Transition Possibilities for Adolescents with Intellectual Disabilities into Adulthood

Transition possibilities for adolescents with intellectual disabilities into adulthood remain a complex issue and often neglected by the healthcare system and non-healthcare system. Given the responsibilities and roles that the healthcare system, non-healthcare system and families have to fulfil to address the transition possibility issue, the lack of knowledge, skills and resources negatively impacts on the transition possibility. In favour of situating adolescents with intellectual disabilities into adulthood, the provision and development of working skills need to be prioritised. Transition possibilities are to be considered to all adolescents with intellectual disabilities

Disclosure of HIV status to sexual partners by people living with HIV

Background: Disclosure of one’s HIV status to a sexual partner can have significant health implications. From a health promotion point of view, disclosure is seen as a cornerstone for the prevention of HIV transmission between partners. Despite its importance as a strategy for controlling the spread of HIV, there are challenges that inhibit voluntary disclosure. Objectives: In exploring factors associated with disclosure of HIV status, the study had two complementary objectives related to: (1) investigation of participants’ views about HIVpositive status disclosure to sexual partners; and (2) a broader identification of factors that influence disclosure of HIV-positive status. Method: The study explored factors associated with disclosure of the HIV status of people living with HIV to their sexual partners. Purposive sampling was used to select 13 participants living with HIV who attended a wellness clinic. Primary data were collected via an in-depth interview with each of the participants. Results: The exploration showed that male participants were notably more reluctant to disclose to their sexual partners for fear of rejection; and secrecy was commonly reported around sexual matters. Female participants (who were in the majority) were relatively more willing to disclose their HIV status to their sexual partners. Despite the complexity of disclosure, all participants understood the importance of disclosure to their sexual partners. Conclusion: There is a need for HIV prevention strategies to focus on men in particular, so as to strengthen disclosure counselling services provided to people living with HIV and to advocate strongly for partner testing.Health Studie

Teenage pregnancy in Nigeria: professional nurses and educators’ perspectives

Background: Teenage pregnancy has been regarded as a negative occurrence in recent times due to its various negative consequences on the overall wellbeing of the teenage mother and her child, the whole family system and the entire community at large. Teenage pregnancy rate is a powerful indicator of the total well-being of a population. Purpose: The aim of the study was to explore professional nurses and secondary school teachers’ own perspectives on teenage pregnancy and to ascertain the current teenage pregnancy prevention programmes within the two selected communities in Kwara and Edo states in Nigeria. Methods: The study was qualitative and contextual with an exploratory strategy. A total of 80 participants, who were professional nurses and secondary school teachers, responded to the semi-structured interview and completed a questionnaire on demographic data. Template analysis style was combined with content analysis for data analysis. Results: Our findings revealed limited teenage pregnancy prevention initiatives in the communities. The majority of the participants expressed that teenage pregnancy is a common occurrence in their communities, but it is not acceptable. More than half of the participants did not accept the usage of contraceptives by teenagers. Conclusions: The study identified a number of factors that may influence the rate of teenage pregnancy in the communities. Therefore, strategies to reduce teenage pregnancy should focus on building social capital for teenagers in communities, making information on contraception more accessible and offering programmes that empower girls in the area of sexuality

Factors Influencing Women’s Preferences for Places to Give Birth in Addis Ababa, Ethiopia

The main aim of this study was to examine factors determining women’s preference for places to give birth in Addis Ababa, Ethiopia. A quantitative and cross-sectional community based study design was employed. Data was collected using structured questionnaire administered to 901 women aged 15–49 years through a stratified two-stage cluster sampling technique. Multinomial logistic regression model was employed to identify predictors of delivery care. More than three-fourth of slum women gave birth at public healthcare facilities compared to slightly more than half of the nonslum residents. Education, wealth quintile, the age of respondent, number of children, pregnancy intention, and cohabitation showed net effect on women’s preference for places to give birth. Despite the high number of ANC attendances, still many pregnant women especially among slum residents chose to deliver at home. Most respondents delivered in public healthcare institutions despite the general doubts about the quality of services in these institutions. Future studies should examine motivating factors for continued deliveries at home and whether there is real significant difference between the quality of maternal care service offered at public and private health facilities

Reproductive health outcomes: Insights from experts and verbal autopsies

Background: Reproductive health outcomes are a measure of maternal and neonatal health. South Africa’s state of maternal health is of particular concern because of the two Millennium Development Goals (MDGs) targets for monitoring maternal health, namely MDG 5a, to reduce the maternal mortality rate by three-quarters, and MDG 5b, to achieve universal access to reproductive health by 2015. Maternal mortality ratio and universal access to reproductive health receive unequal responsiveness from government. Monitoring the maternal mortality ratio has received favourable attention compared to ensuring universal access to reproductive health, hence the limited published research findings on the latter. Objectives: The purpose of this article is to report on the insights from reproductive health experts and verbal autopsies on the determinants of poor reproductive health outcomes. Method: Individual interviews with a purposively selected sample of six reproductive health experts were conducted, augmented by verbal autopsies of 12 next of kin of women and newborn babies who died within the previous 2 years period of the study. Burnard’s (1995) approach of content analysis was used to analyse the data. Results: The findings revealed lack of empowerment, inaccessible reproductive health services and separation of patients living with human immune deficiency virus and those patients diagnosed with acquired immune deficiency syndrome. Conclusion: To meet the reproductive health needs, especially of the rural population, urgent attention is needed to reduce their vulnerability to the risks of poor reproductive outcomes

Stigma and discrimination within the Ethiopian health care settings: Views of inpatients living with human immunodeficiency virus and acquired immune deficiency syndrome

Background: Stigma and discrimination attached to human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) have been recognised as a major obstacle to HIV prevention, treatment, care and support throughout the world. Stigma and discrimination are more devastating when they occur in health care settings where it is least expected. Aim: To explore the factors attributable to stigma and discrimination of people living with HIV in two Ethiopian rural hospitals on what they thought of health care professionals (HCPs) attending to them. Methods: A qualitative exploratory approach was used. Data collection was by means of audio-taped interview and Tesch’s content analysis approach was used. The sample size for this study was determined by saturation of data and consisted of 16 participants who were people living with HIV admitted as inpatients to the two selected hospitals in Amhara region of Ethiopia. Results: Participants’ views were grouped into: fear of contact, delay of services, substandard services, denial of care, impoliteness of health care providers, breach of confidentiality and poor patient follow-up for persons infected with HIV. Conclusion: The health care settings have been recognised as one of the contexts where HIV and AIDS-related stigmatisation and discrimination can occur. Hospital policies and institutional support should be tailored to embrace people living with HIV as the provision of institutional support is imperative in creating a good working environment and improving the commitment of HCPs so as to enable them to provide holistic care for people living with HIV and AIDS (PLWHA) without discrimination

PARENTS AND COMMUNITY LEADERS’ PERCEPTIONS OF TEENAGE PREGNANCY: A QUALITATIVE STUDY

The purpose of this qualitative study was to understand the perceptions and experiences of parents and community leaders of two communities in Nigeria regarding teenage pregnancy and their understanding of teenage sexuality and contraception. In addition, the study set out to ascertain whether teenage pregnancy prevention programmes were available within the communities. The study was qualitative, contextual and exploratory utilising the Community-as-Partner Model. Eighty participants who were parents and community leaders responded to the semi-structured interview and completed a questionnaire on demographic data. Tesch’s approach of data analysis was used, and descriptive statistics were used to display demographic data as well as the count of data segments that constitute categories. The fi ndings reveal that although limited teenage pregnancy prevention initiatives were in existence, most of the participants, especially those from the North Central (NC) region of Nigeria, were not informed about them. Almost half of the participants viewed teenage pregnancy as a common occurrence in their communities of which most were from the NC region. More than two-thirds of the participants discouraged teenagers from using contraceptives. Teenage pregnancy intervention programmes and strategies must be sensitive to differences among various ethnic and religious groups. The involvement of religious and community leaders in teenage pregnancy intervention programmes and initiatives is indispensable in curtailing the high incidence of teenage pregnancies and childbirths among teenagers

The role of gender in the spread of HIV and AIDS among farmworkers in South Africa

Background: Gender inequality and men’s perceived sexual and economic superiority over women are central to human immunodeficiency virus (HIV) infection. The farming community in which the participants in the study live operates along such patriarchal lines, with the men making the important decisions for their families. Aim: To explore and describe the role of gender in the spread of HIV and acquired immunodeficiency syndrome (AIDS) among farmworkers in South Africa. Setting: The study was conducted in the Levubu farms, Vhembe district, Limpopo Province, South Africa. Methods: The researchers adopted a qualitative, explorative and descriptive research design with in-depth semi-structured interviews. Purposive and convenience sampling methods were used to select participants who met the inclusion criteria. Data collected were thematically analysed using Creswell’s data analysis method. Lincoln and Guba’s model to ensure trustworthiness and ethical standards were applied. Results: The findings of the study clearly indicated that powerlessness and lack of decision-making by female farmworkers was common as female farmworkers were dependent on their male partners to make decisions in the workplace as well as decisions regarding sexual matters in a relationship. Conclusion: The main conclusion drawn from the findings were that farmworkers are continuously exposed to exploitation and disempowerment in a variety of ways with very little support from their supervisors, which makes them vulnerable to contracting HIV