The negotiating strategies determining coitus in stable heterosexual relationships

Heterosexual behaviour is a complex subject and one which is aggravated by confounding variables. Few studies have investigated the way in which one variable, namely coitus, is initiated and negotiated in stable marital relationships. As the HIV/AIDS pandemic spreads in sub-Saharan Africa, the subject of marital coitus becomes of increasing concern. This study tests a methodology of semi-structured interviews and diary-keeping techniques to investigate how the activity is initiated and negotiated. A research team monitored the study and evaluated the research techniques. The study concluded that the HIV/AIDS pandemic is affecting the initiation and negotiation of coitus between marital partners and that the partners wish to renegotiate the relationship, but the mechanisms for renegotiation are not at present available

Guide to the design and application of online questionnaire surveys

Collecting research data through traditional approaches (face-to-face, postal or telephone survey) can be costly and time consuming. The emerging data collection approach based on internet/e-based technologies (e.g. online platforms and email), is a relatively cost effective survey alternative. These novel data collection strategies can collect large amounts of data from participants in a short time frame. Similarly, they also seem to be feasible and effective in collecting data on sensitive issues or with samples they are generally hard to reach, for example, men who have sex with men (MSM) or migrants. As a significant proportion of the population currently in the world are digitally connected, the shift from postal (paper-pencil) or telephone towards online survey use in research is in the interests of researchers in academia as well as in the commercial world. However, compared to designing and executing paper version of the questionnaire, there is limited literature to help a starting researcher with the design and a use of online questionnaires. This short paper highlights issues around: a) methodological aspect of online questionnaire survey; b) online survey planning and management; and c) ethical concerns that may arise while using this option. We believe that this paper will be useful for researchers who want to gain knowledge or apply this approach in their research

Social autopsy: a potential health-promotion tool for preventing maternal mortality in low-income countries

Despite significant global improvements, maternal mortality in low-income countries remains unacceptably high. Increasing attention in recent years has focused on how social factors, such as family and peer influences, the community context, health services, legal and policy environments, and cultural and social values, can shape and influence maternal outcomes. Whereas verbal autopsy is used to attribute a clinical cause to a maternal death, the aim of social autopsy is to determine the non-clinical contributing factors. A social autopsy of a maternal death is a group interaction with the family of the deceased woman and her wider local community, where facilitators explore the social causes of the death and identify improvements needed. Although still relatively new, the process has proved useful to capture data for policy-makers on the social determinants of maternal deaths. This article highlights a second aspect of social autopsy – its potential role in health promotion. A social autopsy facilitates “community self-diagnosis” and identification of modifiable social and cultural factors that are attributable to the death. Social autopsy therefore has the potential not only for increasing awareness among community members, but also for promoting behavioural change at the individual and community level. There has been little formal assessment of social autopsy as a tool for health promotion. Rigorous research is now needed to assess the effectiveness and cost effectiveness of social autopsy as a preventive community-based intervention, especially with respect to effects on social determinants. There is also a need to document how communities can take ownership of such activities and achieve a sustainable impact on preventable maternal deaths

Health Promotion opportunities for Auxiliary Nurse Midwives in Nepal

Health promotion moves beyond changing the health-related knowledge, attitudes and behaviour of individuals and covers a wide range of social and environmental interventions. Nepal has also introduced health promotion policies targeting health education, information and communication. Auxiliary Nurse Midwives (ANMs), who are responsible for delivering primary care maternity services, especially in birthing centres located in rural areas of Nepal, also have an important role to play in the promotion of women’s health during pregnancy, intra-partum and post-partum. However, in the present context, health promotion provided by ANMs in Nepal is confined mostly to health education and behavioural-change communication. There are a range of health promotion activities relevant to maternity care and midwifery that ANMs can practice even in low-technology rural birthing centres. Such health promotion offers an opportunity to move away from a very medical and behavioural model to a more empowering one in order to prevent health problems in a cost-effective way

The impact of non-tariff barriers on maize and beef trade in East Africa

On March 2, 2004, the East African Community (EAC) member states signed the protocol for the establishment of the East African Community Customs Union, which commits them, among others, to eliminate non-tariff barriers (NTBs) to increase intraregional trade. However, several NTBs are still applied by member states, raising concerns among policy makers and the business community. There is, however, no information about the magnitude of the impact of these NTBs. This study identifies the existing NTBs on maize and beef trade in East Africa and quantifies their impact on trade and the welfare of EAC citizens using a Spatial Equilibrium Model (SEM). Data on NTBs were collected from traders and transporters of maize and beef cattle in East Africa. In addition, the study found that the main types of NTBs within the three founding members of the EAC (Kenya, Tanzania and Uganda) are similar. They include administrative requirements (mainly licenses, municipal and council permits), taxes/duties (mainly excise and cess duty), roadblocks, customs barriers, weighbridges, licensing, corruption (e.g., through bribes) and transiting. The results of the welfare analysis vary across the three countries, but the net monetary gains are positive in all cases. A complete abolishment or a reduction of the existing NTBs in maize and beef trade increases intra-EAC maize and beef trade flows, with Kenya importing more maize from both Uganda and Tanzania, while Uganda’s beef exports to Kenya and Tanzania increase. As a result, positive net welfare gains are attained for the entire EAC maize and beef sub-sectors. In all cases, those who gain from the proposed reductions in NTBs can potentially compensate the losers, leading to potential improvements in welfare. These findings give compelling evidence in support of the elimination of NTBs within the EAC customs union. The study recommends taking a regional approach to eliminating the existing NTBs since they are similar across the member countries and across commodities so as to exploit economies of scale. Other policy recommendations include streamlining of administrative procedures at border points to improve efficiency, and speeding up the implementation of procedures at point of origin and at the border points. Finally, the study recommends the need to design and implement monitoring systems to provide feedback to the relevant authorities on the implementation of measures to remove unnecessary barriers to trade within the EAC region

Responding to Food Price Crisis in Eastern and Southern Africa: Policy Options for National and Regional Action

This paper addresses the magnitude and implications of food price changes in national and regional markets in Eastern and Southern Africa (ESA) with a view to provide the evidence base for effective policy action. Specifically, the paper: - analyses trends and outlooks in country and regional data, presents evidence on the regional food situation, and explores the nexus between high domestic food prices and global food prices, - highlights regional and national dimensions of food price increases and how they are related to food security in the region, and - provides practical short-, medium- and long-term options for governments and other stakeholders for addressing the problem posed by the food price crisis

Multilingual assessment of early child development: Analyses from repeated observations of children in Kenya.

In many low- and middle-income countries, young children learn a mother tongue or indigenous language at home before entering the formal education system where they will need to understand and speak a countrys official language(s). Thus, assessments of children before school age, conducted in a nations official language, may not fully reflect a childs development, underscoring the importance of test translation and adaptation. To examine differences in vocabulary development by language of assessment, we adapted and validated instruments to measure developmental outcomes, including expressive and receptive vocabulary. We assessed 505 2-to-6-year-old children in rural communities in Western Kenya with comparable vocabulary tests in three languages: Luo (the local language or mother tongue), Swahili, and English (official languages) at two time points, 5-6 weeks apart, between September 2015 and October 2016. Younger children responded to the expressive vocabulary measure exclusively in Luo (44%-59% of 2-to-4-year-olds) much more frequently than did older children (20%-21% of 5-to-6-year-olds). Baseline receptive vocabulary scores in Luo (β = 0.26, SE = 0.05, p < 0.001) and Swahili (β = 0.10, SE = 0.05, p = 0.032) were strongly associated with receptive vocabulary in English at follow-up, even after controlling for English vocabulary at baseline. Parental Luo literacy at baseline (β = 0.11, SE = 0.05, p = 0.045) was associated with child English vocabulary at follow-up, while parental English literacy at baseline was not. Our findings suggest that multilingual testing is essential to understanding the developmental environment and cognitive growth of multilingual children