Advancing the rights of rural women with disabilities in Zimbabwe: challenges and opportunities for the twenty first century

Text in English with abstracts in English, isiXhosa and isiZuluDisability studies largely ignored or neglected the experiences of rural women with disabilities (WWD) in the Global South. This qualitative study documents the challenges faced by Zimbabwean rural WWD in the enjoyment of their fundamental rights and freedoms. Against the backdrop of various global, regional and national efforts to advance WWD’s rights, the study examines possibilities for change. Utilising a phenomenological design, data were collected through in-depth interviews with women and girls with disabilities (WGWD), and semi-structured interviews with state and non-state actors in disability rights. Augmented by observations and extensive literature and policy reviews, the research findings revealed that the majority of rural WWD are not aware of their legal rights and have limited access to productive resources, information, employment, education and food. Rural WWD face mobility challenges and are largely discriminated against in health institutions and excluded from taking part in socioeconomic and political activities. Girls with disabilities in inclusive schools battle against a myriad of attitudinal, environmental and administrative hurdles that limit their academic and social functioning. The results confirm the feminist disability theory’s view that the functioning of WGWD is heavily determined by wider contextual, social, historic and gendered power relations. The findings support recommendations for an urgent alignment of liberal national disability instruments, policies and practices to international human rights norms. The 2013 Constitution effectuates a human rights approach to disability, yet in practice the exclusion of the disabled, rural, female ‘other’ continues unabated. Transformation in this regard must include a restructuring of financial resourcing of various state institutions for advancing disability rights. Various avenues to ensure for effective disability rights mainstreaming, lobbying, advocacy, awareness raising, and capacitation of rural communities are suggested. At the heart of it all is a change in mind-sets to embrace WWD as equal human beings with rights and dignity.Izifundo zobulwelwe azikhange ziyithathele ngqalelo imeko namava abantu basetyhini abayimilwelwe behlala emaphandleni kumazwe asemaZantsi. Esi sifundo somgangatho sibhala ngemingeni ejongene nabasetyhini abayimilwelwe basemaphandleni eZimbabwe xa befuna ukuxhamla amalungelo nenkululeko eyimfanelo yabo yemveli. Ngokuqwalasela imizamo eliqela yehlabathi jikelele, yezithili neyesizwe ekuphuhliseni amalungelo abasetyhini abayimilwelwe, esi sifundo sivavanya amathuba otshintsho. Ngokusebenzisa uyilo lwezifundo ngokwenzekayo, kwaqokelelwa iinkcukacha zolwazi ngokuqhuba udliwano ndlebe olunzulu namakhosikazi namantomabazana ayimilwelwe, kwaqhutywa nodliwano ndlebe lwemibuzo engenampendulo zithe ngqo (semi structured interviews) nemibutho yoburhulumente nengeyoyoburhulumente esebenza ngamalungelo emilwelwe. Uphando olwalukhatshwa kukuzibonela nokufunda nzulu okubhaliweyo ngemigaqo nkqubo, lwaveza ukuba uninzi lwabasetyhini abayimilwelwe basemaphandleni alwazi nto ngamalungelo alo asemthethweni kwaye alufikeleli ngokwaneleyo kwimithombo eluncedo, ulwazi, imisebenzi, imfundo nokutya. Abasetyhini abayimilwelwe basemaphandleni bajamelene nemingeni yokungakwazi ukuhamba kwaye bayacalucalulwa kakhulu kumaziko ezempilo. Ababandakanywa ekuthatheni inxaxheba kwimisebenzi yezentlalo, uqoqosho nezombuso/upolitiko. Amantombazana ayimilwelwe asezikolweni zikawonkewonke asedabini nemiqobo emininzi yendlela acingelwa ngayo, indawo ewangqongileyo nolawulo, zinto ezo zikuthibazayo ukusebenza kwawo kwezemfundo nasekuhlaleni. Iziphumo zophando ziyangqinelana nengcingane yezifundo zabasetyhini ethi indlela yokwenza izinto yabasetyhini abayimilwelwe ilawulwa ikakhulu lunxulumano lweemeko ezigqubayo, ezentlalo, ezembali nezesini. Iziphumo zophando zixhasa iingcebiso ezithi makukhawuleziswe kwenziwe ungqamano phakathi kwezixhobo, imigaqo nkqubo nemisebenzi yobulwelwe esizweni nezimiselo zamalungelo oluntu kwihlabathi ngokubanzi. UMgaqo Siseko wama-2013 ubeka elubala indlela yokujongana nobulwelwe, kodwa kuyaqhubeka kona ukujongelwa phantsi kwemilwelwe, yabasemaphandleni, yabasetyhini. Inguqu kulo mbandela kufuneka iquke ukuyilwa ngokutsha kwenkxaso mali kumaziko oburhulumente ahlukeneyo ukwenzela ukuba kuqhutyelwe phambili amalungelo emilwelwe. Kucetyiswa ngeendlela ezahlukeneyo zokuqinisekisa amalungelo emilwelwe njengokwenza iinkqubo ezifanelekileyo ezingundoqo, ngokuthethathethana nokuphembelela, ngokwazisa uluntu nokuxhobisa uluntu lwasemaphandleni. Esizikithini sako konke kufuneka utshintsho lwengqondo ukwenzela ukuba bamkelwe abasetyhini abayimilwelwe njengabantu abalingana nabanye benamalungelo nesidima.Izifundo ezimayelana nokukhubazeka zivame ukunganaki noma ukungabi nandaba nokwenzeka kubantu besifazane abakhubazekile (ama-WWD) abahlala emaphandleni emazweni angakathuthuki ngokwanele (aseGlobal South). Lolu cwaningo olubheka kabanzi imininingwane engamaqiniso luqopha izingqinamba ezikhungethe abesifazane baseZimbabwe abakhubazekile abahlala emaphandleni ngenkathi bethokozela amalungelo abo asemqoka kanye nenkululeko yabo. Phezu kwemizamo eyahlukahlukene yezinga lomhlaba, lezifunda nelikazwelonke, yokuthuthukisa amalungelo abesifazane akhubazekile, lolu cwaningo lubheka amathuba akhona oguquko. Kwasetshenziswa uhlobo lokucwaninga olubheka okuthize ngokuhlola imibono yalabo abake baba sesimweni salokho okucwaningwa ngakho, ngokufaka imibuzo abesifazane kanye namantombazane akhubazekile, kanye nalabo abadlala indima kwezamalungelo abantu abakhubazekile abasebenzela umbuso nabangasebenzeli umbuso. Ngokufakazelwa kakhulu ngokubonakele kanye nokuhlaziywa kwemibhalo nenqubomgomo, imiphumela yocwaningo enohlonze iveze ukuthi iningi labesifazane abakhubazekile basemaphandleni abawazi amalungelo abo ezomthetho kanti futhi abafinyeleli ngokuphelele emithonjeni elusizo, kwimininingwane, kwimisebenzi, kwezemfundo kanye nasekudleni. Abesifazane abakhubazekile basemaphandleni babhekana nezingqinamba zokungakwazi ukuhamba kahle kanti futhi bayacwaswa ezikhungweni zezempilo, baphinde banganikwa ithuba lokubamba iqhaza kwezenhlalo-mnotho nezepolitiki. Amantombazane akhubazekile ezikoleni ezamukela zonke izinhlobo zabafundi babhekana nezimo eziningi eziyizingqinamba maqondana nendlela aphathwa ngayo, nesimo sendawo kanye nokwenziwa kwezinto okuba nomkhawulo ekwenzeni kwabo maqondana nezemfundo nezenhlalo. Imiphumela iqinisekisa umbono wenzululwazi elwela abesifazane abakhubazekile wokuthi ukusebenza kwabesifazane abakhubazekile, esikhathini esiningi, kuvame ukuvela ngenxa yengqikithi esabalele yobudlelwano bamandla maqondana nenhlalo, umlando kanye nobulili. Imiphumela yocwaningo yeseka izincomo zokuthi kumele kube khona ukulinganiswa okuphuthumayo kwempahla yokusebenza maqondana nokukhubazeka, izinqubomgomo kanye nezindlela zokusebenza ezingeni likazwelonke kanye nokuvamile ezingeni lomhlaba wonke kokuphathelene namalungelo abantu. UMthethosisekelo wonyaka we-2013 wenza kusebenze indlela yokubheka ukukhubazeka ngeso lamalungelo abantu, kodwa indlela okwenziwa ngayo iqhubeka kakhulu nokubandlulula abesifazane abakhubazekile basemaphandleni. Uguquko, maqondana nalokhu, kumele lufake ukuhlelwa kabusha kosizo lwezimali ezikhungweni ezahlukahlukene zombuso eziqhuba phambili amalungelo aba. Kuhlongozwa izindlela ezahlukahlukene zokuqinisekisa amalungelo abakhubazekile okufaka kukho ukufakwa kwemiphakathi yasemaphandleni ezinhlelweni, ukukhulumisana nayo ukuze ibambe iqhaza, ukuyilwela, ukwenza ukuba iqaphele okwenzekayo kanye nokuyinikeza amandla okwenza. Okuyiyona nto ebaluleke kakhulu, wuguquko ekucabangeni ukuze abesifazane abakhubazekile bathathwe njengabantu abalingana nabanye abanamalungelo nesithunzi.Development StudiesD. Phil. (Development Studies

The acceptability of insecticide treated mosquito nets among community members in Zimbabwe

A CAJM article on the advocacy of using treated mosquito nets in rural communities.Objectives: To assess the acceptability of insecticide treated mosquito nets (ITNs) among community members in Zimbabwe for the implementation of effective malaria intervention using ITNs. Design: A cross sectional study and longitudinal study were carried out using questionnaires, which were administered by health workers from rural health centres. Setting: Communities in rural areas from seven districts namely Bulilimamangwe, Chipinge, Gokwe, Hurungwe, Lupane, Mount Darwin and Uzumba Maramba Pfungwe (UMP) in Zimbabwe. Subjects: 1 576 community members who bought ITNs in the project areas. Main Outcome Measure: Acceptance of ITNs and price, reasons for wanting or not wanting nets; ITNs usage and washing pattern among respondents. Results: More than 90% of people said they bought the nets from the project in order to avoid mosquito bites and to prevent malaria. Quite a number of respondents (69%) gave the answer that they bought mosquito nets from the project because they were cheaper (Z$130 to Z$390) than the market price (Z$l 000) and more than half (58.3%) claimed that they could not afford to buy mosquito nets at the market price. The price was accepted by the majority as cheap or very cheap in Gokwe, Hurungwe, Mount Darwin, and UMP (92%, 82%, 98% and 90%, respectively). Other responses given for having bought nets were at health staff’ s-recommendation (71.3 %), and they were suffering from malaria (40.9%). The reasons for not having bought mosquito nets were that they had not suffered from malaria (55.5%), that they did not like to use a mosquito net (31.1%), did not know the efficacy of the net (21.6%), or there were not many mosquitoes at home (28.9%). The percentage of ITN use was very high (90 to 100%) amongst those who bought nets. The percentage of children under five years and pregnant women who were ITN users ranged from six to 24% to 2.8 to 9.7%, respectively. Percentage of “others” which means those above five years and not pregnant was more than 70% in all the districts. The washing pattern of ITNs in Chipinge showed that most of the mosquito nets (74.5%) were washed every three to five months. Conclusion: Acceptability of ITNs was very high based on reported utilisation of ITNs. It is recommended that rural communities should be sensitised on the importance of treated nets for malaria prevention, and advised to purchase mosquito nets whenever cash is readily available in each community

A critical examination of patterns of research in the academic study of Shona traditional religion, with special reference to methodological considerations.

Thesis (Ph.D.)-University of Natal, Pietermaritzburg, 1997.This thesis is a critical examination of patterns of research in the academic study of Shona traditional religion, with special reference to methodological considerations. I analyse the methods and approaches used so far by prominent writers in the study of Zimbabwe's Shona traditional religion so that we may be able to develop better ways of researching it. I then discuss ways that ought to inform and direct the research methods that are most likely to yield adequate empirical studies of the Shona people. I analyse works of the "early writers", as well as those of Michael Gelfand, Gordon Chavunduka and Michael Bourdillon. Where relevant, I explore the connection between the researchers' religious, cultural, academic or professional "baggage" and how this relates to their research. Discussing methodological issues such as: the "insider-outsider" question, the "emic-etic" issue, value-judgment as well as the questions of reductionism, "subjectivity" and "objectivity" in scholarship, I examine these writers' attitudes to, and the ways they wrote about Shona traditional religion and cultural practices. I assess their approaches and research methods in relation to those from various disciplines such as history, phenomenology, theology, anthropology and participant observation. I analyse the extent to which these writers, for example, utilised the historical approach or presented insider perspectives in an endeavour to reach an adequate and thorough understanding of Shona religion and culture. In view of the fact that Shona traditional religion is a polyvalent and polymorphic community religion, I argue that no one approach and method can be said to be "the" only method so as to attain a comprehensive understanding of the meanings veiled in Shona religion and culture. Furthermore, given the nature of Shona traditional religion, it is essential for researchers to exploit as much of oral history as possible. Thus, researchers also need to learn the Shona language, live in the community for a long period of time, attend and observe every bit of Shona life so as to see, hear and understand how these phenomena fit together. It is suggested that methodological conversion and agnostic restraint need to be forged into a multi-disciplinary and poly-methodic science of religion in the quest of a research model to be used in order to attain a better understanding of Shona religion, culture and society

Community based interventions to improve HIV outcomes in youth: a cluster randomised trial in Zimbabwe (CHIEDZA)

Young people fare disproportionately poorly across the HIV care continuum compared to other age-groups; the prevalence of undiagnosed HIV is substantially higher, and coverage of and adherence to antiretroviral therapy is lower, resulting overall in worse virological outcomes. The aim of the CHIEDZA trial is to determine the impact of an integrated community-based package of HIV services incorporating HIV testing, linkage to care and ongoing adherence support, combined with sexual and reproductive health services and general health counselling for 16 to 24 year olds on population level HIV viral load in a high HIV prevalence setting

Facility and community-based index-linked HIV testing strategies for children and adolescents in Zimbabwe

Globally over 2.8 million children aged between 0-18 years were living with HIV in 2019. ART substantially reduces mortality but the pre-requisite step for accessing treatment is HIV diagnosis. Coverage of HIV treatment in children has lagged behind when compared to adults largely because of delayed diagnosis. Children experience unique challenges to access HIV testing. Existing strategies for paediatric HIV testing, which largely are similar to those used for adults, have not been effective in addressing the HIV diagnosis gap in children. Index-linked HIV testing (HIV testing offered to household members and sexual contacts of individuals living with HIV) for children and adolescents may improve HIV testing uptake and have high HIV yield. Offering index-linked HIV testing for children and adolescents in both facility and community settings may be an effective strategy to help bridge the HIV testing gap. The aim of this research was to evaluate facility and community-based approaches for index-linked HIV testing for children and adolescents aged 2-18 years in Zimbabwe. This PhD combined mixed methods research in the city of Bulawayo and in Matabeleland South province between January 2018 and May 2019. Overall, 2870 index patients had 6062 children who were eligible for HIV testing in their households. Indexes were offered a choice of facility-based or community-based HIV testing (either home-based HIV testing by a health provider or an oral mucosal transudate (OMT) HIV test kit given to a caregiver to test their child(ren)). HIV testing was accepted for 5326 (87.9%) children, and 3638 children were tested (60.0% HIV testing uptake). The HIV prevalence and yield were 1.1% and 0.6% respectively. Older children and adolescents were less likely to be tested when compared to children aged 2-5 years. Children had increased odds of being tested if community-based HIV testing was chosen over facility based HIV testing. There was inadequate emphasis on paediatric HIV in routine HIV care which had a negative impact on subsequent uptake of HIV testing for children. Once the decision to test had been made, access to facilities was sometimes challenging and alleviated by community-based HIV testing. OMT tests, although previously validated for HIV testing in adults and widely used in HIVST for adults had not been validated for HIV testing in children <12 years. In this research, OMT sensitivity was 100% [97.5% CI: 94.9% to 100%]) and specificity was 99.9% [95% CI: 99.6% to 100.0%] among children aged 2-18 years when compared to national HIV testing algorithms. A further application of OMT testing evaluated as part of this research was caregiver’s ability to test their children for HIV and interpret test results. Overall, most caregivers correctly collected oral fluid (87.1% without provider demonstrations and 96.8% with demonstrations from a provider, p=0.002). The HIV yield was low when compared with blanket HIV testing approaches in similar settings. There is a need to improve messaging on the importance of HIV testing for children and adolescents and to provide support to caregivers and their families in order to increase HIV testing uptake. Addressing access barriers through the provision of community-based HIV testing can optimise index-linked HIV testing. Caregiver-provided testing using OMTs is a feasible and accurate HIV testing strategy for children and can also be used to improve uptake of HIV testing for children

Feasibility and Accuracy of HIV Testing of Children by Caregivers Using Oral Mucosal Transudate HIV Tests.

BACKGROUND: Children encounter multiple barriers in accessing facilities. HIV self-testing using oral mucosal transudate (OMT) tests has been shown to be effective in reaching hard-to-reach populations. We evaluated the feasibility and accuracy of caregivers conducting HIV testing using OMTs in children in Zimbabwe. METHODS: We offered OMTs to caregivers (>18 years) living with HIV to test children (2-18 years) living in their households. All caregivers were provided with manufacturer instructions. In Phase 1 (January-December 2018, 9 clinics), caregivers additionally received a demonstration by a provider using a test kit and video. In Phase 2 (January-May 2019, 3 clinics), caregivers did not receive a demonstration. We collected demographic data and assessed caregiver's ability to perform the test and interpret results. Caregiver performance was assessed by direct observation and scored using a predefined checklist. Factors associated with obtaining a full score were analyzed using logistic regression. RESULTS: Overall 400 caregivers (83.0% female, median age 38 years) who were observed tested 786 children (54.6% female, median age 8 years). For most tests, caregivers correctly collected oral fluid [87.1% without provider demonstrations (n = 629) and 96.8% with demonstrations (n = 157), P = 0.002]. The majority correctly used a timer (90.3% without demonstrations and 96.8% with demonstrations, P = 0.02). In multivariate logistic regression caregivers who obtained a full score for performance were more likely to have received a demonstration (odds ratio 4.14, 95% confidence interval: 2.01 to 8.50). CONCLUSIONS: Caregiver-provided testing using OMTs is a feasible and accurate HIV testing strategy for children. We recommend operational research to support implementation at scale

Pasteurella gallinarum : Zimbabwean experience of a versatile pathogen

Pasteurella gallinarum-related outbreaks in chickens and African guinea fowls are described. Four outbreaks were recorded in chickens and one in guinea fowls. Periorbital swelling and keratoconjunctivitis were the consistently present clinical signs in all the diseased birds. In several, swollen hocks and wattles were also discerened. Birds which succumbed to the infection showed petechiation in the internal organs and evidence of airsacculitis. Pasteurella gallinarum was isolated from the lesions and also from conjunctival swabs of the apparently healthy in-contact birds. There was no evidence of concurrent infection with Haemophilus, Mycoplasma or Chlamydia. Quinolone therapy when resorted to on one of the farms resolved the clinical signs. Phenotypes of 28 isolates were studied. The results compared well with the Pasteurella gallinarum isolates reported earlier from elsewhere. It was also found that results of xylose fermentation and ONPG test appear to be a variable character. There is no earlier report of P. gallinarum infection in guinea fowls.The articles have been scanned in colour with a HP Scanjet 5590; 600dpi. Adobe Acrobat v.9 was used to OCR the text and also for the merging and conversion to the final presentation PDF-format.UZ Research Board.mn201

Capsular serogroups of Pasteurella multocida isolated from animals in Zimbabwe

Pasteurella multocida is isolated from a variety of disease conditions from different animal species in our diagnostic laboratory. In order to determine serogroup distribution among the isolates, an indirect haemagglutination test using glutaraldehyde-fixed sheep red blood cells was employed. A serological examination of 79 isolates revealed that 47/79 were of capsular serogroup A, 11/79 capsular serogroup D, 4/79 capsular serogroup B and 17/79 were untypable strains. None of the isolates belonged to either serogroup E or F. All those from cases of classical pasteurellosis could be grouped, but a significantly high proportion of those which originated from companion animals were untypable. The significance of these results is discussed. This report appears to be the first detailed information on the prevalence of various serogroups of P. multocida in animals in southern Africa.The articles have been scanned in colour with a HP Scanjet 5590; 600dpi. Adobe Acrobat v.9 was used to OCR the text and also for the merging and conversion to the final presentation PDF-format.Research Board of the University of Zimbabwe. European Union/University of Zimbabwe Link Program.mn201