Effects of Positive HIV Status Disclosure on Sexual Behaviour Change

Introduction: Disclosure of HIV serostatus is critical to controlling the spread of HIV, and understanding the experience for disclosure enhances the development of prevention interventions and ultimately leads to better control of the spread of the disease. The present narrative review aimed to synthesize literature on the effects of positive HIV status disclosure on sexual behaviour change. Method: A narrative review design was utilized. Literature search of articles was from the following databases; Scopus, Science Direct, PUBMED, OVID and Google scholar. The searches were conducted from August 2019 to June 2020. The qualitative analysis was used to presented data into themes. Results: The main findings were discussed under four thematic domains: 1) disclosure, 2) number of sexual partners, 3) type of sexual partners and 4) use condoms. Conclusion: The narrative review presents evidence on; how patients revealing their HIV positive status to their sexual partner(s), family members, or others in their social circle are associated to better, less risky sexual behaviors. This finding implies that when people living with HIV disclose their status, they are most likely to; 1) have less sexual partners, 2) use condoms and 3) minimize casual/temporary sex. The behavior change brought by the positive HIV status disclosure can significantly reduce the transmission of HIV within the society.College of Human Science

The healthcare system and client failures contributing to maternal mortality in rural Kenya

Background The global maternal mortality ratio is estimated at 211/100 000 live births in 2017. In Kenya, progress on reducing maternal mortality appears to be slow and persistently higher than the global average, despite efforts by the government’s provision of free maternity services in both private and public facilities in 2013. We aimed to explore and describe the experiences of midwives on maternal deaths that are associated with the healthcare system and client failures in Migori, Kenya. Methods An explanatory, qualitative approach method was adopted. In-depth interviews were conducted with the purposively selected midwives working in peripartum units of the three sampled hospitals within Migori County in Kenya. The hospitals included two county referral hospitals and one private referral hospital. Saturation was reached with 37 respondents. NVivo 11 software was used for analysis. Content analysis using a qualitative approach was adopted. Accordingly, the data transcripts were synthesised, coded and organised into thematic domains. Results Identified sub-themes: sub-optimal care, staff inadequacy, theatre delays, lack of blood and essential drugs, non-adherence to protocols, staff shortage, inadequate equipment and supplies, unavailable ICU wards, clients’ ANC non-adherence. Conclusion In conclusion, the study notes that the healthcare system and client failures are contributing to maternal mortality in the study setting. The major failures are across the pregnancy continuum starting from antenatal care, and intrapartum to post-natal care. This can illustrate that some pregnant mothers are getting sub-optimal care reducing their survival chances. To reduce maternal mortality in Migori County, the key highlighted healthcare system and client failures should be addressed through a multidisciplinary approach mechanism.Health Studie

Challenges of Caregivers Having Children with Autism in Kenya: Systematic Review

Background: Caring for children with Autism Spectrum Disorder (ASD) is demanding, especially where access to services and support are inadequate. The present study aimed to systematically review the challenges associated with the caregivers whose children have autism. Materials and Methods: A systematic review design was utilized. The searches were conducted from February 2019 to January 2020. A qualitative analysis that was based on meta‑aggregation approach and thematic analysis was used. Thereafter, data was presented into themes. The quality of all included studies was assessed using the Critical Appraisal Skills Program (CASP). Results: The search generated 909 articles of which only 9 met the inclusion criteria. The main findings were discussed under the following three thematic domains: 1) Stigma, 2) Financial burden, and 3) Caregiving burden. Conclusions: Evidence from the data reviewed showed financial burden faced by the caregivers whose children are diagnosed with ASD. This was manifested through both direct and indirect cost of treatment. Another key finding was that majority of the caregivers faced stigma from the community. This implies the low level of awareness of the ASD within the community. The present study calls for more programs on the present research problem within the community so as to increase awareness. Furthermore, the current advocacy of Universal Health Coverage programs in the country should incorporate ASD children.Health Studie