data analysis to elucidate these experiences. To align with the aim of the study, the analysis of gathered data employed a thematic approach grounded in social stress theory. The findings reveal that overt acts of racism and institutional racism perpetually afflict Black students, in post-apartheid South Africa. Five themes, and one overarching theme of coping defences were generated: academic determination, boldness, physically and emotionally escaping, faith, support, and inclusion. Fundamentally, the findings demonstrate that Black students adopt both adaptive and maladaptive defences of coping with their experiences of racism, with perpetual psychological costs to their emotional and academic functioning

Psychic wounds of post-traumatic stress disorder camouflaged under the uniform of an SANDF soldier

The authors explored the lived experiences of traumatisation among active Black military personnel from a psychodynamic (Object Relations) framework. The broad aim of this study was to explore traumatisation and subsequent long-term undiagnosed post-traumatic stress disorder (PTSD) in the presenting behaviour and overall psychological functioning of Black members in the South African National Defence Force (SANDF). N=9 members of the SANDF participated in the study. The study was conducted using a qualitative approach and a phenomenological research design. Data was obtained using individual semi-structured interviews, with IPA as a method of analysis. The findings indicated that participants lived experience of traumatisation is a chronic state of psychic, occupational and relational re-traumatisation. Continuous traumatisation that reactivated past unresolved traumas was characterised by annihilation anxiety, psychic numbing and repression. Phenomenologically overall functional paralysis was evidenced in chronic psychological deterioration, which manifests in irreversible damage to character, with cognitive and relational deficits linked to unresolved long-term traumatisation. These findings highlight a need to incorporate psychotherapeutic models focused on integrative meaning making of psychic distress for adaptive functioning of SANDF members, suffering from long-term undiagnosed PTSD syndrome from pre-integration armed forces combat experiences.https://www.pins.org.zaam2022Psycholog

Conceptualisation and psychometric evaluation of positive psychological outcome measures used in adolescents and young adults living with HIV:a mixed scoping and systematic review protocol

Introduction Sub-Saharan Africa bears the greatest burden of HIV. Concomitant mental disorders are common, necessitating the integration of mental healthcare into routine HIV care. Consequently, it is necessary to holistically evaluate the mental health of adolescents and young adults living with HIV (AYALHIV, 10–24 years old) by measuring negative and positive psychological constructs (eg, anxiety and self-acceptance, respectively). There has been a proliferation of positive psychological outcome measures, but the evidence of their psychometric robustness is fragmented. This review, therefore, seeks to (1) identify positive psychological outcomes used in AYALHIV in sub-Saharan Africa and map the constructs onto corresponding measures and (2) critically appraise the psychometrics of the identified outcomes Methods and analysis This mixed review will be done in two parts. First, a scoping review will identify positive psychological outcomes and map them onto corresponding outcome measures. Subsequently, we will systematically evaluate the psychometric properties of the outcomes identified from the scoping review. Independent and blinded reviewers will search articles in PubMed, Scopus, Web of Science, Africa-Wide Information, CINAHL, PsychINFO and Google Scholar from inception through 30 September 2022. Thereafter, separate independent reviewers will screen the retrieved articles. We will apply a narrative synthesis to map the key constructs emerging from the scoping review. For the systematic review, the risk of bias across studies will be evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The quality of the psychometric properties will be rated using the COSMIN checklist and qualitatively synthesised using the modified Grading of Recommendations Assessment, Development and Evaluation checklist. Ethics and dissemination No ethical approvals are needed. The mixed-review outputs will collectively inform the development, implementation and evaluation of bespoke interventions for AYALHIV. Review outcomes will be disseminated in a peer-reviewed journal, on social media and through policy briefs

Leaving no one behind? Addressing inequitable HIV outcomes by attending to diversity: A qualitative study exploring the needs of LGBTQI+ young people living with HIV in Zimbabwe

Leaving nobody behind in the fight to end the HIV epidemic as a public health threat depends on addressing inequities in optimal HIV outcomes. Consistently overlooked in research, policy and programming are young lesbian, gay, bisexual, transgender, queer/questioning and intersex (LGBTQI+) people who are living with HIV. This study engaged young LGBTQI+ people in Zimbabwe to better understand their experiences of living with HIV and the support they need. Between September 2022 and February 2023, we conducted qualitative research with 14 LGBTQI+ young people (18–24 years), (two focus group discussions and in-depth interviews with 5/14). All 14 participants were accessing a LGBTQI+ HIV support group at Zvandiri (‘As I Am’), a well-established community-based HIV program. We conducted thematic analysis and key findings informed the collaborative development of internal activities to further enhance inclusivity of LGBTQI+ young people within Zvandiri’s programs. There was consensus among participants that being LGBTQI+ and living with HIV leads to “double stigma and double trouble”, involving physical and verbal harassment, social exclusion and family rejection. Participants concealed their LGBTQI+ identity and HIV status in most situations, and many withheld their HIV status in LGBTQI+ social spaces, including community-led LGBTQI+ services. This negatively impacted their psychosocial well-being and social connectedness. Participants described positive experiences of Zvandiri. Interacting with others living with HIV in a destigmatising environment promoted self-acceptance. However, reflecting their prevailing experiences, participants were cautious about revealing their sexuality and/or gender identity at Zvandiri outside of their support group. Ensuring equitable access to HIV care, including mental health support, relies on understanding the challenges experienced by those most marginalised. Critically important is understanding the impact of intersectional stigma on LGBTQI+ young peoples’ social lives, and their access to services. Community-based HIV support programs are well-positioned to support and advance this group’s health rights

Ancient and Recent Adaptive Evolution of Primate Non-Homologous End Joining Genes

In human cells, DNA double-strand breaks are repaired primarily by the non-homologous end joining (NHEJ) pathway. Given their critical nature, we expected NHEJ proteins to be evolutionarily conserved, with relatively little sequence change over time. Here, we report that while critical domains of these proteins are conserved as expected, the sequence of NHEJ proteins has also been shaped by recurrent positive selection, leading to rapid sequence evolution in other protein domains. In order to characterize the molecular evolution of the human NHEJ pathway, we generated large simian primate sequence datasets for NHEJ genes. Codon-based models of gene evolution yielded statistical support for the recurrent positive selection of five NHEJ genes during primate evolution: XRCC4, NBS1, Artemis, POLλ, and CtIP. Analysis of human polymorphism data using the composite of multiple signals (CMS) test revealed that XRCC4 has also been subjected to positive selection in modern humans. Crystal structures are available for XRCC4, Nbs1, and Polλ; and residues under positive selection fall exclusively on the surfaces of these proteins. Despite the positive selection of such residues, biochemical experiments with variants of one positively selected site in Nbs1 confirm that functions necessary for DNA repair and checkpoint signaling have been conserved. However, many viruses interact with the proteins of the NHEJ pathway as part of their infectious lifecycle. We propose that an ongoing evolutionary arms race between viruses and NHEJ genes may be driving the surprisingly rapid evolution of these critical genes

An object relations perspective on accounts of traumatisation among a group of Black South African National Defence Force soldiers

This study explored the lived experience of traumatisation manifesting as enduring undiagnosed post- traumatic stress disorder (PTSD) on the overall psychological functioning of members currently serving in the South African National Defence Force (SANDF) from an object-relations perspective. A qualitative approach with a phenomenological study design using semi-structured interviews and self- report questionnaires to gather data was employed. Prominent themes formed the content for interpretative phenomenological analysis (IPA) from an object-relations perspective on pathology in relation to untreated trauma of the psyche. The findings indicated that servicemen and women in the SANDF lived in a chronic state of psychic, occupational and relational disintegration. Recurrence of reactivated past unresolved traumas experienced in dreams, troubled sleep and internal conflict were characterised by annihilation anxiety, psychic numbing and repression. Further, there was a chronic sense of loss of the self through loss of good internal and external self-objects as well as in meaning of life and work as a soldier. The findings further revealed overall functional paralysis as evidenced in these SANDF members’continued psychological deterioration, which manifested in irreversible damage to character and cognitive deficits linked to chronic trauma in the form of undiagnosed PTSD.Thesis (PhD (Psychology))--University of Pretoria, 2020.PsychologyPhD (Psychology)Unrestricte

Psychic Wounds of Post-Traumatic Stress Disorder camouflaged under the uniform of an SANDF soldier

The authors explored the lived experiences of traumatisation among active Black military personnel from a psychodynamic (Object Relations) framework. The broad aim of this study was to explore traumatisation and subsequent long-term undiagnosed post-traumatic stress disorder (PTSD) in the presenting behaviour and overall psychological functioning of Black members in the South African National Defence Force (SANDF). N=9 members of the SANDF participated in the study. The study was conducted using a qualitative approach and a phenomenological research design. Data was obtained using individual semi-structured interviews, with IPA as a method of analysis. The findings indicated that participants lived experience of traumatisation is a chronic state of psychic, occupational and relational re-traumatisation. Continuous traumatisation that reactivated past unresolved traumas was characterised by annihilation anxiety, psychic numbing and repression. Phenomenologically overall functional paralysis was evidenced in chronic psychological deterioration, which manifests in irreversible damage to character, with cognitive and relational deficits linked to unresolved long-term traumatisation. These findings highlight a need to incorporate psychotherapeutic models focused on integrative meaning making of psychic distress for adaptive functioning of SANDF members, suffering from long-term undiagnosed PTSD syndrome from pre-integration armed forces combat experiences

Reverse Logistics Strategies and Their Effect on the Competitiveness of Fast-Moving Consumer Goods Firms in South Africa

Background: The fast-moving consumer goods (FMCG) sector contributes significantly to the gross domestic product (GDP) growth of a country. This has therefore led to the growth in importance of reverse logistics (RL) since the FMCG sector cannot avoid RL. It is therefore important for the sector to implement RL strategies that can lead to firm competitiveness. Through the implementation of RL strategies, this sector will achieve many goals as well as lead to firm competitiveness. This study mainly sought to investigate RL strategies and their effect on firm competitiveness. Methods: A positivist research philosophy was employed. Data were collected through two close-ended questionnaires via SurveyMonkey from 418 FMCG retailers and consumers. This is because customers and employees are the greatest asset for any sector. Results: The descriptive results revealed the following RL strategies as the highly implemented ones among FMCG retailers: integration of forward logistics (FL) and RL, the implementation of new technology, the adherence to environmental policies and regulations, knowledge management, eco-compatibility and strategic alliances. The structural equation modeling (SEM) analysis revealed that RL strategies have a positive and significant influence on firm competitiveness. Conclusion: The results offer insight into the RL strategies that must be carried out to achieve firm competitiveness

Onsite training of doctors, midwives and nurses in obstetric emergencies, Zimbabwe

PROBLEM: In Zimbabwe, many health facilities are not able to manage serious obstetric complications. Staff most commonly identified inadequate training as the greatest barrier to preventing avoidable maternal deaths. APPROACH: We established an onsite obstetric emergencies training programme for maternity staff in the Mpilo Central Hospital. We trained 12 local staff to become trainers and provided them with the equipment and resources needed for the course. The trainers held one-day courses for 299 staff at the hospital. LOCAL SETTING: Maternal mortality in Zimbabwe has increased from 555 to 960 per 100 000 pregnant women from 2006 to 2011 and 47% of the deaths are believed to be avoidable. Most obstetric emergencies trainings are held off-site, away from the clinical area, for a limited number of staff. RELEVANT CHANGES: Following an in-hospital train-the-trainers course, 90% (138/153) of maternity staff were trained locally within the first year, with 299 hospital staff trained to date. Local system changes included: the introduction of a labour ward board, emergency boxes, colour-coded early warning observation charts and a maternity dashboard. In this hospital, these changes have been associated with a 34% reduction in hospital maternal mortality from 67 maternal deaths per 9078 births (0.74%) in 2011 compared with 48 maternal deaths per 9884 births (0.49%) in 2014. LESSONS LEARNT: Introducing obstetric emergencies training and tools was feasible onsite, improved clinical practice, was sustained by local staff and associated with improved clinical outcomes. Further work to study the implementation and effect of this intervention at scale is required